This interdisciplinary collection of essays highlights the relevance of Buddhist doctrine and practice to issues of globalization. From philosophical, religious, historical, and political perspectives, the authors show that Buddhism—arguably the world’s first transnational religion—is a rich resource for navigating todays interconnected world.

This systematic review identifies and critically evaluates instruments that have been developed to measure clinical trial informed consent comprehension in non-cognitively-impaired adults. Literature searches were carried out on Medline (Ovid), PsycInfo, CINHAL, ERIC, ScienceDirect, and Cochrane Library for English language articles published between January 1980 and September 2008. Instruments were excluded if they focused on consent onto paediatric trials, the construct under study was primarily capacity or competency, or the instrument was developed specifically for psychiatric or cognitively-impaired populations. Instruments selected (...) for review were evaluated against the following criteria: (1) method of item generation; (2) type and format of test items; (3) administration and interpretation of test results; and (4) psychometric properties. Three instruments met our defined inclusion criteria: the Deaconess Informed Consent Comprehension Test (DICCT), the Quality of Informed Consent (QuIC) questionnaire and the Brief Informed Consent Protocol (BICEP). Each instrument varied in terms of content measured. Significantly, these are the first standardized instruments developed to assess comprehension in non-cognitively-impaired adults. Yet, each instrument had its own set of limitations such as the lack of generalizability and the absence of details pertaining to how test results should be used to guide clinical decision-making. Standardized clinical trial informed consent comprehension assessments have been developed to identify gaps in research participants' understanding and ensure that respect for patient autonomy is satisfied. (shrink)

This article is written from within the Catholic, and more particularly the Augustinian/Thomist tradition of moral theology. It analyses the response of the Catholic Magisterium to the prospect of germline-genetic engineering (GGE). This is a very new issue and the Church has little definitive teaching on it. The statements of Popes and Vatican congregations or commissions have not settled the key questions. An analysis of theological themes drawn from secular writers points beyond pragmatic safety considerations toward intrinsic ethical limits to (...) GGE. Given the impossibility of identifying would-have-been-created persons who would be “treated” by this intervention, altering the human genome for the sake of future generations cannot be regarded as “therapy.” Further theological considerations suggest that GGE may not be morally permissible, even in the case of identifiable genetic diseases. This is an area where more theological reflection is needed. (shrink)

Martin Heidegger is, perhaps, the most controversial philosopher of the twentieth-century. Little has been written on him or about his work and its significance for educational thought. This unique collection by a group of international scholars reexamines Heidegger's work and its legacy for educational thought.

In the recent UK debate on the Human Fertilisation and Embryology Bill, there have been conflicting claims about the extent of public support for, or opposition to, human–animal hybrids. Self-selecting polls tend to show opposition to hybrids. Representative-sample polling shows spontaneous opposition but can elicit conditional approval of research, combined with underlying unease. Public opinion is very finely divided, with people generally opposed to this research unless it is likely to lead to medical advances.

That there is a heritable or familial component of susceptibility to chronic non‐communicable diseases such as type 2 diabetes, obesity and cardiovascular disease is well established, but there is increasing evidence that some elements of such heritability are transmitted non‐genomically and that the processes whereby environmental influences act during early development to shape disease risk in later life can have effects beyond a single generation. Such heritability may operate through epigenetic mechanisms involving regulation of either imprinted or non‐imprinted genes but (...) also through broader mechanisms related to parental physiology or behaviour. We review evidence and potential mechanisms for non‐genomic transgenerational inheritance of ‘lifestyle’ disease and propose that the ‘developmental origins of disease’ phenomenon is a maladaptive consequence of an ancestral mechanism of developmental plasticity that may have had adaptive value in the evolution of generalist species such as Homo sapiens. BioEssays 29: 145–154, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

A 2011 National Academies of Sciences report called for an “Information Commons” and a “Knowledge Network” to revolutionize biomedical research and clinical care. We interviewed 41 expert stakeholders to examine governance, access, data collection, and privacy in the context of a medical information commons. Stakeholders' attitudes about MICs align with the NAS vision of an Information Commons; however, differences of opinion regarding clinical use and access warrant further research to explore policy and technological solutions.

Recent claims that the Christian tradition justifies destructive research on human embryos have drawn upon an article by the late Professor Gordon Dunstan which appeared in this journal in 1984. Despite its undoubted influence, this article was flawed and seriously misrepresented the tradition of Christian reflection on the moral status of the human embryo.

Mouse embryo cells, primed to differentiate with the hypomethylating agent 5‐azacytidine (5‐aza‐CR), provide an excellent model system in which cellular differentiation can be studied at the molecular level. An inherent advantage of this system is the availability of clonal populations of cells representative of the non‐differentiated precursor, those whose determinative state is that of a specific lineage, and the end stage, phenotypically mature cell. Analysis of these cultures at the cellular and molecular level will advance our understanding of requirements for (...) and the mechanism of action of growth modulators as well as the necessity for controlled expression of certain proto‐oncogenes. At a more fundamental level, the system can be used to identify, isolate and characterize genes whose expression alters the phenotypic fate of cells. (shrink)

In this essay I show that Structuralism, in order to combat the impression that it is “untenable and outmoded,” needs to be attached to a phenomenology of transcendental intersubjectivity. My argument for this conclusion is: 1) that Peter Caws is right in arguing that Structuralism needs a notion of the transcendental subject because its objects, qua intentional, presuppose such a subject; 2) the objects withwhich Structuralism is concemed are objects in the sense that Husserl speaks of objects ofthe spiritual (...) world; and, 3) the spiritual world, indeed the world in general, is constituted intersubjectively. Therefore, Structuralism needs a notion of transcendental intersubjectivity.Dans cet essai, je démontre que le structuralisme doit être rattaché à une phénoménologie de l’intersubjectivité transcendantale afin d’éviter l’impression qu’il donne d’être «intenable et démodé». J’appuie cette conclusion à l’aide des arguments suivants: 1) Peter Caws a raison d’arguer que le structuralisme a besoin d’une notion de sujet transcendantal parce que ses objets, en tant qu’intentionnels, présupposent un tel sujet; 2) les objets dont s’occupe le structuralisme sont des objets au sens oú Husserl parle d’objets du monde spirituel; et 3) le monde spirituel, enfait le monde en général, est constitué de façon intersubjective. Ainsi, le structuralisme requiert une notion d’intersubjectivité transcendantale. (shrink)

This article investigates the propensity for academic dishonesty by university students using the partitioning method of decision tree analysis. A set of prediction rules are presented, and conclusions are drawn. To provide context for the decision tree approach, the partition process is compared with results of more traditional probit regression models. Results of the decision tree analysis complement the probit models in terms of predictive accuracy and confirm results previously found in the literature. In particular, students’ moral character—whether they believe (...) cheating is acceptable—is found to be the most important factor in determining the propensity for academic dishonesty. (shrink)

What is the future of Philosophy of education? Or as many of scholars and thinkers in this final ‘future-focused’ collective piece from the philosophy of education in a new key Series put it, what are the futures—plural and multiple—of the intersections of ‘philosophy’ and ‘education?’ What is ‘Philosophy’; and what is ‘Education’, and what role may ‘enquiry’ play? Is the future of education and philosophy embracing—or at least taking seriously—and thinking with Indigenous ethicoontoepistemologies? And, perhaps most importantly, what is that (...) ‘Future’? These debates have been located in the work of diverse scholars: from the West, from Global South, from indigenous thinkers. In this collective piece, we purposefully juxtapose diverse takes on the future of these intersections. We have given up the urge to organise, place together, separate with subheadings or connect the paragraphs that follow. Instead, we let these philosophers of education and thinkers who use philosophical texts and ideas to sit together in one long read as potentially ‘strange and unusual bedfellows’. This text urges us to understand how these scholars and thinkers perceive our educational philosophical futures, and how the work and thinking they have done on thinking about what the future of that new key in philosophy of education may look like is embedded in a much deeper and richer literature, and personal experience. (shrink)

The Anthropocene is a term described by Earth Systems Science to capture the recent rupture in the history of the Earth where human action has acquired the power to alter the Earth System as a whole. While normative conclusions cannot be logically derived from this descriptive fact, this paper argues that law and philosophy ought to develop responses that are ordered around human beings. Rather than arguing for legal rights or extending rights to nature, this paper focuses on obligations. Drawing (...) on Hans Jonas, it argues that obligations are a more appropriate tool for cultivating human plurality, restraining human action and protecting future generations. (shrink)

Over the last century, the world's urban population increased from 224 million to over 3.5 billion, and advances in manufacturing, transportation, and communication technologies brought virtually limitless lifestyle and identity options, as well as the greatest inequalities of wealth, risk, and opportunity in history. Yet, as momentous as these changes are, they are dwarfed by the fact that human activity is now affecting planetary processes like climate. Justice concerns about future generations are no longer academic curiosities; they are global ethical (...) imperatives. This talk by Dr. Peter D. Hershock builds on recent efforts to craft an ethics of global justice around the "social emotion" of compassion, making use of Buddhist conceptual resources to de-link justice from fictions of equality and conceive it, instead, as a dynamic function of relationally-achieved equity and diversity. (shrink)

The Experiential Therapist steps outside of the medical model to explore alternative ways of thinking about mental health disorders. Peter D. Ladd argues that successful treatment results from an informed understanding of a patient’s experience, not an ability to name and categorize difficult experiences as classical disorders.

Hegemony is one of the most widely diffused concepts in the contemporary social sciences and humanities internationally, interpreted in a variety of ways in different disciplinary and national contexts. However, its contemporary relevance and conceptual coherence has recently been challenged by various theories of ‘posthegemony’. This article offers a critical assessment of this theoretical initiative. In the first part of the article, I distinguish between three main versions of posthegemony – temporal, foundational and expansive – characterized by different understandings of (...) the temporal and logical implications of hegemony. I then offer a critical assessment of the shared presuppositions of these theories, including their ‘pre-Gramscianism’, their indebtedness to Laclau and Mouffe’s formulation of hegemony, and their characterization of hegemony in terms compatible with modern theories of sovereignty. I conclude by arguing that the contradictions and oversights of the debate on posthegemony encourage us to undertake a reassessment of the real historical complexity of hegemonic politics and its different traditions of conceptualization. (shrink)

A historical perspective on the future of the car Content Type Journal Article Pages 1-3 DOI 10.1007/s11016-010-9479-z Authors Peter D. Norton, Department of Science, Technology and Society, University of Virginia, Charlottesville, VA 22904-4744, USA Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

Much of our understanding of human thinking is based on probabilistic models. This innovative book by Jerome R. Busemeyer and Peter D. Bruza argues that, actually, the underlying mathematical structures from quantum theory provide a much better account of human thinking than traditional models. They introduce the foundations for modelling probabilistic-dynamic systems using two aspects of quantum theory. The first, 'contextuality', is a way to understand interference effects found with inferences and decisions under conditions of uncertainty. The second, 'quantum (...) entanglement', allows cognitive phenomena to be modeled in non-reductionist ways. Employing these principles drawn from quantum theory allows us to view human cognition and decision in a totally new light. Introducing the basic principles in an easy-to-follow way, this book does not assume a physics background or a quantum brain and comes complete with a tutorial and fully worked-out applications in important areas of cognition and decision. (shrink)

This distinctive collection by scholars from around the world focuses upon the cultural, educational, and political significance of Richard Rorty's thought. The nine essays which comprise the collection examine a variety of related themes: Rorty's neopragmatism, his view of philosophy, his philosophy of education and culture, Rorty's comparison between Dewey and Foucault, his relation to postmodern theory, and, also his form of political liberalism.

Many calls have been made for more research on social studies teachers’ practices and preservice training. Instructional practices employed by teachers are important for encouraging student learning. However, there is a history of social studies teachers focusing much of their time on teacher-centered instructional techniques that have not demonstrated strong learning for students. Therefore it is important to examine not just how teachers chose to teach, but also where they may have learned to teach. This study examined data from the (...) Teaching and Learning International Survey (TALIS) 2018 of 240 secondary social studies teachers to understand what instructional practices they report employing and their feelings about their preparation. Data analysis provided direct empirical evidence of the power of teacher preparation programs to shape social studies teachers’ instructional practices well into their teaching careers. (shrink)

“Real knowledge,” as I use the term, is the most highly prized form of true belief sought by an epistemic agent. This paper argues that defeasible infinitism provides a good way to characterize real knowledge and it shows how real knowledge can arise from fallible justification. Then, I argue that there are two ways of interpreting Ernest Sosa's account of real knowledge as belief that is aptly formed and capable of being fully defended. On the one hand, if beliefs are (...) aptly formed only if they have a specific causal etiology, namely that they are efficiently caused fully or partially by virtuous characteristics of the epistemic agent, then Sosa's account falls prey to what I call the problem of the Hazard of Empirical Disconfirmation. The HED problem applies to all forms of causal accounts of real knowledge and is simply that as we gain more empirical knowledge about the causal origins of our true beliefs that are the most highly prized we will discover that they do not always satisfy the required efficient causal constraints. Bluntly put, having sufficiently good reasons for our beliefs might not require that the beliefs have the requisite efficient causal etiology. On the other hand, there is a way of interpreting Sosa's views that does not include an efficient causal prerequisite. That interpretation makes Sosa's account of real knowledge almost identical to defeasible infinitism but expressed in an alternate vocabulary. Such a view is not subject to the HED problem and it can solve the deep problem in epistemology, namely how to get epistemically certain knowledge from fallible justification. (shrink)

This paper explores relationships between environment and education after the Covid-19 pandemic through the lens of philosophy of education in a new key developed by Michael Peters and the Philosophy of Education Society of Australasia. The paper is collectively written by 15 authors who responded to the question: Who remembers Greta Thunberg? Their answers are classified into four main themes and corresponding sections. The first section, ‘As we bake the earth, let's try and bake it from scratch’, gathers wider philosophical (...) considerations about the intersection between environment, education, and the pandemic. The second section, ‘Bump in the road or a catalyst for structural change?’, looks more closely into issues pertaining to education. The third section, ‘If you choose to fail us, we will never forgive you’, focuses to Greta Thunberg’s messages and their responses. The last section, ‘Towards a new normal’, explores future scenarios and develops recommendations for critical emancipatory action. The concluding part brings these insights together, showing that resulting synergy between the answers offers much more then the sum of articles’ parts. With its ethos of collectivity, interconnectedness, and solidarity, philosophy of education in a new key is a crucial tool for development of post-pandemic education. (shrink)

In recent years there has been widespread agreement among Bishop Butler's commentators and critics concerning the nature of his “official” position as a moral philosopher. His moral epistemology is a form of moral sensism, its cognitive aspect best described, after Sidgwick, as perceptual intuitionism. His normative theory is strongly deontologistic in character, and as a moral psychologist he is still celebrated as a devastating critic of psychological egoism and hedonism. Understandably enough, there has been a tendency to discount those remarkable (...) passages in Sermons XI and XII in which Butler seems to be defending an almost diametrically opposed position, compounded of a rationalistic epistemology, a hedonistic-utilitarian normative theory, and a form of psychological egoism. Thus G. D. Broad finds flatly inconsistent those passages in which Butler seems to make self-love coordinate with conscience in its moral authority. When Butler asserts that on calm reflection one is unable to justify any course of action contrary to one's own happiness, Broad maintains that in context this statement must be understood not as a presentation of Butler's own view, but as “a hypothetical concession to an imaginary opponent.” Butler, Broad thinks, is merely once again trying to convince people that reasonable self-love and the dictates of conscience do not conflict. Similarly, A. Duncan-Jones argues that the apparent inconsistency in the passage in question is removed once we understand that Butler is only refuting the egoists' contention that self-love and virtuous benevolence are necessarily opposed. (shrink)

We suggest that in the particular context of medical education, ethics can be considered in a similar way to other kinds of knowledge that are categorised and shaped by academics in the context of wider society. Moreover, the study of medical ethics education is translational in a manner loosely analogous to the study of medical education as adjunct to translational medicine. Some have suggested there is merit in the idea that much as translational research attempts to connect the laboratory scientist's (...) work to its implications for patient care, translational ethics focuses on bringing ethics scholarship into the sphere of personal and public action. We distinguish the term ‘translational ethics’ (the study of ethics being translated between academy, classroom and clinic) from other prominent definitions in the bioethics literature. To do this, we build off a notion of knowledge translation that focuses on the nonlinear movement of information that comes to professionals through multiple competing sources. We suggest that this knowledge, and particularly knowledge about ethics, becomes embodied by the individual. It is through a reflective practice that internally embedded ethics knowledge might be modified, and this work might be best carried out with a moral community that maintains a sense of practical wisdom. Applying this translational approach to the study of medical ethics education can be both academically relevant and practically useful. This view of translation can help bridge the evident, multidirectional relationships between research, education and performance. It might also create further opportunities to develop medical ethics education theory. (shrink)

An ongoing debate among legal scholars and public health advocates is the role of litigation in shaping public policy. For the most part, the debate has been waged at a conceptual level, with opponents and proponents arguing within fairly well-defined boundaries. The debate has been based either on speculation of what litigation could achieve or on ideological grounds as to why litigation should or should not be used this way. With the exception of Rosenberg's study of how litigation shaped policy (...) in civil rights, abortion, and environmental matters, there is almost no empirical support for either position.In recent years, the most ardent proponents of litigation as public policy have been public health advocates. Perhaps out of frustration with the inability to achieve desired public health goals through the legislative branch of government, public health advocates have pursued litigation as an alternative strategy. Beginning with tobacco class action litigation in the early 1990s and continuing with litigation against gun manufacturers at the end of that decade, public health advocates have waged a veritable litigation assault aimed at changing how public health policy is formed. (shrink)

This chapter is offered as a contribution to the logic of down below. We attempt to demonstrate that the nature of human agency necessitates that there actually be such a logic. The ensuing sections develop the suggestion that cognition down below has a structure strikingly similar to the physical structure of quantum states. In its general form, this is not an idea that originates with the present authors. It is known that there exist mathematical models from the cognitive science of (...) cognition down below that have certain formal similarities to quantum mechanics. We want to take this idea seriously. We will propose that the subspaces of von Neumann-Birkhoff lattices are too crisp for modelling requisite cognitive aspects in relation to subsymbolic logic. Instead, we adopt an approach which relies on projections into nonorthogonal density states. The projection operator is motivated from cues which probe human memory. (shrink)

This article is a collective writing experiment undertaken by philosophers of education affiliated with the PESGB (Philosophy of Education Society of Great Britain). When asked to reflect on questions concerning the Philosophy of Education in a New Key in May 2020, it was unsurprising that the effects of the coronavirus pandemic on society and on education were foremost in our minds. We wanted to consider important philosophical and educational questions raised by the pandemic, while acknowledging that, first and foremost, it (...) is a human tragedy. With nearly a million deaths reported worldwide to date, and with everyone effected in one way or another by Covid-19, there is a degree of discomfort, and a responsibility to be sensitive, in reflecting and writing about it academically. Members of this ‘Covid Collective’ come from various countries, with perspectives from Great Britain and Ireland well represented, and we see academic practice as a globally connected enterprise, especially since the digital revolution in academic publishing. The concerns raised in this article relate to but move beyond Covid-19, reflecting the impact of neoliberalism [and other political developments] on geopolitics with educational concerns as central to our focus. (shrink)

Many observers have argued that the US health care system could be more efficient, and achieve better outcomes if providers focused more on improving the community's health, not just the welfare of individual patients. The passage of the Affordable Care Act in 2010 seemed to herald the promise of such reforms, and greater integration of the health care and public systems. In this article, we reassess the quest for integration, a quest we call the “integration project.” After examining the modest (...) steps taken so far toward integration, we consider some conceptual barriers to integration as well as some of the risks it might portend for the public health system. Our assessment contributes to wide-ranging debates among public health advocates, practitioners, and policymakers as to the health care system's role in protecting public health, and how the public health system can best be organized to meet expected population health challenges. (shrink)

This deeply informed book introduces the basic teachings and practices of Buddhism and their spread across Asia. Peter D. Hershock explores the history of the enduring Japanese tradition of Zen—from its beginnings as a form of Buddhist thought and practice imported from China to its reinvention in medieval Japan as a force for religious, political, and cultural change to its role in Japan’s embrace of modernity. He deftly blends historical detail with the felt experiences of Zen practitioners grappling with (...) the meanings of human suffering, personal freedom, and the integration of social and spiritual progress. (shrink)

Uses Buddhist philosophy to discuss diversity as a value, one that can contribute to equity in a globalizing world.

This talk by Dr. Peter D. Hershock makes use of Buddhist conceptual resources to assess how the emerging global attention economy and the confluence of big data, machine learning, and artificial intelligence are reshaping the human experience. Like the Copernican revolution, which de-centered humanity in the cosmos, the intelligence revolution is dissolving once-foundational certainties and opening new realms of opportunity. The results are almost sure to be mixed. Smart cities will be more efficient and more livable; smart health care (...) can potentially reach and benefit the half of humanity that now lacks even basic health services. Yet, smart services and the algorithmic tailoring of individual experience have the potential to first supplement and eventually supplant intelligent human practices, rendering human intelligence superfluous. Focusing in particular on the karmic dimensions of these transformations, the talk will consider who we need to be present as in order to resist the allure of digital sirens and direct the intelligence revolution toward a truly equitable and ethical re-centering of the human. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Out of the Order of Number”: Benjamin and Irigaray Toward a Politics of Pure MeansPeter Fenves* (bio)At the heart of the legal orders that arose in conjunction with the Enlightenment idea of law as rules of conduct universally applicable to all those who belong to a properly instituted political body lies a formula for the justification of the violence on which the law depends in order for it to (...) be an actual, effective, and therefore “living” law—and not merely an idea: violence is justified insofar as it is a means for the control of those violent acts that are not themselves means for the control of immediate threats of violence. As Walter Benjamin indicates in the opening paragraphs of his most explicit exposition of legal and political theory, “Toward the Critique of Violence” (1921), the justification of violence as a means is the point of contention around which arguments over the origin, nature, and purpose of the modern state endlessly circle. Justified violence is supposed to be of a different order than unjustified violence, and so in the context of legal reasoning it is no longer called “violence” but “coercion” or “punishment.” Yet as the formula for the justification of violence indicates, the violence of the legal order is not in general sanctioned for the purpose of subduing immediate threats to one’s own life—this is the justification for the extralegal violence of “private persons”—but for the purpose of preserving the law itself: the law is inviolable. As long as the legal order makes the law effective and thus gives it life, it, too, is inviolable, and all violence other than its own can henceforth be interpreted as an immediate threat not to life itself—however this may be understood—but to the legal order. The end of legally sanctioned violence, its purpose and function, is not to put an end to violence as such but, instead, to thwart all threats to the law in the name of which violence can be sanctioned. Everything that enters into the space over which the legal order imposes its sentence is therefore implicated in the disquieting—or, as Benjamin says, “rotten” [GS 2: 188; SW 242]—ambiguity of legal violence understood as a means whose justification lies in the application of the law: the legal order can justify its own violence only insofar as this violence is a means to an end, but the end it serves can never be separated from itself as means, for the law, by virtue of its universality, is at bottom unconcerned with the life of those upon whom the violence it justifies is exercised or with the life of those whom this violence is supposed to protect. The violence of the legal order is concerned solely with itself, with its own majesty—without, however, ceasing to present itself as a means and reverting to what all legal violence once was: immediate manifestation.Nothing that enters into the space of the legal order can escape the ambiguity of the violence through which the law comes to life. Or at least nothing can escape this ambiguity as long as the space on which the legal order founds itself runs counter to the sole space that accords with the strict universality of the law: a universally accessible, indivisible, and undivided space that is nevertheless capable of the greatest degree of discreteness, differentiation, and individuation. In place of this space the legal orders that arose in Europe over the course of the last five centuries set out something like its parody: [End Page 43] homogeneous and yet fully divided domains whose divisions from one another are momenta of the extralegal violence to which each legal order owes its origin. At least one species of being has always been seen to move outside the space of the legal order—a species whose specificity, speciesness, and spatiality have thus given rise to interminable analysis: the angels. The space that angels traverse—and, in particular, the ones who enter into Luce Irigaray’s writings—does not suffer division into homogeneous domains but does not therefore amount to an undifferentiated expanse, a yawning abyss, or a formless chaos; it is... (shrink)

This website is a supplement to Peter D. McDonald’s book The Literature Police: Apartheid Censorship and its Cultural Consequences, which was first published by Oxford University Press in February 2009. It is intended for anyone curious to know more about the subject and for those interested in doing further research into the vast topic of apartheid censorship.

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological (...) services by age. (shrink)