A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

Les principaux problèmes que Bultmann a posés au plan de l’exégèse historique des textes évangéliques étaient commandés par des positions théologiques et continuent pour ce motif à interroger les théologiens catholiques, qui parfois le rejettent dans le camp tantôt du scientisme tantôt du dogmatisme.Contre la théologie libérale des « vies de Jésus », il élève une double protestation, d’ordre christologique : il revendique le caractère historique de la foi chrétienne, et historique : il prend au sérieux la visée eschatologique de (...) la prédication de Jésus. Marquée en ses origines par un rationalisme dogmatique, l’exégèse historico-critique travaille à son tour la théologie, l’oblige à assumer sa propre historicité et à sortir ainsi de son propre positivisme dogmatique.Réservant – à juste titre – à la foi de dire le sens de la Croix, Bultmann semble séparer le fait et le sens et mettre l’historiographie et la théologie en rapport contradictoire de double vérité. Nous savons mieux aujourd’hui qu’il n’y a de faits qu’interprétés ; la foi atteint la vérité historique des faits, mais doit renoncer à demander de les établir « scientifiquement » à une historiographie censée « objectivement neutre ». En soutenant que le sens de la Croix relève d’une décision de foi, Bultmann nous rappelle utilement, ainsi que l’a reconnu R. Marlé, qu’on ne peut jamais évacuer le skandalon de la foi.The principal problems that Bultmann presented as regards the historical exegesis of evangelical texts were guided by theological positions and continued, for this reason, to question Catholic theologians, who sometimes put him in the camp of scientism and sometimes in that of dogmatism.Against the liberal theology of the “lives of Jesus”, he raised a double protest : of a christological nature and of a historical nature . Marked in its origins by dogmatic rationalism, historical-critical exegesis works in its turn on theology, obliges it to assume its own historicity and this to escape from its own dogmatic positivism.Allowing faith – and for good reason – to decide the meaning of the Cross, Bultmann seems to separate the fact and the meaning and to put historiography and theology in contradictory rapport of a double truth. We know better today that there are only interpreted facts ; faith attains the historical truth of facts, but must renounce the demand to establish them “scientifically” to a historiography believed to the “objectively neutral”. In holding that the meaning of the Cross depends on a decision of faith, Bultmann helpfully reminds us, as R. Marlé recognized, that one can never escape the skandalon of faith. (shrink)

We consider the problem of mixing in the f 0(980)–a 0(980) system when width effects are taken into account. By explicit calculation we show that two mixing angles are necessary to describe the phenomenon.

What are the responsibilities of a business towards the city in which it operates? The Professor of Business Ethics at Nijenrode University, the Netherlands Business School suggests three practical ways of identifying them. This article is the substance of a paper which he delivered as Chairman of the European Business Ethics Network at its 1992 Conference in Paris.

Suppes proposes an analysis of the structure and identity of empirical theories with his model-theoretical approach and undertakes effective reconstructions of theories in diverse disciplinary fields. Here the authors analyse the results of these examinations under the optics of questions concerning the assumed ontological commitments, and for how they satisfy economic and other criteria.

The aim of this essay is to understand the relationship between knowledge and society and to reflect on the links between science and political decision making. The text evolved from a number of reflections the author made while president of the European Astronomical Society, president of the Swiss Academy of Sciences and vice-president of the European Academies Science Advisory Council (EASAC). The book starts by using astronomy as a showcase for what science brings to society in terms of intellectual enrichment, (...) of practical tools and of societal inputs. It then turns to looking generally at science as a human endeavour for which pleasure is a prime motivation and it describes the efforts made by researchers to rationalise their findings, thus making them universally acceptable. The author also describes the role of science in shaping our environment and discusses resulting responsibility of the scientists with respect to the evolution of the world. As part of an analysis of the relationship between science and policy the author describes the way in which scientists can (and must) bring knowledge in the political decision making process. The argument is closed with considerations on global governance, while the conclusion puts evidence based decision making processes in relation with the more emotional aspects of our behaviour. The readership of the book is intended to be all scientists involved in "science for policy" activities, as well as those who should become more active in this domain. This includes, but is not limited to, all members of science academies. Astronomers will find specific elements to help them think about their science. The intended readers of the book also include civil servants and policy makers who develop legislation and societal action in domains in which a solid knowledge base is important. The book should furthermore be of interest to citizens following public life and all those worried by the "post evidence" trends in policy. (shrink)

In this paper, we respond to Andrew Avins's recent review of methods whose use he advocates in clinical trials, to make them more ethical. He recommends in particular, “unbalanced randomisation”. However, we argue that, before such a recommendation can be made, it is important to establish why unequal randomisation might offer ethical advantages over equal randomisation, other things being equal. It is important to make a pragmatic distinction between trials of treatments that are already routinely available and trials of restricted (...) treatments. We conclude that unequal randomisation could, indeed, be an ethical compromise between protecting the interests of participants and those of society. (shrink)

Ventricular Fibrillation is responsible for a majority of sudden cardiac death, but little is known about how ventricular tachycardia (VT) degenerates into ventricular fibrillation. Several clinical studies focused only on preventing VT with a class III antiarrhythmic drug resulted in many deaths. Our simulations investigate the interactions between an antiarrhythmic drug likely to suppress a VT and a Figure 8 reentry. A parameter AAR is introduced to increase the action potential duration and therefore simulate various Class III drugs. Simulations are (...) ran under several conditions (phases of the reentry, values of AAR, durations). They show that a VT can be suppressed whatever the phase of the reentry but it strongly depends on the duration of the effect. It confirms that a drug which can suppress a reentry can also worsen it. It also shows a great variety of activation patterns and thus the complexity of antiarrhythmic drugs effects. Simulations also demonstrate that suppressing VT is an increasing function of AAR. (shrink)