Context: Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives: To explore the decision-making process among women invited to a mammography screening programme.Setting: Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program in 2003.Methods: Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged (...) 50–69 years.Results: The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion: In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine. (shrink)

Cet ouvrage est une réédition numérique d’un livre paru au XXe siècle, désormais indisponible dans son format d’origine.

A formal Ethics Consultation Service (ECS) can provide significant help to patients, families and hospital staff. As with any other form of clinical consultation, documentation of the process and the advice rendered is very important. Upon review of the published consult documentation practices of other ECSs, we judged that none of them were sufficiently detailed or structured to meet the needs and purposes of a clinical ethics consultation. Thus, we decided to share our method in order to advance the practice (...) of ethics consultation. Here, we describe a method of ECS documentation practice, including use of a formal consult report template, as well as a log for maintaining a chronological record of the consultations performed. These two documents facilitate order and organisation of the ECS. They also enable the ECS to keep an account of professional time and experience, enable quick consult trend assessments (by consult theme or ward, for example) and establish a potential registry of consults for future research study. This method of documentation, we believe, not only contributes significantly to the primary purpose of the consultation—namely, the evincing and sharing of ethical opinion about a case—but also enables consultants to improve their practice and to pursue research on clinical ethics consultation. (shrink)

Objective: To analyse the time variation of topics in bioethical publications as a proxy of the relative importance.Methods: We searched the Medline database for bioethics publications using the words “ethics or bioethics”, and for 360 specific topics publications, associating Medical Subject Heading topic descriptors to those words. We calculated the ratio of bioethics publications to the total publications of Medline, and the ratio of each topic publications to the total bioethics publications, for five-year intervals, from 1970 to 2004. We calculated (...) the time variation of ratios, dividing the difference between the highest and lowest ratio of each topic by its highest ratio. Four topics were described, selected to illustrate different patterns of variation: “Induced Abortion”, “Conflict of Interest”, “Acquired Immunodeficiency Syndrome”, “Medical Education.”Results: The ratio of bioethics publications to total Medline publications increased from 0.003 to 0.012. The variation of the topic’s ratios was higher than 0.7 for 68% of the topics. The Induced Abortion ratios decreased from 0.12 to 0.02. Conflict of Interest ratios increased from zero to 0.07. The Acquired Immunodeficiency Syndrome ratios were nearly zero in the first three intervals, had a peak of 0.06 during 1985–9, followed by a decrease to 0.01. Medical Education ratios varied few, from 0.04 to 0.03.Conclusions: There was an increase of bioethical publications in the Medline database. The topics in bioethics literature have an important time variation. Some factors were suggested to explain this variation: current legal cases, resolution of the issue, saturation of a discussion and epidemiologic importance. (shrink)

Lysias, describing how the Thirty were established in the government of Athens, begins with the sentence ναστς δ θηραμνης κλευσεν ὑμς τρι$κοντα νδράσιν πιτρΨαι τν πóλιν τῇ πολιτεᾳ χρσθαι ν Δρακοντδης πφαινεν Commenting on the last clause the judicious Thirlwall observes that ‘the precise meaning of these words is very doubtful. There is almost equal difficulty, whether we suppose that they refer to a proposition then made, or to one which was to be made, by Dracontides.’ Thirlwall has not expressed (...) his meaning as precisely as Lysias; the uncertainty lies, not in the words, nor in the reference intended by Lysias, but in the mind of the historian, who is conscious that, whether he refers the proposition of Dracontides to the occasion indicated by Lysias or to another, he will encounter almost equal difficulty. The difficulty however, arising from the apparent inconsistencies in the evidence of the ancient authorities on the date of the appointment of the Thirty, is not Thirlwall's only, and after a century of discussion it still vexes every student of the period. (shrink)

Following the socialist revolution, a colossal shift in everyday realities began in the 1920s and '30s in the former Russian empire. Faced with the Siberian North, a vast territory considered culturally and technologically backward by the revolutionary government, the Soviets confidently undertook the project of reshaping the ordinary lives of the indigenous peoples in order to fold them into the Soviet state. In Agitating Images, Craig Campbell draws a rich and unsettling cultural portrait of the encounter between indigenous Siberians and (...) Russian communists and reveals how photographs from this period complicate our understanding of this history. Agitating Images provides a glimpse into the first moments of cultural engineering in remote areas of Soviet Siberia. The territories were perceived by outsiders to be on the margins of civilization, replete with shamanic rituals and inhabited by exiles, criminals, and "primitive" indigenous peoples. The Soviets hoped to permanently transform the mythologized landscape by establishing socialist utopian developments designed to incorporate minority cultures into the communist state. This book delves deep into photographic archives from these Soviet programs, but rather than using the photographs to complement an official history, Campbell presents them as anti-illustrations, or intrusions, that confound simple narratives of Soviet bureaucracy and power. Meant to agitate, these images offer critiques that cannot be explained in text alone and, in turn, put into question the nature of photographs as historical artifacts. An innovative approach to challenging historical interpretation, Agitating Images demonstrates how photographs go against accepted premises of Soviet Siberia. All photographs, Campbell argues, communicate in unique ways that present new and even contrary possibilities to the text they illustrate. Ultimately, Agitating Images dissects our very understanding of the production of historical knowledge. (shrink)

"Hegel and the Foundations of Literary Theory: Do the various forms of literary theory - deconstruction, Marxism, new historicism, feminism, post-colonialism, and cultural/digital studies - have anything in common? If so, what are the fundamental principles of theory? What is its ideological orientation? Can it still be of use to us in understanding basic intellectual and ethical dilemmas of our time? These questions continue to perplex both students and teachers of literary theory. Habib finds the answers in theory's largely unacknowledged (...) roots in the thought of German philosopher Hegel. Hegel's insights continue to frame the very terms of theory to this day. Habib explains Hegel's complex ideas and how they have percolated through the intellectual history of the last century. This book will interest teachers and students of literature, literary theory and the history of ideas, illuminating how our modern world came into being, and how we can better understand the salient issues of our own time"--. (shrink)

Analytical account of eastern and western thinkers.

_The first part called the Preamble tackles: (a) the issues of silence and speech, and life and disease; (b) whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c) the phenomenon of Why, How, and What; (d) how are mind and brain related; (e) what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f) bioethics and the four principles of beneficence, non-malfeasance, (...) autonomy, and justice; (g) the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline. The second part called The Issues deals with: (a) the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b) biology, Freud and the reinvention of psychiatry; (c) critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d) the biological, the psychoanalytic, the psychosocial and the cognitive; (e) the issues of clarity, reductionism, and integration; (f) what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry. The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a) psychiatric disorder, mental health, and mental phenomena; (b) issues in psychiatric ethics; (c) social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry. The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a) antipsychiatry revisited; (b) basic arguments of antipsychiatry, Szasz, etc.; (c) psychiatric classification and value judgment; (d) conformity, labeling, and blunting creativity. The fifth part is called The Role of Philosophy, Religion, and Spirituality in Psychiatry. It includes topics like (a) relevance of philosophy to psychiatry; (b) psychiatry, religion, spirituality, and culture; (c) ancient Indian concepts and contemporary psychiatry; (d) Indian holism and Western reductionism; (e) science, humanism, and the nomothetic-idiographic orientation. The last part, called Final Goal, talks of the need for a grand unified theory. The whole discussion is put in the form of refutable points._. (shrink)

Bourbaki suggest that their definition of the number 1 runs to some tens of thousands of symbols. We show that that is a considerable under-estimate, the true number of symbols being that in the title, not counting 1 179 618 517 981 links between symbols that are needed to disambiguate the whole expression.