Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

The paper discusses regularisation of dualities. A given duality between (concrete) categories, e.g. a variety of algebras and a category of representation spaces, is lifted to a duality between the respective categories of semilattice representations in the category of algebras and the category of spaces. In particular, this gives duality for the regularisation of an irregular variety that has a duality. If the type of the variety includes constants, then the regularisation depends critically on the location or absence of constants (...) within the defining identities. The role of schizophrenic objects is discussed, and a number of applications are given. Among these applications are different forms of regularisation of Priestley, Stone and Pontryagin dualities. (shrink)

This book derives from a 1993 National Endowment for the Humanities Summer Institute on Knowledge, Teaching, and Wisdom. The Institute took place at the University of California, Berkeley, and was co-directed by Keith Lehrer and Nicholas D. Smith. The aims of the Institute were several: we sought to reintroduce wisdom as a topic of discussion among contemporary philosophers, to undertake an historical investigation of how and when and why it was that wisdom faded from philosophical view, and to ask how (...) contemporary epistemological theories might apply to the obviously related subjects of teaching and wisdom. In recruiting participants, Lehrer and Smith put the greatest emphasis on those with professional interests in epistemology and the history of philosophy, of the ancient Greeks especially ancient Greek philosophy (because in the writings all three subjects of the Institute were explicitly related and discussed). But in addition to these two groups, some effort was made also to include others, with academic specializations in a variety of fields other than epistemology and the history of philosophy, to ensure that a broad perspective could be achieved in our discussions. To an obvious extent, the papers in this book reflect the recruitment emphases and variety. They also testify to the extent that the Institute managed to bring life to our subjects, and to raise very old questions in a contemporary context. (shrink)

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional (...) nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg’s Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students’ professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses. (shrink)

Solmsen presents an interesting discussion of Aristotle's physical theory. He considers each topic, such as genesis, time, the infinite, in terms of Aristotle's similarities and differences with Pre-Socratic and Platonic thought. His results are piece-meal because "Aristotle himself does not investigate each topic of his physical system with his mind focused on a final synthesis of all major conclusions."--J. A. B.

We propose an Analogy Principle in the context of Unary Inductive Logic and characterize the probability functions which satisfy it. In particular in the case of a language with just two predicates the probability functions satisfying this principle correspond to solutions of Skyrmsʼ ‘Wheel of Fortune’.

By $\mathfrak{B}_2$ we denote the $\sigma$-ideal of all subsets $A$ of the Cantor set $\{0,1\}^\omega$ such that for every infinite subset $T$ of $\omega$ the restriction $A\mid\{0,1\}^T$ is a proper subset of $\{0,1\}^T$. In this paper we investigate set theoretical properties of this and similar ideals.

By B2 we denote the σ-ideal of all subsets A of the Cantor set {0,1}ω such that for every infinite subset T of ω the restriction A∣{0,1}T is a proper subset of {0,1}T. In this paper we investigate set theoretical properties of this and similar ideals.

An attempt to develop a method for the social sciences based upon a "field theory" of "logico-functional integration of elements" as opposed to older thoroughly monistic or pluralistic approaches. Professor Lins' emphasis upon the unity of the sciences, and his insistence that they use similar methods for the solution of similar problems, produce a rather artificial dialectic in his treatment of the social sciences, and allow him to draw rather trivial conclusions. --J. A. B.

A comprehensive study of Plato's last and most difficult work. Professor Morrow's theme is that in the Laws Plato is applying his basic principles to the precise historical conditions of his time, out of consuming interest in the moral and political development of mankind. The concept of the "mixture" or "mean," as developed in the Politicus and Philebus, is treated as the key to the philosophical interpretation of the Laws, law itself being the "limit"; human nature, the natural environment, and (...) existing laws and customs, the "unlimited." Prof. Morrow places the weight of his interpretation on the latter, since a determination of the actual character of Greek institutions, as Plato knew, seems essential to a correct analysis of the "composite" institutions we find in the Laws.--. (shrink)

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim here is (...) to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)

Following a distinction of the sciences into exact and inexact, based on the kinds of methods and reasoning processes involved in explanation and prediction, the authors briefly develop the peculiar method of the inexact branch, with special emphasis on the systematic use of experts in the formation of limited scientific generalizations, and on the use of simulated experiments.-- J. A. B.

Recent corporate legal and ethical meltdowns suggest that avoiding such harms to companies and to society requires a significant culture change within the organization. This paper addresses the issue of what it takes to change a corporate culture. While conventional wisdom may suggest that a change requires only the institution of an ethics office with proper reporting paths and an ethics code, such an approach is only a beginning. Many large corporations, especially those in danger of legal and ethical catastrophes, (...) need to undertake multiple initiatives to generate a new culture that manifests new values and new vocabularies. A cultural change accomplished by changing large numbers of personnel is expensive in financial and human terms. One component of a less costly approach is to tell new and different stories within the corporation because stories establish the cultural DNA that gives organizations, families, and individuals their identities. Such changes in individual firms, however, are influenced by the ideological assumptions within which and under which the industry and the society operates. (shrink)

[opening paragraph]: Our sense of free will depends upon a balance between reliability and flexibility in relation to cause-and-effect. Without the former, all outcomes would be arbitrary; without the latter, all outcomes would be predetermined. In neither case would there be any way of putting one's will into effect. So much is clear, yet establishing that precarious balance has proved so difficult that Kant himself declared ‘freedom of the will’ to be one of only three metaphysical problems which lie beyond (...) the powers of the human intellect . Western debate on this topic reflects a complex ethical and religious inheritance. Insights from Greek philosophy and Hebrew scripture were combined and filtered through Christian and Jewish traditions which developed in late antiquity and through the middle ages. These formed the context for the Enlightenment, whose dominant thinkers in turn provide the backdrop against which today's scholars act and react. (shrink)

These two texts come from a store of papyrus fragments which are at present being examined and worked over at Oxford. They are the property of the Egypt Exploration Society and will be republished in vol. xxxi of the Oxyrhynchus Papyri as Nos. 2544 and 2534; permission for their separate publication here has been granted by the Society in view of the relevance of the former of them to the article by Mr. W. S. Barrett which appears on pp. 58–71 (...) below. We are much indebted to Mr. Barrett and Professor Hugh Lloyd-Jones for many valuable suggestions and criticisms. The nature of both texts was recognized by R. A. Coles, of Magdalen College, Oxford, one of the collaborators in this article. (shrink)