Objective: To determine whether a moral reasoning exercise can improve response quality to surveys of healthcare priorities Methods: A randomised internet survey focussing on patient age in healthcare allocation was repeated twice. From 2574 internet panel members from the USA and Canada, 2020 (79%) completed the baseline survey and 1247 (62%) completed the follow-up. We elicited respondent preferences for age via five allocation scenarios. In each scenario, a hypothetical health planner made a decision to fund one of two programmes identical (...) except for average patient age (35 vs 65 years). Half of the respondents (intervention group) were randomly assigned to receive an additional moral reasoning exercise. Responses were elicited again 7 weeks later. Numerical scores ranging from –5 (strongest preference for younger patients) to +5 (strongest preference for older patients); 0 indicates no age preference. Response quality was assessed by propensity to choose extreme or neutral values, internal consistency, temporal stability and appeal to prejudicial factors. Results: With the exception of a scenario offering palliative care, respondents preferred offering scarce resources to younger patients in all clinical contexts. This preference for younger patients was weaker in the intervention group. Indicators of response quality favoured the intervention group. Conclusions: Although people generally prefer allocating scarce resources to young patients over older ones, these preferences are significantly reduced when participants are encouraged to reflect carefully on a wide range of moral principles. A moral reasoning exercise is a promising strategy to improve response quality to surveys of healthcare priorities. (shrink)

There is currently a debate over whether cognitive architecture is classical or connectionist in nature. One finds the following three comparisons between classical architecture and connectionist architecture made in the pro-connectionist literature in this debate: (1) connectionist architecture is neurally plausible and classical architecture is not; (2) connectionist architecture is far better suited to model pattern recognition capacities than is classical architecture; and (3) connectionist architecture is far better suited to model the acquisition of pattern recognition capacities by learning than (...) is classical architecture. If true, (1)-(3) would yield a compelling case against the view that cognitive architecture is classical, and would offer some reason to think that cognitive architecture may be connectionist. We first present the case for (1)-(3) in the very words of connectionist enthusiasts. We then argue that the currently available evidence fails to support any of (1)-(3). (shrink)

This essay explores some concerns about the quality of informed consent in patients whose autonomy is diminished by fatal illness. It argues that patients with diminished autonomy cannot give free and voluntary consent, and that recruitment of such patients as subjects in human experimentation exploits their vulnerability in a morally objectionable way. Two options are given to overcome this objection: (i) recruit only those patients who desire to contribute to medical knowledge, rather than gain access to experimental treatment, or (ii) (...) provide prospective subjects the choice to participate in standard doubleblind study or receive the experimental treatment. Either option would guarantee that patients in desperate conditions are given a more meaningful choice and a richer freedom, and thus a higher quality of informed consent, than under standard randomized trials. (shrink)

The United States District Court of Kansas, in Gudenkauf v. Stauffer, Znc., granted the defendants motion for summary judgment for the plaintiff's claims of pregnancy-related discrimination under the Americans with Disabilities Act and the Family and Medical Leave Act of 1993, but the court denied a similar motion for the plaintiff's claim under the Pregnancy Discrimination Act. The court found summary judgment to be appropriate for the ADA claim based on its finding that the plaintiff's pregnancy did not constitute an (...) impairment as required by the statute; as for the FMLA claim, it determined that the defendants failure to grant the plaintiff's leave request did not violate the statute. However, the court determined that summary judgment was inappropriate for the PDA claim because of material questions of fact about whether the defendant had acted with discriminatory intent.In considering the motions for summary judgment, the court accepted the following facts as incontrovertible. Plaintiff Michaela Gudenkauf worked for the defendant Stauffer, Inc. (shrink)

Predation and escaping from predation through hiding are two fundamental phenomena in ecology. The most common approach to reducing the chance of predation is to use a refuge. Here, we consider a three species fishery model system with prey refuge induced by a Holling type-II functional response. These three species of fish populations are named prey, middle predator, and top predator. Harvesting is employed in most fishery models to achieve both ecological and commercial benefits. Research proves that non-linear harvesting (Michaelis–Menten (...) type) returns more realistic outcomes. So, we have combined the Michaelis–Menten type of harvesting efforts for all populations. Uniform boundedness conditions for the solutions of the model are discussed. The existence conditions for possible equilibrium points with stability are presented. We explain the dynamical behavior at each equilibrium point through bifurcation analysis. The persistent criteria of the system are examined. Bionomic equilibrium and optimal harvesting control using Pontryagin’s maximum principle are calculated. For validation of the model in the real world, we have implemented this in the freshwater ecosystem of Lake Victoria. Extraction of native fish species and ecological balances are the foremost solicitude of Lake Victoria. We may resolve this concern partially by implementing prey refuge, since it may sustain the ecology of Lake Victoria, and therefore also its economical importance. Lake Victoria is acclaimed worldwide for the trade of fishing. Also, it provides the largest employment in east-central Africa and is beneficial to fishing equipment manufacturers. So, the bionomic equilibrium and harvesting control have significant applications in the fisheries. All the analytical studies are verified by numerical simulations. We have plotted phase portraits, bifurcation diagrams, Lyapunov exponents to explore the dynamics of the proposed model. (shrink)

The central idea of this paper is that forming the black hole horizon is attended with the transition from the classical regime of evolution to the quantum one. We offer and justify the following criterion for discriminating between the classical and the quantum: creations and annihilations of particle-antiparticle pairs are impossible in the classical reality but possible in the quantum reality. In flat spacetime, we can switch from the classical picture of field propagation to the quantum picture by changing the (...) overall sign of the spacetime signature. To describe a self-gravitating object at the final stage of its classical evolution, we propose to use the Foldy–Wouthuysen representation of the Dirac equation in curved spacetimes, and the Gozzi classical path integral. In both approaches, maintaining the dynamics in the classical regime is controlled by supersymmetry. (shrink)

A generally clear and well-written introduction to Thomistic natural theology which, like most such "textbook" treatments, suffers from too much commentary and too little Aquinas. The nature and existence of God are dealt with in some detail, and two interesting sections on "Invalid Reasons for Holding the Existence of God" and "Some Controverted Arguments" are included.--B. P. H.

We interpret the concept of determinism for a classical system as the requirement that the solution to the Cauchy problem for the equations of motion governing this system be unique. This requirement is generally believed to hold for all autonomous classical systems. Our analysis of classical electrodynamics in a world with one temporal and one spatial dimension provides counterexamples of this belief. Given the initial conditions of a particular type, the Cauchy problem may have an infinite set of solutions. Therefore, (...) random behavior of closed classical systems is indeed possible. With this finding, we give a qualitative explanation of how classical strings can split. We propose a modified path integral formulation of classical mechanics to include indeterministic systems. (shrink)

Nurses and midwives are the majority of healthcare professionals globally, including Africa, and they provide care at all levels of the health system including community levels. Nurses and midwives contribute to the care of patients with rigid or dogmatic religious beliefs or those with suicidal ideations. This review paper discusses acute and chronic diseases that have suicidal tendencies such as terminal cancer, diseases with excruciating pain, physical disability, stroke, end-stage renal failure, and diabetics who are amputated. It was reiterated that (...) nurses and midwives taking care of these patients should be alert and observant to identify their suicidal tendencies. The paper also discusses religious or spiritual inclinations that negatively affect healthcare access and adherence, especially to biomedical or western medicine. It was emphasized that some religious beliefs do not allow their followers to employ biomedical treatment and nurses and midwives should not impose their faith on patients and their families. The paper ends with a discussion on the specific roles of nurses and midwives in the care of patients with suicidal ideations such as assessment, counseling, administering medication, observation, social interaction, ensuring safety measures, and providing an enabling environment for the family to part of the care and for the observation of religious coping strategies. Nurses and midwives should enhance their knowledge and skills on suicide and increase public education on suicide prevention and identification of those at risk. (shrink)

Containing essays on the nature and scope of rhetoric, as well as philosophical analyses of persuasion and argumentation, this book claims to deal with a "new field of philosophy" in which "the concepts of rhetoric and argumentation, including the rhetoric and argumentation of the philosopher himself, are subjected to philosophical scrutiny." Leaving aside the "newness" of such an endeavor, it is heartening to see new interest in the questions of rhetorical argument. Perhaps analytic philosophers should pay more attention to the (...) history of rhetoric and modern rhetoricians to the new developments in philosophy. This book is a first step in that direction.—B. P. H. (shrink)

How are we to understand Cato the Younger? To be sure, this question implies that there is something important we can learn by studying the life of Cato the Younger, that we can garner fundamental political insights by understanding his actions and thoughts. Although this essay will be a modest attempt to articulate some of these insights by presenting a paradigm with which Cato's life can be understood, the very fact that Cato commands the attention of a diverse number of (...) diplomats, philosophers and poets should make us as political scientists and historians at least somewhat interested in his life as a whole. (shrink)