The growth of managed care was accompanied by concern about the impact that changes in health care organization would have on the doctor-patient relationship. We now are in a “post-managed care era,” where some of these changes in health care delivery have come to pass while others have not. A re-examination of the DPR in this setting suggests some surprising results. Rather than posing a new and unprecedented threat, managed care was simply the most recent of numerous strains on the (...) DPR that have occurred throughout the century. These strains are a constant, inevitable consequence of the varying needs and concerns of patient and physicians as they seek to balance their desires for a certain type of DPR with their simultaneous desire for other aspects of care such as lower costs, greater technological sophistication, and improved outcomes. (shrink)

Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care or traditional indemnity insurance. Historically, there have been two distinct bases for arguing that physicians should not consider costs in their clinical decisions—an “aspirational ethic” that exhorts physicians to treat all patients the same regardless of their ability to pay, and an “agency ethic” that calls on physicians to (...) be trustworthy advisors to their patients. In the setting of greater patient cost-sharing, physicians' aspiration and agency roles increasingly conflict. Satisfactorily navigating the new terrain of consumer-driven healthcare requires physicians to consider these two roles and how they can best be reconciled so as to maximize quality of care while respecting the heterogeneity of patients' financial resources and willingness to pay. (shrink)

Contemporary religious studies contains many studies of Orthodox theology of the twentieth century, but there are almost no studies of the most prominent modern trend in Orthodox theology, neo-patristics. In particular, in the works of L. Voronkova, G. Gabinsky, M. Gordienko, Y. Kalinin, P. Kurochkin, I. Mozgovy, V. Molokov, M. Novikov, N. Petelinskaya, V. Chertikhin, A. Chertkov, a thorough analysis of tendencies was carried out Modernism of Orthodox theology of the Russian Church. Of these, only M. Novikov briefly criticizes the (...) views of V. Lossky, a representative of Neopatristics, but the researcher does not realize the originality of this trend in Orthodox theology. Especially the tendencies of the development of Orthodox theology of spiritual academic schools of the XIX-beg. XX century. M. Ivanov, M. Glubokovsky, I. Kondratieva, G. Pankov, O. Pechurina, O. Sarapin, L. Fokina were thoroughly researched, but these studies were usually conducted outside the context of all Orthodox theology of the XX century. (shrink)

Λαϊκισμός εναντίον Αντι-Λαϊκισμού: Μια διαχρονική διαμάχη, Νόημα, 21 (2024): 45-55.

In his Philosophical Theology James Ross claims to have uncovered an assumption essential to the proof of God's existence advanced by Duns Scotus: the equivalence of logical and real possibility. Ross argues that the omission is reparable, and that Scotus's proof is ultimately satisfactory. In this paper I examine his claim and determine that while Scotus may have believed there to be a significant connection between these two concepts, his proof of God does not depend on it. Ross's attempt to (...) rework the Scotist demonstration merits consideration on its own terms, however. In calling attention to the relation between real and metaphysical possibility, Ross has hit on a way of circumventing one of the major impediments to the acceptability of Scotus's original proof: the infinite regress of causes. Since Scotus argues against the possibility of the infinite regress in copious detail, we must wonder whether he could have countenanced the alternate route suggested by Ross. While I shall argue that indeed Ross's gambit is flawed in a way that Scotus may have foreseen, his proof nevertheless deserves recognition as an original and noteworthy contribution to the literature. (shrink)

This paper contains an axiomatic theory of first order modal logic with operations, identity, and descriptions together with a formal semantics which interprets the theory in such a manner that empty universes of discourse and denotationless terms are allowed for at each possible world. The intuitive basis of the theory is discussed in preliminary sections, the syntax and semantics of theory are then characterized, its semantical adequacy is demonstrated, and certain important axioms and theorems are discussed in detail in later (...) sections. (shrink)

πγχυ δ' εμαρες σνετον πóησαι | πντι τοτο, sang Sappho ; but, to judge from the controversies which have marked the scholarly discussion of her poem in the sixty-five years since its first publication, her confidence was at least premature. Some problems can indeed be considered to have been settled, either through new finds or through gradual consensus: thus the man of line 7 is Menelaus, not Paris, and few today would see in the poem merely an affirmation of exclusively (...) feminine as opposed to masculine values. But to the twin questions of the function first of the story of Helen in the poem, and especially second of the words with which Helen is introduced — γρ πóλυ περσκθοισα | κλλος νθρώπων 'Eλνα — no satisfactory answer has yet been found. The strictures of Fränkel and of Page on this passage are well known; yet even where their judgements have not been simply taken over, the explanations that have been offered for these two distinct but closely connected problems fail to convince. (shrink)

The Stepford Wives, a novel by Ira Levin, provides the theme for this allegory. The men of Stepford belong to the Men’s Association. Their wives are “perfect”, in that they do nothing other than clean, cook, preen, and provide satisfaction without argument for their husbands. They are, furthermore, content with their lot, and believe that their previous interests and freedoms were self indulgent. Levin never informs his readers how the men came to obtain total mastery over their “Stepford wives”, although (...) there is the suggestion that the real wives have been replaced by robotic lookalikes. (shrink)

In this unique work, Professor G.A. Powell Jr. writes: "Thinkers are different from writers—writers are prostitutes. Thinkers desire to be prostitutes." Daily Conversations with My Interloper is first and foremost a celebration of the narrative paradigm, its evolution, latitude of expression, and radical subjectivity in the forms of aphorisms and feuilletons. Following in the literary tradition of Ralph Waldo Emerson, Albert Camus, John Cage, Emile Cioran, and Susan Sontag, et al., the text chronicles Professor Powell's reflections about the ongoing metamorphoses (...) of cultures, influential literary figures, travel, film, history, ennui, quotidian, and the mundane day-to-day existence in which all people participate. Daily Conversations with my Interloper, is a provocative read for the public and private intellectual interested in a panoply of ideas. (shrink)