George Engel’s biopsychosocial model was associated with the critique of biomedical dogmatism and acknowledged the historical precedence of the work of Adolf Meyer. However, the importance of Meyer’s psychobiology is not always recognized. One of the reasons may be because of his tendency to compromise with biomedical attitudes. This paper restates the Meyerian perspective, explicitly acknowledging the split between biomedical and biopsychological approaches in the origin of modern psychiatry. Our present-day understanding of this conflict is confounded by reactions to (...) ‘anti-psychiatry.’ Neo-Meyerian principles can only be reestablished by a challenge to biomedicine that accepts, as did Meyer, the inherent uncertainty of medicine and psychiatry. (shrink)

The Sound of Liberating Truth: Buddhist-Christian Dialogues in Honor of Frederick J. Streng. Edited by Sallie B. King and Paul O. Ingram. Curzon Press, Richmond 1999. xxxii, 276 pp. £40.00. ISBN 0-7007-1121-X.

Background: Caring for terminally ill patients is a meaningful task, however the patient’s suffering can be a considerable burden and cause of frustration.Objectives: The aim of this study is to describe the experiences of general practitioners in The Netherlands in dealing with a request for euthanasia from a terminally ill patient.Methods: The data, collected through in-depth interviews, were analysed according to the constant comparative method.Results: Having to face a request for euthanasia when attempting to relieve a patient’s suffering was described (...) as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient’s suffering without “intentionally hastening a patient’s death on his request”. The other GPs explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient’s request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient’s suffering through euthanasia and their personal values.Conclusion: Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient’s suffering and to promote a peaceful death. (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)

It is assumed that the coupling of the field quantities Dμv (x) and F αβ (x) is nonlocal. This hypothesis leads to a theory of an electromagnetic field that has the following properties.(1) The source of the field F αβ (x) exhibits a center of charge and a center of mass that do not coincide, in general.(2) The field componentF 0i=−c2Ei is regular at the origin.(3) In the first-order approximation the new field equations are equivalent to the conventional Maxwell field (...) equations.(4) The conventional cutoff procedure in momentum space as practiced in the Maxwell-Lorentz theory is equivalent to the first-order approximation in terms of an invariant length ξ2.(5) The gyromagnetic ratio of the source of F αβ (x) is equal toc/mc for a quantum of chargee and massm. (shrink)

Le seul fait qu'il surgisse après que tout a été révoqué en doute ne suffit pas à faire du cogito-plus précisément, de ego sum - un principe métaphysique, une vérité première: la chose doit être démontrée. Or cette démonstration est bien là, dans la II e Méditation. Elle se fait en deux temps: y participent (a) l'expérience du morceau de cire et (b) le bref recours à l'imagination (AT VII, 27-28; IX/1, 21-22) par lequel Descartes vise à déterminer s'il est (...) davantage qu'une res cogitans. Ainsi s'explique la rémanence dans le texte de cette tentative que Descartes qualifie d' «erreur», et qui aura pu paraître redondante à ses lecteurs. (shrink)

Do our lives have meaning? Should we create more people? Is death bad? Should we commit suicide? Would it be better if we were immortal? Should we be optimistic or pessimistic? Life, Death, and Meaning brings together key readings, primarily by English-speaking philosophers, on such 'big questions.'.

Do our lives have meaning? Should we create more people? Is death bad? Should we commit suicide? Would it be better to be immortal? Should we be optimistic or pessimistic? Since Life, Death, and Meaning: Key Philosophical Readings on the Big Questions first appeared, David Benatar's distinctive anthology designed to introduce students to the key existential questions of philosophy has won a devoted following among users in a variety of upper-level and even introductory courses.

Twenty essays based on papers delivered at the International Symposium on the Varieties of Marxism held at the VanLeer Jerusalem Foundation 16-19 June 1974 and dedicated to the memory of George Lichtheim, an eminent historian of Marxism. The overall message is that, far from being a monolithic, crystal clear explanation of the universe, Marxism continues to be a multi-faceted ideology with diverse expressions in diverse cultures, spawning a wide spectrum of "official" prophets, each sincerely convinced that he or she (...) is correct and all others are wrong. Kamenka in his contribution, while somewhat too easily chiding Marx for being too absolute in his prescriptive ethics, suggests that the varieties of Marxism stem from "ambiguities and tensions at the very heart of Marx’s thought," and that it "speaks to us, like Christianity, with many voices and in accents that are at best suggestive and at worst deliberately seductive rather than precise". Eight of the articles, including that of Kamenka, can be described as being theoretical, concerned about clarification of such questions as the methodology of Marx, the place of Engels in Marxism, Marxian Ethics, Totality in Lukacs and Adorno, Sartrean Marxism, the transformation of the concept of practice from Kant via Marx to Lukacs, and the reawakened interest in the "Asiatic Mode of Production" as a stage in the evolution towards Socialism. Ten articles discuss the manifestations of Marxism in Western Europe, Russia, Italy, Zionism, the Arab world, Czechoslovakia, Poland, Latin America, and the radical student movements of the 1960s in the United States, France, and Israel. Two other articles examine the differences and reasons for differences with Marx expressed by two major commentators, Trotsky and Mao. (shrink)

Book reviewed in this article: Ethics and Critical Care Medicine. John C. Moskop and Loretta Kopelman, eds. Dordrecht: D. Reidel “Ethical Moments in Critical Care Medicine,” symposium issue of Critical Care Clinics. James P. Orlowski and George A. Kanoti, eds.