State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

The sequencing of the human genome and decreasing costs of sequencing technology have led to the notion of ‘personalized medicine’. This has been taken by some authors to indicate that personalized medicine will provide individualized treatments solely based on one’s DNA sequence. We argue this is overly optimistic and misconstrues the notion of personalization. Such interpretations fail to account for economic, policy and structural constraints on the delivery of healthcare. Furthermore, notions of individualization based on genomic data potentially take us (...) down the road of genetic reductionism obscuring the role of environmental factors in disease and ill health. We propose that one should see personalized medicine as a way of using personal genomic information to stratify individuals into subpopulations and suggest that personalized medicine be seen within a broader idea of personalized healthcare, reflecting healthcare that integrates personal genomic data into cultural, environmental and personal contexts. (shrink)

Power has been studied in various guises in both the social cognition and the reasoning literatures. In this paper, three experiments are reported in which this factor was investigated in the domain of deontic thinking. Power of source of deontic statements was varied within several scenarios, and participants judged the degree to which they thought an injunction would be carried out. In the first experiment, permission statements were used, and it was found that, as predicted, power was positively related to (...) degree of endorsement of deontic conclusions across scenarios. In the second experiment, these findings were generalised across three further deontic domains (threat, warning, and promise) and two different syntactic forms (conjunctive and disjunctive). In the third experiment, the hypothesis that power effects were mediated by subjective judgements of conditional probability was investigated and confirmed. It is argued that these results favour theories that give a general role to probabilistic factors, rather than those based on domain-specific schemas. (shrink)

Physicians have developed a number of implicit and explicit approaches to complex medical decisions. Decision analysis is an explicit, quantitative method of clinical decision making that involves the separation of the probabilities of events from their relative values, or utilities. Its use can help physicians make difficult choices in a manner that promotes true patient participation. Decision analysis also provides a framework for the incorporation of data from multiple sources and for the assessment of the impact of uncertain data on (...) the final decision. Although this approach is imperfect, it represents a significant advance in clinical decision making. (shrink)

This long-awaited new edition contains eight of the dialogues of Plato, and is the first in a new five-volume complete edition of his works in the OCT series.

This paper examines narrativism’s claim that the historical past cannot be known once and for all because it must be continuously re-described from the standpoint of the present. We argue that this claim is based on a non sequitur. We take narrativism’s claim that the past must be re-described continuously from the perspective of the present to be the result of the following train of thought: 1) “all knowledge is conceptually mediated”; 2) “the conceptual framework through which knowledge of reality (...) is mediated changes with every new generation of historians”; therefore (narrativism’s claim) “the historical past changes with every new generation of historians”. The idea of an unchanging past, for the narrativist, requires denying premise 1 (all knowledge is conceptually mediated”) and therefore rests on a problematic commitment to the chimerical notion of the past as it is in-itself, wie es eigentlich gewesen. We argue that the narrativist’s conclusion does not follow unless one adds a further premise, namely 3) “it is not possible to view reality through the categorial framework of historical agents”. If one asserts the possibility of grasping reality through the categorial framework of others, be they contemporary or past agents (as much philosophy of history written in an idealist key does), then one no longer has to accept the narrativist’s inference that since the past cannot be known in-itself or independently of conceptual mediation, then it cannot be known as it always was for the historical agents. Narrativism’s inference that the past cannot be known as it always was does not follow from premises 1 and 2 unless one smuggles in another problematic premise, premise 3. In this paper we defend the claim that the past can be known as it always was (not as it is in-itself) by invoking a different conception of the role of conceptual mediation in historical knowledge, one which assumes the possibility of viewing reality through the categorial framework of others. This notion of the role of conceptual mediation in historical knowledge is prevalent in the idealist tradition but, in the interest of brevity, we will defend this notion of mediacy by specific reference to the idealist philosophy of R.G. Collingwood. (shrink)

L'A. se base sur deux oeuvres artistiques sur la Trinité qui se correspondent et qui soulèvent des questions sérieuses au sujet de la négociation chrétienne avec les autres religions. Ces deux oeuvres traitent de la Trinité en relation avec les autres traditions religieuses. Il s'agit de l'icône intitulée la Trinité de l'orthodoxe russe André Roublev qui date du 15siècle et de l'oeuvre contemporaine de l'artiste indien catholique romain Jyoti Sahi intitulée Abraham et Sarah recevant les trois anges. Par cette étude (...) comparative, l'A. souligne la richesse du Dieu trinitaire dans l'ouverture à la multiplicité des représentations du mystère infini. Ces représentations, visibles dans les créations, sont parfois le fruit de l'imagination des artistes et des théologiens, imagination qui est nécessaire. (shrink)

Early versions of satellite and radiosonde datasets suggested that the tropical surface had warmed more than the troposphere, while climate models consistently showed tropospheric amplification of surface warming in response to human-caused increases in greenhouse gases. We revisit such comparisons here using new observational estimates of surface and tropospheric temperature changes. We find that there is no longer a serious discrepancy between modeled and observed trends in the tropics. Our results contradict a recent claim that all simulated temperature trends in (...) the tropical troposphere are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”.This emerging reconciliation of models and observations has two primary explanations. First, because of changes in the treatment of buoy and satellite information, new surface temperature datasets yield slightly reduced tropical warming relative to earlier versions. Second, recently developed satellite and radiosonde datasets now show larger warming of the tropical lower troposphere. In the case of a new satellite dataset from remote sensing systems, enhancedRSS warming is due to an improved procedure of adjusting for inter-satellite biases. When the RSS-derived tropospheric temperature trend is compared with four different observed estimates of surface temperature change, the surface warming is invariably amplified in the tropical troposphere, consistent with model results. Even if we use data from a second satellite dataset with smaller tropospheric warming than in remote sensing systems RSS, observed tropical lapse rates are not significantly different from those in all model simulations.Our results contradict a recent claim that all simulated temperature trends in the tropical troposphere and in tropical lapse rates are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”. (shrink)