Objectives: To discover the current state of opinion and practice among doctors in Victoria, Australia, regarding end-of-life decisions and the legalisation of voluntary euthanasia. Longitudinal comparison with similar 1987 and 1993 studies.Design and participants: Cross-sectional postal survey of doctors in Victoria.Results: 53% of doctors in Victoria support the legalisation of voluntary euthanasia. Of doctors who have experienced requests from patients to hasten death, 35% have administered drugs with the intention of hastening death. There is substantial disagreement among doctors concerning the (...) definition of euthanasia.Conclusions: Disagreement among doctors concerning the meaning of the term euthanasia may contribute to misunderstanding in the debate over voluntary euthanasia. Among doctors in Victoria, support for the legalisation of voluntary euthanasia appears to have weakened slightly over the past 17 years. Opinion on this issue is sharply polarised. (shrink)

The Embodied Mind provides a unique, sophisticated treatment of the spontaneous and reflective dimension of human experience.

It’s a familiar fact that there is something it is like to see red, eat chocolate or feel pain. More recently philosophers have insisted that in addition to this objectual phenomenology there is something it is like for me to eat chocolate, and this for-me-ness is no less there than the chocolatishness. Recognizing this subjective feature of consciousness helps shape certain theories of consciousness, introspection and the self. Though it does this heavy philosophical work, and it is supposed to be (...) relatively obvious to anyone who introspects, it is rather difficult to see just what this phenomenal me-ness is supposed to be; indeed, many philosophers deny it exists. In this paper we try to provide a clear sense of what phenomenal me-ness involves, and then then consider some arguments for the existence of phenomenal me-ness experience as well as some accounts of what gives rise to it. In the end, we argue that the plausible senses of me-ness are a good deal thinner than what often seems to be claimed. (shrink)

Codes of conduct are a conspicuous feature of modern business organization, but doubts have been raised regarding their efficacy in ensuring high standards of behavior. Although some of the issues involved have been discussed at some length in the business ethics literature, the amount of systematic empirical evidence on the impact of codes is very limited. This paper seeks to make a contribution to that body of knowledge by studying the policies and procedures of a sample of banks which have (...) signed a statement on banking and the environment promulgated by the United Nations Development Programme. Although some differences are found when compared with a sample of banks which did not sign the Statement, they are not extensive. The implications of the findings, for codes of conduct and for future empirical studies, are then discussed. (shrink)

This discussion paper aims to explore potential ethical and moral implications of (patient) centredness in nursing and healthcare. Healthcare is experiencing a philosophical shift from a perspective where the health professional is positioned as the expert to one that re‐centres care and service provision central to the needs and desires of the persons served. This centred approach to healthcare delivery has gained a moral authority as the right thing to do. However, little attention has been given to its moral and (...) ethical theoretical grounding and potential implications for nurses, persons served and the healthcare system. Based upon a review of academic and grey literature, centredness is proposed as a value‐laden concept in nursing inquiry. Potential moral and ethical implications of centredness on nurses/healthcare providers, persons served and the healthcare system are discussed. These challenges are then considered within the context of normative and relational ethical theories. These perspectives may offer guidance relative to how one should act in those circumstances as well as an understanding as to how interdependency and engagement with the other person(s) can help navigate the challenges of a centred care approach. Viewing centredness through an ethical theoretical lens provides a valuable discourse to nursing in efforts to expand the knowledge base and integrate centred approaches into practice and policy. (shrink)

A mathematical model based upon catastrophe theory is derived to describe the kinematics of the wing beat in Dipteran flight. The parameters of the model correspond to anatomical and physiological characteristics of the insect.

Recent magnetic resonance imaging and pathological studies have indicated that axonal loss is a major contributor to disease progression in multiple sclerosis. 1 H magnetic resonance spectroscopy, through measurement of N -acetyl aspartate, a neuronal marker, provides a unique tool to investigate this. Patients with primary progressive multiple sclerosis have few lesions on conventional MRI, suggesting that changes in normal appearing white matter, such as axonal loss, may be particularly relevant to disease progression in this group. To test this hypothesis (...) NAWM was studied with MRS, measuring the concentration of N -acetyl derived groups. Single-voxel MRS using a water-suppressed PRESS sequence was carried out in 24 patients with primary progressive multiple sclerosis and in 16 age-matched controls. Ratios of metabolite to creatine concentration were calculated in all subjects, and absolute concentrations were measured in 18 patients and all controls. NA/Cr was significantly lower in NAWM in patients than in controls, as was the absolute concentration of NA. There was no significant difference in the absolute concentration of creatine between the groups. This study supports the hypothesis that axonal loss occurs in NAWM in primary progressive multiple sclerosis and may well be a mechanism for disease progression in this group. (shrink)

The Politics of the Soul: Eric Voegelin on Religious Experience includes eight essays examining one of the most profound studies of religious experience to appear in the last century: that of the political philosopher Eric Voegelin. Voegelin is increasingly recognized as a political theorist of exceptional scope and erudition and the most important philosopher of his time since Toynbee, and his treatment of religious experience is a crucial part of his overall analysis of existence and history. This collection of essays (...) by prominenet Voegelin scholars is the first book to explore the relevance of that analysis to the contemporary understanding of political theory, theology, history, and philosophy of consciousness, and as such it constitutes a significant contribution not only to Voegelin scholarship but to the current quest for theoretical foundations. (shrink)

Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public’s health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to (...) be expanded in two ways to reflect a ‘public health notion of post-market effectiveness’, which incorporates normative public health considerations: effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize a vaccine’s effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

The Edinburgh Medical Group Research Project is unique in Britain. Part of its function is to experiment with teaching medical ethics both inside and outside of the Medical School. The papers which follow have been written by two full-time reseach fellows working with the Project and two of the professional advisers, one nursing and one medical. Together they give a picture of the wide scope of exerimental teaching taking place in Edinburgh and present some preliminary results from these experiments.

This book reconstructs the concept and practice of dialectics as a means of grounding a critical theory of society. At the center of this project is the thesis of phronetic criticism or a form of reason that is able to synthesize human value with objective rationality. This book argues that defects in modern forms of social reason are the result of the powers of social structure and the norms and purposes they embody. Increasingly, modern societies are driven not by substantive (...) values concerning human good but by the technical imperatives of economic management leading to a cultural condition of nihilism that has eroded dialectical consciousness. The first half of the book demonstrates the various ways that social power erodes and undermines critical-rational forms of consciousness. The second part of the book constructs an alternative basis for critical reason by showing how it requires seeing human value as essentially ontological: that is, constituted by objective forms of sociality that either promote human freedom or pervert our capacities and drives toward pathological forms of life. The philosophical claim is that a critical theory of ethics must be rooted in these concrete forms of life and that this will serve as a critical vantage point for critical political judgment and transformational praxis. Descent of the Dialectic will be of interest to researchers working in philosophy, political theory, social theory, and critical theory. (shrink)

We propose a naturalistic version of the “guesser–knower” paradigm in which the experimental subject has an opportunity to choose which individual to follow to a hidden food source. This design allows nonhumans to display the attribution of knowledge to another conspecific, rather than a human, in a naturalistic context (finding food), and it is readily adapted to different species.

Different explanations of color vision favor different philosophical positions: Computational vision is more compatible with objectivism (the color is in the object), psychophysics and neurophysiology with subjectivism (the color is in the head). Comparative research suggests that an explanation of color must be both experientialist (unlike objectivism) and ecological (unlike subjectivism). Computational vision's emphasis on optimally prespecified features of the environment (i.e., distal properties, independent of the sensory-motor capacities of the animal) is unsatisfactory. Conceiving of visual perception instead as the (...) visual guidance of activity in an environment that is determined largely by that very activity suggests new directions for research. (shrink)

Although widely studied in other domains, relatively little is known about the metacognitive processes that monitor and control behaviour during reasoning and decision-making. In this paper, we examined the conditions under which two fluency cues are used to monitor initial reasoning: answer fluency, or the speed with which the initial, intuitive answer is produced, and perceptual fluency, or the ease with which problems can be read. The first two experiments demonstrated that answer fluency reliably predicted Feeling of Rightness judgments to (...) conditional inferences and base rate problems, which subsequently predicted the amount of deliberate processing as measured by thinking time and answer changes; answer fluency also predicted retrospective confidence judgments. Moreover, the effect of answer fluency on reasoning was independent from the effect of perceptual fluency, establishing that these are empirically independent constructs. In five experiments with a variety of reasoning problems similar to those of Alter et al., we found no effect of perceptual fluency on FOR, retrospective confidence or accuracy; however, we did observe that participants spent more time thinking about hard to read stimuli, although this additional time did not result in answer changes. In our final two experiments, we found that perceptual disfluency increased accuracy on the CRT, but only amongst participants of high cognitive ability. As Alter et al.’s samples were gathered from prestigious universities, collectively, the data to this point suggest that perceptual fluency prompts additional processing in general, but this processing may results in higher accuracy only for the most cognitively able. (shrink)

The analysis of dispositions is used to consider cases where the effect of one disposition operating is the existence of another disposition. This may arise from rearrangements within aggregated structures of dispositional parts, or, it is argued, also as stages of derivative dispositions within a set of multiple generative levels. Inspection of examples in both classical and quantum physics suggests a general principle of `Conditional Forward Causation': that dispositions act 'forwards' in a way conditional on certain circumstances or occasions already (...) existing at the `later' levels. (shrink)

Reporting peers’ counterproductive work behaviors (CWBs) is important for maintaining an ethical organization, but is a significant and potentially risky action. In Bandura’s Theory of Moral Thought and Action (Bandura, 1991) he states that such acts require significant moral agency, which is generated when an individual possesses adequate moral self-regulatory capacities to address the issue and is in a context that activates and reinforces those capacities. Guided by this theory, we assess moral potency (i.e., moral courage, moral efficacy, and moral (...) ownership) as key capacities predicting peer reporting intentions and assess three contextual factors influencing the generation and effects of moral potency: whether a potential informant (1) works for an ethical leader, (2) is embedded in a psychologically safe climate promoting interpersonal risk-taking, and (3) operates in a more normal or extreme context. We assess the proposed model across three field studies entailing both normal and extreme (i.e., firefighting units) contexts. Results show that ethical leaders raise employees’ moral potency, promoting greater willingness to report their peers’ CWBs. In normal work contexts, psychological safety positively moderated both the relationship between ethical leadership and moral potency and between moral potency and peer reporting intentions. However, psychological safety had the opposite effects in more extreme work contexts. Whereas psychological safety strengthens the positive association between moral potency and peer reporting intentions in normal work contexts, in contexts where individuals are more frequently exposed to extreme events, psychological safety weakens this relationship, thus highlighting the unforeseen downsides of psychological safety in extreme contexts. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

We live in an era where our health is linked to that of others across the globe, and nothing brings this home better than the specter of a pandemic. This paper explores the findings of town hall meetings associated with the Canadian Program of Research on Ethics in a Pandemic , in which focus groups met to discuss issues related to the global governance of an influenza pandemic. Two competing discourses were found to be at work: the first was based (...) upon an economic rationality and the second upon a humanitarian rationality. The implications for public support and the long-term sustainability of new global norms, networks, and regulations in global public health are discussed. (shrink)

In this reply, we provide an analysis of Alter et al. response to our earlier paper. In that paper, we reported difficulty in replicating Alter, Oppenheimer, Epley, and Eyre’s main finding, namely that a sense of disfluency produced by making stimuli difficult to perceive, increased accuracy on a variety of reasoning tasks. Alter, Oppenheimer, and Epley argue that we misunderstood the meaning of accuracy on these tasks, a claim that we reject. We argue and provide evidence that the tasks were (...) not too difficult for our populations and point out that in many cases performance on our tasks was well above chance or on a par with Alter et al.’s participants. Finally, we reiterate our claim that the distinction between answer fluency and perceptual fluency is genuine, and argue that Thompson et al. provided evidence that these are distinct factors that have different downstream effects on cognitive processes. (shrink)

This paper presents students’ views about honest and dishonest actions within the pharmacy and medical learning environments. Students also offered their views on solutions to ameliorating dishonest action. Three research questions were posed in this paper: (1) what reasons would students articulate in reference to engaging in dishonest behaviours? (2) What reasons would students articulate in reference to maintaining high levels of integrity? (3) What strategies would students suggest to decrease engagement in dishonest behaviours and/or promote honest behaviours? The design (...) of the study incorporated an initial descriptive analysis to interpret students’ responses to an 18-item questionnaire about justifications for dishonest action. This was followed by a qualitative analysis of students’ commentaries in reference to why students would engage in either honest or dishonest action. Finally a qualitative analysis was conducted on students’ views regarding solutions to dishonest action. The quantitative results showed that students were more likely to use time management and seriousness justifications for dishonest actions. The qualitative findings found that students’ actions (honest or dishonest) were guided by family and friends, the need to do well, issues of morality and institutional guidelines. Students suggested that dishonest action could be ameliorated by external agencies and polarised views between punitive and rewards-based mechanisms were offered. These results suggest that these students engaged in dishonest action for various reasons and solutions addressing dishonest action need to consider diverse mechanisms that likely extend beyond the educational institution. (shrink)

Electrical resistivity and ac-calorimetric measurements reveal a complex magnetic phase diagram for single crystals of the ferromagnetic Kondo-lattice compound CeAgSb2 at high pressures up to 80 kbar. The ferromagnetic order at TC = 9.6 K at ambient pressure is completely suppressed at a critical pressure PC = 35 kbar. Another magnetic transition, possibly antiferromagnetic, found above 27 kbar, attains a maximum value TN 6 K at 44 kbar and then appears to be completely suppressed by 50 kbar. Thermodynamic and transport (...) measurements in the ferromagnetic state indicate an energy gap Δ 30 K in the spin-wave excitation spectrum at ambient pressure which decreases to Δ 10 K at P = 30 kbar. No superconductivity is observed at ambient pressure above T 0.1 K, under applied pressure in the ferromagnetic state (P = 28.5 kbar), nor in the antiferromagnetic state (P = 33 − 46 kbar) above 0.3 K. © 2003 The American Physical Society. (shrink)

We explore psychological contracts as mechanisms by which individuals gain influence in organizations. Using two distinct research settings and longitudinal analysis, we demonstrate that ideological contracts endow individuals with increased centrality in the organization’s influence network. More generally, we propose that an important outcome of different psychological contract types may be how they affect the nature of influence in organizations.

Under the influence of recurrent deleterious mutation and selection, asexual and sexual populations reach a deterministic equilibrium with individuals carrying 0,1,2,. . . harmful mutations. When a favourable mutation (aA) occurs in an asexual population it will usually occur in an individual who has one or more (k) deleterious mutations. Muller's ratchet then applies as A will thereafter never occur in an individual with less than k mutations. If the selective advantage of A is less than the selective disadvantage of (...) k harmful mutations then A will not spread. If it is greater it may spread carrying k deleterious mutations to fixation. Sexual populations are not affected in this way. A will spread through the population experiencing genomes with 0,1,2,. . . deleterious mutations in accordance with the deterministic equilibrium. (shrink)