Background: Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level. Objectives: To describe the experience of intensive care nurses practicing limitation of therapeutic effort. Method: A qualitative, phenomenological study was performed within the intensive care units of the Madrid Hospitals Health Service. Purposeful and snowball sampling methods were used, and data collection methods included semi-structured and unstructured interviews, researcher field notes, and participants’ (...) personal letters. The Giorgi proposal for data analysis was used on the data. Ethical considerations: This study was approved by the Ethical Research Committee of the relevant hospital and by the Ethics Committee of the Rey Juan Carlos University and was guided by the ethical principles of voluntary enrollment, anonymity, privacy, and confidentiality. Results: In total, 22 nurses participated and 3 themes were identified regarding the nurses’ experiences when faced with limitation of therapeutic effort: (a) experiencing relief, (b) accepting the medical decision, and (c) implementing limitation of therapeutic effort. Conclusion: Nurses felt that, although they were burdened with the responsibility of implementing limitation of therapeutic effort, they were being left out of the final decision-making process regarding the same. (shrink)

The hypothesis that family size limitation by parents enhances the upward mobility chances of their children in (post)industrial populations has a long-standing record in many disciplines, including sociology and economics, as well as evolutionary anthropology and social biology. Yet the empirical record supporting or contradicting the theory is surprisingly limited. The aim of this contribution is to develop a test of the effect of family size limitation on children’s intergenerational mobility. This test is applied to an urban population (...) in Belgium that was in the process of experiencing its demographic transition, including the decline of fertility, at the end of the 19th century. The results indicate that the effect of family size was strong, even after controlling for parental social status as well as birth order. Surprisingly, the effects of birth order and family size appear to be largely independent. (shrink)

Dans la Politique, Aristote s’attache à distinguer, pour les articuler et les hiérarchiser, la sphère économique et la sphère politique. Tout en reconnaissant l’autonomie propre des activités économiques, il s’attache à exposer les motifs qui légitiment la limitation de celles-ci par le pouvoir politique. En consacrant l’éminence de la politique par rapport à la sphère marchande, Aristote manifeste l’impérieuse nécessité de subordonner la recherche et l’acquisition des biens et des richesses matérielles – légitimes dans leur ordre – aux activités (...) les plus hautes de l’homme qui, seules, sont susceptibles de lui procurer le bonheur véritable. Recherchées pour elles-mêmes, celles-ci sont l’expression d’une sortie par l’homme d’une logique de l’utilité et témoignent d’une forme authentique de liberté dans laquelle se déploient sa vertu et son excellence. C’est in fine uniquement une éducation à la vie de loisir qui fait advenir, dans la communauté, des individus susceptibles d’assumer la destination morale et politique à laquelle la cité est appelée. Classification JEL : B11. (shrink)

Ever since Elga presented his famous puzzle of Sleeping Beauty, philosophers have debated between the Thirder and the Halfer positions. In his recent article, Daniel Singer proposes a new position, according to which Beauty ought to assign [0, 1/2] to the coin’s landing heads. For this argument, he exploits the similarity between Elga’s original puzzle and Bovens’s modified one. According to Singer, Beauty ought to assign the same credence to H in both versions of Sleeping Beauty. Since Beauty ought to (...) assign [0, 1/2] to H in Bovens’s version, she ought to assign [0, 1/2] to H in Elga’s original version, too. Let us call this “the Impreciser view.” In this paper, I will contend that Singer’s argument fails. First, he depends on false assumptions in defending his Impreciser view. Second, Bovens’s version of Sleeping Beauty turns out to be underdescribed in an important aspect. If we try to provide a fuller description for it, either Beauty does not have to assign [0, 1/2] to H or the thus complemented version of Bovens’s puzzle will fail to be analogous with Elga’s original one. In either case, Singer’s discussion does not establish his Impreciser view. (shrink)

In his medical and scientific works John Wesley provided an interpretation of the universe that was structured, though not pre-ordained, by God. The empirical method he adopted was measured in terms of efficacy and judged according to rationalistic standards. Its practical success, however, was used by Wesley to underpin his vocation of practical piety, which developed out of a holistic view of nature inspired by the spiritualism of Primitive Christianity. Accordingly, the providential ordering of Man and nature meant that safeguarding (...) physical health became a spiritual act, though Wesley separated the discourse of religion and terminology of medicine. This distinction was essential because it ensured intellectual integrity whilst leaving a protective space for religious faith. He made this move on the one hand but saw no contradiction in bringing the discourses of religion and medicine together to serve his mission. For Wesley, social and personal improvement did not rely exclusively on enlightened thinking or religious faith. Rather it depended on showing how rationalism and faith could display separate strengths within an overall framework of holism. (shrink)

This paper will investigate whether constraints on possible forms of limitation of the autonomy of science can be derived from epistemological considerations. Proponents of the autonomy of science often link autonomy with virtues such as epistemic fecundity, capacity to generate technological innovations and capacity to produce neutral expertise. I will critically discuss several important epistemological assumptions underlying these links, in particular the “unpredictability argument”. This will allow me to spell out conditions to be met by any form of (...) class='Hi'>limitation of the autonomy of science to be epistemologically acceptable. These conditions can then be used as a framework to evaluate possible or existing forms of limitations of the autonomy of science. And it will turn out that the option of direct public participation might not be the best way to go to democratize the setting of research agenda. (shrink)

La comprensión de la muerte varía según la época, la cultura, la religión y la edad. Con anterioridad al desarrollo que la ciencia médica ha experimentado desde finales del siglo XIX, en la mayoría de las culturas y religiones había una aceptación de la muerte y se consideraba como parte del ciclo vital de la persona donde se trascendía a una forma celestial y puramente sobrenatural. Los avances científicos de la medicina han venido a cambiar esta situación. La muerte se (...) empezó a ver como un enemigo y dio comienzo a una lucha encarnizada entre ambas. El concepto de "muerte natural" se sustituyó por el de "muerte intervenida," dando origen a numerosas cuestiones relacionadas con la toma de decisiones y actuaciones a realizar en pacientes ingresados y en situación terminal. En este trabajo se realiza una reflexión teórica que tiene como objetivo el análisis bioético acerca de las diferencias entre los aspectos religiosos y culturales relacionados con la práctica de la limitación del esfuerzo terapéutico. The understanding of death varies according to time, culture, religion, and age. Previous to the development that medical sciences has undergone since the end of the XIX Century, in most cultures and religions there have been an acceptation of death and considered as part of the person vital cycle in which one would transcend to a celestial and purely supernatural form. The scientific advances in medicine have emerged to change this situation. Death began to be seen as an enemy and gave rise to an enraged struggle between both of them. The concept of natural death was changed into intervened death, which originated numerous related questions with decision and action taking to be performed in hospitalized patients and those in terminal situation. In this work a theoretical reflection is performed whose objective is the bioethical analysis on the differences among religious and cultural aspects related to the practice of therapeutic effort limitation. (shrink)

This volume presents the philosophical and heuristic framework Cantor developed and explores its lasting effect on modern mathematics. "Establishes a new plateau for historical comprehension of Cantor's monumental contribution to mathematics." --The American Mathematical Monthly.

ABSTRACT It is accepted that treatment of previously competent, now incompetent patients can be limited if that is what the patient would desire, if she were now competent. Expressed past preferences or an advance directive are often taken to constitute sufficient evidence of what a patient would now desire. I distinguish between desires and rational desires. I argue that for a desire to be an expression of a person's autonomy, it must be or satisfy that person's rational desires. A person (...) rationally desires a course of action if that person desires it while being in possession of all available relevant facts, without committing relevant error of logic, and “vividly imagining” what its consequences would be like for her. I argue that some competent, expressed desires obstruct autonomy. I show that several psychological mechanisms operate to prevent a person rationally evaluating what future life in a disabled state would be like. Rational evaluation is difficult. However, treatment limitation, if it is to respect autonomy, must be in accord with a patient's rational desires, and not merely her expressed desires. I illustrate the implications of these arguments for the use of advance directives and for the treatment of competent patients. (shrink)

: As Heidegger acknowledges, our understanding is essentially situated and so limited by the context and tradition into which it is thrown. But this ‘situatedness’ does not exhaust Heidegger's concept of ‘thrownness’. By examining this concept and its grammar, I develop a more complete interpretation. I identify several different kinds of finitude or limitation in our understanding, and touch on ways in which we confront and carry different dimensions of our past.

There is a vast literature that seeks to uncover features underlying moral judgment by eliciting reactions to hypothetical scenarios such as trolley problems. These thought experiments assume that participants accept the outcomes stipulated in the scenarios. Across seven studies, we demonstrate that intuition overrides stipulated outcomes even when participants are explicitly told that an action will result in a particular outcome. Participants instead substitute their own estimates of the probability of outcomes for stipulated outcomes, and these probability estimates in turn (...) influence moral judgments. Our findings demonstrate that intuitive likelihoods are one critical factor in moral judgment, one that is not suspended even in moral dilemmas that explicitly stipulate outcomes. Features thought to underlie moral reasoning, such as intention, may operate, in part, by affecting the intuitive likelihood of outcomes, and, problematically, moral differences between scenarios may be confounded with non-moral intuitive probabilities. (shrink)

This commentary presents an epistemological perspective on grand challenges (GCs) suggesting that the distinction between Umwelt (what social systems observe) and environment (the surrounding but unobserved world) can help us provide deeper analyses of GCs. I argue that indifference to the environment outside the observed Umwelt is a root cause of GCs and suggest that organizations must compensate for society’s inability to address GCs by developing forms of intelligent self-limitation.

Publication date: 2 May 2019 Source: Author: Zoran Mastilo Aim of this paper is to, by means of comparative analysis, demonstrate that contemporary pension systems are limitation factors of development of the Republic of Srpska, and that they should be reformed and improved. Ultimately, pension systems should be the basis for development of the Republic of Srpska. They should significantly improve strengthening of financial markets, enhancement of capital markets, higher growth rates of the Republic of Srpska, idecrease of unemployment. (...) Private pension funds are to change the habits and ideas of every future insurance holder, aiming to make the pension rights a matter of concern of every individual, instead being the obligation and ballast of the society. Today, stabile financing of pension systems and their funds is becoming increasingly questionable. A gap is emerging between the area of rights gained by law and financial possibilities for their implementation. Pay-as-you-go systems, i.e. systems of inter-generation solidarityare particularly endangered. Adequate systematization of gathered data, i.e. evidence, should provide conclusions that pension systems are a limitation todevelopment of national economy. This claim is present in underdeveloped and developing countries, with developed economies also facing grave problems. (shrink)

The usual objections to infinite numbers, and classes, and series, and the notion that the infinite as such is self-contradictory, may... be dismissed as groundless. There remains, however, a very grave difficulty, connected with the contradiction [of the class of all classes not members of themselves]. This difficulty does not concern the infinite as such, but only certain very large infinite classes.

The article deals with a study of a distinct criminal punishment established in the Criminal Code and the Code of Punishment Enforcement of the Republic of Lithuania—restriction of liberty, as an alternative to imprisonment. Without investigating extensively the course of development of this penalty, in the article it is sought to overview the development trends of restriction of liberty; analyse the problems of enforcing this penalty and suggest measures to eliminate them; investigate whether the legal regulation of Lithuania is in (...) line with the provisions of the main international instruments relating to non-custodial sanctions (1990 United Nations Standard Minimum Rules for Non-custodial Measures (the so-called Tokyo Rules), Recommendation R (92) 16 of the Committee of Ministers of the Council of Europe to Member States on the European rules on community sanctions and measures, Recommendation Rec (2000) 22 of the Committee of Ministers of the Council of Europe to Member States on improving the implementation of the European rules on community sanctions and measures); review the progressive legal regulation of restriction of liberty in place in individual states and provide a comparison between the national and foreign experience in relation to the penalty of restriction of liberty. In addition, the article offers guidelines for the improvement of the legal regulation and implementation of the legal institute of restriction of liberty. (shrink)

This is a book review of Cantorian set theory and limitations of size by Michael Hallett.

In June 2015, the major North American and European critical care societies released new joint guidelines that delineate a process-based approach to resolving intractable conflicts over the appropriateness of providing or continuing LST.2 This article frames the new guidelines within the history, ethical arguments, legal landscape, and empirical evidence regarding limitation of LST without surrogate consent in cases of intractable conflict.

To many, judgment has seemed a locus of cognitive agency, a kind of cognitive mental act. In one minimal sense, judgment is something one does. I consider whether judgment is more robustly agential: is it a kind of action done with an aim? The most attractive version of this sort of position takes judging that p to affirming that p with an alethic aim, an aim such as affirming truly. I argue that such views have unacceptable consequences. Acts done with (...) aims, in general, can be based only indirectly on evidence that one would attain the aim in so acting. It follows that if alethic aims theories of judgment were correct, a judgment that p could be based only indirectly on evidence for p. This itself would be problematic. But the problems extend further. Given the connection between judgment and belief-formation, it would follow, further, that the beliefs we form through judgment could at best be only indirectly based on evidence for p. On these theories, the direct bases for a judgment that p would have to be either a belief that p or a belief that it’s likely that p. The former cannot support belief-formation and the latter supports at best epistemically inappropriate belief-formation. I conclude that there is a hard limit on how robustly agential judgment can be. (shrink)

This article explores the paradox between the classical doctrine of divine aseity and the notion of divine self-limitation. Drawing from biblical narratives and theological concepts such as divine accommodation and kenosis, the article shows that God’s choice to enter into a temporal and relational interaction with creation affects God in such a way that God would not have been affected without the creation. Given the foregoing, open and relational theists conceptualised the notion of divine self-limitation in which, as (...) a result of the creation and human libertarian freedom, God cannot maximally exemplify his great-making properties upheld in traditional theism. I argued in this article that although God seems to become vulnerable because of the act of creation, He nevertheless remains a se because He is not only the source of his existence, but the creation of significant others could not cause God to lose his essential attribute of independence. Therefore, God is still omnipotent, omniscient, eternal, immutable and the like because the possession of these divine attributes does not rule out the possibility that God can enter into a temporal relationship with the creatures. Divine self-limitation predicates real limitations of God contrary to the negating language of the Scripture and, therefore, undermines God’s Almightiness.Contribution: It is argued in this article that although it may be possible to speak about God’s vulnerability because of his act of creation, which seems like a hard choice because He is omniscient, a weaker version of divine aseity that ascribes real limitations to God is not viable. (shrink)

PORTER S and O’HALLORAN P. Nursing Inquiry 2012; 19: 18–28 The use and limitation of realistic evaluation as a tool for evidence‐based practice: a critical realist perspectiveIn this paper, we assess realistic evaluation’s articulation with evidence‐based practice (EBP) from the perspective of critical realism. We argue that the adoption by realistic evaluation of a realist causal ontology means that it is better placed to explain complex healthcare interventions than the traditional method used by EBP, the randomized controlled trial (RCT). (...) However, we do not conclude from this that the use of RCTs is without merit, arguing that it is possible to use both methods in combination under the rubric of realist theory. More negatively, we contend that the rejection of critical theory and utopianism by realistic evaluation in favour of the pragmatism of piecemeal social engineering means that it is vulnerable to accusations that it promotes technocratic interpretations of human problems. We conclude that, insofar as realistic evaluation adheres to the ontology of critical realism, it provides a sound contribution to EBP, but insofar as it rejects the critical turn of Bhaskar’s realism, it replicates the technocratic tendencies inherent in EBP. (shrink)

In matters of rights, constitutions tend to avoid settling controversies. With few exceptions, rights are formulated in open-ended language, seeking consensus on an abstraction without purporting to resolve the many moral-political questions implicated by rights. The resulting view has been that rights extend everywhere but are everywhere infringed by legislation seeking to resolve the very moral-political questions the constitution seeks to avoid. The Negotiable Constitution challenges this view. Arguing that underspecified rights call for greater specification, Grégoire C. N. Webber draws (...) on limitation clauses common to most bills of rights to develop a new understanding of the relationship between rights and legislation. The legislature is situated as a key constitutional actor tasked with completing the specification of constitutional rights. In turn, because the constitutional project is incomplete with regards to rights, it is open to being re-negotiated by legislation struggling with the very moral-political questions left underdetermined at the constitutional level. (shrink)

All research has limitations, for example, from paradigm, concept, theory, tradition, and discipline. In this article Lynda Stone describes three exemplars that are variations on limitation and are “extraordinary” in that they change what constitutes future research in each domain. Malcolm Gladwell's present day study of outliers makes a statistical term into a sociological concept. Carlo Ginzburg's study of a sixteenth-century miller who challenges Church doctrine initiates the field of microhistory. Gilles Deleuze and Felix Guattari's philosophy of the rhizome (...) offers a poststructuralist study of the doing of philosophy and the form of philosophical text. Although Gladwell's study is the only one specifically on the topic of outliers, the other two investigations are outliers as well. Overall the three studies demonstrate what can be revealed and learned when limitation is transgressed. This is an important lesson for educational research—wherein heretofore unimagined societal possibility and reform of education might result. (shrink)

The human in continuous century envisage the skepticism. When the human envisage the deficiency of his knowledge, will be in trouble of skepticism, when the knowledge of human fundamentally is doubted, all internal or external impressions will be doubted, so the man envisage the unlimited skepticism. But is it possible and logical? The possibility of it is a psychological question too, but my effort is the epistemological surveying of it. We can survey this question in two ways. One way is (...) justifier reasons of skepticism. Are there sufficient for unlimited skepticism? Every deduction is based on preludes and if they’re uncertain the result will be uncertain too. There any deduction can’t justify unlimited skepticism. The other way is the surveying results of this skepticism. We have beliefs thatnever can doubt them like our existence. This inability express that the unlimited skepticism doesn’t agree the logic of our subject. Moreover the unlimited skepticism brings the mixed continuums. If we doubt anything, doubt this doubting too and this involving haven’t extremity, the demoniac hang that can’t be accepted by our. (shrink)

The claimants brought civil suits against child care institutions and authorities for the sexual abuse to which they were subject whilst under the defendants’ responsibility. These cases were not initiated until the claimants were well into adulthood and began recognising the harms they had suffered, and as a result, their claims were time-barred at first instance. However, after A v Hoare (and Other Appeals), in which the House of Lords significantly altered the laws on limitation, their cases were reheard (...) and allowed to proceed. In this respect, AB and Others v Nugent Care Society; GR v Wirral MBC demonstrates the benefits of the ruling in Hoare; but at the same time, this note argues that the Court of Appeal utilises a problematic conceptualisation of the harm of sexual abuse and the case highlights the potential for inconsistency and uncertainty in such delayed claims following the decision in Hoare—which is not the panacea it initially appears to be. (shrink)

In this paper I argue that, in Leibniz’s mature metaphysics, primary matter is not a positive constituent which must be added to the form in order to have a substance. Primary matter is merely a way to express the negation of some further perfection. It does not have a positive ontological status and merely indicates the limitation or imperfection of a substance. To be sure, Leibniz is less than explicit on this point, and in many texts he writes as (...) if primary matter were a positive constituent of a substance. It seems to me, however, that the view most in keeping with the thrust of his mature philosophical system is that captured by a striking remark of 1695: “Materia rerum est nihilum: id est limitatio [The matter of things is nothing: that is, limitation].” This becomes especially apparent in texts showing that Leibniz’s conception of primary matter corresponds to his conception of creaturely limitation. I start by discussing the notion of primary matter in the scholastic tradition. I then show that although Leibniz places the scholastic terminology of primary matter at a crucial juncture of his metaphysics, he thinks of primary matter in a way which significantly deviates from earlier scholastic views. I conclude that despite his adoption of distinctive terminology of Aristotelian scholasticism, instead of holding a broadly Aristotelian concept of primary matter as the ultimate subject of inherence, Leibniz thinks of primary matter according to a Neoplatonic blue-print in which matter is non-being, privation, mere absence of perfection. (shrink)