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

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)

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)

It is usual to read nomina, with which three interpretations are possible. The stronger arrogates to himself the titles of moderation and justice. So in the excellent Rumanian translation of 1871 by Gavrilu J. Munteanu: ‘Cându are sâ decida pumnulu, celu mai tare si atribue titlu de moderatu şi de onestu.’.

This considerably revised second edition of Wittgenstein's 1914-16 notebooks contains a new appendix with photographs of Wittgenstein's original work, a new preface by Elizabeth Anscombe, and a useful index by E.D. Klemke. Corrections have been made throughout the text, and notes have been added, making this the definitive edition of the notebooks. The writings intersperse Wittgenstein's technical logical notations with his thoughts on the meaning of life, happiness, and death. "When the first edition of this collection of remarks appeared in (...) 1961 we were provided with a glimpse of the workings of Wittgenstein's mind during the period when the seminal ideas of the _Tractatus Logico-Philosophicus_ were being worked out. This second edition provided the occasion to be struck anew by the breadth, rigor, and above all the restlessness of that mind."—T. Michael McNulty, S. J., _The Modern Schoolman_. (shrink)

This paper explores ethical issues relating to the management of patients who are terminally ill and unable to maintain their own nutrition and hydration. A policy of sedation without hydration or nutrition is used in palliative medicine under certain circumstances. The author argues that this policy is dangerous, medically, ethically and legally, and can be disturbing for relatives. The role of the family in management is discussed. This issue requires wide debate by the public and the profession.

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)

Traditionally, surgical practice has been experiential and based on the contemporary understanding of basic mechanisms of disease. It was both a science and an art and depended to far too great an extent on the individualism and self belief of its main exponents. “Evidence based medicine” emerged in the 1980s and a new gospel of “Rules of Evidence” was introduced. There is no doubt that the net effect of EBM has been beneficial, but over reliance on randomised controlled trials and (...) the lack of generalisability of scientific evidence to individual patients has perhaps led to less enthusiasm for its tenets among surgeons. There are valid and spurious reasons for this that are discussed. The situation is improving but inevitable tensions remain between the surgeon committed to the individual patient here and now, and the clinical researcher whose focus is the benefit of future patients in the larger community. (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)

Context: Radical constructivism (RC) is seen as a fruitful way to teach innovation, as Ernst von Glasersfeld’s concepts of knowing, learning, and teaching provide an epistemological framework fostering processes of generating an autonomous conceptual understanding. Problem: Classical educational approaches do not meet the requirements for teaching and learning innovation because they mostly aim at students’ competent performance, not at students’ understanding and developing their creative capabilities. Method: Analysis of theoretical principles from the constructivist framework and how they can be used (...) as a foundation for designing a course in the field of innovation. The empirical results are based on qualitative journal entries that were coded and categorized according to Charmaz’s grounded theory approach. Results: It is shown that there is a close relationship between learning and innovation processes. The proposed investigated course design based on RC incorporates the following concepts: the course setting is understood as a framework to guide understanding; students work in teams and are subjective constructors of their own knowledge; instructors take on the role of coaches, guiding students through an innovation process as co-creators. Such a framework facilitates dynamic processes of assimilation and accommodation, as well as perturbation through the “other,” which potentially lead to novel, and viable, conceptual structures crucial for sustainable innovation. Constructivist Content: The paper argues in favor of RC principles in the context of teaching and learning. The proposed course setting is oriented at von Glasersfeld’s understanding of knowing, learning, and teaching (vs. training. It outlines theoretical and practical aspects of these principles in the context of a course design for innovation. Furthermore, it shows the importance of von Glasersfeld’s concept of intersubjectivity for processes of accommodation and the generation of (novel) autonomous conceptual structures. The interplay between creating coherence, perturbation, and irritation through interacting with the “other” (in the form of co-students and instructors) is assumed to be vital for such processes, as it leads to the creation of not only novel but also viable conceptual structures, therefore re-establishing a relative equilibrium critical for sustainable innovation. (shrink)

O texto busca refletir criticamente sobre alguns fenômenos sociais contemporâneos, fortemente imbricados, notadamente as tendências contemporâneas de entrincheiramento e achatamento do eu; o reforço da iconomania e da compulsiva produção de avatares de si, em meio a bolhas narcísicas digitais, franqueadas pelas recentes tecnologias de informação e comunicação; e a virtual destruição da intimidade e da privacidade, diante da emergência de panópticos digitais e da vigilância algorítmica. Para tanto, toma-se como ponto de partida proposições apresentadas por Christopher Lasch em sua (...) obra _The Minimal Self: Psychic Survival in Troubled Times_, publicada originalmente em 1984, em particular a própria noção de mínimo eu, as quais são, então, entretecidas com argumentos de Christophe Dejours, Günther Anders, Theodor Adorno, Hebert Marcuse, Jonathan Crary, entre outros. Em acréscimo, busca-se salientar a ancoragem desses processos à hodierna dinâmica de acumulação de capital, a partir da crítica da economia política, perspectiva que atravessa todo o texto, bem como assinalar a atualidade do pensamento de Lasch. (shrink)