Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...) Results Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the _main_ reasons for futile care. Conclusions Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. (shrink)

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

Evidence does not support the claim that observers universally recognize basic emotions from signals on the face. The percentage of observers who matched the face with the predicted emotion (matching score) is not universal, but varies with culture and language. Matching scores are also inflated by the commonly used methods: within-subject design; posed, exaggerated facial expressions (devoid of context); multiple examples of each type of expression; and a response format that funnels a variety of interpretations into one word specified by (...) the experimenter. Without these methodological aids, matching scores are modest and subject to various explanations. (shrink)

Etrange personnage que Pierre Nicole. La postérité l'a rangé parmi les deuxièmes rôles de Port-Royal, une sorte de permanent du parti janséniste. Il a secondé le grand Arnauld, instruit Racine dans les Petites Ecoles, aidé Pascal et traduit en latin ses Provinciales. Fidèle entre les fidèles, et en même temps mal à l'aise dans cette atmosphère de fronde et de résistance que représente le milieu de Port-Royal, au sein de la France du XVII e siècle, ce latiniste timoré ne (...) songeait qu'aux Moyens de conserver la paix avec les hommes - titre de l'un de ses essais les plus célèbres. Dès que les tensions semblent s'apaiser, pendant la trêve appelée "la Paix de l'Eglise", Nicole peut enfin laisser libre cours à sa vocation de moraliste et de psychologue. Il publie, volume après volume ses Essais de morale : le succès sera tel que le libraire, après la mort de Pierre Nicole, s'ingéniera à en augmenter la série jusqu'à atteindre vingt-cinq volumes. Depuis la fin du XVIII e siècle, ce classique de la littérature morale était devenu pour ainsi dire inaccessible. On en publie parfois quelques pages choisies, défigurées par les coupures et les corrections. Il est proposé ici au lecteur moderne de redécouvrir dix essais de Nicole, donnés dans leur intégralité. Certains nous replongent dans les principes moraux d'un autre âge (et tirent de cet exotisme une part de leur valeur). D'autres présentent les qualités de finesse, le piquant, le goût du paradoxe qui ont longtemps fait juger Nicole comme un des grands représentants, à côté de Pascal et de La Rochefoucauld, de la littérature morale classique. L'oeuvre morale de Nicole s'avère ainsi demeurer passionnante pour un lecteur moderne, au moins à trois égards : 1/ ses considérations sur l'amour-propre, qui constituent les premiers jalons d'un utilitarisme économique ; 2/ ses réflexions sur la sociabilité et une approche originale de la civilité ; 3/ ses observations pédagogiques, émanant d'un des principaux maîtres des Petites Ecoles de Port-Royal. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Recent studies reveal some of the neurophysiological mechanisms involved in drug addiction. This prompts some theorists to claim that drug addiction diminishes responsibility. Stephen Morse however rejects this claim. Morse argues that these studies show that drug addiction involves neither compulsion, coercion, nor irrationality. He also adds that addicted people are responsible for becoming addicted and for failing to take measures to manage their addiction. After summarizing relevant neuroscience of addiction literature, this chapter engages critically with Morse to argue that (...) a subgroup of addicted people does meet plausible criteria for compulsion, coercion, or irrationality; that few addicted people are fully responsible for becoming addicted; and that some addicted people can be at least partly excused for failing to manage their addiction. Pickard and Lacey’s “responsibility without blame” approach is also suggested as a fruitful basis for future work in this field. (shrink)

A heterogeneous survey sample of for-profit, non-profit and government employees revealed that organizational factors but not personal characteristics were significant antecedents of misconduct and job satisfaction. Formal organizational compliance practices and ethical climate were independent predictors of misconduct, and compliance practices also moderated the relationship between ethical climate and misconduct, as well as between pressure to compromise ethical standards and misconduct. Misconduct was not predicted by level of moral reasoning, age, sex, ethnicity, job status, or size and type of organization. (...) Demographic variables predicted job satisfaction and organizational variables added significant incremental variance. Results suggest the importance of promoting a moral organization through the words and actions of senior managers and supervisors, independent of formal mechanisms such as codes of conduct. (shrink)

Where should computer simulations be located on the ‘usual methodological map’ which distinguishes experiment from theory? Specifically, do simulations ultimately qualify as experiments or as thought experiments? Ever since Galison raised that question, a passionate debate has developed, pushing many issues to the forefront of discussions concerning the epistemology and methodology of computer simulation. This review article illuminates the positions in that debate, evaluates the discourse and gives an outlook on questions that have not yet been addressed.

This book offers advice to academics on building resilience and resistance to forces that undermine well-being by drawing on ancient wisdom traditions, indigenous cultures, Jungian psychology, and contemplative practices from around the world.

This essay analyzes the 4B movement, which originates in Korea, as a feminist movement. In particular, I conceptualize it as a labor strike, considered against the backdrop of recent empirical research on comparative rates of unpaid labor, happiness, and well-being between men and women in heterosexual relationships. In doing so, I situate it within a historical context of the successes and failures of second-wave and recent "Girl Boss" feminist movements, particularly as regards their intersections with capitalism.

Two experiments examined false recall for lists of semantically and phonologically associated words as a function of presentation duration. Veridical recall increased with long exposure durations for all lists. For semantically associated lists, false recall increased from 20–250 ms, then decreased. There was a high level of false recall with 20 ms durations for phonologically associated lists , which declined as duration increased. In Experiment 2, for lists presented at 20 and 50 ms rates, false recall given zero correct recall (...) was observed frequently, suggesting that conscious recollection of studied words was not necessary for phonological false memory. Differences between phonologically and semantically associated lists were consistent with a feature integration model based on automatic initial processing of phonetic features of words. (shrink)

SummaryThis article documents understandings and responses to mass drug administration for the treatment and prevention of lymphatic filariasis among adults and children in northern coastal Tanzania from 2004 to 2011. Assessment of village-level distribution registers, combined with self-reported drug uptake surveys of adults, participant observation and interviews, revealed that at study sites in Pangani and Muheza districts the uptake of drugs was persistently low. The majority of people living at these highly endemic locations either did not receive or actively rejected (...) free treatment. A combination of social, economic and political reasons explain the low uptake of drugs. These include a fear of treatment ; divergence between biomedical and local understandings of lymphatic filariasis; and limited and ineffective communication about the rationale for mass treatment. Other contributory factors are the reliance upon volunteers for distribution within villages and, in some locations, strained relationships between different groups of people within villages as well as between local leaders and government officials. The article also highlights a disjuncture between self-reported uptake of drugs by adults at a village level and the higher uptake of drugs recorded in official reports. The latter informs claims that elimination will be a possibility by 2020. This gives voice to a broader problem: there is considerable pressure for those implementing MDA to report positive results. The very real challenges of making MDA work are pushed to one side – adding to a rhetoric of success at the expense of engaging with local realities. It is vital to address the kind of issues raised in this article if current attempts to eliminate lymphatic filariasis in mainland coastal Tanzania are to achieve their goal. (shrink)

This paper draws on an in-depth phenomenological analysis of some interviews taken from volunteers, inviting them to reflect on their lived experiences of meaningfulness in the context of volunteering and citizenship. It is found that while some testimonies reinforce the standard conceptions of meaningfulness, other testimonies vary from it. The main challenge of this contribution consists in phenomenologically describing this alternative picture of meaningfulness, depicted as the event of witnessing. In a final part, the authors consider how volunteering is at (...) times especially prone to further experiences of witnessing. (shrink)

With advances in assisted reproductive technologies, globalization, and the ease of contact via the internet, the use of gestational surrogates as a family building option has grown significantly over the past decade. In a gestational surrogacy arrangement, unlike a traditional surrogacy arrangement, the surrogate is not the genetic mother of the child she carries; the genetic mother is either an egg donor or the commissioning parent. There are only a handful of countries in which commercial surrogacy is permitted, with the (...) United States and India prominent among them. More surrogacy arrangements are carried out in the United States than in any other nation, and the number of gestational.. (shrink)

Is it possible for postmodernism to offer viable, coherent accounts of ethics? Or are our social and intellectual worlds too fragmented for any broad consensus about the moral life? These issues have emerged as some of the most contentious in literary and philosophical studies. In Renegotiating Ethics in Literature, Philosophy, and Theory a distinguished international gathering of philosophers and literary scholars address the reconceptualisations involved in this 'turn towards ethics'. An important feature of this has been a renewed interest in (...) the literary text as a focus for the exploration of ethical issues. Exponents of this trend include Charles Taylor, Bernard Williams, Iris Murdoch, Cora Diamond, Richard Rorty and Martha Nussbaum, the latter a contributor and a key figure in this volume. This book assesses the significance of this development for ethical and literary theory and attempts to articulate an alternative postmodern account of ethics which does not rely on earlier appeals to universal truths. (shrink)

Relativism in psychology unravels the truth-claims and oppressive\npractices of the discipline, but simply relativizing psychological knowledge\nhas not been sufficient to comprehend and combat the discipline\nas part of the ‘psy-complex’. For that, a balanced review of the contribution\nand problems of relativism needs to work dialectically, and so\nthis article reviews four problematic rhetorical balancing strategies in\nrelativism before turning to the contribution of critical realism. Critical\nrealism exposes positivist psychology’s pretensions to model itself\non what it imagines the natural sciences to be, and it grounds (...) discursive\naccounts of mentation in social practices. The problem is that those\nsympathetic to mainstream psychology are also appealing to ‘realism’\nto warrant it as a science and to discredit critical research that situates\npsychological phenomena. Our use of critical realism calls for an\naccount of how psychological facts are socially constructed within\npresent social arrangements and for an analysis of the underlying historical\nconditions that gave rise to the ‘psy-complex’. Only by understanding\nhow the discipline of psychology reproduces notions of\nindividuality and human nature, a critical realist endeavour, will it be\npossible to transform it, and to socially construct it as something different. (shrink)

Our natural environment is in a lamentable state, notwithstanding today’s increasing ecological awareness. One cause frequently cited is our diminished perception of and relation to nature on ontological grounds. None of the alternative visions offered to date has been considered to really challenge the prevailing detached utilitarian and empirical framework. However, continued attempts on various levels are needed to rearticulate and reinvigorate the currently dormant and neglected plurality of approaches to nature. Although neither Heidegger nor Levinas was primarily concerned with (...) the relation of humans to nature, their works do seem to offer a voice to express our genuine way of being as a “Dasein in the world,” and the depth of its implications, as well as to reveal the “exteriority of nature.” A close examination of their views can show how they may contribute to a broadening of our perception, so that nature may appear to us not primarily as a commodity but foremost as an inspiring source of meaningfulness that at the same time appeals to our ethical ability. (shrink)

In this article, I argue that Hannah Arendt’s well-known but controversial distinction between labour, work, and action provides, perhaps unexpectedly, a conceptual grounding for transforming politics and policy-making at the EU level. Beyond the analysis and critique of modernity, Arendt brings the conceptual resources needed for the EU to move beyond the modern trap it fell into thirty years ago. At that time, the European Commission shifted its purpose away from enhancing interdependence among Member States with a common market towards (...) achieving an internal market in the name of boosting growth and creating jobs. Arendt provides the conceptual tools to transform the conceptualisation of relations and of agents that fuels the growing dissatisfaction among many Europeans with EU policy-making. This argument is made through stretching and re-articulating Arendt’s labour-work-action distinction and taking seriously both the biological and plural dimensions of the human condition, besides its rational one. By applying this shift in an EU context, EU policies could change their priorities and better address the needs and expectations of plural political agents and of European citizens. (shrink)

The color of the book’s cover alludes to the time and context in which this critical volume originated: the 3rd Interdisciplinary Conference Celebrating International Women’s Day at the New School for Social Research in New York City. At that time, ‘orange alerts’ were issued by the United States to create a climate of fear and thereby stifle any critical debate of its foreign and domestic policy. The feminist thinkers presented in this volume are alert that such a critique is needed. (...) They draw on the various languages of their fields to address wide-ranging topics and key questions in feminist politics, theory, and philosophy. They confront the state of the urgency of women in all classes of society and all research fields. This unique collection ranges across disciplines; as such, the four major topics – aesthetics and female representation, love and psychoanalysis, care and ethics, the different understandings of ‘women’ – represent current topics of cross-disciplinary interest for Women’s and Gender Studies, Philosophy, and Political Science. (shrink)

Evidence from visual-search experiments is discussed that indicates that there is spatially parallel encoding based on three-dimensional (3-D) spatial relations between complex image features. In one paradigm, subjects had to detect an odd part of cube-like figures, formed by grouping of corner junctions. Performance with cube-like figures was unaffected by the number of corner junctions present, though performance was affected when the corners did not configure into a cube. It is suggested from the data that junctions can be grouped to (...) form 3-D shapes in a spatially parallel manner. Further, performance with cube-like figures was more robust to noncollinearity between junctions than was performance when junctions grouped to form two-dimensional planes. In the second paradigm, subjects searched for targets defined by their size. Performance was affected by a size illusion, induced by linear-perspective cues from local background neighbourhoods. Search was made more efficient when the size illusion was consistent with the real size difference between targets and nontargets, and it was made less efficient when the size illusion was inconsistent with the real size difference. This last result occurred even though search was little affected by the display size in a control condition. We suggest that early, parallel visual processes are influenced by 3-D spatial relations between visual elements, that grouping based on 3-D spatial relations is relatively robust to noncollinearity between junctions, and that, at least in some circumstances, 3-D relations dominate those coded in two-dimensions. (shrink)

I analyse Drenthen's article ‘Ecological restoration and place attachment: emplacing non-places?’ ( Environmental Values 18(3): 285-312), focusing in particular on his use of the notions of ‘appropriation’ and ‘estrangement’ from the perspective of meaningfulness. I show that, for deeper meaningfulness as place attachment, within the appropriable there is always a tension with the non-appropriable; there is a successful connection between both. Estrangement and loss of meaning occur the moment the non-appropriable resides outside the familiar. Drenthen unintentionally causes confusion by failing (...) to take this subtlety into account systematically. (shrink)

The discipline of nursing has experienced the movement from modernism to postmodernism through expressions ranging from dualistic and polarized discourse to contradicting pluralistic positions. For the purpose of this paper, these responses are described as ways of knowing and are examined for their impact on the evolution of the nursing discipline. Reciprocal interdependence is offered as an alternate way of knowing capable of incorporating differing world views into a coherent and comprehensive systemic whole. The reflexive and potentially transformational impact of (...) reciprocal interdependence on the advancement of nursing knowledge is reviewed through a discussion of the value of polarity, as well as the contribution of complementary and dialectical perspectives to the maintenance of interactions between the whole and its constituents. (shrink)

The human animal feels fear: the ancient tranquil hordes, inhabitants of infinite plains where time stood still, have dissolved into a swarming, formless mass rushing into the future as if into the void: without a plan, without a leader, without roots; perhaps the only thing that guides it is the vague feeling of being a body whose limbs can not survive if separated.

Philosophers who write about the meaning of life are few nowadays. Thesubject has lost its attractiveness. Perceived from a viewpoint of logical positivism or language philosophy, the whole issue of meaningfulness seems rather pointless. It is often considered to be related to metaphysics, making it less suitable for philosophical inquiry. The topic of meaningfulness seems too intangible. Indeed, the few philosophers that have embarked on examining meaningfulness have proven to be well aware of the challenges this poses. At times they (...) acknowledge that the more they concentrate on the subject, the more it seems to fall apart into unintelligible pieces about whichnothing of philosophical value can be said. (shrink)

The question of the meaning and meaningfulness of life is neglected by philosophers today. Meaning is implicitly assumed to be associated with individual choices and preferences. This article argues that meaningfulness works in another way as well, when something provokes meaningfulness. One of the consequences of this vision is that there may well be implicit "standards" for meaning. Certain benchmarks for meaning-references concerned with our "being-in-the-world"-have not been explored fully enough. Another point that as been neglected in the recent discussion (...) on meaningfulness is the very structure of being that is appealed to. This is the key to the experience of a deeper kind of meaningfulness. (shrink)

The island of Palawan stretches northward from Borneo like a bridge to Luzon in the South China Sea. This tropical forest environment, rich in thousands of species of plants and animals, is home to about 50,000 people, known as the Palawan. Besides hunting with blowpipes, traps, spears, and dogs, these people also practice shifting cultivation. Hunting and gathering activities as well as work in the fields follow the alternation of two seasons, the “monsoon” and the “heat,” barat and bulag. As (...) an integral ecosystem, swidden places a high value on mobility rather than on land property. Land tenure, and recourse to physical violence of all kinds are considered unethical behavior. Social life among the Palawan is governed by a bilateral or undifferentiated kinship system, a complex customary law based on rules and values dictated by “the tradition of the Ancestors,” Adat ät Kägunggurangan. (shrink)