Starting from simple topological arguments due to Dirac on the classical rotational properties of extended rigid bodies, we abstract the concept of a finite-size spinor (FSS). The FSS is a concept distinct from both point spinors (e.g., electrons) and composite spinors (e.g., nuclei), and suggests a new model for baryons. The FSS offers a natural explanation of “threeness” for the quarks, excludes the existence of free quarks, denies the operational definition of quark spin statistics, and, moreover, leads to the dual (...) model of hadronic interactions. (shrink)

The practice of respecting patients’ autonomy is rooted in the healthcare professionals’ empathy for patients’ situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients’ experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi’s method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two major themes (...) emerged from the analyses: (a) a voluntary yet necessary alternative—to undergo a surgery and (b) alternatives compelled by the unalterable decision—the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel. (shrink)

In recent times, daily, ordinary medical practices have incontrovertibly been developing under the condition of complexity. Complexity jeopardizes the moral core of practicing medicine: helping people, with their illnesses and suffering, in a medically competent way. Practical wisdom has been proposed as part of the solution to navigate complexity, aiming at the provision of morally good care. Practical wisdom should help practitioners to maneuver in complexity, where the presupposed linear ways of operating prove to be insufficient. However, this solution is (...) unsatisfactory, because the proposed versions of practical wisdom are too individualistic of nature, while physicians are continuously operating in varying teams, and dealing with complicated technologies and pressing structures. A second point of critique is, that these versions are theory based, and thus insufficiently attuned to the actual context of everyday medical practices. Now, our proposal is to use an approach of practical wisdom that enables medical practices to counter the complexity issue and to re-invent the moral core of medical practicing as well. This implies a practice oriented approach, as thematized by practice theory, qualitative empirical research from the inside, and abduction from actual performed practical wisdom towards an apt understanding of phronèsis. (shrink)

Holding that the Whitehead of Principia Mathematica is still to be found in the later speculation of Process and Reality, Lango attempts to show in some detail how the various particular entities and relations of Whitehead’s metaphysics are definable in terms of the formal properties of a universal relation which he calls "synonty," the relation by which one entity "has being for" another entity. This universal relation, he claims, is implicit in Whitehead’s "principle of relativity," according to which each entity (...) in the universe is related to every other entity such that all entities, actual and non-actual, are characterized by the "potentiality for being an element in a real concrescence of many entities into one actuality." Lango then draws out the more general principle that "it belongs to the nature of a ‘being', that it is a potential for entities of all types." Thus, the prehension of one actual entity by another is a special case of the universal relation of synonty. Lango then proceeds to show how "derivative created entities," such as prehensions, subjective forms, and contrasts, are also special cases whose logical properties can be defined in terms of the universal relation of synonty. (shrink)

Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

Holding that the Whitehead of Principia Mathematica is still to be found in the later speculation of Process and Reality, Lango attempts to show in some detail how the various particular entities and relations of Whitehead’s metaphysics are definable in terms of the formal properties of a universal relation which he calls "synonty," the relation by which one entity "has being for" another entity. This universal relation, he claims, is implicit in Whitehead’s "principle of relativity," according to which each entity (...) in the universe is related to every other entity such that all entities, actual and non-actual, are characterized by the "potentiality for being an element in a real concrescence of many entities into one actuality." Lango then draws out the more general principle that "it belongs to the nature of a ‘being', that it is a potential for entities of all types." Thus, the prehension of one actual entity by another is a special case of the universal relation of synonty. Lango then proceeds to show how "derivative created entities," such as prehensions, subjective forms, and contrasts, are also special cases whose logical properties can be defined in terms of the universal relation of synonty. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

Relatives of persons with severe mental illness face a straining life situation and need support. Exclusion of relatives in mental health care has long been reported. The aim of this study was to describe conceptions of nurses in mental health care about supporting relatives of persons with severe mental illness. Focus group interviews with nurses from all levels of mental health care in Norway were performed. A phenomenographic approach was used. The nurses found that their responsibility first and foremost was (...) the patient, especially to develop an alliance with him or her. Additional premises for supporting relatives were the context framing the nursing care, aspects of the actors, and relational concerns between them. Competing or contradictory demands were found within these premises. Two paths were identified concerning the nurses’ support of relatives: seeing the relative in the shadow of the patient or as an individual person. (shrink)

11We thank Rohan French for a detailed discussion of this review. We also wish to reciprocally thank Shawn Standefer for detailed discussions about the book.Logical pluralism is the view according...

BackgroundIn research ethics, the most basic question would always be, “which is an ethical issue, which is not?” Interestingly, depending on which ethics guideline we consult, we may have various answers to this question. Though we already have several international ethics guidelines for biomedical research involving human participants, ironically, we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus. In this manuscript, we attempted to do just that.MethodsWe extracted (...) the imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. In doing so, we gathered data on how many guidelines support a specific imperative.ResultsWe found that there is no consensus on the majority of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. Of the 12 clusters, Informed Consent has the highest level of consensus and Research Collaboration and Regulatory Sanctions have the least.ConclusionThere was a lack of consensus in the majority of imperatives from the five internationally-known ethics guidelines. This may be partly explained by the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences. (shrink)

We present the system SUBSEXPL used for simulating and comparing explicit substitutions calculi. The system allows the manipulation of expressions of the λ-calculus and of three different styles of explicit substitutions: the λσ, the λse and the suspension calculus. A variation of the suspension calculus, which allows for combination of steps of β-contraction is included too. Implementations of the η-reduction are provided for each style. Other explicit substitutions calculi can be easily incorporated into the system due to its modular structure. (...) The uses of the system include: the visualization of the contractions of the λ-calculus in de Bruijn notation, and of guided one-step reductions as well as normalization via each of the associated substitution calculi. Many useful facilities are included: reductions can be easily recorded as text files, LATEX outputs can be generated and several examples for dealing with arithmetic operations and computational operators such as conditionals and repetitions in the λ-calculus are available. The system can be executed over Emacs using the x-symbol mode in such a way that λ-terms and terms of the explicit substitutions calculi are represented in its natural syntax avoiding the necessity of repeatedly generating LATEX outputs. The system has been of great help for systematically comparing explicit substitutions calculi, as well as for understanding properties of explicit substitutions such as the Preservation of Strong Normalization. In addition, it has been used for teaching basic properties of the λ-calculus such as: computational adequacy, the usefulness of de Bruijn's notation and of making explicit substitutions in real implementations. (shrink)