Background: Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. Purpose: This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. Research design: A descriptive qualitative design was used (...) to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study’s coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. Findings: HIV service providers encountered ethical challenges in all the four Beauchamp and Childress’ biomedical ethics of respect for patients’ autonomy, beneficence, justice, and nonmaleficence. Discussion: The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Conclusion: Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care. (shrink)

One might legitimately wonder why, if Christopher Middleton, in his Selected Letters of Friedrich Nietzsche, published translations of approximately ten per cent of the total available Nietzschean correspondence, the current translators have elected to repeat roughly sixty per cent of these in the present work. One might extend this misgiving to a further questioning as to why the co-translators have chosen to include "representative" passages of these letters when Middleton translates them in their entirety. Stripping sentences from paragraphs (...) and paragraphs from pages is surely no way to present a meaningful portrait of their author. If this were done with the intention of presenting a simple, non-contradictory view of Nietzsche's development or personality, it would be understandable, if unjustifiable. But it is not. If the present translations were markedly fresh and lucid in contrast to previously bungled efforts, it would be understandable. But they are not. If Middleton's content footnotes were occasionally lifted from Schlechta, they made up in substance what they lacked in originality. The few footnotes scattered here might be copiously expanded to explain what is going on--going on in the letter, going on in Nietzsche's development, going on in the book. As it is, all one can do is ask: Why bother?--R. J. G. (shrink)

As with the problem of universals, late medieval thinkers were very concerned with the ontological status of relations, for they were central to numerous theological and philosophical problems. These relations were of various types: relations of identity, qualitative similarity, quantitative equality, causal relations, and intentional relations, such as those between knower and the object known. Each of these relations was taken to be an Aristotelian accident. Does it differ from the substance which is related? Broadly speaking, I have discovered four (...) alternative theories: as sentence of the form "a is related by a real relation R to b" is true only if the relation R is an extra-mental thing really distinct from a and b ; R only exists as a concept in a mind ; a and b exist in a certain real way ; the term "R" is connotative, signifying a directly and connoting b . Using printed sources and my critical edition of various codices, I ask the following thinkers whether a real relation is distinct from that which is related: Thomas Aquinas, Giles of Rome, Henry of Ghent, Richard of Middleton, John Duns Scotus, Henry of Harclay, Hervaeus Natalis, and Peter Aurioli. (shrink)

L'humanisme classique et le monde moderne, par R. Grousset. -- L'actualité du message chrétien, par K, Barth. -- L'actualité du message chrétien, par R. P. Maydieu. -- L'homme des civilisations orientales, par P. Masson-Oursel. -- L'homme des révolutions techniques et industrielles, par M. Leroy. -- L'homme des révolutions politiques et sociales, par H. Lefebvre. -- L'homme dans l'univers au regard d'un savant, par J. B. S. Haldane. -- L'hommee dans l'univers au regard d'un écrivain, par J. Middleton-Murry. -- Conditions (...) et possibilites d'un nouvel humanisme, par K. Jaspers. (shrink)

PREFACE The first three of these lectures, or rather an abbreviated version of them, were first given as the Lindsay Memorial Lectures at the University of ...

Human societies are extraordinarily cooperative compared to those of most other animals. In the vast majority of species, individuals live solitary lives, meeting to only to mate and, sometimes, raise their young. In social species, cooperation is limited to relatives and (maybe) small groups of reciprocators. After a brief period of maternal support, individuals acquire virtually all of the food that they eat. There is little division of labor, no trade, and no large scale conflict. Communication is limited to a (...) small repertoire of self-verifying signals. No one cares for the sick, or feeds the hungry or disabled. The strong take from the weak without fear of sanctions by third parties. Amend Hobbes to account for nepotism, and his picture of the state of nature is not so far off for most other animals. In contrast, people in even the simplest human societies regularly cooperate with many unrelated individuals. Human language allows low-cost honest communication of virtually unlimited complexity. The sick are cared for, and sharing leads to substantial flows of food from the middle aged to the young and old. Division of labor and trade are prominent features of every historically known human society, and archaeology indicates that they have a long history. Violent conflict among sizable groups is common. In every human society, social life is regulated by commonly held moral systems that specify the rights and duties of individuals enforced, albeit imperfectly, by third party sanctions. (shrink)

The most glamorous and even glorious moments in a legal system come when a high court recognizes an abstract principle involving, for example, human liberty or equality. Indeed, Americans, and not a few non-Americans, have been greatly stirred--and divided--by the opinions of the Supreme Court, especially in the area of race relations, where the Court has tried to revolutionize American society. But these stirring decisions are aberrations, says Cass R. Sunstein, and perhaps thankfully so. In Legal Reasoning and Political Conflict, (...) Sunstein, one of America's best known commentators on our legal system, offers a bold, new thesis about how the law should work in America, arguing that the courts best enable people to live together, despite their diversity, by resolving particular cases without taking sides in broader, more abstract conflicts. Sunstein offers a close analysis of the way the law can mediate disputes in a diverse society, examining how the law works in practical terms, and showing that, to arrive at workable, practical solutions, judges must avoid broad, abstract reasoning. Why? For one thing, critics and adversaries who would never agree on fundamental ideals are often willing to accept the concrete details of a particular decision. Likewise, a plea bargain for someone caught exceeding the speed limit need not--indeed, must not--delve into sweeping issues of government regulation and personal liberty. Thus judges purposely limit the scope of their decisions to avoid reopening large-scale controversies. Sunstein calls such actions incompletely theorized agreements. In identifying them as the core feature of legal reasoning--and as a central part of constitutional thinking in America, South Africa, and Eastern Europe-- he takes issue with advocates of comprehensive theories and systemization, from Robert Bork to Jeremy Bentham, the father of utilitarianism, and Ronald Dworkin, who defends an ambitious role for courts in the elaboration of rights. Equally important, Sunstein goes on to argue that it is the living practice of the nation's citizens that truly makes law. For example, he cites Griswold v. Connecticut, a groundbreaking case in which the Supreme Court struck down Connecticut's restrictions on the use of contraceptives by married couples--a law that was no longer enforced by prosecutors. In overturning the legislation, the Court invoked the abstract right of privacy; the author asserts that the justices should have appealed to the narrower principle that citizens need not comply with laws that lack real enforcement. By avoiding large-scale issues and values, such a decision could have led to a different outcome in Bowers v. Hardwick, the decision that upheld Georgia's rarely prosecuted ban on sodomy. And by pointing to the need for flexibility over time and circumstances, Sunstein offers a novel understanding of the old ideal of the rule of law. Legal reasoning can seem impenetrable, mysterious, baroque. This book helps dissolve the mystery. Whether discussing the interpretation of the Constitution or the spell cast by the revolutionary Warren Court, Cass Sunstein writes with grace and power, offering a striking and original vision of the role of the law in a diverse society. In his flexible, practical approach to legal reasoning, he moves the debate over fundamental values and principles out of the courts and back to its rightful place in a democratic state: the legislatures elected by the people. (shrink)

This book critically examines the case for and against the belief in personal survival of bodily death. It discusses key philosophical questions. How could a discarnate individual be identified as a person who was once alive? What is the relationship between minds and their brains? Is a 'next world' conceivable? The book also examines classic arguments for the immortality of the soul, and focuses on types of prima facie evidence of survival: near-death experiences, apparitions, mediumistic communications, and ostensible reincarnation cases.