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)

We extend the theory of “Fine structure and iteration trees” to models having more than one Woodin cardinal.

XLRI, in association with a few Tata Group companies, established the XLRI-JRD Tata Foundation in Business Ethics in 1991 to mark their long-standing commitment and contribution to business ethics in India. The foundation seeks to address this by publicly affirming the urgent need for ethics in business and the need to bring about a conducive culture in which it can thrive.

From the 5th edition of Beauchamp and Childress' Principles of Biomedical Ethics, the problem of common morality has been given a more prominent role and emphasis. With the publication of the 6th and latest edition, the authors not only attempt to ground their theory in common morality, but there is also an increased tendency to identify the former with the latter. While this stratagem may give the impression of a more robust, and hence stable, foundation for their theoretical construct, we (...) fear that it comes with a cost, namely the need to keep any theory in medical ethics open to, and thereby aware of, the challenges arising from biomedical research and clinical practice, as well as healthcare systems. By too readily identifying the moral life of common morality with rule-following behaviour, Beauchamp and Childress may even be wrong about the nature of common morality as such, thereby founding their, by now, classic theory on quicksand instead of solid rock. (shrink)

“Towards a Theory of Taxation” is a proper theme for an Englishman to take when giving a paper in America. After all it was from the absence of such a theory that the United States derived its existence. The Colonists felt strongly that there should be no taxation without representation, and George III was unable to explain to them convincingly why they should contribute to the cost of their defense. Since that time, understanding has not advanced much. In Britain we (...) still maintain the fiction that taxes are a voluntary gift to the Crown, and taxing statutes are given the Royal Assent with the special formula, “La Reine remercie ses bons sujets, accepte leur benevolence, et ainsi le veult” instead of the simple “La Reine le veult,” and in the United States taxes have regularly been levied on residents of the District of Columbia who until recently had no representation in Congress, and by the State of New York on those who worked but did not reside in the State, and so did not have a vote. Taxes are regularly levied, in America as elsewhere, on those who have no say on whether they should be levied or how they should be spent. I am taxed by the Federal Government on my American earnings and by state governments on my American spending, but I should be hard put to it to make out that it was unjust. Florida is wondering whether to follow California in taxing multinational corporations on their world-wide earnings. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

This article investigates the claim that some truths are fundamentally or really true — and that other truths are not. Such a distinction can help us reconcile radically minimal metaphysical views with the verities of common sense. I develop an understanding of the distinction whereby Fundamentality is not itself a metaphysical distinction, but rather a device that must be presupposed to express metaphysical distinctions. Drawing on recent work by Rayo on anti-Quinean theories of ontological commitments, I formulate a rigourous theory (...) of the notion. In the final sections, I show how this package dovetails with ' interpretationist' theories of meaning to give sober content to thought that some things — perhaps sets, or gerrymandered mereological sums — can be 'postulated into existence'. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

A change in sense of self is an outcome commonly associated with Buddhist meditation. However, the sense of self is construed in multiple ways, and which changes in self-related processing are expected, intended, or possible through meditation is not well understood. In a qualitative study of meditation-related challenges, six discrete changes in sense of self were reported by Buddhist meditators: change in narrative self, loss of sense of ownership, loss of sense of agency, change in sense of embodiment, change in (...) self-other or self-world boundaries, and loss of sense of basic self. Changes in sense of self could be transient or enduring, positive or distressing, enhancing or impairing. These changes were also given varied appraisals, ranging from insights associated with Buddhist doctrines to psychopathologies such as depersonalization. In this study of practitioners reporting meditation-related challenges, more global changes in sense of self were associated with higher levels of impairment. These results have implications for both Buddhist meditation as well as mindfulness-based interventions. (shrink)