The ability of the medical profession to sustain life, or more appropriately, to prolong dying, in patients with terminal illness, creates a most complex and controversial situation for all involved: the patient, if mentally alert; the patient's family; and the medical care team including physicians, nurses and attendants. This situation is especially complex in large acute care hospitals where medical and nursing students, residents and house officers receive advanced medical training. A major problem, prolonging the dying of the terminally ill, (...) with its medical, legal, ethical and economic complexities now confronts American society. The problem is particularly acute in teaching hospitals, in which one finds a disproportionate number of terminally ill patients. The ability to work at these questions as a community rather than as adversaries will determine much about the ability of the health care system to respect the dignity and autonomy of those who seek aid and comfort when faced with serious illness and impending death. Better communication between the physicians, health care providers, the lawyers and ethicists must be developed in order to solve these problems. Over the next ten years society and our elected representatives will be making very demanding decisions about the use of the health dollar. One possible way to prevent increasing costs is to reach significant agreement on the proper care of the dying. Proper care for the dying is being considered, discussed, and evaluated by very thoughtful people. It is not governments which should decide who is to live or who is to die. There is the serious problem of the 'slippery slope' to euthanasia by omission if cost containment becomes the major force in formulating policy on the proper care of the dying. (shrink)

Esta obra se concentra en cuatro temas cruciales de la formación de docentes, tanto antes como durante el servicio y en la enseñanza en diferentes áreas y niveles educativos. En primer lugar, se aborda el asunto de las creencias que los docentes tienen sobre el proceso educativo, las cuales parecen influir en la práctica profesional que estos desarrollan y, por lo tanto, deberían recibir la atención explícita de los procesos de formación de docentes que deseen promover prácticas específicas. El segundo (...) tema de la obra es la relación entre la formación de docentes y la política pública que la rige. En particular, se analizan las reformas curriculares implementadas por varias licenciaturas en universidades privadas colombianas, en respuesta a reformas a la normatividad sobre las condiciones de calidad que a las que deben ajustarse todas las licenciaturas del país. El tercer tema analizado es en qué medida los docentes en educación superior van más allá del dominio de su saber disciplinar atribuyendo importancia a la pedagogía, la didáctica y la práctica reflexiva en su propia práctica docente. Finalmente, se discuten aspectos de la formación de docentes relacionados con los procesos vividos y los retos encontrados por los docentes al entrar en la profesión, su socialización en la comunidad docente, sus identidades como maestros y su motivación para ser docentes. Vale la pena señalar que las contribuciones a este libro comparten el uso de metodologías cualitativas y presentan los resultados de historias de vida, entrevistas, observaciones, y análisis documentales, entre otros. (shrink)

This text explores the problem of transcendental stupidity in Sigmund Freud, Gilles Deleuze and Jacques Derrida’s works, seeking to combine it with (1) the paradoxical figure of Oedipus (the original complex) in psychoanalytical and philosophical tradition and (2) the symptomatic situation of some important animals (wolf and dog, symbols of wild and domestic life [i.e.: Freud’s Wolfs, Freud’s Chow-Chows]) in analyses and therapies. The case of the Man of the Wolves (der Wolfmann), the case of Mr. Sergei K. Pankejeff described (...) in Aus der Geschichte einer infantilen Neurose, a fundamental dream in contemporary culture history, would be the point of departure. (shrink)

Abstract In the last 20 years the ruthless competition for natural resources, political instability, armed conflicts, and the terrorist attacks of 9/11 have paved the way for private military and security companies (PMSCs) to operate in areas which were until recently the preserve of the state. PMSCs, less regulated than the toy industry, commit grave human rights violations with impunity. The United Nations has elaborated an international binding instrument to regulate their activities but the opposition of the U.S., U.K., and (...) other Western governments?and from PMSCs, which prefer self-regulation?have prevented any advancement. (shrink)

PurposePlaying styles play a key role in winning soccer matches, but the technical and physical styles of play between home and away match considering team quality in the Chinese Soccer Super League remain unclear. The aim of this study was to explore the technical and physical styles of play between home and away matches integrating with team quality in the CSL.Materials and methodsThe study sample consists of 480 performance records from 240 matches during the 2019 competitive season in the CSL. (...) These match events were collected using a semi-automatic computerized video tracking system, Amisco Pro®. A k-means cluster analysis was used to evaluate team quality and then using principal component analysis to identify the playing styles between home and away matches according to team quality. Differences between home and away matches in terms of playing styles were analyzed using a linear mixed model.ResultsOur study found that PC1 presented a positive correlation with physical-related variables such as HIRD, HIRE, HSRD, and HSRE while PC2 was positively associated with the passing-related variables such as Pass, FPass, PassAcc, and FPAcc. Therefore, PC1 typically represents intense-play styles while PC2 represents possession-play styles at home and away matches, respectively. In addition, strong teams preferred to utilize intensity play whereas medium and weak teams utilized possession play whenever playing at home or away matches. Furthermore, the first five teams in the final overall ranking in the CSL presented a compensated technical-physical playing style whereas the last five teams showed inferior performance in terms of intensity and possession play.ConclusionIntensity or possession play was associated with the final overall ranking in the CSL, and playing styles that combine these two factors could be more liable to win the competition. Our study provides a detailed explanation for the impact of playing styles on match performances whereby coaches can adjust and combine different playing styles for ultimate success. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Interpreting a Classic: Demosthenes and His Ancient CommentatorsK. KapparisCraig A. Gibson. Interpreting a Classic: Demosthenes and His Ancient Commentators. Berkeley and Los Angeles: University of California Press, 2002. xii + 261 pp. Cloth, $55.This book aims to provide a comprehensive account of the ancient scholarship on Demosthenes. Gibson points out that Demosthenes was widely read in later antiquity, and this created the need for linguistic and historical commentaries (...) on his speeches. Of these, some have partially survived on papyrus, while excerpts have also been preserved in later lexicographers and the Byzantine scholia found in the margins of Demosthenic manuscripts. The purpose of Gibson's study is to clarify some confusing and difficult issues related to the ancient scholarship on Demosthenes and to provide the text and commentary on the main sources. [End Page 481]Gibson's introduction includes an informative outline of key parameters in the debate, such as the accuracy of excerption from an ancient commentary, the significance of date and place, and the intended readership of these commentaries. The first chapter discusses the form and transmission of ancient commentaries, their relation with lexicographic works, and their impact on the Byzantine scholia. Gibson convincingly argues that the scholia do not reveal direct dependency upon the surviving ancient commentaries but were compiled from lexicographic works such as Harpocration or the Suda, and possibly other works lost for us. The second chapter deals with the sources, critical agenda, and readership of the ancient commentaries. Here, Gibson provides a clear account of the purposes and guiding principles behind the composition of these works. He concludes that ancient commentators were familiar with interpretative problems of the Demosthenic text and tried to explain allusions and references to specific events, people, and places and also provide semantic, etymological and textual explanations of difficult or unusual terms. In this and the third chapter, Gibson discusses in considerable detail the scholarship on Didymus. He rejects the view that Didymus was merely a filter for a "golden era" of Alexandrian scholarship and argues that his prominent position as a commentator is due to the vast quantity of his work and its impact on later scholars. In sum, the first part of the study offers an informative account of ancient Demosthenic scholarship written in a clear and accessible style.The second part of the book contains the texts of ancient commentators of Demosthenes, with English translations, and also linguistic and historical commentary. In the translation, Gibson chooses to leave out many lines from the papyrus texts where only single words or fragments of words are legible; he translates only the most extant sections of the text. This is a valid choice, but readers should be aware of the fact that many important details may be hiding in the leftovers and fragments that have been omitted. Gibson does not provide the readily available text of P.Berol.inv. 9780, the most extensive surviving work of Didymus, while he cites the rest of the texts from reliable modern editions. In the commentary there are interesting discussions on the Spartan mora, the building of the Parthenon, the Helliastic courts, and many other topics noted by the ancient commentators on Demosthenes. An appendix presents and discusses P.Lond.Lit. 179, a prologue and commentary on Dem. 21. The reader will probably find useful the indexes and rich bibliography provided in the last part of this study.Gibson's commentary is certainly thorough but contains a number of errors in detail, and important bibliography is missing on individual topics. For example:Page 113: Gibson adopts the text of Pearson-Stephens. The adjective is, or, as here (later Greek),. Therefore the text should be (see LSJ s.v.).Page 120: Gibson has missed several important contributions to the issue of the theoric fund in recent years (M. H. Hansen, GRBS 17 [1976] 235-46; E. M. [End Page 482] Harris in E. M. Harris and R. Wallace, eds., Transitions to Empire: Essays in Greco-Roman History 360-146 B.C., in Honor of E. Badian [Norman, Okla., 1996]; C. Carey, Apollodoros Against Neaira [Warminster, 1992] 152-57). As a result, his note on P.Berol. 9780, Col. 8.32-44 is... (shrink)

Malgré l’accent porté sur les aspects publics, ritualistes de la pratique ancienne, les images et les objets grecs attestent des rencontres privées et personnelles avec des dieux. Cet article recourt à la documentation archéologique pour explorer les traits personnels, vécus, de la vie religieuse de l’Athènes attique. Bien qu’elles soient parfois décrites comme des « transactions », le développement des relations personnelles avec les dieux et de la manipulation de choses matérielles semble être l’un des éléments les plus saillants de (...) l’expérience religieuse des Grecs. Cette étude examine la matérialité religieuse et l’attitude dévotionnelle telle qu’elle existait en dehors de systèmes rituels organisés et des espaces sacrés. La documentation grecque suggère que la culture matérielle était « de la religion » sous forme physique et une part des méthodes des dévots pour développer des relations remarquablement intimes avec des figures sacrées dans un processus appelé « dévotionalisme ». Les femmes athéniennes utilisaient un objet commun de la vie quotidienne comme une forme de médium religieux: la tainia (ruban). Les femmes l’employaient dans tous les lieux de leur vie, y compris les maisons, les lieux de fêtes et les sanctuaires. La céramique suggère que les Athéniens ont employé de tels média dévotionnels pour interagir avec les défunts dans les cimetières. (shrink)

Self-understanding is to a great extent defined by narrative: who we are as human beings is determined by the stories we, and others, tell about ourselves. Yet many are unable to compose coherent personal narratives, as their experiences do not fall within the scope of an accepted conceptual framework. Survivors of trauma are particularly apt to fall into this “narrative rift,” where there can be no words to describe, and hence can be no assimilation of, their experiences. Using the example (...) of child sexual abuse, and drawing on the work of Bass, Spence, Schafer, and Guignon, I propose an examination of the nature of narrative fragmentation itself. Philosophical counselling may succeed where psychoanalysis might not: for where the latter has theoretical commitments to specific narratives, the former, through its reluctance to force epistemological or metaphysical assumptions on the narrator, may well facilitate a more comprehensive self-understanding. (shrink)

Jehovah’s Witnesses should be required to sign transfusion contracts in order to be eligible for transplant.Human donor organs continue to be in short supply, and many potential transplant recipients die while waiting for an allograft to become available.1 Because the organ supply is so limited and the offering of organs is based on the generosity of patients and families, proper stewardship of these organs is an ethical obligation for transplant teams, as well as organ recipients. Preventable graft loss must be (...) protected against, and factors that foster preventable graft loss—for example, non-compliance must be proactively contemplated when patients are reviewed as potential transplant candidates. Post-transplant treatment refusal is one example of behaviour that can compromise transplant success.JEHOVAH’S WITNESSES AS TRANSPLANT RECIPIENTSIt is widely known that one of the most significant teachings of the Jehovah’s Witness church is abstinence from receiving blood transfusions.2 Believers derive this tenet from the Bible verse: “You are to abstain from …blood”.3 While blood loss is a risk of transplant surgery, some centres do not view patient refusal of blood transfusion as a transplant exclusion criterion. The first published case of transplantation of a Jehovah’s Witness appeared in 1986 from the University of California Los Angeles heart transplant team.4 Since then, numerous other cases have been published, including liver,5 kidney,6 pancreas,6 and lung.7 For experienced centres with superior blood management skills, transplant can indeed be a surgical success; however, optimal blood management before and during surgery are only two thirds of the patient’s clinical time clock. In the remaining third, the post-transplant period, the patient has received his/her organ, yet the potential for clinical need of blood transfusion remains.THE DILEMMAWhether due to postoperative complication, or future illness or trauma, all transplant recipients have …. (shrink)

The founders of reformational philosophy, H. Dooyeweerd and D.H.Th. Vollenhoven, each published in short succession, viz. 1949 and 1950, a voluminous study in the history of philosophy. Whoever reads both works is struck by the remarkable differences in treatment. In this contribution these differences are analysed, but there is also indication of agreement. The article ends with a number of conclusions based on the analysis.

A formal Ethics Consultation Service (ECS) can provide significant help to patients, families and hospital staff. As with any other form of clinical consultation, documentation of the process and the advice rendered is very important. Upon review of the published consult documentation practices of other ECSs, we judged that none of them were sufficiently detailed or structured to meet the needs and purposes of a clinical ethics consultation. Thus, we decided to share our method in order to advance the practice (...) of ethics consultation. Here, we describe a method of ECS documentation practice, including use of a formal consult report template, as well as a log for maintaining a chronological record of the consultations performed. These two documents facilitate order and organisation of the ECS. They also enable the ECS to keep an account of professional time and experience, enable quick consult trend assessments (by consult theme or ward, for example) and establish a potential registry of consults for future research study. This method of documentation, we believe, not only contributes significantly to the primary purpose of the consultation—namely, the evincing and sharing of ethical opinion about a case—but also enables consultants to improve their practice and to pursue research on clinical ethics consultation. (shrink)

A comprehensive review of Marxism and its development by Engels, Lenin, and contemporary Soviet philosophers. Two sections of equal length deal with "Marxism as a Philosophy" and "Marxism as a Theory of History." The results of recent scholarship done in many parts of the world are presented in a systematic account of Marx and his relationship to Engels, Lenin and others. In post-Marxian philosophy, major emphasis is placed on the "classical" dialectical materialism, but other types of Marxism are considered as (...) well. Extensive notes and an excellent annotated bibliography are included. This volume will be of use both as a text book and as a resource to those who are interested in Marx or Marxism-Leninism.—K. A. M. (shrink)