Building Better Health Care Leadership for Canada explains the development and implementation of the Executive Training in Research Application program. Managed and funded by the Canadian Health Services Research Foundation in partnership with the Canadian Medical Association, the Canadian Nursing Association, and the Canadian College of Health Care executives, EXTRA is a two-year national fellowship program that uses the principles of adult learning theory as well as practical projects to educate senior health care leaders in making more consistent use of (...) research evidence in their management roles. Fellows apply the theory learned in residency sessions and educational activities to projects within their home organizations. The authors identify the imperative for better use of evidence, outline the core elements of the curriculum, and capture the real-world experience of regional leaders and fellows involved in making specific changes informed by research-based evidence within their organization. Contributors include Jean-Louis Denis, Terrence Sullivan, Owen Adams, Malcolm Anderson, Lynda Atack, Robert Bell, Sam G Campbell, Sylvie Cantin, Ward Flemons, Dorothy Forbes, J. Sonja Glass, Paula Goering, Karen Golden-Biddle, Jeffrey S. Hoch, Paul Lamarche, Ann Langley, John N. Lavis, Jonathan Lomas, Margo Orchard, Raynald Pineault, Brian D. Postl, Christine Power, Trish Reay, Jean Rochon, Denis A. Roy, Andrea Seymour, Samuel B. Sheps, Micheline Ste-Marie, Nina Stipich, David Streiner, Carl Taillon, and Muriah Umoquit. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 695 Salvation Outside the Church? Tracing the History of the Catholic Response. By FRANCIS A. SULLIVAN. New York/Mahwah: Paulist Press, 1992. Pp. i + 224. $12.95 (paper). The subtitle of the volume describes well its purpose and content. The author surveys in chronological order, beginning with the earliest ecclesiastical writers and ending with John Paul II, the various interpretations of the axiom extra ecclesiam nulla salus. What (...) prompted Sullivan to undertake a historical rather than systematic approach in his volume is the conviction that without taking into account the historical and cultural factors that conditioned the formulation of this axiom it is impossible to make sense of the shift from the exclusivism of the pre-Vatican II Church to the inclusiveness of Vatican II and post-Vatican II theology with regard to the salvation of those who are not members of,the Roman Catholic Church. The principle that guides Sullivan's attempt to disclose the meaning embodied in the manifold formulations of the axiom " there is no salvation outside the Church" is Pope John XXHI's distinction between " the substance of the ancient doctrine of the deposit of faith " and " the way in which it is presented," and the more recent emphasis of the Declaration Mysterium Ecclesiae (1973) on the historical condition affecting the expression of divine revelation. As a historical study, Salvation Outside the Church? is an excellent continuation of Louis Caperan's two-volume work Le probleme du salut des infideles, which is still unavailable in English. Obviously an over· view of almost two thousand years of theological discussion of this problem has to be highly selective if one is not to miss the forest for the trees, and Sullivan's choice of authors as well as of historical periods for discussion is judiciously made. If a complaint is to be made in this regard, it is that he has focused too much attention on magisterial documents, and Roman documents at that, and not enough on contemporary theology. True, he devotes a chapter to the theory of " anonymous Christians," espoused mainly by Karl Rahner (chapter 10), and defends it against criticisms by Henri de Lubac, Hans Urs von Balthasar, Hans Kiing, and Max Seckler. He is well aware that Rahner's theory has become the position of mainstream Catholic theology and cites authors who support it in one way or another (p. 181). However, a book that claims to present " the Catholic response " to the problem posed by the axiom extra ecclesiam nulla salus should, one would expect, have discussed in greater detail the various positions of contemporary Catholic theologians on this issue. It is to be fervently hoped that Sullivan will take up this task in his next book. 696 BOOK REVIEWS Sullivan's basic thesis is that the substance underlying the various negative formulations of the axiom extra ecclesiam nulla salus is the positive belief ithat " God has assigned to the church a necessary role in the accomplishment of his plan for the salvation of humanity " (p. 12). Such a thesis is, of course, neither new nor startling. Hans Kling had already said that much in his 1967 Die Kirche (English translation, p. 318). What is helpful in Sullivan's account is his explanation of both the intent of those who affirmed this axiom with its apparent exclusiveness and the limitations that prevented them from perceiving the universality of God's saving grace. With regard to intent, Sullivan shows con· vincingly that the patristic usage of the axiom is intended as a warning for those Christians who had separated themselves from the catholica either by schism or by heresy that they must remain within it in order to be saved, whereas ithe medieval usage is intended to warn pagans and Jews that they should accept the message of the Gospel now that it had been announced to them. With regard to limitations, Sullivan singles out two: the geographical and the psychological. On the one hand, there was before the discovery of America the conviction that the world was identical with Christian Europe. This belief led theologians to postulate that the Gospel had been spread throughout the world. On the other hand, their ignorance... (shrink)

The presence or absence of consciousness is the linchpin of taxonomy for disorders of consciousness (DOCs), as well as a focal point for end-of-life decision making for patients with DOCs. Focus on consciousness in this latter context has been criticized for a number of reasons, including the uncertainty of the diagnostic criteria for consciousness, the irrelevance of some forms of consciousness for determining a patient’s interests, and the ambiguous distinction between consciousness and unconsciousness. As a result, there have been recent (...) suggestions that perhaps consciousness ought not to play the focal role that it does in decision making for persons with DOCs, and that other considerations, such as patient and family values, ought to take center stage. In this article, I take a step back and reexamine the meaning of consciousness in the DOC taxonomy. I propose that, while consciousness in DOC taxonomy is defined as “wakeful awareness,” this definition, while clinically expedient, occasions ethical misunderstanding. Using resources from non-Western philosophy of mind, I argue that the form of consciousness that is ethically relevant in DOCs is intransitive, or pure. I contrast this pure experience with transitive consciousness to highlight why ethical conclusions ought not define consciousness solely as “wakeful awareness,” even if clinical criteria do. (shrink)

It is through the dialectics of form and function in architecture, and in particular in the contradiction between the two, that the artistic and aesthetic dimensions of architecture can be developed: its expression of ideas, reflection of human identity, its ethics of responsibility to engage human culture, and its beauty. Architecture is capable of facilitating intellectual development, and of expressing ideas which transcend its material, programmatic and structural functions; in short, architecture is capable of being art, or poetry. Through its (...) forms, and in the dialectic between form and function, architecture is capable of expressing important aspects of individual and cultural identity, as a humanistic art form. As a form of artistic expression, architecture can have more value in people’s lives. (shrink)

Gilbert (2015) suggests that predictive and advisory brain implants threaten autonomy. He analyzes these threats in terms of one patient's “sense of autonomy,” reporting that the patient felt more...

Did modernity begin with the Renaissance and end with post-modernism? Dupre challenges both these assumptions, discussing the roots, development and impact of modern thought and tracing the principles of modernity to the late 14th century.

With several never-before published writings, this volume gathers Althusser's major essays on psychoanalytic thought----documenting his intense and ambivalent relationship with Lacan, and dramatizing his intellectual journey and troubled personal life.

Argues that outdated institutional structures and higher educational philosophies are negatively contrasting with significant changes in today's faculties and student bodies with a result that higher education is more competitive and less ...

This essay argues for the necessity of a phenomenological perspective on mind and mental disorder while also emphasizing the inherent difficulty of adopting such an orientation. Here I adopt a via negativa approach—by considering three forms of error that the phenomenologists Edmund Husserl, Martin Heidegger, and Maurice Merleau-Ponty recognize as needing to be guarded against, lest they subvert the project of attaining an adequate understanding of consciousness or subjectivity: namely (1) prejudices deriving from theory and common sense, (2) distorting effects (...) of reflection, and (3) what Heidegger termed the forgetting of the ontological difference. Phenomenology insists on the importance of studying subjective life while also acknowledging the epistemological paradoxes inherent to this domain—a domain whose very self-evidence is inseparable from mystery, whose visibility conceals a deeper invisibility. I consider these issues in light of phenomenology’s relevance for certain issues in psychopathology and literary representation. (shrink)

Purpose of review This review considers the literature on ethical and conceptual issues in eating disorders from the last 18 months. Some reference to earlier work is necessary in order to provide context for the recent findings from research that is ongoing. -/- Recent findings Empirical ethics research on anorexia nervosa includes novel ethical and conceptual findings on the role of authenticity and personal identity in individuals’ reports of their experience, as well as new evidence on the role of affective (...) states and values in decision making at later stages of the illness. Evidence points to the hypothesis that anorexia nervosa may be a distinct affective syndrome that organizes feelings and emotions in accordance with a fixed idea. -/- Summary There has been impressive progress in empirical ethics research on anorexia nervosa, with important implications for ethical and conceptual issues that surround decision-making capacity and our understanding of the illness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:PHARAOH'S.MAGICIANS: THE ETHICS AND EFFICA:CY OF HUMAN FETAiL TISSUE TRANSPLANTS ROBERT BARRY, O.P. Program for the Study of Religion University of Illinois, Champaign-Urbana DARREL KESLER Department of Animal Sciences University of Illinois, Champaign-Urbana. IN RECENT YEARS increasing attention ha;s been given to v:rurious types of scientific riese,arch involving the human fetus. In the 1970s, :a tremendous amount of concern was expres1 sed IJ.'egiaroing the fetus,a;.s a rSU!bject of e~erimenrtation. (...) In this debate, the announced " research impeiiat:i:ve " was pos,ed against other moral imperativ;es.1 Following much soctiet :JaJl drebarte, protootlive meiaisumeis 1 WeIDe il!dopited 1by oompireihensive regiutatiions in 1975 estaiblishiing protections foT a number of research sUibjects. These regulrutions protect the fetus from non-beneficiail experimentation. that iworuild pose more than minima;l risk rto the fetus. Current debates in science and ethics now swirl arlOiund a new topic regarding human '.fetal life: the fetus as a sourrce of tissue for triansplaintation into other persons ais run e~erimental thempy. It is an issue that is rapidly moving torward the same Jevel of" research imperative" as did the earlier debate on the 1 See Paul Ramsey, The Ethics of Fetal Research (New Haven: Yale University Press, 1975): "Today one often hears statements like' Fetal Research must be done,' or 'It would be immoral not to do this research'" (P. xv). The validity of such opinions and utterances entirely depends on a netbenefits ethics, and the validity of that moral universe has been called increasingly into question in recent years. 575 576 ROBERT BARRY, O.P. AND DARREL KESLER ~etus as subject. Recently,,a new level of intensity was added to this deharte rby the imposition of an indefinite moratorium on federal support for research on transplantrution experiments inv;olving human.fetirul tissue and other!humans. 1Thls " :indefinite moratorium " w1as a result of a process that 1 began with research p110posaJs considered rby the National In- 'stituites of Health (NIH) in October 1987. In Marich 1988 a momtorium wa;g plaioed on the r:eseareh, and an 1advisory panel was summoned to consider the ethical issues involved. This panel presented 1a cveoommendation for the procedures. However, the Secretary of the Department of Health and Ruman Se1wfoes (HHS), Dr. Louis Sullivan, decided against the research proposal on etmcal grounds. His decision w:as with the 'concU'l'Tenoe of the Assistant Secretary :£m.· Health of HHS, Dr. James Mason, who has Tespons~bility for the NIH. Secretary SulliV1an's decision was oommumcarted to the Acting Director of the NIH, Dr. William Raub, in Nov,ember 1989. A :firestorm of criticism erupted from,rudv;ocates of this research, including the Council of Judicial and Ethical Affairs of tihe American Medical Association, which 5.n June 1989 called for an end to the:ban.2 In this article, we wish to question both the science and the ethics of the rproposed fotal tissue transplantation therapy. We!Will 1support the £edeml funding moratorium and surggest new pmtections for the fetuses (whether po,ssibly living or de2 " Medical Applications of Fetal Tissue Transplantation", JAMA, Vol. 263, No. 4, January 26, 1990, 'PP· 565-570. There has been a.great deal of public debate, not only in the U.S. but also in Europe over whether human embryo research should be supported with public funds. Many Catholic countries in Europe have prohibited such research, while a number of other nations have allowed it. Dickson, D., "Europe Split on Embyro Research", Science, Vol. 242, November 21, 1988, pp. 1117-1118. The most interesting controversy is in West Germany where there is a strong movement to prohibit it because many there believe such an experimentation requires judgments that there are certain forms of human life that do not deserve to survive. Ibid., p. 1117. Many Germans regard these sorts of judgments as too close to those made by Nazis, and there is strong sentiment to prohibit such research altogether. Ibid. HUMAN FETAL TISSUE TRANSPLANTS 577 oea:sed) of elective a.bortfons. We will also describe new reseaooh directions in t~apy.for the diseases in which it is claimed that fetal... (shrink)

The Lonely Labyrinth winds the suggestion that "Kierkegaard was a profoundly sick man, and that the character of his sickness established a privileged perspective for the understanding of his work." In the light of this thesis, his "works turn out to be, not abstruse theologico-philosophical treatises or mysterious aesthetic essays, but successive moves in a complicated dialectic of therapy." They are "efforts... to find not truth but health." Part One of Thompson's book sketches the biographical, psychological, philosophical, and literary background (...) of Kierkegaard's authorship. Part Two--the major division of the book--offers readings of the pseudonymous works from Either/or through Concluding Unscientific Postscript. (shrink)

The distinction between ‘passion’ and ‘emotion’ has been largely overlooked in the history of psychiatry and the psychopathology of affectivity. A version of the distinction that has gone completely unnoticed is the one proposed by Florentine physician Vincenzo Chiarugi (1759–1820). The purpose of the present discussion is to introduce this Italian version of the distinction and to inquire into its origins.

After examining these decisions in their one-period setting, they devote most of the book to a multiperiod context, which adds the long-term perspective most risk management analyses require.