The Fourth Edition of this bestselling, highly regarded book has been fully revised to incorporate changes in law and clinical guidance making a vital impact on patient management, encompassing: The Equalities Act 2010 which provides a right of older people to treatment without discrimination ; Case law on withdrawing nutrition and hydration ; Updated guidance on resuscitation from the Resuscitation Council, the British Medical Association and the Royal College of Nursing ; The redefining of good medical practice by the General (...) Medical Council ; The abolition of the Liverpool Care Pathway with an updated guidance on end of life care and advance care planning. Expanded throughout, this new edition also integrates two entirely new chapters covering testamentary capacity and role of the physician, and religious beliefs and end of life issues. Its practical, reflective and informative approach continue to make it essential reading for all health professionals, particularly trainees, involved in making difficult decisions in the care of older persons. It is also highly recommended for undergraduate medical students. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

This book traces the intellectual revolution initiated by Thales in the sixth century BC to its culmination in the metaphysics of Parmenides.

We consider work extraction from two finite reservoirs with constant heat capacity, when the thermodynamic coordinates of the process are not fully specified, i.e., are described by probabilities only. Incomplete information refers to both the specific value of the temperature as well as the label of the reservoir to which it is assigned. Based on the concept of inference, we characterize the reduced performance resulting from this lack of control. Indeed, the estimates for the average efficiency reveal that uncertainty regarding (...) the exact labels reduces the maximal expected efficiency below the Carnot value ), its minimum value reproducing the well known Curzon–Ahlborn value: \ . We also estimate the efficiency before the value of the temperature is revealed. It is found that if the labels are known with certainty, then in the near-equilibrium limit the efficiency scales as \ , while if there is maximal uncertainty in the labels, then the average estimate for efficiency drops to \ . We also suggest how the inferred properties of the incomplete model can be mapped onto a model with complete information but with an additional source of thermodynamic irreversibility. (shrink)

The most searching elaboration of the detective image of the historian has come from the pen of R. G. Collingwood. His short detective story "Who Killed John Doe?" implied that, in spite of the often tentative nature of the question-answer process in a successful historical investigation, the pieces of the puzzle fit together and their coherence becomes self-evident. The predominance of physical evidence in Collingwood's detective story had its counterpart in his research on Hadrian's Wall. In examining the questions raised (...) by his investigations, and distinguishing between direct and circumstantial evidence, Collingwood was able to formulate a comprehensive theory concerning the date of the Wall's construction, the purpose of the Wall, the date of the related turf wall at Birdoswald, the chronological position of the fourteen forts along the Wall, and the role and date of the Vallum following the Walls' course. The pattern of research into the mysteries of Hadrian's Wall has hardly conformed to the linear, step-by-step schema of Collingwood's logic of question and answer. As with much detective work, it has embodied its share of informed guesswork, mistaken inference, false leads, and fortuitous revelations. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Open peer commentary on the article “The Banathy Conversation Methodology” by Gordon Dyer, Jed Jones, Gordon Rowland & Silvia Zweifel. Upshot: This commentary will address the implicit and explicit connections between Banathy’s Conversation Methodology, which is the heart of the process used at the IFSR Conversations held every two years in Austria, and constructivist theories in application.

This book traces the intellectual revolution initiated by Thales in the sixth century BC to its culmination in the metaphysics of Parmenides.

The present and future rapid increase in the hospital population of geriatric patients is discussed with particular reference to the problem of advanced brain degeneration. The consequences of various clinical management options are outlined and it is suggested that extreme attempts either to preserve or terminate life are medically, morally and socially unacceptable. The preservation of life in senile patients has important economic consequences. In achieving a decision on the medical management of patients with advanced brain decay it is suggested (...) that substantial help would be derived from: knowledge of the previously declared wishes of individual patients; improvements in geriatric assessments; broader consultation with relatives, and greater use of inter-disciplinary discussion in the preparation of criteria for terminating medical efforts to maintain survival. (shrink)

Popper proposes a technical concept of 'verisimilitude' as a test of the progressiveness of scientific theories. The paper attempts to show its uselessness and inapplicability on mathematical and practical grounds, As well as raising doubts about the value of any such attempt to give a mechanical test of scientific progress.

The article focuses on the concept of the state in the works of the German sociologist M. Weber and his contemporary, the anarchist G. Landauer. Specifically, it is commonly thought that Weber has a unique interpretation of the state, its nature, and inalienable characteristics. This Weberian approach did not fit into any of the traditions that existed at that time in Germany (for example, represented by H. Kelsen, G. Jellinek, and O. von Gierke). However, the author of the article tries (...) to demonstrate that three main Weberian aspects of the state — 1) the monopoly on legitimate physical violence, 2) the relationship of domination, which is accompanied by a minimum desire to obey, and 3) the chance for the regular reproducibility of these relationships — are consonant with Landauer’s concept of the state. This discovered conceptual affinity allows one to look at Weber’s sociology from new angles, without being impacted by the personal beliefs of the German scientist, who very critically treated anarchism as a socio-political movement. In the final section of the paper, the author discusses the modern project of “anarchist sociology”, which also uses Weberian methodology. The paper argues that “anarchist sociology” might be a promising social science with ts unique vision of several key sociological topics, such as domination, power, or social inequality. (shrink)

We propose partial measurements as a conceptual tool to understand how to operate with counterfactual claims in quantum physics. Indeed, unlike standard von Neumann measurements, partial measurements can be reversed probabilistically. We first analyze the consequences of this rather unusual feature for the principle of superposition, for the complementarity principle, and for the issue of hidden variables. Then we move on to exploring non-local contexts, by reformulating the EPR paradox, the quantum teleportation experiment, and the entanglement-swapping protocol for the situation (...) in which one uses partial measurements followed by their stochastic reversal. This leads to a number of counter-intuitive results, which are shown to be resolved if we give up the idea of attributing reality to the wavefunction of a single quantum system. (shrink)

We show that local realism applied to states characterized by a single quantum equally and coherently shared between a number of qubits (so-called W states) produces predictions incompatible with quantum theory. The origin of this incompatibility is shown to originate from the destructive interference of amplitude probabilities associated with nonlocal states, a phenomenon that has no classical analog.

By means of a Clebsch representation which differs from that previously applied to electromagnetic field theory it is shown that Maxwell's equations are derivable from a variational principle. In contrast to the standard approach, the Hamiltonian complex associated with this principle is identical with the generally accepted energy-momentum tensor of the fields. In addition, the Clebsch representation of a contravariant vector field makes it possible to consistently construct a field theory based upon a direction-dependent Lagrangian density (it is this kind (...) of Lagrangian density that may arise when developing the Finslerian extension of general relativity). The corresponding field equations are proved to be independent of any gauge of Clebsch potentials. The law of energy-momentum conservation of the field appears to be covariant and integrable in a rather wide class of direction-dependent Lagrangian densities. (shrink)

I present the current experimental and theoretical work on interference in complementary spaces. These ideas are applicable to both light and matter waves. I give a detailed treatment for classical light beams in frequency and time domains. I also present a description which gives the totality of interferences.

Fustel de Coulanges noted a paradoxical feature in historical research: when we have practically unlimited quantities of facts and evidence, the difficulties in a rational reconstruction of the past become insurmountable. For normal historical research a line must be drawn between the contemporary period and the past. As long as there is no such a line, judgments of taste dictate the topics and the optics of research. Hence, it is more difficult than it might appear at first glance to write (...) a history of social thought in the Soviet period. Nonetheless, such a work is necessary. (shrink)