Research shows that the physician’s personal attributes and social characteristics have a strong association with their end-of-life decision making. Despite efforts to increase patient, family and surrogate input into EOL decision making, research shows the physician’s input to be dominant. Our research finds that physician’s social values, independent of religiosity, have a significant association with physician’s tendency to withhold or withdraw life sustaining, EOL treatments. It is suggested that physicians employ personal social values in their EOL medical coping, because they (...) have to cope with existential dilemmas posed by the mystery of death, and left unresolved by medical decision making mechanisms such as advanced directives and hospital ethics committees. (shrink)

This volume is dedicated to Mario Bunge in honor of his sixtieth birthday. Mario Bunge is a philosopher of great repute, whose enormous output includes dozens of books in several languages, which will culminate with his Treatise on Basic Philosophy projected in seven volumes, four of which have already appeared [Reidel, I 974ff. ]. He is known for his works on research methods, the foundations of physics, biology, the social sciences, the diverse applications of mathematical methods and of systems analysis, (...) and more. Bunge stands for exact philosophy, classical liberal social philosophy, rationalism and enlightenment. He is brave, even relentless, in his attacks on subjectivism, mentalism, and spiritualism, as well as on positivism, mechanism, and dialectics. He believes in logic and clarity, in science and open-mindedness - not as the philosopher's equivalent to the poli tician's rhetoric of motherhood and apple pie, but as a matter of everyday practice, as qualities to cultivate daily in our pursuit of the life worth living. Bunge's philosophy often has the quality of Columbus's egg, and he is prone to come to swift and decisive conclusions on the basis of argu ments which seem to him valid; he will not be perturbed by the fact that most of the advanced thinkers in the field hold different views. (shrink)

Should engineering ethics be taught? Despite the obvious truism that we all want our students to be moral engineers who practice virtuous professional behavior, I argue, in this article that the question itself obscures several ambiguities that prompt preliminary resolution. Upon clarification of these ambiguities, and an attempt to delineate key issues that make the question a philosophically interesting one, I conclude that engineering ethics not only should not, but cannot, be taught if we understand “teaching engineering ethics” to mean (...) training engineers to be moral individuals (as some advocates seem to have proposed). However, I also conclude that there is a justification to teaching engineering ethics, insofar as we are able to clearly identify the most desirable and efficacious pedagogical approach to the subject area, which I propose to be a case study-based format that utilizes the principle of human cognitive pattern recognition. (shrink)

Despite its importance, the linkage between genetic and cultural evolution has until now been little explored. An understanding of this linkage is needed to extend evolutionary theory so that it can deal for the first time with the phenomena of mind and human social history. We characterize the process of gene-culture coevolution, in which culture is shaped by biological imperatives while biological traits are simultaneously altered by genetic evolution in response to cultural history. A case is made from both theory (...) and evidence that genetic and cultural evolution are inseverable, and that the human mind has tended to evolve so as to bias individuals toward certain patterns of cognition and choice rather than others. With the aid of mathematical models we trace the coevolutionary circuit: The genes prescribe structure in developmental pathways that lay down endocrine and neural systems, imposing regularities in the development of cognition and behavior; these regularities translate upward into holistic patterns of culture, which can be predicted in the form of probability density distributions ; natural selection acts within human history to favor certain epigenetic rules over others; and the selection alters the frequencies of the underlying genes. The effects of genetic and cultural changes reverberate throughout the circuit and are consequently tested with the passage of each life cycle. In addition to modeling gene-culture coevolution, we apply methods from island biogeography and information theory to examine the cultural capacity of the genes, the factors determining the magnitude of cultural diversity, and the possible reasons for the uniqueness of the human achievement. (shrink)

The Belmont Report’s distinction between research and the practice of accepted therapy has led various authors to suggest that these purportedly distinct activities should be governed by different ethical principles. We consider some of the ethical consequences of attempts to separate the two and conclude that separation fails along ontological, ethical, and epistemological dimensions. Clinical practice and clinical research, as with yin and yang, can be thought of as complementary forces interacting to form a dynamic system in which the whole (...) exceeds the sum of its parts. Just as effective clinical practice cannot exist without clinical research, meaningful clinical research requires the context of clinical practice. We defend this thesis by triangulation, that is, by outlining how multiple investigators have reached this conclusion on the basis of varied theoretical and applied approaches. More confidence can be placed in a result if different methods/viewpoints have led to that result. (shrink)

Memory exhibits episodic superposition, an analog of the quantum superposition of physical states: Before a cue for a presented or unpresented item is administered on a memory test, the item has the simultaneous potential to occupy all members of a mutually exclusive set of episodic states, though it occupies only one of those states after the cue is administered. This phenomenon can be modeled with a nonadditive probability model called overdistribution (OD), which implements fuzzy-trace theory's distinction between verbatim and gist (...) representations. We show that it can also be modeled based on quantum probability theory. A quantum episodic memory (QEM) model is developed, which is derived from quantum probability theory but also implements the process conceptions of global matching memory models. OD and QEM have different strengths, and the current challenge is to identify contrasting empirical predictions that can be used to pit them against each other. (shrink)

The purpose of this paper is to review the rising influence of commercialism in American medicine and to examine some of the consequences of this trend. Increased competition subverts physician collegiality, draws hospitals into for-profit ownership and behavior, and leads clinical investigators into secrecy and possibly into bias and abuse. Medicine faces a deprofessionalization evidenced in loss of control over the clinical setting and over self-regulation. Health care becomes a commodity relying on cultivation of desires instead of satisfaction of needs, (...) even as many basic needs go unmet. Patients become consumers empowered with lawsuits and the connection of medicine to the relief of suffering is attenuated. Medical encounters are increasingly impersonal, dominated by specialization, technology, and bureaucracy. Patients are losing their physician-advocates to new conflicts of interests, physicians are losing their impulse to charity, and trust in the doctor-patient relationship and in medicine generally is eroding. (shrink)

In this essay, we defend the design of the Salk polio vaccine trial and try to put some limits on the role schemata should play in designing clinical research studies. Our presentation is structured as a response to de Freitas and Pietrobon who identified the CONSORT statement as a schema that would have, had it existed at the time, ruled out the design of the Salk polio vaccine trial of 1954 in favor of a completely randomized controlled clinical trial. We (...) argue that large-scale public health interventions often require evidence beyond simple efficacy, the limit of what an RCT can provide, and that the design actually adopted for the Salk trial represented a reasonable—albeit imperfect—compromise. This is of more than historical interest in that many contemporary studies are of the scale and scope to require a more pragmatic, rather than explanatory, approach to study design. (shrink)

This cutting-edge book offers a theoretical account of the evolution of multiple memory systems of the brain. The authors conceptualize these memory systems from both behavioral and neurobiological perspectives.

Since the publication of Husserl's Logische Untersuchungen at the outset of this century, the notion of phenomenology has had a long and important history on the European continent. Of the many claims made on its behalf perhaps the most interesting is that phenomenology is able to ground philosophical assertions in a manner which is neither purely formal nor purely empirical, i.e., that phenomenology as a method is capable of transcending this very distinction. For example, phenomenologists argue that their reduction of (...) essences provides a way of knowing which is neither analytic nor synthetic but both. Having reached such an eidetic intuition phenomenologists claim to have attained a non-trivial universality and necessity. (shrink)