Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

"Kevin Hart and Geoffrey H. Hartman bring together essays by prominent scholars from a range of disciplines to focus on Blanchot's diverse concerns: literature, art, community, politics, ethics, spirituality, and the Holocaust."--Jacket.

*The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

The Joint International Conference on Logic Programming, sponsored by the Association for Logic Programming, is a major forum for presentations of research, applications, and implementations in this important area of computer science. Logic programming is one of the most promising steps toward declarative programming and forms the theoretical basis of the programming language Prolog and its various extensions. Logic programming is also fundamental to work in artificial intelligence, where it has been used for nonmonotonic and commonsense reasoning, expert systems implementation, (...) deductive databases, and applications such as computer-aided manufacturing. Krzysztof R. Apt is project leader at the Centre for Mathematics and Computer Science in Amsterdam and part-time Professor in Computer Science at the University of Amsterdam. Topics covered: Theory Foundations. Programming Languages. Implementation. Programming Methodologies and Tools. Applications. Deductive Databases. Artificial Intelligence. Parallelism. (shrink)

*Disclaimer: The views expressed are the author's and should not be ascribed to the American Medical Association.

It is interesting, that with the notable exception of the Cologne-based geneticist Benno Müller-Hill, German historians of medicine have not bothered a great deal with looking into German medical history during the Third Reich. We owe Pennsylvania State University's Robert N Proctor a great deal of gratitude for uncovering more and more of this history, and for making it accessible in a highly readable format. Proctor has established himself rapidly as the pre-eminent US American historian of science on all aspects (...) of Nazi medical research and health policy. In this most recent book Proctor looks at Nazism's pioneering contributions in public health research and policy, as well as in environmental health, occupational health, and preventive medicine. This book holds some disturbing lessons for those who hold the view that basically good people will undertake ethical research, and support good health …. (shrink)

In this article, the author aims to demonstrate how Agamben’s concept of Homo Sacer is ideally epitomized by a soldier in war. A soldier in war holds a peculiar position, as killing of soldiers is considered neither illegal by laws nor immoral by ethics, and so a soldier is not considered to be legally or morally “guilty” in the usual sense of the word if he or she kills another soldier in war. The author analyzes the notion of Homo Sacer (...) – a figure representing a human that can be killed without the killer being punished, but at the same time someone who cannot be sacrificed – and further demonstrates that a soldier in war can be said to hold precisely such a status. The reason why a soldier cannot be sacrificed resides in the fact that he has already been “sacrificed to war” by his own society, in exchange for the safety of all other members of society. Perceiving a soldier as Homo Sacer provides a novel explanation and an additional argument for the moral symmetry of combatants, one of the pillars of non-revisionist Just War Theory, as all soldiers can be understood as persons sacrificed by their own societies. (shrink)

1. Aim of the guidelines2. Principles of good practice3. Circumcision for medical purposes4. Non-therapeutic circumcision 4.1. The law 4.1.1. Summary: the law 4.2. Consent and refusal 4.2.1. Children’s own consent 4.2.2. Parents’ consent 4.2.3. Summary: consent and refusal 4.3. Best interests 4.3.1. Summary: best interests 4.4. Health issues 4.5. Standards 4.6. Facilities 4.7. Charging patients 4.8. Conscientious objection5. Useful addresses.

Most phobias are focussed on a small number of fear-inducing stimuli (e.g., snakes, spiders). A review of the evidence supporting biological and cognitive explanations of this uneven distribution of phobias suggests that the readiness with which such stimuli become associated with aversive outcomes arises from biases in the processing of information about threatening stimuli rather than from phylogenetically based associative predispositions or “biological preparedness.” This cognitive bias, consisting of a heightened expectation of aversive outcomes following fear-relevant stimuli, generates and maintains (...) robust learned associations between them. Some of the features of such stimuli which determine this expectancy bias are estimates of how dangerous they are, the semiotic similarity between them and their aversive outcomes, and the degree of prior fear they elicit. Ontogenetic and cultural factors influence these features of fear-relevant stimuli and are hence important in determining expectancy bias. The available evidence does not exclude the possibility that both expectancy biases and specific evolved predispositions coexist, but the former can explain a number of important findings that the latter cannot. (shrink)

This composition text focuses on argument and persuasion using examples, exercises, readings, and writing assignments. The text guides students through developing a thesis, finding and organizing evidence, and writing and revising several different types of argumentative papers. The second edition de-emphasizes the language of formal logic, and all the readings, examples, and exercises have been updated. Additional coverage has been given to refutation. Widely used in both advanced composition and second semester freshman courses.

Professions have traditionally treated advocacy as a collective duty, best assigned to professional associations to perform. In North American nursing, advocacy for issues affecting identifiable patients is assigned instead to their nurses. We argue that nursing associations’ withdrawal from advocacy for patient care issues is detrimental to nurses and patients alike. Most nurses work in large institutions whose internal policies they cannot influence. When these create obstacles to good care, the inability of nurses to affect change can result in avoidable (...) distress for them and for their patients. We illustrate this point with a case study: the circumstances of the death of Michael Joseph LeBlanc, an inmate at Kingston Penitentiary Regional Hospital (Ontario). We conclude that patients and their nurses will suffer unnecessarily unless or until nursing associations cease to burden individual nurses with the responsibility for patient advocacy. (shrink)

Human agents draw a variety of inferences effortlessly, spontaneously, and with remarkable efficiency – as though these inferences were a reflexive response of their cognitive apparatus. Furthermore, these inferences are drawn with reference to a large body of background knowledge. This remarkable human ability seems paradoxical given the complexity of reasoning reported by researchers in artificial intelligence. It also poses a challenge for cognitive science and computational neuroscience: How can a system of simple and slow neuronlike elements represent a large (...) body of systemic knowledge and perform a range of inferences with such speed? We describe a computational model that takes a step toward addressing the cognitive science challenge and resolving the artificial intelligence paradox. We show how a connectionist network can encode millions of facts and rules involving n-ary predicates and variables and perform a class of inferences in a few hundred milliseconds. Efficient reasoning requires the rapid representation and propagation of dynamic bindings. Our model (which we refer to as SHRUTI) achieves this by representing (1) dynamic bindings as the synchronous firing of appropriate nodes, (2) rules as interconnection patterns that direct the propagation of rhythmic activity, and (3) long-term facts as temporal pattern-matching subnetworks. The model is consistent with recent neurophysiological evidence that synchronous activity occurs in the brain and may play a representational role in neural information processing. The model also makes specific psychologically significant predictions about the nature of reflexive reasoning. It identifies constraints on the form of rules that may participate in such reasoning and relates the capacity of the working memory underlying reflexive reasoning to biological parameters such as the lowest frequency at which nodes can sustain synchronous oscillations and the coarseness of synchronization. (shrink)

Of the many proposals for inferring genetic regulatory structure from microarray measurements of mRNA transcript hybridization, several aim to estimate regulatory structure from the associations of gene expression levels measured in repeated samples. The repeated samples may be from a single experimental condition, or from several distinct experimental conditions; they may be “equilibrium” measurements or time series; the associations may be estimated by correlation coefficients or by conditional frequencies (for discretized measurements) or by some other statistic. This paper describes two (...) elementary statistical difficulties for all such procedures, no matter whether based on Bayesian updating, conditional independence testing, or other machine learning procedures such as simulated annealing or neural net pruning. One difficulty obtains if large numbers of cells are aggregated in a measurement of expression levels from a common population of cells; the other obtains if small numbers of cells are aggregated or if samples are separately aggregated over different populations of cells. (shrink)

The structure of pluralist arguments -- The inadequacy of multiculturalism -- The incompatibility of subsidiarity -- Associative democracy and the corporatist temptation -- Two conceptions of sovereignty -- A positivist pluralism? -- Law as intelligibility -- Pluralist authority -- This unity of life and action -- The personality of associations -- Property, personality, and public justification -- The spectre of intractability.

Since the publication of John Rawls'sA Theory of Justice, normative democratic theory has focused principally on three tasks: refining principles of justice, clarifying the nature of political justification, and exploring the public policies required to ensure a just distribution of education, health care, and other basic resources. Much less attention has been devoted to examining the political institutions and social arrangements that might plausibly implement reasonable political principles. Moreover, the amount of attention paid to issues of organizational and institutional implementation (...) has varied sharply across the different species of normative theory. Neoliberal theorists, concerned chiefly with protecting liberty by taming power, and essentially hostile to the affirmative state, have been far more sensitive to such issues than egalitarian-democratic theorists, who simultaneously embrace classically liberal concerns with choice, egalitarian concerns with the distribution of resources, and a republican emphasis on the values of citizen participation and public debate. Neglect of how such values might be implemented has deepened the vulnerability of egalitarian-democratic views to the charge of being unrealistic: “good in theory but not so good in practice.”. (shrink)

The aim of our study was to explore the first three associations for the following two stimulus words: compassion and self-compassion. In addition, we were interested in whether the participants would conceptualise these words more in terms of emotions, cognitions, or behaviours. The sample consisted of 151 psychology students. A consensual qualitative research approach was adopted. Three members of the core team and an auditor analysed the free associations of compassion and self-compassion. The data showed that there were four domains (...) for both compassion and self-compassion: the Emotional, Cognitive, Behavioural and Evaluative Aspects of compassion/self-compassion. The only domains that differed were the Biological Aspect of compassion and the Situational Aspect of self-compassion. The most frequently represented domain for both compassion and self-compassion was the Emotional Aspect, while both more positive as well as negative emotions were associated with self-compassion than was the case with compassion. The findings of our study show that the participants perceived compassion as mainly consisting of empathy; the emotions of love, sadness and remorse; cognitive understanding; and behavioural displays of help, physical or mental closeness. Compassion was seen as being mainly directed at those close to them, such as family and friends, and at vulnerable people. Compassion occurs in situations of loss or any other kind of suffering. The participants viewed self-compassion primarily in terms of the positive emotions of love and calmness; the negative emotions of unhappiness, sadness and remorse; cognitive understanding; and behavioural displays of self-help through the provision of self-support and self-assurance. Self-compassion is triggered mainly in situations involving internal suffering caused by criticism or externally as a response to a difficult situation. Self-compassion is evaluated in both negative (because of its misuse) as well as positive terms (because of its connection to virtues). The findings of our qualitative study support the idea that compassion is a multidimensional construct consisting of emotional, cognitive, and behavioural aspects. (shrink)