Rid and Wendler propose the development of a Patient Preference Predictor (PPP), an actuarial model for predicting incapacitated patient’s life-sustaining treatment preferences across a wide range of end-of-life scenarios. An actuarial approach to end-of-life decision making has enormous potential, but transferring the logic of actuarial prediction to end-of-life decision making raises several conceptual complexities and logistical problems that need further consideration. Actuarial models have proven effective in targeted prediction tasks, but no evidence supports their effectiveness in the kind of broad (...) spectrum prediction task that is the proposed goal of the PPP. We argue that a more focused approach, targeting specific medical conditions and generating treatment predictions based on the preferences of individuals with actual disease experience, is both more firmly grounded in past research and is a more prudent initial strategy for exploring the efficacy of actuarial prediction in end-of-life decision making. (shrink)

A scholarly edition of a work by David Hume. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

Standard defences of preservationism, and of the intrinsic value of nature more generally, are vulnerable to at least three objections. The first of these comes from social constructivism, the second from the claim that it is incoherent to argue that nature is both 'other' and something with which we can feel unity, whilst the third links defences of nature to authoritarian objectivism and dangerously misanthropic normative dichotomies which set pure nature against impure humanity. I argue that all these objections may (...) be answered by recasting the relationship between man and nature into a tripartite spectrum of ontological form between nature and artifact, with the key question being the extent to which nature has been humanised in accordance with certain modes of strongly instrumental rationality, these in turn being defined by reference to the split between abstract reason and natural feeling which was exacerbated by specific elements in the Enlightenment period. This new model may grant normative force by linking external nature to a broader conception of human psychological wellbeing than that offered by the quantitatively orientated models of human rationality and agency. (shrink)

The basic notions of the theory of term rewriting are defined for terms that may involve function letters of infinite arity. A sufficient condition for completeness is derived, and its use demonstrated by the example of abstract clones over infinitary signatures.

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Medical ethics has been described as a thread woven into the fabric of the Nottingham curriculum. There exist a wide variety of relevant learning experiences, occurring at intervals throughout each of the five years of the course. The introduction of the students to clinical method from the start creates the need for early consideration of ethical aspects of professional behaviour and this in turn stimulates spontaneous discussion and inquiry amongst the students. The school has chosen to rely on having a (...) sufficient number of medical teachers from various disciplines willing to discuss in all the necessary detail their own clinical decisions. (shrink)

The proposition that Jesus was ‘Bad, Mad or God’ is central to C.S. Lewis's popular apologetics. It is fêted by American Evangelicals, cautiously endorsed by Roman Catholics and Protestants, but often scorned by philosophers of religion. Most, mistakenly, regard Lewis's trilemma as unique. This paper examines the roots of this proposition in a two thousand year old theological and philosophical tradition (that is, aut Deus aut malus homo), grounded in the Johannine trilemma (‘unbalanced liar’, or ‘demonically possessed’, or ‘the God (...) of Israel come amongst his people’). Jesus can only be understood in the context of the Jewish religious categories he was born into; therefore, for Lewis, Jesus is who he reveals himself to be. Jesus' self-understanding reflects his identity, his triune salvific role; this is for Lewis, the transposed reality of divine Sonship. Reason and logic are paramount here, reflected in the structure of Lewis's argument. Lewis's trilemma is not so much a proof of God's existence, but a question, a dilemma, where each and every person must come to a decision. For all its perceived faults, its simplistic language, Lewis's trilemma still is a very successful piece of Christian apologetic, grounded in a serious philosophical and theological tradition. (shrink)

(1) It remains to be seen if in the field of Psychiatry just as in that of Psychology the verbal output of a subject can be submitted to verification. Many statements of a highly emotional character being merely symptoms of certain dispositions have no direct communicative sense at all.(2) It being one of the characteristics of the mentally ill to loose contact and exchange of ideas with other people, the question naturally suggests itself if this symptom may be at the (...) bottom of the phenomenon of these persons taking refuge in logical and ideological terminologies, their talk being a kind of verbal autism. (shrink)

IntroductionBisphenol A is highly debated and studied in relation to a variety of health outcomes. This large variation in the literature makes BPA a topic that is prone to selective use of literature, in order to underpin one’s own findings and opinion. Over time, selective use of literature, by means of citations, can lead to a skewed knowledge development and a biased scientific consensus. In this study, we assess which factors drive citation and whether this results in the overrepresentation of (...) harmful health effects of BPA.MethodsA citation network analysis was performed to test various determinants of citation. A systematic search identified all relevant publications on the human health effect of BPA. Data were extracted on potential determinants of selective citation, such as study outcome, study design, sample size, journal impact factor, authority of the author, self-citation, and funding source. We applied random effect logistic regression to assess whether these determinants influence the likelihood of citation.ResultsOne hundred sixty-nine publications on BPA were identified, with 12,432 potential citation pathways of which 808 citations occurred. The network consisted of 63 cross-sectional studies, 34 cohort studies, 29 case-control studies, 35 narrative reviews, and 8 systematic reviews. Positive studies have a 1.5 times greater chance of being cited compared to negative studies. Additionally, the authority of the author and self-citation are consistently found to be positively associated with the likelihood of being cited. Overall, the network seems to be highly influenced by two highly cited publications, whereas 60 out of 169 publications received no citations.ConclusionIn the literature on BPA, citation is mostly driven by positive study outcome and author-related factors, such as high authority within the network. Interpreting the impact of these factors and the big influence of a few highly cited publications, it can be questioned to which extent the knowledge development in human literature on BPA is actually evidence-based. (shrink)

The aim of this paper is to explore in the light of recent scientific discoveries, coupled with a return to biblical orthodoxy, the question of the Fall, and the apparent intergenerational conditions of original sin. This is the human condition – East of Eden. Invoking Darwin's theory of evolution through natural selection from random mutation as a means of repudiating the existence of original sin can no longer be sustained, scientifically; the biology of horizontal gene transfer, transgenerational epigenetics, accelerated evolution (...) and biological plasticity has rendered Darwinism grounded in a Naturalistic methodology an inadequate explanation. If humanity is ‘born this way’ – mired in sin – have we condemned ourselves and our children to this status? How does this affect the relationship between biology and free will, between a form of predestination and decision-making? Therefore, this paper is towards an understanding of the ontology of the original, or first, sin, and is a biblical and scientific exploration of postlapsarian humanity's self-willed state, ‘East of Eden.’. (shrink)