Many medical ethicists accept the thesis that there is no moral difference between withholding and withdrawing life-sustaining therapy. In this paper, we offer an interesting counterexample which shows that this thesis is not always true. Withholding is distinguished from withdrawing by the simple fact that therapy must have already been initiated in order to speak coherently about withdrawal. Provided that there is a genuine need and that therapy is biomedically effective, the historical fact that therapy has been initiated entails a (...) claim to continue therapy that cannot be attributed to patients who have not yet received therapy. This intrinsic difference between withholding and withdrawing therapy is of moral importance. In many instances, patients will waive this claim. But when one considers withdrawing therapy from one patient to help another in a setting of scarce resources, this intrinsic moral difference comes into sharp focus. In an era of shrinking medical resources, this difference cannot be ignored. (shrink)

Horace, Janus, and Pighius' Acta In PBSR 54 , 213–28 Andrew Lintott dusts down the fragments of the Acta Urbana published by S. V. Pighius in 1615 and universally supposed today to be a forgery. Lintott himself, after a most learned discussion, concurs, but one senses a wistful longing for the fragments to be genuine. The purpose of this note is to offer another reason why sadly this is unlikely.

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did (...) not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)

First published in 1966. Professor Dryer has furnished a highly illuminating account of Kant’s _Critique of Pure Reason _by unfolding its central argument. _Kant’s Solution for Verification in Metaphysics _brings out the light which Kant has to throw on central topics of philosophy. It takes its place as an indispensable guide to every student of the _Critique of Pure Reason. _.

Science studies not only material entities and phenomena, but their reflections in the minds of men, in the form of sensations, perceptions, concepts, and the like. The study of a phenomenon like language involves simultaneous examinations of material entities and the aspect of language which pertains to meaning, which takes shape as a result of man's reflection in cognition of the world around him.

A laboratory-testable, solid-state Maxwell demon is proposed that utilizes the electric field energy of an open-gap p-n junction. Numerical results from a commercial semiconductor device simulator (Silvaco International–Atlas) verify primary results from a 1-D analytic model. Present day fabrication techniques appear adequate for laboratory tests of principle.

Following a detailed review of the accomplishments and aspirations of the Journal of Research Practice, we have undertaken a restructuring of the editorial board, with inputs from people associated with this journal. In designing the new structure, we have taken into account the need for building the journal’s profile in the six focus areas recently clarified: (1) Research Applications, (2) Research Spaces, (3) Research Education, (4) Research Experiences, (5) Research Philosophy, and (6) Research on Research. Focus Editors will ensure that (...) the journal remains well engaged with the developments in these focus areas. The new structure allows us to involve all contributors to the journal in playing a role to enhance the journal’s relevance to researchers and reflective professionals. This restructuring exercise has presented us with an opportunity to build on the strengths of the journal and address areas of concern so as to strengthen the journal’s quality, relevance, and impact. A review of different notions of impact has led us to a set of proposed measures for enhancing the relevance and utilisation of the journal in future. (shrink)

Notions of purity, perfection, or immaculateness have powered our imagination over the ages. Various images of perfection have held sway in their hallowed times, providing secure streams for channelling human energy. Unfortunately, with the unfolding of the human drama on the world stage, all the images of perfection have suffered damage, epoch on epoch. Different responses have emerged to attempt a restoration. Revival of some of the old images is one such response. Production of new images to serve as worthwhile (...) anchors of value and meaning is another common response. For reasons possibly known only to philosophers and historians, the enterprise called modern science has got thickly embroiled in this civilisational process--first, as the culprit behind the decline of some of the established images, then as the producer of new images, and now, perhaps, as a constant reminder of the perpetual lack of purity and immaculateness in all things human. (shrink)