In healthcare, it should be a primary requirement that we define accurately what we are trying to do. The necessity for this intensifies when we are under stress, a part of which is caused by increased technological ingenuity outstripping the general ability to pay for it. Dealing with human beings and their problems, we are person and event oriented; our creed has always been and is the best that can be done for an individual, at a point in time. Increasingly, (...) we must modify this traditional approach by viewing episodic care of the individual as a part of two continua, of the individual in relation to their life span, and of the individual in relation to the community and healthcare system to which all belong. We are not skilled or practised in defining our overall aims. (shrink)

The Ebola epidemic in Western Africa has highlighted issues related to weak health systems, the politics of drug and vaccine development and the need for transparent and ethical criteria for use of scarce local and global resources during public health emergency. In this paper we explore two key themes. First, we argue that independent of any use of experimental drugs or vaccine interventions, simultaneous implementation of proven public health principles, community engagement and culturally sensitive communication are critical as these measures (...) represent the most cost-effective and fair utilization of available resources. Second, we attempt to clarify the ethical issues related to use of scarce experimental drugs or vaccines and explore in detail the most critical ethical question related to Ebola drug or vaccine distribution in the current outbreak: who among those infected or at risk should be prioritized to receive any new experimental drugs or vaccines? We conclude that healthcare workers should be prioritised for these experimental interventions, for a variety of reasons. (shrink)

Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin’s surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome (...) to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients’ unprompted descriptions of any enhanced touch sensations and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including “warmth” and “tingling” with treatment efficacy. The conclusion offers a “neurophenomenological” account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture. (shrink)

A propagator for a path space integral can be used to represent the and provides a natural way to model a control signal that is temporally segmented by placement of pairs of stimulating and recording electrodes. Although care must be exercised in interpreting the resulting measurement, the technique should prove useful to experimenters who study cerebellar functioning.

In Beyond Physicalism, an interdisciplinary group of physical scientists, behavioral and social scientists, and humanists from the Esalen Institute’s Center for Theory and Research argue that physicalism must be replaced by an expanded scientific naturalism that accommodates something spiritual at the heart of nature.

Spinoza's writings on metaphysics, ethics, and politics have had a remarkably diverse reception in recent times and have contributed to the current dialogue among philosophers, intellectual historians, and literary theorists. Errol E. Harris has written a brief and simplified introductory presentation of the major branches of Spinoza's philosophy. Spinoza's ideas are put forward in plain language and supported by convincing argument. Technicalities are either clearly explained or entirely avoided. Professor Harris also shows the student how Spinoza succeeded in reconciling the (...) insights of both the British empiricists and the continental rationalists. (shrink)

This Article explores the connections between disability and health justice in service of further tethering the two theories and practices. The author contends that disability should shift from marker of health inequity alone to critical demographic in the analytical and practical application of health justice. This theoretical move creates a more robust understanding of the harms of health injustice, its complexities, and, remedially, reveals underexplored legal and policy pathways to promote health justice.

Body integrity identity disorder is a very rare condition in which people experience long-standing anguish because there is a mismatch between their bodies and their internal image of how their bodies should be. Most typically, these people are deeply distressed by the presence of what they openly acknowledge as a perfectly normal leg. Some with the condition request that their limb be amputated. 1 We and others have argued that such requests should be acceded to in carefully selected patients.1–4 Consistent (...) with this view, a group at the University of Sydney is developing a programme to better understand and treat BIID and to offer amputation if appropriate. In a recent paper, Patrone argues that such amputations should be prohibited.5 He suggests that authors supporting amputation in BIID depend on analogies with more familiar conditions and then claim that the ‘the desires, choices and requests of BIID patients should be held to exactly the same standards and treated with exactly the same respect as the desires, choices and requests of any more conventional patient’.5 He believes that these analogies are invalid and that therefore the arguments for amputation are invalid.Patrone concentrates a great deal upon whether a decision to have a particular medical intervention is to be regarded as ‘rational’. Unfortunately, he makes no attempt to define what he …. (shrink)

To what extent do the mother's and father's jobs and occupational sex-typing influence the status and sex-typing of their children's occupation at first entry into the labour market? Referring to a database containing 5027 respondents of two merged Dutch surveys held between 1992 and 1995, this study finds that the effect of the mother's occupational status on her daughter's is significant, but smaller than either the effect of father's status on his son's or his daughter's status. The mother's occupational sex-typing (...) is related to her daughter's occupational sex-typing. The more female sex-typed the daughter's occupation, the lower her occupational status. In the same way, the father's occupational sex-typing is related to his son's occupational sex-typing. While the extension of the classical status attainment models by the mother's occupation and occupational sex-typing leads to interesting and new coefficients, the authors conclude that the more elementary classical model is not invalidated by these new perspectives. (shrink)

In his review of Phillip Grier’s anthology, Dialectic and Contemporary Science, Darrel Christensen expresses his regret that I “did not find occasion… to give more attention… to the sorts of well-informed and pointed criticism that E. McMullin raised.. in ‘Is the Progress of Science Dialectical?’” In that book it would hardly have been possible or appropriate, for me to have done so, because I did not write it, and although the editor invited me to respond to the authors who contributed, (...) Ernan McMullin was not one of them. The paper to which Christensen refers was presented to the first meeting of the Hegel Society of America in 1970, at which I was present; but after so long an interval of time I cannot now remember if or how, I responded to it. So far as my recollection serves, my own paper, although distributed to those attending the meeting, was not read and was not fully discussed. So there may well be some need for taking up Christensen’s challenge, even at this late hour. (shrink)