An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. (...) Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

Aim To explore the views in non-Western cultures about ending the lives of damaged newborns.Method 254 university students from India and 150 from Kuwait rated the acceptability of ending the lives of newborns with genetic defects in 54 vignettes consisting of all combinations of four factors: gestational age ; severity of genetic defect ; the parents’ attitude about prolonging care ; and the procedure used .Results Four clusters were identified by cluster analysis and subjected to analysis of variance. Cluster I, (...) labelled ‘Never Acceptable’, included 4% of the Indians and 59% of the Kuwaitis. Cluster II, ‘No Firm Opinion’, had little variation in rating from one scenario to the next; it included 38% of the Indians and 18% of the Kuwaitis. In Cluster III, ‘Parents’ Attitude+Severity+Procedure’, all three factors affected the ratings; it was composed of 18% of the Indians and 16% of the Kuwaitis. Cluster IV was called ‘Severity+Parents’ Attitude’ because these had the strongest impact; it was composed of 40% of the Indians and 7% of the Kuwaitis.Conclusions In accordance with the teachings of Islam versus Hinduism, Kuwaiti students were more likely to oppose ending a newborn's life under all conditions, Indian students more likely to favour it and to judge its acceptability in light of the different circumstances. (shrink)

The superfluid state of fermion-antifermion fields developed in our previous papers is generalized to include higher orbital and spin states. In addition to single-particle excitations, the system is capable of having real and virtual bound or quasibound composite excitations which are akin to bosons of spinJ P equal to0 −, 1−, 2+, etc. These pseudoscalar, vector, and tensor bosons can be massive or massless and provide the vehicles for strong, electromagnetic, weak, and gravitational interactions. The concept that the basic (unmanifest) (...) fermion-antifermion interaction can lead to a multiplicity of manifest interactions seems to provide a basis for a unified field theory. (shrink)

This article proposes a geostatistical solution for area-to-point spatial prediction (downscaling) taking into account boundary effects. Such effects are often poorly considered in downscaling, even though they often have significant impact on the results. The geostatistical approach proposed in this article considers two types of boundary conditions (BC), that is, a Dirichlet-type condition and a Neumann-type condition, while satisfying several critical issues in downscaling: the coherence of predictions, the explicit consideration of support differences, and the assessment of uncertainty regarding the (...) point predictions. An updating algorithm is used to reduce the computational cost of area-to-point prediction under a given BC. In a case study, area-to-point prediction under a Dirichlet-type BC and a Neumann-type BC is illustrated using simulated data, and the resulting predictions and error variances are compared with those obtained without considering such conditions. (shrink)

Aim To study the views of people in a largely Muslim country, Kuwait, of the acceptability of a life-ending action such as physician-assisted suicide (PAS). Method 330 Kuwaiti university students judged the acceptability of PAS in 36 scenarios composed of all combinations of four factors: the patient's age (35, 60 or 85 years); the level of incurability of the illness (completely incurable vs extremely difficult to cure); the type of suffering (extreme physical pain or complete dependence) and the extent to (...) which the patient requests a life-ending procedure, euthanasia or PAS (no request, some form of request, repeated requests). In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results Five clusters were found. For 44%, PAS was always very unacceptable, no matter what the circumstances. For 23%, it was unacceptable, but less so if the patient was older or requested it repeatedly. For 16%, it was unacceptable if the patient was young but was acceptable if the patient was elderly. For 5%, it was unacceptable if the patient had extreme pain but was acceptable if completely dependent. For 11%, it was unacceptable if the patient did not request it but acceptable if she did. Conclusion The majority of the Kuwaiti university students opposed PAS either categorically or with a slight variation according to circumstances. Nonetheless, a minority approved of PAS in some cases, particularly when the patient was elderly. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (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)

The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (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)

Traduçáo: Normal 0 21 false false false MicrosoftInternetExplorer4 Retirado de Carlos E. Caorsi (Ed.). Ensayos sobre Strawson . Universidad de la República/Faculdad de Humanidades y Ciencias de la Educación, Montevidéo,1992, p. 55-71.

Recent advances in string theory and inflationary cosmology have led to a surge of interest in the possible existence of an ensemble of cosmic regions, or “universes”, among the members of which key physical parameters, such as the masses of elementary particles and the coupling constants, might assume different values. The observed values in our cosmic region are then attributed to an observer selection effect (the so-called anthropic principle). The assemblage of universes has been dubbed “the multiverse”. In this paper (...) we review the multiverse concept and the criticisms that have been advanced against it on both scientific and philosophical grounds. (shrink)

A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes from 26 Triticeae cDNA libraries, were mapped to wheat homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported (...) elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 327 Tragic Vision and Divine Compassion: A Contemporary Theodicy. By WENDY FARLEY. Louisville, Kentucky: Westminster/John Knox Press, 1990. 150 pp. Wendy Farley sets herself an ambitious task in her book. She is dissatisfied with past theodicies, which account for evil and suffering as punishment for sin, as counterpoints in a larger aesthetic cosmic harmony, as means of purification and formation of character, or something that will be (...) as compensated for by other-worldly vindication and reward. These four theories may explain some forms of evil and suffering, but in the face of " radical suffering " they are " unable to exorcise the demons that whisper that life is futile, suffering is meaningless, and the cosmos an empty and evil void " (p. 22). By " radical suffering " Farley means that kind of suffering which debases and destroys the human dignity of the sufferer: " Radical suffering pinches the spirit of the sufferer, numbing it and diminishing its range. The distinctiveness of radical suffering does not lie in its intensity or its injustice but its power over the sufferer" (p. 54). Radical suffering drives the person to self-loathing and despair and therefore destroys her or his capacity to resist it. Despite its massive destructive power radical suffering is not rare; it occurs in familial, cultural, poli· tical, and economic relations under the forms of, e.g., child abuse, sexism, racism, violation of human rights, poverty, and starvation. To account for radical suffering, Farley proposes that (a) one place suffering rather than sin at the center of the problem of evil; (b) one replace the notion of a primordial fall with that of tragedy; (c) one repudiate the idea of divine omnipotence in favor of that of divine compassion (pp. 12-13). The second and third proposals are captured in the title of the book, " Tragic Vision and Divine Compassion." Farley's first proposal leads one to expect that she would do away with the notion of sin altogether, hut this is not the case. Strangely, she devotes a good deal of attention to sin, describing it as " catastrophic because it introduces chaos and disharmony into history " (p. 43). She sees sin as (self)-deception, callousness, bondage, and guilt (pp. 4451 ). Whereas traditional theology perceives a causal link between sin and suffering, the logic of Farley's alternative proposal entails her locating the origin of suffering elsewhere, namely, the tragic character of human existence: "... tragic vision locates the possihilirty of suffering in the conditions of existence and in the fragility of human freedom " (p. 29). A tragic vision of life does not, Farley claims, rationalize (radical) 3~8 BOOK REVIEWS suffering, nor is it atheistic. It recognizes, honestly and bluntly, that " the conditions of finite existence include conflict and fragility " (p. 31). Multiplicity ·and' variety enrich creation hut they inevitably lead to division and.separation; relationships warm the heart hut they must include some and exclude others; values sometimes conflict, such as mercy and justice; embodiment allows us to enjoy the pleasures of life but it leads to decay and death. Even human freedom, Farley points out, is infected with fragility caused by anxiety and desire: "Freedom is the tragic flaw of human existence, at once the stamp of its greatness and its destruction " ·(p. 37). What should one do in face of inevitable suffering? One must have compassion. Farley takes compassion to mean an enduring disposition horn of sympathetic knowledge of another person's suffering leading to love (which is a liberation from egocentrism that enables one to care for others) and working for justice (especially removing social in· justice). In contrast to dominating power, compassion empowers the sufferers to speak and act in their own defenses. It rejects the tempta· tion of passivity before evil and the use of violence to overthrow it. Rather, it empowers sufferers to resist evil. For Farley, God's power must he understood as compassion or love. As a noncoercive form of power, divine love (a) creates a tragic world in which radical suffering is inevitable and (b) because of suffering redeems it. Hence, divine compassion is both creative and redemptive. But why does God go through this seemingly redundant exercise? Why doesn't God create... (shrink)

BackgroundEuthanasia is performed on occasion, even on newborns, but is highly controversial, and it is prohibited by law and condemned by medical ethics in most countries.AimTo characterise and compare the judgments of lay persons, nurses, and physicians of the acceptability of actively ending the life of a damaged newborn.MethodsConvenience samples of 237 lay persons, 214 nurses, and 76 physicians in the south of France rated the acceptability on a scale of 0–10 of giving a lethal injection in 54 scenarios composed (...) of all combinations of 4 within-subject factors: gestational age of 6,7, or 9 months; 3 levels of severity of either perinatal asphyxia or of genetic disease; attitude of the parents about prolonging care unknown, favourable, or unfavourable; and decision made individually by the physician or collectively by the medical team. Overall ratings were subjected to cluster analysis and each cluster to analysis of variance and graphic representation.ResultsLay persons (mean acceptability rating 4.29) were significantly more favourable to euthanasia than nurses (2.84), p<.005, or physicians (2.12), p<.005. Five clusters were found with different judgment rules, i.e., how the information was integrated. More physicians (30 per cent) than nurses (14 per cent), p<.01, or lay persons (11 percent), p<.01, rated euthanasia as never, under any condition, acceptable. Most, however, asserted that it was increasingly acceptable as the factors combined to favour it, especially when the parents desired to stop treatment. More physicians (45 per cent) and nurses (46 per cent) than lay persons (21 per cent), p<.01, used a complex conjunctive rule (level of parent’s attitude x level of severity of damage x consultation with team or not) rather than a simple additive rule.ConclusionsUnlike lawand medical ethics, most of the lay persons. nurses, and physicians judged the acceptability of euthanasia as a function of the circumstances. Most health professionals combined the factors in a conjunctive (multiplicative), rather than additive, fashion in accordance with legislation for adults in the Netherlands and elsewhere that requires a set of criteria to be fulfilled before it is legitimate to end apatient’s life. (shrink)

A critical discussion is provided of three central assumptions underlying Nunez's approach to modeling cortical activity. A plea is made for neurophysiologically realistic models involving nonlinearities, multiple time scales, and stochasticity.

The preparation of layers of amorphous Se by plasma-enhanced CVD using the hydride H2Se as precursor gas is described. Information concerning the structure of the films was obtained from Raman spectroscopy. The spectra of amorphous Se indicated that the dominant molecular structure is the eight-membered ring and/or a chain with Se8 molecular fragments. This material exhibited reversible photodarkening when illuminated at 77 K. In order to explain this phenomenon, we propose a mechanism which takes into account the role of the (...) lone-pair electron orbitals of Se in their contribution to structural ordering. Illumination can cause a distortion in the normal bonding direction between nearest-neighbour Se atoms and induce in this way intrinsic defect states located at the band edges. In the photo-darkened state, optical transition will occur between these defect states. (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)

of a logarithmic time dependence of the fine structure constant is apparently within the limits discussed if there is a corresponding logarithmic time dependence of the strong coupling constant also. Moreover the recent discover> of naturally occurring ' Pu places the Gamow hypothesis of e' r much nearer the allov'able limits than had previously been supposed.