That Hermias, the despot of Atarneus, was a barbarian as alleged by Theopompus, fr. 242, Oxf., Letter to Philip, in Didymus in Dem., col. 5, 24, has been denied by Jaeger, Aristoteles, p. 113 n., on the ground that in Aristotle's hymn and epigram he is put forward as a Hellene; cf. ibid., p. 119, on Callisthenes and Hermias. In confirmation may be added that, had he been a barbarian, he could hardly have induced the Eleans to declare the Olympic (...) truce to him as Theopompus says they did, Did. 5, 29. Demetrius the Magnesian, Diog. L. V. 3, said he was a Bithynian; and possibly Theopompus said the same in the defective passage in fr. 210, Did. 4, 69. He may have been in fact a Bithynian by place of birth, yet not by blood: at such Greeks the taunt ‘barbarian’ was readily cast; cf. Birds 1700 on Gorgias, and Aeschines on Demosthenes. But we may go much further in scepticism. (shrink)

It is the argument of this paper that many aspects of Lucan's characterization in the Bellum Civile of Caesar and Pompey, and of the conflict itself, reflect a ritual combat for kingship such as the combat and murder codified in the myth of Romulus and Remus. It was a well-established convention by Ennius's time, further developed in the late Republic, that the conflict between the founding brothers over control of Rome was the ultimate cause for the Civil Wars. The religious (...) basis of this myth can be found in the rites of the priest of Diana at Aricia, the rex nemorensis, which were still extant in Lucan's time. The evidence for Lucan's use of this paradigm is reviewed, and Book 3 of the Bellum Civile is then reassessed in the terms that it suggests. The themes of sacred place , scared combat, and the necessary murder are most clearly presented in Book 3. It is further argued that seeming inconsistencies in the nature of the gods in Lucan's epic can be at least partially resolved if we understand that the gods must remain aloof and outside the action while the ritual takes place, even though they themselves have instituted the ritual of kingship murder, and will, when it is completed, receive the murderer as their ritually validated priest-king. In the conclusion, ways are suggested in which this paradigm, if accepted, begins to clarify various puzzling choices Lucan has made elsewhere in the epic regarding his narrative of events, his development of character, and the recurrent images of lightning, tree, and blood-sacrifice owed to the gods. (shrink)

The objective of the study was to investigate the relationship between childhood IQ of parents and characteristics of their adult offspring. It was a prospective family cohort study linked to a mental ability survey of the parents and set in Renfrew and Paisley in Scotland. Participants were 1921-born men and women who took part in the Scottish Mental Survey in 1932 and the Renfrew/Paisley study in the 1970s, and whose offspring took part in the Midspan Family study in 1996. There (...) were 286 offspring from 179 families. Parental IQ was related to some, but not all characteristics of offspring. Greater parental IQ was associated with taller offspring. Parental IQ was inversely related to number of cigarettes smoked by offspring. Higher parental IQ was associated with better education, offspring social class and offspring deprivation category. There were no significant relationships between parental IQ and offspring systolic blood pressure, diastolic blood pressure, cholesterol, glucose, lung function, weight, body mass index, waist hip ratio, housing, alcohol consumption, marital status, car use and exercise. Structural equation modelling showed parental IQ associated with offspring education directly and mediated via parental social class. Offspring education was associated with offspring smoking and social class. The smoking finding may have implications for targeting of health education. (shrink)

This bibliographical study involved first the exploitation of four data-banks: Medline, CNRS, Bioethics and AIDS, with the following key words (in conjunction with AIDS): ethics, human rights, confidentiality, legislation, jurisprudence. A total of 412 references were listed between 1983 and the end of 1987. Examination of the quantitative increase of articles over these years shows that, while references to AIDS and/or HIV infection--referred to as 'AIDS' for brevity--increased by about one third per year, the number of papers treating ethical problems (...) linked to AIDS doubled each year. This increase makes it clear that these problems are important and pressing, that they are evolving rapidly and can be given no easy solution. After reading and analysis of accessible articles in readily comprehensible languages, the different themes can be classified in two categories: 1: Measures intended to protect society (starting with the most coercive); quarantine and isolation; discriminatory measures concerning specific groups; non-respect of the confidential nature of medical information; application of the penal code; screening; obligatory declaration and registration; testing of blood given by donors; vaccination and medical innovations, therapeutic assays; information, education. 2. Measures intended to protect the individual: fundamental rights of the patient: his/her right to confidentiality, to information and to treatment; civil rights: civil liberty, right to education, right to work, etc...; rights of the healthy individual: right of those in contact with the patients, safety of hospital staff, of those receiving blood-transfusions, etc... The legislation adopted in the various countries and the main opinions to be found in these articles are listed and analysed, and for each particular theme it is possible to refer to a list of the 232 most important articles. While the debate seems to concentrate on the conflict between the right of society to protect itself against the spread of infection and the 'civil' rights of the infected minorities, our conclusion tends to reduce this antagonism, showing that, particularly as far as the confidential nature of medical information is concerned, measures intended to protect the individual also protect society. (shrink)

Although it is commonly believed that the concept of brain death was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile’s definition of (...) death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord’s statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain-dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. (shrink)

Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood (...) glucose to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

Awareness is a personal experience, which is only accessible to the rest of world through interpretation. We set out to identify a neural correlate of visual awareness, using brief subliminal and supraliminal verbal stimuli while measuring cerebral blood flow distribution with H215O PET. Awareness of visual verbal stimuli differentially activated medial parietal association cortex (precuneus), which is a polymodal sensory cortex, and dorsolateral prefrontal cortex, which is thought to be primarily executive. Our results suggest participation of these higher order (...) perceptual and executive cortical structures in visual verbal awareness. (shrink)

Serum prolactin has been measured in single blood samples collected within the first 22 post-partum months from 97 nursing mothers from an urban area (Bukavu) of Zaïre. Nursing mothers are hyperprolactinemic, higher serum prolactin levels being associated with more frequent suckling episodes per day. Furthermore, serum prolactin declines rapidly in mothers who are giving the breast less than four times per day: the levels are within the normal range found in non-lactating women after the 6th post-partum month. Among mothers (...) giving the breast more than six times per day, serum prolactin does not decline significantly during the 1st post-partum year. (shrink)

A cut or crush injury to a peripheral nerve results in the degeneration of that portion of the axon isolated from the cell body. The rapid degeneration of this distal segment was for many years believed to be a process intrinsic to the nerve. It was believed that Schwann cells both phagocytosed degenerating axons and myelin sheaths and also provided growth factors to promote regeneration of the damaged axons. In recent years, it has become apparent that the degenerating distal segment (...) is invaded by monocytes from the blood. We will review the evidence that these recruited macrophages play a role in both degeneration and regeneration of peripheral nerve axons after injury and consider whether the slow degeneration and poor monocyte recruitment in the central nervous system may contribute to the poor regeneration there. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications (...) of the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

While across the animal kingdom offspring are born smaller than their parents, notable exceptions exist. Several dipteran species belonging to the Hippoboscoidea superfamily can produce offspring larger than themselves. In this essay, the blood‐feeding tsetse is focused on. It is suggested that the extreme reproductive strategy of this fly is enabled by feeding solely on highly nutritious blood, and producing larval offspring that are soft and malleable. This immense reproductive expenditure may have evolved to avoid competition with other (...) biting flies. Tsetse also transmit blood‐borne parasites that cause the fatal diseases called African trypanosomiases. It is discussed how tsetse life history and reproductive strategy profoundly influence the type of vector control interventions used to reduce fly populations. In closing, it is argued that the unusual life history of tsetse warrants their preservation in the areas where human and animal health is not threatened. (shrink)

The ectoplasmic specialization (ES) is a testis‐specific, actin‐based hybrid anchoring and tight junction. It is confined to the interface between Sertoli cells at the blood–testis barrier, known as the basal ES, as well as between Sertoli cells and developing spermatids designated the apical ES. The ES shares features of adherens junctions, tight junctions and focal contacts. By adopting the best features of each junction type, this hybrid nature of ES facilitates the extensive junction‐restructuring events in the seminiferous epithelium during (...) spermatogenesis. For instance, the α6β1‐integrin–laminin 333 complex, which is usually limited to the cell–matrix interface in other epithelia to facilitate cell movement, is a putative apical ES constituent. Furthermore, JAM‐C and CAR, two tight junction integral membrane proteins, are also components of apical ES involving in spermatid orientation. We discuss herein the mechanisms that maintain the cross‐talk between ES and blood–testis barrier to facilitate cell movement and orientation in the seminiferous epithelium. BioEssays 29: 36–48, 2007. © 2006 Wiley Periodicals, Inc. (shrink)

Glucocorticoids are understood to represent useful biomarkers of stress and can be measured in saliva, hair, and breastmilk. The collection of such biosamples is increasingly included in biobank and cohort studies. While collection is considered “non-invasive” by biomedical researchers (compared to sampling blood), community perspectives may differ. This cross-sectional, qualitative study utilising eight focus groups aimed to determine the feasibility and acceptability of collecting ostensibly “non-invasive” biological samples in Malawi. Breastfeeding women, couples, field workers, and healthcare providers were purposively (...) sampled. Data about prior understandings of, barriers to, and feasibility of “non-invasive” biosampling were analysed. Participants described biomaterials intended for “non-invasive” collection as sometimes highly sensitive, with sampling procedures raising community concerns. Sampling methods framed as physically “non-invasive” within biomedicine can consequently be considered socially “invasive” by prospective sample donors. Biomedical and community framings of “invasiveness’ can therefore diverge, and the former must respond to and be informed by the perspectives of the latter. Further, considerations of collection procedures are shaped by therapeutic misconceptions about the immediate health-related utility of biomedical and public health research. When researchers engage with communities about biosampling, they must ensure they are not furthering therapeutic misconceptions and actively seek to dispel these. (shrink)

Port-wine birthmarks (PWBs) are caused by somatic, mosaic mutations in the G protein guanine nucleotide binding protein alpha subunit q (GNAQ) and are characterized by the formation of dilated, dysfunctional blood vessels in the dermis, eyes, and/or brain. Cutaneous PWBs can be treated by current dermatologic therapy, like laser intervention, to lighten the lesions and diminish nodules that occur in the lesion. Involvement of the eyes and/or brain can result in serious complications and this variation is termed Sturge-Weber syndrome (...) (SWS). Some of the biggest hurdles preventing development of new therapeutics are unanswered questions regarding disease biology and lack of models for drug screening. In this review, we discuss the current understanding of GNAQ signaling, the standard of care for patients, overlap with other GNAQ-associated or phenotypically similar diseases, as well as deficiencies in current in vivo and in vitro vascular malformation models. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Beastly Vagueness in Charles Sanders Peirce and Henry JamesMegan M. QuigleyIn 1878, Charles Sanders Peirce closed the first section of "How to Make our Ideas Clear"—an article that William James later declared a "birth certificate of Pragmatism"—on a strangely anecdotal note.1 Using what would become known as the pragmatic method to demolish the notion of Grand Ideas ("Our idea of anything is our idea of its sensible effects"), Peirce (...) also included a lesson from an "old German story":Many a man has cherished for years some vague shadow of an idea, too meaningless to be positively false; he has nevertheless, passionately loved it, has made it his companion by day and by night, and has given to it his strength and his life, leaving all other occupations for its sake, and in short has lived with it and for it, until it has become, as it were, flesh of his flesh and bone of his bone; and then he has waked up some morning to find it gone, cleaned vanished away like the beautiful Melusina of the fable, and the essence of his life gone with it. I have myself known such a man.(WCSP, p. 261)The story of the fled Melusina (a half-woman, half-serpent who gives birth to monsters) acts ostensibly as a warning against the danger inherent in "vague" ideas. "A vague shadow of an idea" can sap the life-blood out of a young man and, therefore, Peirce asserted, we must strive to be clear. But Peirce's anecdote did more than further his argument; it was an autobiographical aside—so personal, in fact, that he ordered the passage to be deleted in all future printings of his essay.Melusina was not just an allusion to a mythological figure; it was also a reference to the middle name of his wife, Harriet Melusina Fay. Since his schooldays, Peirce's friend and, later, wife, whom he called [End Page 362] "Zina," had been his constant companion and even the scribe for his fervent aspirations. Under the title "Theories of C. S. Peirce, 1854" she had transcribed his ambitious declaration: "My life is built upon a theory: and if this theory turns out false, my life will turn out a failure" (Brent, p. 51). By the mid 1870s, Peirce's theory, "passionately loved... his companion by day and by night," was finally being elucidated in his articles; however, Melusina herself had "cleaned vanished away," after two decades of intimacy, leaving Peirce in Paris to what his friend Henry James described as "a very lonely and dreary existence." Peirce's inclusion of an anecdote about his own loneliness—"I have myself known such a man"—is poignant even as it reveals his anger. Melusina is both a monster and "beautiful," and with her disappearance, Peirce has lost, "the essence of his life." The personal allusion also highlights the anxiety in the young Peirce's writing. What if his theories came to nothing, remained merely vague, and he lost his whole life and his wife to a misguided dedication? And how ironic would that be given that the idea itself aimed to explode the fallacy of grand ideas? Such an irony was not lost on his main companion during the winter of 1875, Henry James.In the following pages I aim to demonstrate that Charles S. Peirce's anxiety acted as a germ for the beast of John Marcher in James's late story, "The Beast in the Jungle." "More than any of Henry James's tales," Paul Lindholdt writes, "'The Beast in the Jungle,' has prompted source studies and psychoanalytic discussions by critics striving to identify" John Marcher.2 Eager to diagnose the relationship between Marcher and May Bartram, critics have sought both autobiographical and literary sources for Marcher's character.3 Strangely, however, no one has noted the connection between Peirce and Marcher, an omission that is especially odd given the critical attention directed at the relationship between the story and pragmatism. Since Richard Hocks's Henry James and Pragmatistic Thought highlighted the pragmatic tendencies of James's story and called Marcher the "anti-pragmatist" hero, "an epitome of William's... (shrink)

In our society, some aspects of life are off-limits to commerce. We prohibit the selling of children and the buying of wives, juries, and kidneys. Tainted blood is an inevitable consequence of paying blood donors; even sophisticated laboratory tests cannot supplant the gift-giving relationship as a safeguard of the purity of blood. Like blood, health care is too precious, intimate, and corruptible to entrust to the market.The hospice movement in the United States is approximately 40 years (...) old. During these past four decades, the concept of holistic, multidisciplinary care for patients who are suffering from a terminal illness has evolved from a modest, grassroots constellation of primarily volunteer-run and community-governed endeavors to a multimillion dollar industry where the surviving nonprofits compete with for-profit providers, often publicly traded, managed by M.B.A.-trained executives, and governed by corporate boards. The relatively recent emergence of for-profit hospice reflects an increasing commercialization of health care in the United States, the potentially adverse impact of which has been well documented. (shrink)

BackgroundThe Public Health Service Increased Risk designation identified organ donors at increased risk of transmitting hepatitis B, hepatitis C, and human immunodeficiency virus. Despite clear data demonstrating a low absolute risk of disease transmission from these donors, patients are hesitant to consent to receiving organs from these donors. We hypothesize that patients who consent to receiving offers from these donors have decreased time to transplant and decreased waitlist mortality.MethodsWe performed a single-center retrospective review of all-comers waitlisted for liver transplant from (...) 2013 to 2019. The three competing risk events (transplant, death, and removal from transplant list) were analyzed. 1603 patients were included, of which 1244 (77.6%) consented to offers from increased risk donors.ResultsCompared to those who did not consent, those who did had 2.3 times the rate of transplant (SHR 2.29, 95% CI 1.88–2.79, p < 0.0001), with a median time to transplant of 11 months versus 14 months (p < 0.0001), as well as a 44% decrease in the rate of death on the waitlist (SHR 0.56, 95% CI 0.42–0.74, p < 0.0001). All findings remained significant after controlling for the recipient age, race, gender, blood type, and MELD. Of those who did not consent, 63/359 (17.5%) received a transplant, all of which were from standard criteria donors, and of those who did consent, 615/1244 (49.4%) received a transplant, of which 183/615 (29.8%) were from increased risk donors.ConclusionsThe findings of decreased rates of transplantation and increased risk of death on the waiting list by patients who were unwilling to accept risks of viral transmission of 1/300–1/1000 in the worst case scenarios suggests that this consent process may be harmful especially when involving “trigger” words such as HIV. The rigor of the consent process for the use of these organs was recently changed but a broader discussion about informed consent in similar situations is important. (shrink)

Features include a comprehensive review of existing material, combined with new perspectives to equip students for the challenges in the work environment; chapter overviews and student learning objectives offer a solid and useful framework in which to organise study; diagrams and charts present overviews and contexts for the subject to act as useful revision aids; effective pedagogy including a review of the arguments considered, a menu of seminar topics, and questions in every chapter, serving as an ideal basis for seminar (...) study; and additional open-ended simulations to allow students to work through unfolding scenarios. (shrink)

Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral NS3/4A (...) protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

In their simplest form, hybrid languages are propositional modal languages which can refer to states. They were introduced by Arthur Prior, the inventor of tense logic, and played an important role in his work: because they make reference to specific times possible, they remove the most serious obstacle to developing modal approaches to temporal representation and reasoning. However very little is known about the computational complexity of hybrid temporal logics.In this paper we analyze the complexity of the satisfiability problem of (...) a number of hybrid temporal logics: the basic hybrid language over transitive trees; nominal Until logic; and referential interval logic. We discuss the effects of including nominals, the @ operator, the somewhere modality E, and the difference operator D. Adding nominals to tense logic leads for several frame-classes to an increase in complexity of the satisfiability problem from PSPACE to EXPTIME. On transitive trees, however, the satisfiability problem for this language can be decided in PSPACE. Along the way we make a detour through hybrid propositional dynamic logic: we establish upper bounds for a number of temporal logics by generalizing results due to Passy and Tinchev [29] and De Giacomo [16]. We conclude with some remarks on the relevance of our results to description logic, and draw attention to the utility of the spypoint technique for proving upper and lower bounds. (shrink)

Recent evaluation of the practice of euthanasia and related medical decisions at the end of life in the Netherlands has shown a slight decrease in the frequency of physician-assisted death since the enactment of the Euthanasia Law in 2002. This paper focuses on the absence of euthanasia cases concerning patients with dementia and a written advance euthanasia directive, despite the fact that the only real innovation of the Euthanasia Law consisted precisely in allowing physicians to act upon such directives. The (...) author discusses two principal reasons for this absence. One relates to the uncertainty about whether patients with advanced dementia truly experience the suffering they formerly feared. There is reason to assume that they don’t, as a consequence of psychological adaptation and progressive unawareness (anosognosia). The second, more fundamental reason touches upon the ethical relevance of shared understanding and reciprocity. The author argues that, next to autonomy and mercifulness, “reciprocity” is a condition sine qua non for euthanasia. The absence thereof in advanced dementia renders euthanasia morally inconceivable, even if there are signs of suffering and notwithstanding the presence of an advance euthanasia directive. This does not mean, however, that advance euthanasia directives of patients with dementia are worthless. They might very well have a role in the earlier stages of certain subtypes of the disease. To illustrate this point the author presents a case in which the advance directive helped to create a window of opportunity for reciprocity and shared decision-making. (shrink)

In this article, I show that David Hume’s argument of Section 10 of the Enquiry Concerning Human Understanding does not encourage dogmatism. Instead, it suggests a program for how to categorically deny the existence of miracles without bringing about the stagnation of science. In recognizing the entailments of Hume’s notion of proof while realizing his commitments regarding the laws of nature, we must acknowledge that miracles are possible. Yet this is consistent with Hume’s claim that we are never justified in (...) believing the testimony affirming them. This conclusion is strengthened when we realize that only a doxastic notion of lawlikeness is at work in Hume’s argument rather than a robust, efficacious notion of metaphysical laws. When properly understood, we see that the course he advocates does not impede the advances of science, as has sometimes been suggested. Instead, Hume’s deliberate use of specific examples of two very different sorts propounds a procedure for dealing with purported miracles that is much richer than merely denying them, and tells us when revisions to our conception of the laws of nature are necessary and when they are not. (shrink)

Alchemy is central to Jung's hypothesis of the collective unconscious. In this volume he begins with an outline of the process and aims of psychotherapy, and then moves on to work out the analogies between alchemy, Christian dogma and symbolism and his own understanding of the analytic process. Introducing the basic concepts of alchemy, Jung reminds us of the dual nature of alchemy, comprising both the chemical process and a parallel mystical component. He also discusses the seemingly deliberate mystification of (...) the alchemists. Finally, in using the alchemical process as providing insights into individuation, Jung emphasises the importance of alchemy in relating to us the transcendent nature of the psyche. (shrink)

Philosophical atheism claims not only that there are no sufficient reasons for believing there is a God, but also that there are sufficient reasons for thinking no such deity exists. The purpose of this article is to explicate the typical commitments of this position. After distinguished several related views, the article will then consider typical grounds for the rejection of theistic commitments, first by showing that the theistic position makes a stronger claim and therefore carries the burden of proof. The (...) article will then consider rejections of theistic attempts to shift this burden and atheist responses, including considerations of both natural and revealed theology. The intent is to present the general shape of rejections and commitments rather than proffering conclusive refutations and defenses. (shrink)

In recent analytic philosophy, there is a growing interest in the project of conceptual engineering. This paper examines two ways this project might be applied to scientific research, specifically anthropological research. It argues that both of them are harmful to this research. Specifically, it argues that a reliance on the axiological standards of analytic philosophy conflicts with the goal of empirical adequacy. Section one proffers two forms that the engineering project might take when applied to the science. Section two proffers (...) a case study drawn from anthropology. Specifically, it lays out Evans-Pritchard’s Witchcraft, Oracles, and Magic Among the Azande, paying particular attention to the inconsistency he discovered in Azande witchcraft. Sections three and four argue that attempting to remove this inconsistency via the two forms of engineering disable critical features of emic research and discard empirical findings. Finally, I close by noting how the conflict between axiological standards and empirical adequacy might generalize beyond anthropology. (shrink)

Among the scanty remains of poetry attributed to Eumelus of Corinth two lines 2 stand out as different from the rest, first because they are concerned not with the legendary past but with an actual, present occasion, and secondly because they are composed not for Corinthians but for Messenians. Our evidence comes from Pausanias and may be set out at the start.

This paper starts with an overview of C.G. Jung’s notion of archetypes. His ideas imply that Jungian archetypes can be viewed as the most general examples of the shared awarenesses that occur in groups of people of all sizes, ranging from families to humanity as a whole. The term ‘archetype’ is used in connection with such shared awarenesses in the subsequent discussion. The distinction that Jung made between archetypal representations and archetypes themselves is retained and emphasized. It is then pointed (...) out that archetypal representations are sets of Dawkins’ memes appearing in awareness. Pursuing the line of thought suggested by this, it is further proposed that the meme set can be regarded as analogous to the genotype in biology, while the representation itself resembles the phenotype in heuristically useful respects. Archetypes, as opposed to their representations, are the factors which predispose particular sets of memes to spread within a group of people and enter their awarenesses. It follows from the biological analogy that archetypes can be thought of as regularities that occur in an ‘ecology’ of representations. Because memes are subject to pseudo-Darwinian influences, parallels between the behaviour of representations and the phenomena of parasitology and epidemiology will sometimes be observed. The view of archetypes arrived at opens up a possibility that they might be responsible for some mass behaviours; e.g. those involved in the production of social movements such as Nazism or certain medical conditions of obscure aetiology. Archetypal representations possess in some circumstances the power to fill the consciousnesses of individuals ‘infected’ by them for long periods of time. These points are illustrated in a brief account of fatigue syndromes. Finally, should consciousness have a quantum theoretical basis, details of the epidemiology of archetypal representations will differ from those to be expected if it has no such basis. The phenomenon of alien abduction, presumed to be of archetypal origin, is discussed as an example. (shrink)

Among bioethicists and members of the public, genetics is often regarded as unique in its ethical challenges. As medical researchers and clinicians increasingly combine genetic information with a range of non-genetic information in the study and clinical management of patients with common diseases, the unique ethical challenges attributed to genetics must be re-examined. A process of genetic routinisation that will have implications for research and clinical ethics, as well as for public conceptions of genetic information, is constituted by the emergence (...) of new forms of genetic medicine, in which genetic information is interpreted in a multifactorial frame of reference. Although the integration of genetics in medical research and treatment may be a helpful corrective to the mistaken assumptions of genetic essentialism or determinism, the routinisation of genetics may have unintended consequences for the protection of genetic information, perceptions of non-genetic information and the loss of genetic research as a laboratory for exploring issues in research and clinical ethics. Consequently, new ethical challenges are presented by the increasing routinisation of genetic information in both biomedical and public spheres. (shrink)