It is a fundamental cornerstone of thermodynamics that entropy (SU,V\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$S_{U,V}$$\end{document}) increases in spontaneous processes in isolated systems (often called closed or thermally closed systems when the transfer of energy as work is considered to be negligible) and achieves a maximum when the system reaches equilibrium. But with a different sign convention entropy could just as well be said to decrease to a minimum in spontaneous constant U, V processes. It would then (...) change in the same direction as the thermodynamic potentials in spontaneous processes. This article discusses but does not advocate such a change. (shrink)

Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in recommending a principled (...) version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors. (shrink)

Research ethics committees are charged with providing an opinion on whether research proposals are ethical. These committees are overseen by a central office that acts for the Department of Health and hence the State. An advisory group has recently reported back to the Department of Health, recommending that it should deal with inconsistency in the decisions made by different RECs. This article questions the desirability and feasibility of questing for consistent ethical decisions.

The usual way for new cells to come into being is by division of old cells. So the zygote, which is a—new—single cell formed from two, the sperm and ovum, is an exception. Textbooks of human genetics usually say that this new cell is beginning of a new human individual. What this indicates is that they suddenly forget about identical twins.

This book comprises material on colour which was written by Wittgenstein in the last eighteen months of his life. It is one of the few documents which shows him concentratedly at work on a single philosophical issue. The principal theme is the features of different colours, of different kinds of colour and of luminosity—a theme which Wittgenstein treats in such a way as to destroy the traditional idea that colour is a simple and logically uniform kind of thing. This edition (...) consists of Wittgenstein's basic German text, together with an English translation. (shrink)

Traditionally clinicians have determined their patients' resuscitation status without consultation. This has been condemned as morally indefensible in cases where not for resuscitation (NFR) orders are based on quality of life considerations and when the patient's true wishes are not known. Such instances would encompass most resuscitation decisions in elderly patients. Having previously involved patients in CPR decision-making, we chose formally to explore the reasons behind the choices made. Although the patients were not upset, and readily decided at the time (...) of initial consultation, on later analysing the decision-making we found poor understanding of the procedure, poor recall of information given and in some cases evidence of harm. This may be attributed to impaired decision-making capacity of elderly hospitalised patients as previously shown, or to the discomfort precipitated by having to contemplate the apparent immediacy of cardiac arrest by these patients. We propose that subscribing to autonomy as a general principle needs to be balanced against particular cases where distress may be caused by, or result in, diminished competence and limited autonomy. (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

Many years ago, when Michael was lecturing in Oxford on the Philosophy of Physics and was trying to explain the logic of Aspect's experiments in Paris, he turned to me to expound the correct doctrine of counter-factual truth. I was flummoxed. It had been much discussed in late- and postmediaeval times, especially in the Iberian peninsula, and had recently enjoyed a revival in the Eastern United States. But Middle Knowledge, as the Schoolmen called it, was beyond my comprehension, and I (...) could only exemplify once again the truism that philosophers were better at raising problems than resolving them. (shrink)

Background The post-trial period is the time period after the end of study drug administration. It is unclear whether post-trial arrangements for patient surveillance are routinely included in study protocols and consents, and whether research ethics boards (REB) consider the post-trial period. Objectives The objective was to determine whether trial protocols and consent forms reviewed by the REB describe procedures for post-trial period surveillance. Methods An observational study of protocols of randomised trials of chronic therapies for cardiac conditions, approved by (...) the REB of two academic institutions affiliated with the University of Toronto in Canada (University Health Network and Mount Sinai Hospital) from 1995 to 2007. Plans for patient surveillance in the post-trial period described in the protocol or in the consent form before and after REB approval were recorded. Results 42 studies were identified including 18 heart failure and 15 coronary artery disease trials. Only four studies planned a clinical visit after trial termination, and an additional three planned a telephone contact after trial completion. Five trials submitted consent forms to the REB with a discussion of the post-trial period. Conclusions The majority of protocols and consent forms did not discuss plans for post-trial period surveillance. The post-trial period and the REB approval process could be improved by systematic follow-up being described in the protocol and consent form. The small number of trial protocols evaluated in the study may impair the degree to which the results can be generalised. (shrink)

Individual and Society in Buddhism. W. G. Weeraratne. Metro Printers Ltd., Colombo. 101pp £2.

Facing increased competition, universities are driven to project a positive image to their internal and external stakeholders. Therefore some of these institutions have begun to develop and implement corporate identity programs as part of their corporate strategies. This study describes a Turkish higher education institution’s social responsibility initiatives. Along with this example, the study also analyzes a specific case using concepts from the Corporate Identity and Corporate Social Responsibility literature. The motives leading the university to manage its corporate identity, the (...) social responsibility initiatives in the local and national communities, and the possible benefits of these initiatives for the parties involved are all identified. The major finding is that philanthropy is one of the main elements of Istanbul Bilgi University’s corporate identity program and that the university has altruistic motives for its social responsibility initiatives. (shrink)

A significant proportion of conservationists' work is directed towards efforts to save disappearing species. This relies upon the belief that species extinction is undesirable. When justifications are offered for this belief, they very often rest upon the assumption that extinction brought about by humans is different in kind from other forms of extinction. This paper examines this assumption and reveals that there is indeed good reason to suppose current anthropogenic extinctions to be different in kind from extinctions brought about at (...) other times or by other factors. Having considered – and rejected – quantity and rate of extinction as useful distinguishing factors, four alternative arguments are offered, each identifying a way in which anthropogenic extinction is significantly different from other forms of extinction, even mass extinction: (1) Humans are a different kind of natural cause from other causes of extinction; (2) Extinctions brought about by humans are uniquely persistent; (3) Anthropogenic extinctions are effectively random whereas past mass extinctions are rule-bound; (4) The impact of the current anthropogenic extinction event differs from the impact of other extinction events of the past, such that future recovery may not follow past patterns. Together, these four arguments suggest that the present-day extinction event brought about by humans may be unprecedented and that we cannot clearly extrapolate from past to present recovery from extinctions. Although insufficient as justification for the claim that present-day extinctions are undesirable, the arguments provide some ammunition for conservationists' conviction that species extinction – in which humans play an accelerating role – ought to be prevented. (shrink)

The meaning of the once widely used term the Gibbs Free Energy in terms of available work energy is perfectly illustrated for chemical reactions by the Van’t Hoff Equilibrium Box. Combining this with DeDonder’s extent of reaction variable and using the reaction of $$\hbox {NH}_3$$ to $$\hbox {H}_2$$ and $$\hbox {N}_2$$ at $$200^{\circ }\hbox {C}$$ as an example shows the difference between total work energy and available work energy, and in addition allows calculation of the equilibrium composition, demonstration of the (...) minimum in the Gibbs energy curve, and the standard relationship between $$\Delta _\textrm{r}G^{\circ }$$ and $$\ln {K}$$. (shrink)

In _Violence and Civility_, Étienne Balibar boldly confronts the insidious causes of violence, racism, nationalism, and ethnic cleansing worldwide, as well as mass poverty and dispossession. Through a novel synthesis of theory and empirical studies of contemporary violence, the acclaimed thinker pushes past the limits of political philosophy to reconceive war, revolution, sovereignty, and class. Through the pathbreaking thought of Derrida, Balibar builds a topography of cruelty converted into extremism by ideology, juxtaposing its subjective forms and its objective manifestations. Engaging (...) with Marx, Hegel, Hobbes, Clausewitz, Schmitt, and Luxemburg, Balibar introduces a new, productive understanding of politics as antiviolence and a fresh approach to achieving and sustaining civility. Rooted in the principles of transformation and empowerment, this theory brings hope to a world increasingly divided even as it draws closer together. (shrink)

Modern medicine is increasingly aware of the significance of patient autonomy in making treatment choices. This would seem to be particularly important where the therapy requested was "voluntary" as in fertility treatment or cosmetic surgery. However, the Hippocratic doctrine "Primum non nocere", seems especially relevant where the treatment sought may have a low chance of a successful outcome or even be life-threatening. Mrs A's case demonstrates the difficulty faced by the physician who wants to maximise her patient's autonomy, but "Above (...) all, do no harm". (shrink)

The author reviews and continues the debate initiated by her recent paper in this journal. The paper was critical of certain aspects of palliative medicine, and caused Ashby and Stoffell to modify the framework they proposed in 1991. It now takes account of the need for artificial hydration to satisfy thirst, or other symptoms due to lack of fluid intake in the terminally ill. There is also a more positive attitude to the emotional needs and ethical views of the patient's (...) family and care-givers. However, clinical concerns about the general reluctance to use artificial hydration in terminal care remain, and doubts persist about the ethical and legal arguments used by some palliative medicine specialists and others, to justify their approach. Published contributions to the debate to date, in professional journals, are reviewed. Key statements relating to the care of sedated terminally ill patients are discussed, and where necessary criticised. (shrink)

“Free riding,” used as a descriptive term, refers to taking a jointly produced benefit without contributing towards its production. Used as a term of criticism, it refers to the wrongful failure to contribute towards the joint production of benefits that one receives. On either usage, the central interest of moral philosophy in free riding is the same: to specify the conditions under which not contributing towards the joint production of benefits that one receives is wrong, and to explain why.

This second volume in the serial Reviews in Fluorescence is a collection of up to 10 invited reviews on current trends and emerging hot topics in fluorescence. This new annual series compliments the other fluorescence titles published by Springer, while feeding the requirement from the fluorescence community for annual informative updates and developments.