Background Defensive medicine is physicians’ deviation from standard medical care which is primarily intended either to reduce or avoid medico legal litigation. Although the Federal Ethics Committee review in Ethiopia has shown that applications for medical/surgical error investigation claims are increasing at an alarming rate, there is no study to date done to estimate the degree of defensive practice done by the physicians with an intention of avoiding this increasing legal claim. This study assessed the practice of defensive medicine among (...) highly litigious disciplines (surgery) and described factors associated with its practice. Methods Cross sectional quantitative study using online survey questionnaires was conducted to assess the degree of defensive practice and six factors (age, years of experience, specialty, monthly income, place of practice and previous medico legal history) associated with its practice were assessed among surgeons working in Ethiopia. Results A total of 430 surgeons directly received an online survey questionnaire and 236 of them successfully completed the questionnaire making the response rate 51.2%. Nearly half of the study participants (51.7%) were aware of the concept of defensive medicine and 174 (74%) reported performing one form of defensive practice. Twenty-nine (12.3%) of the participants have legal dispute history, though only 1.3% of them ended up in penalty. Avoiding high risk procedures was the commonest defensive act performed by 60% of the participants, followed by ordering tests unnecessarily (52.1%). Multinomial logistic regression model showed that there was no association between age of the participant, place of practice, year of experience and defensive practice. This model also showed that cardiothoracic and vascular surgeons perform less defensively than surgeons with other specialty with P value of 0.02. Conclusion The practice of defensive medicine is widespread among surveyed Ethiopian surgeons and further studies are required to objectively estimate the effect of defensive practice on the health care system of the country. Policy makers need to develop strategy towards decreasing this high rate of defensive practice. (shrink)

Este artigo examina a relação entre subjetividade e vontade à luz de alguns resultados parciais obtidos em nossa pesquisa sobre a filosofia de Henri Bergson, cujo carro-chefe é a noção de “duração”. Pensar a subjetividade a partir da duração significa admitir que a transição ininterrupta que vai do passado para o futuro passando pelo presente é a temporalidade atuando no nível mais simples de nossa relação com o mundo. Destacamos a subjetividade a partir da duração porque já na percepção estamos (...) evocando o passado para iluminar o presente e, assim, podemos compreender o “problema” da subjetividade a partir de uma ação na qual se observa uma diferença de funções: a diferença entre o presente que atua e o passado que já não atua. É precisamente esse caráter temporal da ação que leva os comentadores de Bergson a interpretarem de maneira original a gênese da subjetividade, o papel da memória na percepção e a conceberem novos sentidos para o conceito de “vontade”. Por conseguinte, a estrutura argumentativa que adotamos neste texto deverá mover-se em três níveis de análise que correspondem, respectivamente, a três aspectos da subjetividade humana (percepção, memória e vontade). Desse modo, pretendemos ressaltar a temporalidade viva como marca registrada do bergsonismo. (shrink)

We discuss the problem of finding forcing posets which introduce closed unbounded subsets to a given stationary set.

This volume presents the concept of Ecoscape as spatial interrelations, or spatially patterned processes, that are constitutive of an environment_an ecosystem. Contributors investigate environmental issues concerning the human impact on geohistory, food distribution, genetically modified biota, waste management, scientific mapping, and the rethinking of human identity.

Human rights protect the conditions of a minimally decent life of which mental health is an indispensable element. Adequate care for mental health is thus recognized as part of the human right to health. However, for populations living far from urban centers, adequate in-person (mental) health care is often extremely costly and thus not provided. Digital mental health care options have become an effective alternative to in-person treatment. Benefitting from these new digital opportunities, though, requires sufficient access to the internet. (...) Because everyone has a human right to adequate health care, and digital mental health care is now an effective option for progressively realizing this human right for people who live in remote regions, these people also have to be understood to have a right to access to the internet. This right to internet access creates duties for public authorities and the international community to create the required digital infrastructure and (where needed) to cover the costs of internet access where this is the only feasible way of delivering, or progressively realizing, the mental health care that is indispensable for having the opportunity to lead minimally decent lives. (shrink)

The thought about this book has been developed with the view of adding value to the teaching of Research Methodology for undergraduate and graduate students in developing economies like Sierra Leone. At the same time, it is a very useful tool for professionals engaged in research as part of their work life and for which their understanding of the dichotomy between Research Methods and Research Methodology needs to be addressed. It is divided into distinct sections, which makes it very easy (...) for the beginner researcher to understand the difference in concepts used, while at the same time enhancing their basic understanding of scientific tool(s) needed to pursue ontological research, with the aim of adding new value in the body of knowledge. The main motivation for producing the first edition is based on the following: ● To write a book that focused on using and applying the techniques of research methodology in a research setting. ● To write a book that is accessible to students and practicing researchers in developing country like Sierra Leone, where the subject matter is not so well taught, but critical in developing knowledge capacity for graduates entering the profession of research. ● To pursue critical research, particularly in the social science field pertaining to Econometrics, Sociology, Development Economics and many more. (shrink)

This text proposes an interpretation of the work of Franklin Leopoldo e Silva based on the reading of some of his numerous published articles and books, without neglecting the classes and guidance received from the stage of Scientific Initiation to Postdoctoral studies. Precisely, by highlighting the importance of three thinkers widely studied by Professor Franklin – Berkeley, Bergson and William James –, we suggest that at the heart of this philosophical experience there would be a constant: empiricism. Whether in the (...) classical or radical version, the line we draw in this multiplicity reveals an openness to concrete empiricism. (shrink)

Response to Samuel Moyn's "Amos Funkenstein on the Theological Origins of Historicism," published in the Journal of the History of Ideas, volume 64 (2003), pages 639-57.

We propose a class [I,S] of loss functions for modeling the imprecise preferences of the decision maker in Bayesian Decision Theory. This class is built upon two extreme loss functions I and S which reflect the limited information about the loss function. We give an approximation of the set of Bayes actions for every loss function in [I,S] and every prior in a mixture class; if the decision space is a subset of R, we obtain the exact set.

Recent literature on the role of pictorial representation in the life sciences has focused on the relationship between detailed representations of empirical data and more abstract, formal representations of theory. The standard argument is that in both a historical and epistemic sense, this relationship is a directional one: beginning with raw, unmediated images and moving towards diagrams that are more interpreted and more theoretically rich. Using the neural network diagrams of Warren McCulloch and Walter Pitts as a case study, I (...) argue that while in the empirical sciences, pictorial representation tends to move from data to theory, in areas of the life sciences that are predominantly theoretical, when abstraction occurs at the outset, the relationship between detail and abstraction in pictorial representations can be of a different character. (shrink)

Book reviewed in this article: Mama Might Be Better Off Dead: The Failure of Health Care in Urban America. By Laurie Kaye Abraham. Not All of Us Are Saints: A Doctor's Journey with the Poor. By David Hilfiker.

Abraham Verghese proposes to renew medicine by training physicians to read the right texts—literary fiction and patients' bodies—with skilled attention. Analyzing Verghese's proposal with reference to Foucault's idea of the "clinical gaze," I find that Verghese conceives of patients as texts that only physicians can read, meaning that physicians become the storytellers of the bodies, lives, and deaths of the people they meet as patients. I conclude that Verghese's project is unsustainable and alternatively propose thinking analogically of physicians as (...) ship captains who maintain therapeutic distance to reopen interpretative spaces for communities outside of medicine. (shrink)

Ancient Peripatetics and Neoplatonists had great difficulty coming up with a consistent, interpretatively reasonable, and empirically adequate Aristotelian theory of complete mixture or complexion. I explain some of the main problems, with special attention to authors with whom Avicenna was familiar. I then show how Avicenna used a new doctrine of the occultness of substantial form to address these problems. The result was in some respects an improvement, but it also gave rise to a new set of problems, which were (...) later to prove fateful in the history of early modern philosophy. (shrink)

ABSTRACT:The major aim of this article is to show that John Rawls’s theory of justice cannot be applied effectively to questions of business ethics and corporate governance. I begin with a reading of Rawls that emphasizes both the critical and pragmatic nature of his theory. In the second section I look more closely at the notion of society’s “basic structure” and its place within Rawls’s theory. In the third section, I argue that “the corporation” cannot be understood as part of (...) this basic structure and is not, therefore, a subject of justice for Rawls or his interpreters. Finally, I show that Rawls’s inability to speak to the corporation is a weakness, regardless of one’s particular view on the corporation. I conclude by considering what Rawls’s theory helps us to understand about the problems involved in integrating corporate governance, business ethics, and political philosophy. (shrink)

ABSTRACT:In his 2018 presidential address to the Society of Business Ethics, Jeffery Smith claimed that political approaches to business ethics must be attentive to both the distinctive nature of commercial activity and, at the same time, the degree to which such commercial activity is structured by political decisions and choices. In what we take to be a friendly extension of the argument, we claim that Smith does not go far enough with this insight. Smith’s political approach to business ethics focuses (...) solely on the outcomes of political choices. But if we think of politics in terms of processes—as in, ongoing disagreement and contest—and not merely a series of legal, administrative, or institutional outcomes, a different view of business ethics emerges. In particular, we argue that such an emphasis points us toward seeing business actors as having a normative duty to preserve the integrity and functioning of democracy. (shrink)

Abraham Pais's Subtle Is the Lord was a publishing phenomenon: a mathematically sophisticated exposition of the science and the life of Albert Einstein that reached a huge audience and won an American Book Award. Reviewers hailed the book as "a monument to sound scholarship and graceful style", "an extraordinary biography of an extraordinary man", and "a fine book". In this groundbreaking new volume, Pais undertakes a history of the physics of matter and of physical forces since the discovery of (...) x-rays. The book attempts to relate not only what has happened over the last hundred years but why it happened the way it did, what it was like for those scientists involved, and how what at the time may have seemed a series of bizarre or unrelated events, now with hindsight emerges as a logical sequence of events. Pais, a noted physicist, was personally involved in many of the developments he describes, and thus Inward Bound, like his earlier book, is filled with unique insights into the world of big and small physics. Between 1895 and 1983, the period he covers, the smallest distances explored have shrunk a hundred millionfold, Pais notes. Along this incompletely traveled "road inward," scientists have established markers that later generations will rank among the principal monuments of the twentieth century. In alternating technical and nontechnical sections, this magisterial survey richly conveys what has been discovered about the constituents of matter, the laws to which they are subject, and the forces that act on them. But the advances have certainly not come smoothly. The book shows that these have been times of progress and stagnation, of order and chaos, of clarity and confusion, of belief and incredulity, of the conventional and the bizarre; also of revolutionaries and conservatives, of science by individuals and by consortia, of little gadgets and big machines, and of modest funds and big money. About the Author: Abraham Pais is Detlev W. Bronk Professor of Physics at the Rockefeller University. The author of the prizewinning biography of Einstein now undertakes a history of modern physics. (shrink)

In this volume, a distinguished philosopher and moral rights theorist examines important changes that have occurred in our thinking about rights since first mention of them was made in early modern times. His inquiry is framed by an opening question and a concluding response. The question is whether the Greeks had any conception of a moral right. Some argue that they did not, on the ground that they had no word for a right. Others claim that they did, since they (...) employed certain locutions, the equivalents of which in our language are tied to some notion of a moral right. Professor Melden reviews in detail some of the most important historical conceptions of rights and examines serious questions raised by the fact that there have been striking changes in our thinking about rights. His discussion elucidates the place of moral rights in the broader network of moral concepts, along with the role they should play in our moral lives. Among the fundamental issues raised and discussed are those concerning the ways in which we are to understand various sorts of rights, the relation of special moral rights to our basic human rights, the now familiar claim that there are animal rights, the nature of moral progress, and the dream of a moral science. (shrink)