The Patient Protection and Affordable Care Act of 2010 purportedly assures almost all Americans of the right to health insurance coverage. The long-term success of this legislation in improving the public’s health in the United States will likely hinge in no small part on the degree to which statutorily establishing a right to health insurance coverage translates into actual timely, meaningful access to health services, particularly physician services, for specific individuals.

Families frequently act as substitute decisionmakers for their older members who suffer from diminished mental capacity to make and express their own medical choices. Substitute decisionmaking takes on particular ethical and legal urgency within the nursing home environment, especially when choices concern potential medical treatment near the end of the nursing home resident's life. This article examines current legal mechanisms in the United States that enable a family to make substitute medical decisions, the ethical underpinnings of those mechanisms, and specific (...) ethical and legal considerations implicated by their application to the nursing home setting. The article offers advice to nursing home professionals, including physicians, in working with families as substitute decisionmakers. (shrink)

Empowering the elderly to make their own decisions regarding medical care is a noble social, political, and ethical cause; but society must guard against excesses that might ironically, deny the elderly their autonomy by forcing it upon them.

An in-depth investigation of the influence that apprehension about litigation and legal liability exerts on ethical medical practice today.

This paper reports on a mail survey of Jewish nursing homes nationally regarding their compliance with the federal Patient Self-Determination Act that became effective in December, 1991. Data is presented about the extent to which institutions' religious affiliation has influenced their advance directive policies and the procedures they have adopted to implement those policies. A content analysis of written advance directive policies used in Jewish nursing homes is presented also.

If one were to find a date for the games put on by Pompey to celebrate the opening of his theatre in 55 B.C., it would be possible to assign a more precise date to the delivery of Cicero's speech in Pisonem than seems to have been done so far. Asconius states quite firmly that the in Pisonem was delivered in the second consulship of Pompey and Crassus, a few days before the lavish games celebrating the opening of Pompey's theatre. (...) Asconius rejects a counter-view that the speech was delivered late in the following year. (shrink)

Thirty years ago when I, an attorney, took a tenure-track faculty position at an innovative, newly opened medical school, I was an oddity — truly, a stranger in a strange land. Today it is not uncommon for American medical schools to employ an attorney as a tenured or tenure-track member of its faculty. Over these last three decades, the educational roles and responsibilities of health law faculty who teach in law schools have become increasingly well defined, with numerous health law (...) courses and textbooks now generally accepted as part of the typical law school curriculum. However, the roles and responsibilities of attorney faculty members who teach in medical schools remain less clearly defined and likely are more individualized to the particular medical schools in which they teach. This essay explores some of the challenges and the opportunities which are given to attorney faculty members who teach in medical schools. (shrink)

The interplay between emotion and learning is a continuing source of debate and inquiry in organization studies, attracting an increasing number of important contributions. However, a detailed understanding of the interaction between emotion and learning remains elusive. In an effort to extend the existing debate, this article offers an alternative approach that draws on the tradition of pragmatist philosophy, where emotion and learning can both be defined as dynamic processes that emerge in the relational context of social transactions. The mutually (...) constructing interplay between these two processes is then illustrated with an example of a collaborative project in which anxiety, love, guilt, and hostility are all entangled in the learning process. (shrink)

Large-scale genetic databases are being developed in several countries around the world. However, these databases depend on public participation and acquiescence. In the past, information campaigns have been waged and little attention has been paid to dialogue. Nowadays, it is important to include the public in the development of scientific research and to encourage a free, open and useful dialogue among those involved. This paper is a review of community consultation strategies as part of four proposed large-scale genetic databases in (...) Iceland, Estonia, United Kingdom and Quebec. The Iceland Health Sector Database and Estonian Genome Project have followed a “communication approach” in order to address public concerns, whereas, UK Biobank and Quebec CARTaGENE have chosen a “partnership approach” to involve the public in decision-making processes. (shrink)

If we reject τις, which appears only in derivative manuscripts, then the sentence is notable in the following ways. First, the position of τι—not that it separates ἕκαστος from ὑμν, but because we expect it, if present at all, to appear as πρός ὃ τι … and ἓαστός τι in itself is a conspicuously discordant juxtaposition—hence presumably the corruption to ἓαστός τις. Second, the sense: the sentence must surely mean not that each juryman has a criterion, but that each has (...) a different criterion, that he would like to see satisfied. (shrink)

In the opening sentence of 2.6, which is of key significance, the meanings or references of are disputed, rendering the whole passage difficult. In the most widely established version, while —‘Evidence for the statement that Athens grew morethan other places because of migration is provided by the following, viz. that...’ This is consistent with taking either Athens or the other places as the subject of the infinitive, ‘Athens grew more’ or ‘the other places grew less’. If recapitulates the end of (...) 2.2, appears to refer to those migrations; but since it is a rare word, abnormal in that sense, and is obscure, Ullrich proposed, which makes a straight reference to migration, disposes of the obscurity, and provides an explicit subject for the infinitive. Gomme accepts this. I disagree, but yet believe that the established version, though capable of much improvement, is the best to date. (shrink)

Is there a link between how a firm manages its internal and external stakeholders? More specifically, are firms that give employees stock ownership and more say in running the enterprise more likely to engage with external stakeholders? This study seeks to answer these questions by elaborating on mechanisms that link employees to external stakeholders, such as the community, suppliers, and the environment. It tests these relationships using a sample of 347 private, mostly small-to-medium size firms, which completed a stakeholder impact (...) assessment organized by the non-profit B Lab. The results support the hypotheses that both employee ownership and employee involvement are positively associated with external stakeholder engagement. Further, we found that certification plays a role, as employee ownership contributes to external stakeholder engagement only in certified B Corporations, and not in firms that merely completed the B Lab Impact assessment. Our findings have import for stakeholder engagement frameworks, as we show that there is interplay between internal employee stakeholders and external stakeholders that may be important to overall firm–stakeholder management. (shrink)

We propose an experimental method to study the possible emergence of sensemaking in artificial agents. This method involves analyzing the agent's behavior in a test bed environment that presents regularities in the possibilities of interaction afforded to the agent, while the agent has no presuppositions about the underlying functioning of the environment that explains such regularities. We propose a particular environment that permits such an experiment, called the Small Loop Problem. We argue that the agent's behavior demonstrates sensemaking if the (...) agent learns to exploit regularities of interaction to fulfill its self-motivation as if it understood (at least partially) the underlying functioning of the environment. As a corollary, we argue that sensemaking and self-motivation come together. We propose a new method to generate self-motivation in an artificial agent called interactional motivation. An interactionally motivated agent seeks to perform interactions with predefined positive values and avoid.. (shrink)