A report of a problem-based learning project on the ethics of terminal care, offered as one of the options available to first year MB ChB students in Edinburgh University Medical School. The project formed part of the 'clinical correlation course' in the new curriculum. Six students took part under the supervision of two clinical tutors and a moral philosopher. The course was case-based and practical with students being given the opportunity over a period of eight weeks to meet patients, relatives (...) and hospital staff at a local geriatrics hospital and terminal care home. The main issue studied was the degree of choice available to patients electing to be treated at home, in hospital or in a hospice. Other issues included: pre-death, disposal of the dead, certification of death, communication with relatives and follow-up bereavement services. (shrink)

One hundred inpatients on an acute hospital elderly care unit and 43 of their relatives were interviewed shortly before hospital discharge. Eighty per cent of elderly patients and their relatives were aware of cardiopulmonary resuscitation (CPR). Television drama was their main source of information. Patients and relatives overestimated the effectiveness of CPR. Eighty-six per cent of patients were willing to be routinely consulted by doctors about their own CPR status, but relatives were less enthusiastic about routine consultation. Patients' and relatives' (...) views about the appropriateness of CPR did not differ significantly. Seventeen percent of patients did not desire CPR. However, 64 per cent of patients were ultimately willing to follow their doctor's advice about the appropriateness of CPR. The conclusion reached is that mentally competent, elderly patients but not their relatives should be routinely consulted about their own desire for CPR in order to avoid resuscitating patients against their wishes. Further research is required to find out how patients would feel about resuscitation if they were terminally ill or chronically confused, and how carers would feel about resuscitating such patients. (shrink)

The case presents a teenage girl, Sam*, in the end stages of a rare disease, with no proven therapeutic options and an investigational hematopoietic stem cell transplant has been offered thr...

In lieu of an abstract, here is a brief excerpt of the content:THE GREAT GATSBY: ROMANCE OR HOLOCAUST? Thomas J. Cousineau Washington College In an otherwise appreciative response to The Great Gatsby, H. L. Mencken expressed a reservation about the plot ofthe novel, which he characterized as "no more than a glorified anecdote" (Claridge 156). Writing to Edmund Wilson, Fitzgerald suggested, in turn, that what Mencken did not find in Gatsby was "any emotional backbone at the very height of it" (...) (Turnbull 342). Critics ofthe novel, however, have tended to overlook the self-evident fact that the novel's ostensible emotional center—the reunion between Gatsby and Daisy—does not possess sufficient significance to justify the classic status that has been largely accorded to Fitzgerald's novel. We need only remember Daisy's effusive appreciation ofGatsby's "beautiful shirts," or the even more telling detail that the truly "romantic" moments in Daisy and Gatsby's relationship all occurred several years earlier in Louisville and that the period of the reunion is scarcely mentioned in the novel to convince ourselves that the putative grandeur of Gatsby's dream does not adequately account for the novel's power or its lasting significance. Reading Gatsby as a novel about its hero's dream makes of it, in fact, a precarious literary achievement, one whose numerous absurdities were perceptively delineated by the English novelist L.P. Hartley, who admired Fitzgerald's literary gifts but thought that he had squandered them in Gatsby. In a 1926 review of the novel, Hartley offered the following summary of its plot: An adventurer of shady antecedents builds a palace at a New York seaside resort, entertains on a scale which Lucullus would have marveled at but could not have approved, and spends untold sums ofmoney, all to 22Thomas J. Cousineau catch the eye ofhis one time sweetheart, who lives on an island opposite, unhappily but very successfully married. At last, after superhuman feats ofostentation and display, the fly walks into the web. A train ofdisasters follows, comparable in quantity and quality with the scale ofthe Great Gatsby's prodigies of hospitality. Coincidence leaps to the helm and throws a mistress under a motor-car. The car does not stop, which, all things considered, is the most natural thing that happens in the book. An injured husband finds the Great Gatsby in suicidal mood sitting on a raft in his artificial lake and (apparently) forestalls him; anyhowthey are both discovered dead. The elder Gatsby is unearthed and gives a pathetic account ofhis son's early years. All the characters behave as though they were entitled to grieve over a great sorrow, and the book closes with the airs oftragedy. (Claridge 178) Minor inaccuracies aside, this must be among the most cogent, disabused responses that the plot of The Great Gatsby has ever received. It is such a welcome antidote to the reams of interpretation ofthe novel produced by critics who, dutifully aping Nick Carraway in this respect, have allowed their conviction as to Gatsby's "greatness" to be matched only by their equally adamant certainty as to the moral tawdriness of Tom and Daisy Buchanan. As Hartley's exasperated summary reminds us, The Great Gatsby, read as the account ofthe eponymous hero's dream, simply cannot support the weight of morally serious interpretation that it would like to invite or that so many ofits critics, in their turn, would like to bestow upon it.1 Nor do we move any closer to appreciating the greatness of Gatsby by shiftingourattention tothe growth in moral awareness thatcountless critics have attributed toNick Carraway, whose self-evaluation as "one ofthe few honest people that I have ever known" (64) should in itself arouse our suspicions.2 As we shall see, the fruits ofNick's presumed moral education The seemingly indestructible resistance to Hartley's lucidity that has been displayed by the great majority ofthe novel's critics may be observed in the chapter that Jeffrey Hart devotes to Gatsby in his recently published Smiling Through the Cultural Catastrophe. Arguing that "magical transformation" is the novel's true subject (230), Hart credits Nick with achieving an "epiphany" whereby he recognizes Gatsby's superiority to "the whole damn bunch put together" (238) and concludes that the larger... (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

Turnbull offers a close and detailed reading of the Parmenides, using his interpretation to illuminate Plato's major late dialogues. The picture presented of Plato's later philosophy is plausible, highly interesting, and original.

Permissivism is the thesis that, for some body of evidence and a proposition p, there is more than one rational doxastic attitude any agent with that evidence can take toward p. Proponents of uniqueness deny permissivism, maintaining that every body of evidence always determines a single rational doxastic attitude. In this paper, we explore the debate between permissivism and uniqueness about evidence, outlining some of the major arguments on each side. We then consider how permissivism can be understood as an (...) underdetermination thesis, and show how this moves the debate forward in fruitful ways: in distinguishing between different types of permissivism, in dispelling classic objections to permissivism, and in shedding light on the relationship between permissivism and evidentialism. (shrink)

Intellectual Impostures seemed at first to create something of dilemma for me. My position was obviously an example of the kind that Sokal and Bricmont's set out to critique, but I found myself entertaining a variety of responses, why be so nasty, so sneering, why overstate the case, why attribute failings of individual's arguments to all of some supposedly homogeneous group be they constructivists, sociologists of science postmodernists or whatever? Why be so earnestly tendentious? Yet, did I not agree with (...) much with what they had to say? I too find plenty of contemporary scholarship obscure and irrelevant, and most importantly, I agree with them about the necessity of criticism, especially political criticism. Hence it seemed inappropriate to respond with equally over the top denunciation. Fortunately, I had time to look at some of the associated literature particularly Flight From Science and Reason and A House Built on Sand where I discovered two writers dealing with important issues in the Culture Wars. Philip Kitcher trying to find some middle ground and a way to recognise that some important and valuable work is being done in Science Studies, and Meera Nanda formulating some telling criticisms of the 'localist' thesis including some of my own work. (shrink)

Jamie Turnbull - Kierkegaard and Socrates: A Study in Philosophy and Faith - Journal of the History of Philosophy 45:3 Journal of the History of Philosophy 45.3 503-504 Muse Search Journals This Journal Contents Reviewed by Jamie Turnbull University of Hertfordshire Jacob Howland. Kierkegaard and Socrates: A Study in Philosophy and Faith. Cambridge-New York: Cambridge University Press, 2006. Pp. xi + 231. Cloth, $80.00. The subject of Jacob Howland's stimulating and insightful book is Kierkegaard's ambivalent relationship to Socrates, (...) as manifest in Kierkegaard's short but important work Philosophical Fragments. Howland's book is the first full length study of Socrates' role in Philosophical Fragments, and thereby in Kierkegaard's thought as a whole. The aim of this work is to establish the critical importance of.. (shrink)

The development of any novel reproductive technology involving manipulation of human embryos is almost inevitably going to be controversial and evoke sincerely held, but diametrically opposing views. The plethora of scientific, ethical and legal issues that surround the clinical use of such techniques fuels this divergence of opinion. During the policy change that was required to allow the use of mitochondrial donation in the UK, many of these issues were intensely scrutinised by a variety of people and in multiple contexts. (...) This extensive process resulted in the publication of several reports that informed the recommendations made to government. We have been intrinsically involved in the development of mitochondrial donation, from refining the basic technique for use in human embryos through to clinical service delivery, and have taken the opportunity in this article to offer our own perspective on the issues it raises. (shrink)

As founder of modern political economics and prominent theorist of the commercial society, Adam Smith’s importance is universally recognized. Little, however, has been done so far to develop Adam Smith’s virtue ethics in the context of modern business, characterized by digitalization. This article aims to rediscover Adam Smith’s virtue of prudence and its relevance for the “e-commercial society”: It presents a framework that considers the central place of prudence in the relationship between a prosperous e-commercial system and societal flourishing. In (...) Smith’s view of the commercial society, prudence enables people to develop habits of character related to industriousness, genuineness, spirit of sacrifice, and self-command, which help in the conduct of a prosperous business activity. This article translates Smith’s virtue of prudence into a language typical of consumers in the current e-commerce scenario, considering their development as persons and the contribution of their activities to the good of society. (shrink)

The underdetermination of scientific theory choice by evidence is a familiar but multifaceted concept in the philosophy of science. I answer two pressing questions about underdetermination: “What is underdetermination?” and “Why should we care about underdetermination?” To answer the first question, I provide a general definition of underdetermination, identify four forms of underdetermination, and discuss major criticisms of each form. To answer the second question, I then survey two common uses of underdetermination in broader arguments against scientific realism and in (...) support of the use of values in scientific theory choice. I conclude that philosophers should also care about underdetermination because it impacts scientists in their practice. (shrink)

Telling a patient that the outcome of his illness is not good, or even hopeless, requires sensitivity and the ability to communicate with him in the setting of a hospital which is an unnatural environment divorced from family and friends. It is a task which must be taught and learned by doctors and nurses.

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 achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

Living out of silence, out of a fully functioning, lovingly attentive mind, and not just out of thought, out of a partially functioning mind, is requisite for depth or profundity in living or relating. A fully attentive, truly silent or meditative mind sees that there is real dualism of time and the timeless and that time and the timeless each has its own unique value. The timeless, or real silence, that which alone can make for depth in one's living and (...) relating, can be there only when, in one's awareness, time and all that is related to time, have come to an end. An examination of a wide variety of statements made by writers, both past and present, shows that these understandings are seldom there in contemporary writings, just as they were not there in writings that have come down to us from the past. 'Living beyond the One and the Many' invites readers to consider the possibility that what is presented in it can bring deep meaning to one's way of living in the world"--Publisher's description, back cover. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.