Rationing healthcare is a difficult task, which includes preventing patients from accessing potentially beneficial treatments. Proponents of implicit rationing argue that politicians cannot resist pressure from strong patient groups for treatments and conclude that physicians should ration without informing patients or the public. The authors subdivide this specific programme of implicit rationing, or “hidden rationing”, into local hidden rationing, unsophisticated global hidden rationing and sophisticated global hidden rationing. They evaluate the appropriateness of these methods of rationing from the perspectives of (...) individual and political autonomy and conclude that local hidden rationing and unsophisticated global hidden rationing clearly violate patients’ individual autonomy, that is, their right to participate in medical decision-making. While sophisticated global hidden rationing avoids this charge, the authors point out that it nonetheless violates the political autonomy of patients, that is, their right to engage in public affairs as citizens. A defence of any of the forms of hidden rationing is therefore considered to be incompatible with a defence of autonomy. (shrink)

Aim: To examine how physicians’ life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making.Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large (...) life-stance groups in each country.Results: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten the patient’s death , physicians with specific religious affiliations had significantly less accepting attitudes, and less willingness to perform it, than non-religious physicians. They had also actually performed PAD less often. However, in most countries, both Catholics and Protestants reported ever having made such a decision.Discussion: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients and circumstances. Physicians seem to embrace religious belief in a non-imperative way, allowing adaptation to particular situations. (shrink)

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

Objectives: To investigate the extent to which family physicians in Lithuania inform their patients about possible side-effects when a common treatment is proposed. To examine the relation between physicians’ estimation of the severity and frequency of these side-effects and their willingness to inform patients. To identify the reasons for informing or not informing the patients.Methods: A questionnaire, presenting three hypothetical cases involving decisions about ordinary medical treatments and a series of general questions about information about side-effects, was distributed to 500 (...) Lithuanian GPs. The response rate was 42%.Results: The respondents differed considerably with regard to their willingness to inform patients about side-effects, but they informed their patients significantly more if the side effect was considered to be common and serious, than in cases when it was considered to be rare and trivial. The majority of the respondents informed their patients primarily to enable them to react appropriately to the side-effects in question. The major reason for not informing was that the side-effects were considered too rare to be relevant to the patient’s decision-making.Conclusion: Information, given to patients about side-effects by Lithuanian GPs, is not in accordance with the principle of respect for patients’ autonomy and requirements of Lithuanian legislation. (shrink)

Among Plato's works, the Statesman is usually seen as transitional between the Republic and the Laws. This book argues that the dialogue deserves a special place of its own. Whereas Plato is usually thought of as defending unchanging knowledge, Dr Lane demonstrates how, by placing change at the heart of political affairs, Plato reconceives the link between knowledge and authority. The statesman is shown to master the timing of affairs of state, and to use this expertise in managing the conflict (...) of opposed civic factions. To this political argument corresponds a methodological approach which is seen to rely not only on the familiar method of 'division', but equally on the unfamiliar centrality of the use of 'example'. The demonstration that method and politics are interrelated transforms our understanding of the Statesman and its fellow dialogues. (shrink)

George Greenough was one of the influential group of early nineteenth-century English geologists who rejected both Hutton's and Werner's attempts to propound all-embracing geological theories, and followed a deliberately empirical approach. He travelled through Scotland in 1805, studying geological phenomena in the light of both the Plutonist and the Neptunist theories, and generally concluded that neither was entirely satisfactory as an explanation of the observable facts. He was also the first to suggest that the ‘Parallel Roads’ of Glen Roy were (...) the successive beach-levels of a former lake: this theory was later attacked by Darwin but ultimately vindicated by Agassiz's glacial theory. The more important geological passages from Greenough's MS. journal of the tour are reproduced and discussed in this paper. They illustrate some of the scientific problems that were involved in accepting either Hutton's or Werner's theory entire. (shrink)

A survey was carried out on 108 Chilean children and a selection of their families. The factors studied were: (1) social, (2) demographic and dietaryto assess the incidence and degree of malnutrition and (4) haematology—to determine the incidence of anaemia.

The Greek original of Galen's is lost, nor has a copy of the complete translation into Arabic, made by Hunayn b. Ishāq in the first half of the ninth century, come down to us, though some passages of it are quoted by various Arab authors. A summary of the translation, however, was discovered by P. Kraus in a miscellaneous manuscript in Cairo and published by him in the Bulletin of the Faculty of Arts of the University of Egypt, vol. v/i.

‘It is supposed’, declared the poet Wordsworth in 1802, ‘that by the act of writing in verse an author makes a formal engagement that he will gratify certain known habits of association; that he not only thus apprizes the reader that certain classes of ideas and expressions will be found in his book, but that others will be carefully excluded. This exponent or symbol held forth by metrical language must in different eras of literature have excited very different expectations.’ For (...) his own era of literature Wordsworth proposed a language derived from the ‘simple and unelaborated expressions’ of the ‘language really spoken by men’, at the expense of ‘devices to elevate the style’ and ‘what is usually called poetic diction’. (shrink)

Abstract:The present paper focuses on the linkage between two academic paradigms in the enquiry into business ethics: normative philosophy and empirical social sciences. The paper first reviews existing research pertaining to a normative-empirical dialogue. Further empirical data on the relationship between various standards of morality are discussed in relation to the normative frameworks of ethics. Lastly, future directions for such a dialogue in business ethics are suggested.

The practice of evidence based medicine has changed the role of the physician from information dispenser to gatherer and analyser. Studies and controlled trials that may contain unknown errors, or uncertainties, are the primary sources for evidence based decisions in medicine. These sources may be corrupted by a number of means, such as inaccurate statistical analysis, statistical manipulation, population bias, or relevance to the patient in question. Regardless of whether any of these inaccuracies are apparent, the uncertainty of their presence (...) in physician information should be disclosed to the patient. These uncertainties are not, however, shared by physicians with patients, and have caused a direct increase in patient responsibilities and mistrust. Only when disclosure of uncertainty becomes commonplace in medical practice will the physician/patient relationship evolve to a level of greater understanding and satisfaction for both the physician and patient. (shrink)

The study ascertained (1) whether an observer's scope of justice with reference to either the moral agent or the target person of a moral act, would affect his/her judgements of the ethicality of the act, and (2) whether observer judgements of ethicality parallel the moral agent's decision processes in systematically evaluating the intensity of the moral issue. A scenario approach was used. Results affirmed both research questions. Discussions covered the implications of the findings for the underlying cognitive processes of moral (...) judgements, for the link between judgements of fairness and ethicality, as well as for the debate of ethical absolutism versus relativism. (shrink)

M. S. Ronald Commers is Professor of Moral Philosophy and head of the department of Philosophy and Moral Science at Ghent University. He is the director of the Center for Ethics & Value Inquiry at...

Zhizneopisanie -- Kniga znanii︠a︡ -- Ukazanii︠a︡ i nastavlenii︠a︡ -- Kniga o dushe.

Business is a representative institution of our times; it represents the spirit of our age. Modern business in general has displaced a remarkable ability to change. But the change yet to come will be something unprecedented. What is the nature of this change? What is the type of vision and sirategy that will help business as a social institution, and the organizations that are part of it, to navigate this evolutionary transition successfully? Or, in other words, what is the nature (...) of the paradigm shift needed to manage future change? These are the main questions business leaders and managers will be facing in the future. This article examines these questions in the light of Sri Aurobindo's vision. (shrink)

t. 1. A-D -- t. 2. E-M -- t. 3. N-S -- t.4. T-I︠A︡.

Motivation holds the key for harnessing the human potential in an organization. However, in modern management, motivation is used mainly as a strategy for enhancing the efficiency, productivity and performance of the employee. But for a more integral and effective realization of the human potential in an organization, motivation has to be used as a lever for human evolution and development, with enhanced performance as a spontaneous result. This article provides a comprehensive framework for evolving a motivational strategy, which will (...) lead to the progressive evolution of human potential in an organization. The article tries to integrate modern theories of motivation with ancient Indian perspectives, based on an integral psychology. (shrink)

The term ‘organizational development’ is defined in management textbooks as a ‘collection of planned change interventions built on democratic–humanistic values that seek to improve organizational effectiveness and well–being’. But we use the term in a simpler and broader sense as the evolution and development of an organization towards its highest potential. In this article we present the broad outlines of a strategic vision of organizational development based on the aims and principles of yoga. The word ‘yoga’ has now become well (...) known all over the world. But the popular conceptions of yoga conjure up images of a hatha–yogi standing upside down or a hermit in the Himalayas. The deeper psychological and pragmatic significance of yoga is not fully understood. ‘Yoga,’ says Sri Aurobindo, ‘is nothing but practical psychology’ (Sri Aurobindo 1972b: 39). It contributes to the psychological and spiritual development of the human organism. Yoga is the scientific, psychological process or discipline by which the inner development of the human being is triggered and can be accelerated. (shrink)