A report of a problem-based learning project on the ethics of terminal care, offered as one of the options available to first year MB ChB students in Edinburgh University Medical School. The project formed part of the 'clinical correlation course' in the new curriculum. Six students took part under the supervision of two clinical tutors and a moral philosopher. The course was case-based and practical with students being given the opportunity over a period of eight weeks to meet patients, relatives (...) and hospital staff at a local geriatrics hospital and terminal care home. The main issue studied was the degree of choice available to patients electing to be treated at home, in hospital or in a hospice. Other issues included: pre-death, disposal of the dead, certification of death, communication with relatives and follow-up bereavement services. (shrink)

In this commentary we argue that evolution of the human brain to host the language system was accomplished by the selective development of frontal and temporal areas in the left hemisphere. The unilateral development of Broca's and Wernicke's areas could have resulted from one or more transcription factors that have an expression pattern restricted to the left hemisphere.

In lieu of an abstract, here is a brief excerpt of the content:When an Arab Laughs in Toledo: Cervantes’s Interpellation of Early Modern Spanish OrientalismE. C. Graf (bio)My purpose has been to place in the plaza of our republic a game table which everyone can approach to entertain themselves without fear of being harmed by the rods; by which I mean without harm to spirit or body, because honest and agreeable exercises are always more likely to do good than harm.—Miguel (...) de Cervantes Saavedra, Prologue to Novelas ejemplares [my translation]We are engaged in a technical enterprise at the species scale.—Jacques Lacan, “L’agressivité en psychanalyse” [my translation]While I was all intent on watching him, he looked at me, and with his hands he spread his chest and said: “See how I split myself!”!—Dante Alighieri, Inferno 28.28–30 Click for larger view View full resolutionFigure 1.Sandro Botticelli, The Virgin and Child (c. 1490). Courtesy of the Fogg Art Museum, Harvard University; ©1999 President and Fellows of Harvard College. Click for larger view View full resolutionFigure 2.Salvador Dalí, Dream Caused by the Flight of a Bee around a Pomegranate One Second Before Awakening (1941). Courtesy of Museo Thyssen-Bornemisza, Madrid; ©1999 Artists' Rights Society (ARS), New York.For much of this century, Hispanists have labored in an effort to elevate Miguel de Cervantes Saavedra’s El ingenioso hidalgo don Quijote de la Mancha (1605, 1615) to the coveted status of the “first modern novel.” Today this kind of criticism may strike our postmodern sensibilities as a rather traditional enterprise, the kind more interested in establishing an elite hierarchy of literary tastes than in saying anything new about an author or text. For many, the study of literature is still an aesthetic beauty pageant in which “great books” like Laurence Sterne’s Tristram Shandy (1767) or Marie de la Vergne de La Fayette’s La princesse de Clèves (1678) are paraded across the stage in a contest to seduce the Western intelligentsia. 1 The postmodern student of literature may not have much concern for this age-old territorial contest, but she might be interested to learn that the fallout from Hispanism’s quest for the “first modern novel” has involved so much attention to, indeed complication of, Don Quixote, that the book now resembles more a postmodern text than an early modern one. At the turn of the century, we have been left with what Jorge Luis Borges would recognize as an “aleph”: an infinite ideological labyrinth that reflects and/or cannibalizes all forms, thereby escaping all attempts [End Page 68] to describe it. 2 Whatever we currently mean by “Cervantes” (an author, a collection of texts, an ideological construction, and so forth) carries with it an impressive range of critical responses. Cervantes has been labeled converso (Castro, Canavaggio), Christian humanist (Castro, Bataillon, Forcione, Herrero, Vilanova), disillusioned secularist (Lukács, Cascardi), precapitalist (Johnson), anti-essentialist (Wilson), anti-Eusebian (Presberg), Menippean (Bakhtin), feminist (El Saffar, Rabin, Cruz), sadist (Nabokov), ethnocentric imperialist (Mariscal), medieval (Gorfkle), homophobic (Martín), non-organicist Aristotelian (Read), and either discursively or actually homosexual (Combet, Rossi, Smith, Arrabal). This list is nowhere near complete, but the reader will grasp the robust effects of the plurality of perspectives on Cervantes.Each of these interpretations is valid to varying degrees within various contexts, but at present I am interested in reading Cervantes as the author of a multicultural manifesto on behalf of the Moriscos of Southern Spain. 3 Within the contexts of French Marxist philosopher Louis Althusser and Palestinian postcolonial literary critic Edward Said, materialist, postcolonial, and multicultural critiques of various forms of power and their ideologies can be seen as the fundamental propositions of Cervantes’s Don Quixote. 4 Cervantes’s ultimate orientation may perhaps be inescapably Eurocentric, but his responses to the European experience of the rise and expansion of an ethnocentric militaristic nation state are relatively centrifugal when compared to the attitudes of many of his contemporaries.In surveying some of the antihegemonic details of Cervantes’s novel, I am also interested in dispelling the popular myth of Don Quixote. Especially in the English-speaking world, and particularly in the United States, Don Quixote remains captive to a... (shrink)

In his target article Lockhead calls attention to numerous complications that prevent a valid straightforward or Fechnerian interpretation of psychophysical data. Here I describe three additional sources of bias, all involving the influence of stimuli presented before the start of an investigation.

The aim of the present investigation was to describe and to classify significant ethical problems encountered by the members of the staff during the daily clinical work at a hospital medical department. A set of definitions was prepared for the purpose, including the definition of a 'significant ethical problem'. During a three month period 426 inpatients and 173 outpatients were admitted. Significant ethical problems were encountered during the management of 106 in-patients (25 per cent) and 9 out-patients (5 per cent). (...) No significant difference was found between the frequency of ethical problems in female and male patients, but a positive correlation was noted between the number of problems and the patients' age. The problem types were classified according to a problem list. The results of this investigation suggest that greater attention must be paid to discussions about ethical problems among doctors and other categories of health personnel and that, among others, medical students ought to be taught the analysis of ethical problems. (shrink)

_Purpose._ The authors aim to disclose the anthropological dimension of ecocide during and after Russia’s war against Ukraine, relying on the multidisciplinary practices and intellectual production of ecofeminist women thinkers, including philosophers, sociologists, historians, psychologists, and others. _The theoretical basis_ methodological approaches in philosophical anthropology, phenomenology, analytical philosophy, communicative philosophy, existentialism, ethics of justice, and ethics of care determine the study’s theoretical basis._ Originality._ For the first time, a systematic analysis of the anthropological dimension of ecocide has been carried out (...) based on ecofeminist methodology. The specifics of the Ukrainian resistance to ecocide were revealed as part of a single struggle – an anti-imperial and ecological struggle for independence and prosperity. It is emphasized that during the war, the opposition to ecocide is a component of the fight for national sovereignty and territorial integrity of the country, and therefore, the ideas of pacifism in this period are subordinated to this primary goal. After the war, preventing threats of ecocide should become an integral part of the struggle for stable peace and prosperity. Ecofeminist pacifist perspectives should be a priority among the most essential goals for that period. _Conclusions._ Ecofeminist methodological assessments offer valuable insights into the anthropological dimension of ecocide in wartime and post-war contexts, highlighting the complex interplay between gender, violence, and environmental destruction. By focusing on the experiences and perspectives of women and marginalized communities, ecofeminist analyses contribute to a more holistic understanding of ecocide and its impacts on both human populations and ecosystems. (shrink)

Towards the conclusion of his interesting remarks on the meaning of the Homeric phrase, τ δ' πτερος πλετο μθος, Professor J. A. K. Thomson writes, ‘When a classical author uses the word πτερος it means “wingless” or “featherless” and nothing else,’ and he accordingly rejects Headlam's interpretation of πτερος φτις at Aesch. Ag. 288 together with the same scholar's proposal to read at P. V. 707 πτερος for the unmetrical απνδιος It may be true that the phrase, πτρ τάχει, which (...) Headlam adduced in his note on the Agam. passage in support of his rendering, is not by itself convincing, but there are other considerations which Professor Thomson has, I imagine, overlooked. What follows is not an attempt to demonstrate that πτερος does mean ‘wing-swift’ in Aeschylus, but only to suggest that there is evidence to show that the word could bear that meaning in classical Greek authors, and that Headlam's interpretation and emendation should therefore not be rejected out of hand. (shrink)

If mental anomalism is to be interpreted as a thesisunique to psychology, the anomalousness must begrounded in some feature unique to the mental,presumably its rational nature. While the ground forsuch arguments from normativity has been notoriouslyslippery terrain, there are two recently influentialstrategies which make the argument precise. The firstis to deny the possibility of psychophysical bridgelaws because of the different constitutive essences ofmental and physical laws, and the second is to arguethat mental anomalism follows from the uncodifiabilityof rationality. In this (...) paper I argue that bothstrategies fail – the latter because it conflates primafacie and all things considered rationality and theformer because it rests on a false premise, theprinciple of the rational character of belief. Idistinguish four different formulations of thisprinciple and argue that those formulations which areplausible cannot support the argument for mentalanomalism. (shrink)

Objectives: To quantify the use of do-not-resuscitate orders in a tertiary-care children’s hospital and to characterise the circumstances in which such orders are written.Design: Retrospective study conducted in a 500-bed children’s hospital in Taiwan.Patients: The course of 101 patients who died between January 2002 and December 2005 was reviewed. The following data were collected: age at death, gender, disease and its status, place of death and survival. There were 59 males and 42 females with a median age of 103 months (...) . 50 children had leukaemias, and 51 had malignancies other than leukaemia. The t test and the χ2 test were applied as appropriate.Results: The study found that 44% of patient deaths occurred in the paediatric oncology ward; 29% of patient deaths occurred in the intensive care unit; and 28% of patients died in their home or at another hospital. Other findings included the following: 46 of 101 patients died after attempted cardiopulmonary resuscitation and 55 died with a DNR order in effect. The mean age at death was 9.8 years in both groups with or without DNR orders.Conclusions: From the study of patient deaths in this tertiary-care children’s hospital, it was concluded that an explicit DNR order is now the rule rather than the exception, with more DNR orders being written for patients who have been ill longer, who have solid tumours, who are not in remission and who are in the ward. (shrink)

The quantitative problem of old evidence is the problem of how to measure the degree to which e confirms h for agent A at time t when A regards e as justified at t. Existing attempts to solve this problem have applied the e-difference approach, which compares A's probability for h at t with what probability A would assign h if A did not regard e as justified at t. The quantitative problem has been widely regarded as unsolvable primarily on (...) the grounds that the e-difference approach suffers from intractable problems. Various philosophers have proposed that 'Bayesianism' should be rejected as a research strategy in confirmation theory in part because of the unsolvability of this problem. I develop a version of the e-difference approach which overcomes these problems and possesses various advantages (but also certain limitations). I develop an alternative 'theistic' approach which handles many cases that my development of the e-difference approach does not handle. I conclude with an assessment of the significance of the quantitative problem for Bayesianism and argue that this problem is misunderstood in so far as it is regarded as unsolvable, and in so far as it is regarded as a problem only for Bayesians. (shrink)

Frank Jackson’s defense of a Lockean representationalist theory of perception is both tightly and boldly argued. It is a first-rate analytic dissection of the relevant arguments for and objections against the representationalist position and takes up swords with D. M. Armstrong, J. J. C. Smart, G. J. Warnock, Aune, Anscombe, Price, and others, with meticulous care. It is equally forthright in accepting and defending implications of the theory which have heretofore, for one reason or another, caused the less clear and (...) more timid to quiver, if not tremble. For example, in dealing with the question whether sense-data exist in space, he writes, "I am sometimes asked why I do not follow the lead of those who locate mental objects in a special, private space. To me, this is like saying, ‘I find it mysterious that mental objects are in normal space, so I will locate them in mysterious space'". (shrink)

Every healthcare organisation enacts a multitude of policies, but there has been no discussion as to what procedural and substantive requirements a policy writing process should meet in order to achieve good outcomes and to possess sufficient authority for those who are asked to follow it.Using, as an example, the controversy about patient’s refusal of blood transfusions, I argue that a hospital wide policy is preferable to individual decision making, because it ensures autonomy, quality, fairness, and efficiency.Policy writing for morally (...) controversial medical practices needs additional justification compared to policies on standard medical practices and secures legitimate authority for HCO members by meeting five requirements: all parties directed by the policy are represented; the deliberative process encompasses all of the HCO’s obligations; the rationales for the policy are made available; there is a mechanism for criticising, and for evaluating the policy. (shrink)

I review theories and problems of inconsistencies in the description of higher spin wave equations.

A frequently recounted episode in early modern medicine concerns the physician Helvetius's introduction of ipecacuanha to French medical practice after curing Louis XIV's son of dysentery using this medicinal drug. To this day, the Helvetius story remains riven with contradictions, obscurity, and confusion, even down to the nature of the drug involved. This article, challenging histories of “information” as homogeneous and neutral, explores how Helvetius's reputation as a physician and pharmaceutical entrepreneur was crafted through print and correspondence. Rather than seeking (...) to establish a definitive account of “what actually happened,” it addresses the ways in which different media shaped and mediated the politics of knowledge surrounding Helvetius and his drug. Considerations of intellectual and commercial property inflected medical knowledge in different ways, producing distinct strategies of publicity. While Helvetius capitalized on courtly connections to promote himself and his drug, rivals eyed the Republic of Letters as an alternate route for establishing natural knowledge-claims. Yet the arch-newsmonger of the Republic of Letters, Leibniz, elected to preserve the connection between Helvetius and ipecacuanha in print. I argue that Leibniz's actions stemmed from a view of the public domain that downplayed discovery and emphasized disclosure of medical secrets in the public interest. (shrink)

Leuridan (2011) questions whether mechanisms can really replace laws at the heart of our thinking about science. In doing so, he enters a long-standing discussion about the relationship between the mech-anistic structures evident in the theories of contemporary biology and the laws of nature privileged especially in traditional empiricist traditions of the philosophy of science (see e.g. Wimsatt 1974; Bechtel and Abrahamsen 2005; Bogen 2005; Darden 2006; Glennan 1996; MDC 2000; Schaffner 1993; Tabery 2003; Weber 2005). In our view, Leuridan (...) misconstrues this discussion. His weak positive claim that mechanistic sciences appeal to generalizations is true but uninteresting. His stronger claim, that all causal claims require laws, is unsupported by his arguments. Though we proceed by criticizing Leuridan’s arguments, our greater purpose is to embellish his arguments in order to show how thinking about mechanisms enriches and transforms old philosophical debates about laws in biology and provides new insights into how generalizations afford prediction, explanation and control. (shrink)

We introduce and discuss a concept of approximation of a topological algebraic system A by finite algebraic systems from a given class K. If A is discrete, this concept agrees with the familiar notion of a local embedding of A in a class K of algebraic systems. One characterization of this concept states that A is locally embedded in K iff it is a subsystem of an ultraproduct of systems from K. In this paper we obtain a similar characterization of (...) approximability of a locally compact system A by systems from K using the language of nonstandard analysis. In the signature of A we introduce positive bounded formulas and their approximations; these are similar to those introduced by Henson [14] for Banach space structures (see also [15, 16]). We prove that a positive bounded formula φ holds in A if and only if all precise enough approximations of φ hold in all precise enough approximations of A. We also prove that a locally compact field cannot be approximated arbitrarily closely by finite (associative) rings (even if the rings are allowed to be non-commutative). Finite approximations of the field R can be considered as possible computer systems for real arithmetic. Thus, our results show that there do not exist arbitrarily accurate computer arithmetics for the reals that are associative rings. (shrink)

Our think tank tasked by the Dutch Health Council, consisting of Radboud University Nijmegen Honours Academy students with various backgrounds, investigated the implications of Deep Brain Stimulation for psychiatric patients. During this investigation, a number of methodological, ethical and societal difficulties were identified. We consider these difficulties to be a reflection of a still fragmented field of research that can be overcome with improved organization and communication. To this effect, we suggest that it would be useful to found a centralized (...) DBS organization. Such an organization makes it possible to 1) set up and maintain a repository, 2) facilitate DBS studies with a larger sample size, 3) improve communication amongst researchers, clinicians and ethical committees, and 4) improve communication between DBS experts and the public at large. (shrink)

High-spin states in the odd-odd N = Z nucleus Co-54 have been investigated by the fusion-evaporation reaction Si-28(S-32,1 alpha 1p1n)Co-54. Gamma-ray information gathered with the Ge detector array Gammasphere was correlated with evaporated particles detected in the charged particle detector system Microball and a 1 pi neutron detector array. A significantly extended excitation scheme of Co-54 is presented, which includes a candidate for the isospin T = 1, 6(+) state of the 1f(7/2)(-2) multiplet. The results are compared to large-scale shell-model (...) calculations in the fp shell. Effective interactions with and without isospin-breaking terms have been used to probe isospin symmetry and isospin mixing. A quest for deformed high-spin rotational cascades proved negative. This feature is discussed by means of cranking calculations. (shrink)