Objective To evaluate the modes of death and treatment offered in the last 24 h of life to patients dying in 10 Brazilian intensive care units (ICUs) over a period of 2 years. Design and setting Cross-sectional, multicentre, retrospective study based on medical chart review. The medical records of all patients that died in seven paediatric and three adult ICUs belonging to university and tertiary hospitals over a period of 2 years were included. Deaths in the first 24 h of (...) admission to the ICU and brain death were excluded. Intervention Two intensive care fellows of each ICU were trained in fulfilling a standard protocol (κ=0.9) to record demographic data and all medical management provided in the last 48 h of life. The Student t test, Mann–Whitney U test, χ2 test and RR were used for data comparison. Measurements and main results 1053 medical charts were included (59.4% adult patients). Life support limitation was more frequent in the adult group (86% vs 43.5%; p<0.001). A ‘do not resuscitate’ order was the most common life support limitation in both groups (75% and 66%), whereas withholding/withdrawing were more frequent in the paediatric group (33.9% vs 24.9%; p=0.02). The life support limitation was rarely reported in the medical chart in both groups (52.6% and 33.7%) with scarce family involvement in the decision making process (23.0% vs 8.7%; p<0.001). Conclusion Life support limitation decision making in Brazilian ICUs is predominantly centred on the medical perspective with scarce participation of the family, and consequently several non-coherent medical interventions are observed in patients with life support limitation. (shrink)

After a long period during which the involvement of laypersons was considered undesirable in the Western tradition of science, we have recently witnessed numerous collaborations which suggest that the desirability of societal involvement in the scientific practice is becoming recognized. This article argues that the historical considerations that once led to this division in cognitive labour have been in transformation, having undergone diverse shifts. In a first instance, the exclusion of laypersons from science is analysed in terms of the key (...) concepts of systematicity, universality, and authority. For that, two examples are given: the case of the British photographic survey and that of the American Museum of Natural History. Next, the dissolution of these barriers between scientists and laypersons is discussed and illustrated by examples: the Dystrophic Epidermolysis Bullosa Research Association in Austria, Fukushima nuclear monitoring stations, and the French Association of Muscular Dystrophy. It is concluded that, for science to be truly democratized, co-produced knowledge needs to be integrated in political decision-making processes, which is currently still lacking. Furthermore, since expertise can also be found in society, non-certified experts should work in conjunction with scientists, yet at the same time, the divide between experts and non-experts must be maintained. The inclusion of non-scientific experts in decision-making is fundamentally different from the inclusion of lay stakeholders. Hence, different participatory roles should be expected from stakeholders, experts, or scientists, and the most important challenge now is how to formally define such roles. (shrink)

Este artigo trata da presença, da interpretação e do diálogo com o ceticismo na primeira fase do pensamento de Denis Diderot, em particular nos seus Pensamentos Filosóficos, palco de uma crise metafísica e religiosa que antecedeu a formulação do seu materialismo ateu.

Reflection Principles are commonly thought to produce only strong axioms of infinity consistent with V = L. It would be desirable to have some notion of strong reflection to remedy this, and we have proposed Global Reflection Principles based on a somewhat Cantorian view of the universe. Such principles justify the kind of cardinals needed for, inter alia , Woodin’s Ω-Logic.

Stingless bees are among the most dominant pollinators in the south tropics. As such, the rational beekeeping of stingless bee species, called meliponiculture, is an ancient and relevant activity, related to sustainable agricultural development, and which connects traditional knowledge to innovation and novelty. Given the relevance of this topic, this paper discusses the possibilities of a semiotically mediated communication between humans and Meliponini (stingless bees). Zoosemiotics, as the studies of animal views of the world, is the ideal modelling system for (...) the investigation of the possibilities of mutual understanding between these two species. Starting from the premise that, for there to be inter-specific communication, there must be a shared code, and that this depends on the biological makeup and sensory apparatus of both organisms involved in the communication process, this research suggests that a possible way to communicate with stingless bees is with the use of olfactory (chemical) signals, since this channel seems to be common to both humans and bees. Considering that for human-animal relations one party must be able to recognize the other (iconic learning), it is revealed that chemical signals do allow bees to recognize individual humans, even going so far as profiling this person as ‘not a threat’. Finally, bees are seen to act cooperatively while the beekeeper is taking action to protect and maintain the nest, something that can be interpreted as an opening of semiotic relations, where the bees are deeming the beekeeper as part of their social group. (shrink)

: Este artigo é o segundo de uma tríade que trata do diálogo, mais precisamente do envolvimento, entre a filosofia de Denis Diderot e o ceticismo. O primeiro artigo, intitulado “O jovem Diderot e o ceticismo dos Pensamentos”, foi publicado na revista Dois Pontos, em sua edição dedicada ao tema do ceticismo (cf. PIVA, 2007), e limitou-se a uma análise minuciosa do problema da postura cética nos Pensamentos filosóficos, de 1746. O presente artigo, por seu turno, examina duas questões (...) fundamentais, desta vez em O passeio do cético ou As alamedas, de 1747, último livro em que o ceticismo é evocado com destaque pelo enciclopedista, dois anos antes de ele render-se definitivamente ao materialismo ateu: 1) a interpretação que Diderot desenvolve do ceticismo e 2) sua posição diante dele. Já o terceiro e derradeiro texto da tríade examinará – evidentemente, numa próxima oportunidade – a presença do ceticismo no pensamento diderotiano da maturidade, ou seja, no período que se inicia em 1749, com a redação da Carta sobre os cegos, quando a questão da dúvida cética passa a perder em suas obras a relevância que tinha na origem de suas reflexões, mudando, até mesmo, de registro. (shrink)

This paper completes a triad developed around the issue of scepticism in the enlightened thinking of Denis Diderot. The first one, entitled "The young Diderot and the scepticism of Thoughts ", was published in the journal Two Points , in its edition devoted to the subject of scepticism (cf. PIVA, 2007), and was limited to an analysis of the problem of attitude sceptical on Thoughts philosophical , in 1746. The second, "The clearing of Diderot with scepticism", published in the (...) journal Transformation (cf. PIVA, 2009), deals with two fundamental questions, this time on The tour of the sceptic or The boulevards , of 1747, latest book in that the scepticism is raised to prominence by encyclopedist, since two years later he finally surrenders to the atheistic materialism. They are: 1) the interpretation that develops Diderot's scepticism and 2) its position before him. In this paper we will examine the presence of scepticism in thought diderotiano of maturity, namely the period beginning in 1749 with the drafting of the Charter for the blind , considering how they and where it is addressed records in some of the most significant texts its philosophical maturity. (shrink)

Hamblin distinguished between formal and descriptive dialectic. Formal normative models of deliberation dialogue have been strongly emphasized as argumentation frameworks in computer science. But making such models of deliberation applicable to real natural language examples has reached a point where the descriptive aspect needs more interdisciplinary work. The new formal and computational models of deliberation dialogue that are being built in computer science seem to be closely related to some already existing and very well established computing technologies such as problem (...) solving and decision making, but whether or how dialectical argumentation can be helpful to support these systems remains an open question. The aim of this paper is to examine some real examples of argumentation that seem to hover on the borderlines between deliberation, problem solving and decision making. (shrink)

Para deleite dos religiosos, a história da filosofia oficial − que continua, ao que parece, infectada pelo espírito teológico − consagrou a "aposta de Pascal" como uma das soluções modelares ao problema ético suscitado pela questáo clássica da existência ou náo de Deus. No raciocínio de Blaise Pascal (1623-1662), aquele que aposta na existência do deus judaico-cristáo ganhará a felicidade eterna caso ele efetivamente exista; em contrapartida, uma vez sendo este Deus uma realidade, a aposta na sua inexistência resultará na (...) danaçáo do apostador equivocado. Ocorre que a história da filosofia oficial parece desconhecer a alternativa ateísta que Denis Diderot (1713-1784) propõe a essa questáo das conseqüências da existência ou náo de Deus na vida e na morte dos seres humanos. Lançando máo de uma fábula que permite uma analogia com o tema do ateísmo, em que um ateu, depois de morrer, constata que a alma é de fato imortal, que Deus realmente existe, e que, portanto, náo ter tido fé em vida náo foi uma aposta inteligente, Diderot, no seu Diálogo de um filósofo com a Marechala de... (1774), reflete sobre os desdobramentos para o ateu dessa experiência inesperada. É sobre essa náo-aposta do ateu que trata este artigo. Palavras-chave : Aposta de Pascal, Ateísmo, Deus, Diderot, Virtude. (shrink)

The purpose of this essay is to analyze and relate two proposals for illustration made by the European philosophy of the eighteenth century, their singularities and seeking more differences than their commonalities. Both of them were developed in countries with different cultural and political conjunctures and based on the peculiarities of their respective enlightenments. This is the Aufklärung of Immanuel Kant (1724-1804), who became famous with the booklet Answer the question: what is "Enlightenment"?, written in 1784, and the Lumières embodied (...) by the speculator Denis Diderot (1713-1784) and mainly expressed in the entry "Philosopher" of the Encyclopedia of 1765. (shrink)

Verifica-se atualmente grande quantidade de pessoas envolvidas de alguma forma com o uso prejudicial de álcool e outras drogas, o que representa um desafio para a saúde pública e para os profissionais. Este artigo tem como objetivo investigar a organização dos Centros de Atenção Psicossociais Álcool..

Douglas Walton’s work is extremely vast, multifaceted, and interdisciplinary. He developed theoretical proposals that have been used in disciplines that are not traditionally related to philosophy, such as law, education, discourse analysis, artificial intelligence, or medical communication. Through his papers and books, Walton redefined the boundaries not only of argumentation theory, but also logic and philosophy. He was a philosopher in the sense that his interest was developing theoretical models that can help explain reality, and more importantly interact with it. (...) For this reason, he proposed methods that have been used for analyzing different types of dialogical interactions, and modeling procedures for regulating them. (shrink)

Inleidend overzicht van de wijsgerige ethiek.

Scientific realists have suggested that changes in our scientific communities over the course of their history have rendered those communities progressively less vulnerable to the problem of unconcieved alternatives over time. I argue in response not only that the most fundamental historical transformations of the scientific enterprise have generated steadily mounting obstacles to revolutionary, transformative, or unorthodox scientific theorizing, but also that we have substantial independent evidence that the institutional apparatus of contemporary scientific inquiry fosters an exceedingly and increasingly theoretically (...) conservative form of that inquiry. I conclude that contemporary scientific communities are actually more vulnerable to the problem of unconceived alternatives than their historical predecessors, and I briefly suggest how we might seek to pursue scientific inquiry in a less theoretically conservative way. (shrink)

Douglas Walton’s work is extremely vast, multifaceted, and interdisciplinary. He developed theoretical proposals that have been used in disciplines that are not traditionally related to philosophy, such as law, education, discourse analysis, artificial intelligence, or medical communication. Through his papers and books, Walton redefined the boundaries not only of argumentation theory, but also logic and philosophy. He was a philosopher in the sense that his interest was developing theoretical models that can help explain reality, and more importantly interact with it. (...) For this reason, he proposed methods that have been used for analyzing different types of dialogical interactions, and modeling procedures for regulating them. (shrink)

Com base nas suas obras Sistema da natureza ou das leis do mundo físico e do mundo moral, de 1770, e A moral universal ou os deveres do homem fundamentados na sua natureza, de 1776, o objetivo deste artigo é tratar dos fundamentos teóricos e das consequências práticas da filosofia moral do pensador materialista e ateu e iluminista Barão de Holbach (1723-1789), a qual tem na felicidade a sua finalidade última, na educação e na política os seus meios concretos, e (...) nas leis gerais da matéria, que seriam absolutamente físicas, seu fato primordial e, ao mesmo tempo, o seu principal desafio. (shrink)

인간의 이성적 의식과 법의 관계를 밝히고 법의 해석 과 판단에 인간의 의식이 어떻게 작용하는가를 고찰 한 저술. 제1부에서는 법의 형이상학적인 측면에서 법의 실체, 그리스의 법, 데카르트의 법, 로크와 법, 칸트와 법, 헤겔과 법, 아담스미스의 법의 경제, 중국의 도덕과 법사상을 다루었다. 제2부에서는 심리학적 분석으로 헌법의 심리학적 해석, 법의 판결절차, 증거법, 형법과 죄, 청소년과 가족법, 조세법, 플라톤의 법, 칸트의 도덕론의 경험적 확인, 헤겔의 자아와 노동법, 법의 4차원에 대해 다뤘다.

George Berkeley is one of the greatest and most influential modern philosophers. In defending the immaterialism for which he is most famous, he redirected modern thinking about the nature of objectivity and the mind's capacity to come to terms with it. Along the way, he made striking and influential proposals concerning the psychology of the senses, the workings of language, the aims of science, and the scope of mathematics. In this Companion volume a team of distinguished authors not only examines (...) Berkeley's achievements but also his neglected contributions to moral and political philosophy, his writings on economics and development, and his defense of religious commitment and religious life. The volume places Berkeley's achievements in the context of the many social and intellectual traditions - philosophical, scientific, ethical, and religious - to which he fashioned a distinctive response. (shrink)

One diagnosis of what is wrong with the Knowledge Argument rests on the Ability Hypothesis. This couples an ability analysis of knowing what an experience is like together with a denial that phenomenal propositions exist. I argue against both components. I consider three arguments against the existence of phenomenal propositions and find them wanting. Nevertheless I deny that knowing phenomenal propositions is part of knowing what an experience is like. I provide a hybrid account of knowing what an experience is (...) like which is the coherent expression of a single idea: knowing what an experience is like is knowing what it would be like to have the phenomenal content of the experience as the content of an experience one is currently having. I explain how my conclusions indicate that the focus of discussion should be on the alleged explanatory gap between phenomenal facts and physical facts and not on the Knowledge Argument. The latter is a poor expression of the difficulty Physicalists face. (shrink)

Philosophers, theologians, physicists, and psychologists join their efforts to reflect on the crucial issues of limit and infinity, time and eternity, empty space and material space. The volume offers an invaluable contribution to some of the most important issues of our times: questions on God and consciousness are discussed in parallel with quantum theory, black holes, the inflationary universe, the Big Bang, and string theory, from different perspectives and angles, ranging from neuroscience to AI.

Typical discussions of virtual reality (VR) fixate on technology for providing sensory stimulation of a certain kind. They thus fail to understand reality as the place wherein we live and work, misunderstanding it instead as merely a sort of presentation. The first half of the paper examines popular conceptions of VR. The most common conception is a shallow one according to which VR is a matter of simulating appearances. Yet there is, even in popular depictions, a second, more subtle conception (...) according to which VR is a matter of facilitating new kinds of interaction. The latter half of the paper turns to questions about the contemporary technology of Internet chatrooms. The fact that chatrooms can be used in certain ways suggests something about the prospects for VR. The penultimate section asks whether chatrooms may legitimately be thought of as places. (In a sense, they may.) The final section asks whether cybersex may legitimately be thought of as sex. (Again, yes.) Chatroom technology thus provides an argument for the second conception of VR over its much ballyhooed rival. (shrink)

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires (...) interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

As family physicians, general practitioners play a key role in safeguarding children. Should they suspect child abuse or neglect they may experience a conflict between responding to the needs and interests of the child and those of an adult patient. English law insists on the paramountcy of the interests of the child, but in family practice many other interests may be at stake. The authors argue that uncritical adoption of the paramountcy principle is too simplistic and can lead, paradoxically, to (...) greater harm. They argue for a more subtle and nuanced view of interests and of conflicts of interest in safeguarding children. (shrink)