Savulescu has recently introduced the "rational non-interventional paternalist" model of the patient-doctor relationship. This paper addresses objections to such a model from the perspective of an anaesthetist. Patients need to make their own decisions if they are to be fully autonomous. Rational non-interventional paternalism undermines the importance of patient choice and so threatens autonomy. Doctors should provide an evaluative judgment of the best medical course of action, but ought to restrict themselves to helping patients to make their own choices rather (...) than making such choices for them. (shrink)

1. Amūnīyūs ibn Hirmiyās wa-atharuh fī falsafat al-Farābī = Ammonius son of Hermias and his influence on the philosophy of Al-Farabi--2. Simbilīlīkūs wa-atharuh fī mītāfīzīqā Ibn Sīnā = Simplicius and his influence on Avicenna's metaphysics.

This paper defends a 'punctivist' conception of consciousness from recent attacks by Ian Phillips and Matthew Soteriou. As we intend it, 'punctivism' is the view that a subject's experience over some interval is determined by their experiential states at each instant during it. Phillips and Soteriou both offer ingenious arguments purporting to show that the punctivist is unable to make sense of motion perception; and that only by adopting an 'holistic' conception -- whereby a subject's instantaneous experiences are determined by (...) their experience over the interval -- can we make sense of the puzzles such phenomena pose. We contend that both arguments invoke dubious claims, their proffered solutions come with highly controversial commitments, and, if we take punctivism seriously, it is difficult to see why the so-called puzzles should be puzzling in the first place. A punctivist model of motion perception is proposed in response, and objections anticipated. (shrink)

Receptor‐mediated stimulation induces massive actin polymerization and cyto‐skeletal reorganization. The activity of a potent actin‐modulating protein, gelsolin, is regulated both by Ca2+ and polyphos‐phoinositides, and it may have a pivotal role in restructuring the actin cytoskeleton in response to agonist stimulation. Structure‐function analysis of gelsolin has (1) indicated that its NH2‐terminal half is primarily responsible for modulating actin filament length and polymerization; and (2) elucidated mechanisms by which Ca2+ and phospholipids may regulate such functions. Gelsolin is functionally and structurally similar (...) to villin, another Ca2+‐activated actin‐severing protein found in microvilli, suggesting that gelsolin may be a prototype of this family of actin‐modulating proteins. A molecular variant of gelsolin is secreted and may be involved in the clearance of actin filaments released during tissue damage. The two forms of gelsolin are encoded by a single gene, and distinct messages are derived by alternative message splicing. (shrink)

A fundamental link between system theory and statistical mechanics has been found to be established by the Kolmogorov entropy K. By this quantity the temporal evolution of dynamical systems can be classified into regular, chaotic, and stochastic processes. Since K represents a measure for the internal information creation rate of dynamical systems, it provides an approach to irreversibility. The formal relationship to statistical mechanics is derived by means of an operator formalism originally introduced by Prigogine. For a Liouville operator L (...) and an information operator $\tilde M$ acting on a distribution in phase space, it is shown that i[L, $\tilde M$ ]≡KI (I=identity operator). As a first consequence of this equivalence, a relation is obtained between the chaotic correlation time of a system and Prigogine's concept of a “finite duration of presence.” Finally, the existence of chaos in quantum systems is discussed with respect to the existence of a quantum mechanical time operator. (shrink)

H. Tristram Engelhardt, Jr.; Can Philosophy Save Christianity? Are the Roots of the Foundations of Christian Bioethics Ecumenical? Reflections on the Nature of.

The challenge in maintaining patient autonomy regarding medical decision-making and confidentiality lies not only in control over information transferred to and regarding patients, but in the ambiguity of autonomy itself. post-modernity is characterized by the recognition of not just numerous accounts of autonomy, but by the inability in a principled fashion to select one as canonical. Autonomy is understood as a good, a right-making condition, and an element of human flourishing. In each case, it can have a different content, depending (...) in part on whether it is given a nomological or a volitional construal. Different accounts of autonomy can lead to strikingly different understandings of appropriate behavior, including the argument that one ought on behalf of autonomy to liberate individuals from the sense of autonomy they themselves affirm. In the face of competing accounts of moral probity, autonomy in a secular morality and bioethics must by default be understood in terms of the permission of patients, which makes space for numerous moral accounts and different communal construals of free choice, which in turn will legitimate different practices of informing patients and maintaining confidentiality. (shrink)

The moral case for experimentation on animals rests both on the goods to be realized, the evils to be avoided thereby, and on the duty to respect persons and to secure them in the enjoyment of their natural moral rights. Some experimentation on animals presents no problems of justification as it involves no harm at all to the animals which are the subject of experiments and is such as to seek to achieve an advance in knowledge. Experiments on non-sentient animals, (...) like those on plant life, may harm the subjects but in ways that in themselves need raise no morally significant issues. Moral issues may arise if the subjects of experiments are members of an endangered species and for like reasons but not simply on account of the harm caused by the experiment to the subjects. Other experimentation on animals is to be justified solely in terms of its benefit to animals, even though it involves harm to the animals upon which experiments are performed. There are many poisons and diseases to which animals and not human beings are exposed which give rise to the need for experiments to determine effective therapies, treatments, or other remedies. Examples include annual rye grass toxicity, foot-and-mouth disease, the many fowl diseases, and so on. Human beings commonly have an interest in successfully experimenting to find effective remedies, either a financial interest as with farm animals, race horses and the like, amusement interest as with pets, or a concern not to have a species or variety become extinct. The moral case for such experiments may be strengthened by reference to such interests if they in turn have a moral basis, but generally it does not depend for its validity on this. Other experimentation that harms the animals involved is to be justified in terms of the benefits to be realized and evils lessened for persons by the knowledge and the use of the knowledge gained, where the knowledge is used to secure the enjoyment of their moral rights by persons. Much experimentation benefits both persons, contributing to the securing of their enjoyment of their moral rights, and animals which do not possess moral rights, and is to be morally justified on both counts. Obviously a great amount of experimentation occurs today which does not admit of justification along any of these lines, and hence, is such that it must be condemned as being morally wrong. (shrink)

OBJECTIVES: To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. DESIGN: Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed (...) to a randomly selected sample of doctors and nurses. SETTING: 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. RESULTS: 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed. (shrink)

H. Tristram Engelhardt, Jr.; Medicine and the Biomedical Sciences After God: Do Right-Worshipping Christians Know More Than Others About the Content of Morality.

H. Tristram Engelhardt, Jr.; Bioethics after the Enlightenment, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 8, Issue 3, 1 January 20.

H. Tristram Engelhardt, Jr.; Controversies, Conflicts, and Consensus: A Concluding, Untheological Postscript, Christian bioethics: Non-Ecumenical Studies in Med.