To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

Guido de Ruggiero (1888-1948) was perhaps the greatest Italian intellectual historian in the twentieth century. He was a fierce champion of liberalism, an ardent opponent of Fascism, an insightful critic and interpreter of his contemporaries, and a formidable philosopher in his own right. Idealism & Experience: The Philosophy of Guido de Ruggiero comprises eight new critical essays, as well as English translations of five of de Ruggiero's most important shorter writings, which chart the development of his thought between 1914 and (...) 1946. Taken together, these essays reveal the range, richness and philosophical sophistication of de Ruggiero's ideas, enabling Anglophone readers to appreciate their enduring relevance in our own troubled times. (shrink)

There is a growing interest in comparison of international health care data with the hope that such studies will enable individual systems to learn from other systems. Such comparisons, however, presuppose that there exist common criteria for evaluating health care systems. The main thesis of this paper is that these comparative studies are misleading because they employ inappropriate operationalizations of these criteria because the operarionalizations are based upon mistaken global conceptualizations of the criteria in question. The essay provides a methodological (...) critique of what has been done and sets a new agenda for future research. (shrink)

To controlforceaccurately under a wide range of behavioral conditions, the central nervous system would either require a detailed, continuously updated representation of the state of each muscle (and the load against which each is acting) or else force feedback with sufficient gain to cope with variations in the properties of the muscles and loads. The evidence for force feedback with adequate gain or for an appropriate central representation is not sufficient to conclude that force is the major controlled variable in (...) normal limb movements.Morton's hypothesis, thatlengthis controlled by a follow-up servo, has a number of difficulties related to the delays, gains, variability, and specificity in feedback pathways comprising potential servo loops. However, experimental evidence is consistent with these pathways providing servo assistance for some movements produced by coactivation of α- and static γ-motoneurons. Dynamic γ-motoneurons may provide an additional input for adaptive control of different types of movements.The idea that feedback is used to compensate for changes in musclestiffnesshas received experimental support under static postural conditions. However, reflexes tend to increase rather than decrease the range of variation in muscle stiffness during some cyclic movements. Theoretical problems associated with the regulation of stiffness are also discussed. The possibilities of separate control systems forvelocityorviscosityare considered, but the evidence is either negative or lacking. I conclude that different physical variables can be controlled depending on the type of limb movement required. The concept of stiffness regulation is also useful under some conditions, but should probably be extended to the regulation of the visco-elastic properties (i.e., the mechanical impedance) of a muscle or joint. (shrink)

In this paper a formalized logic of propositions, PA1, is presented. It is proven consistent and its relationships to traditional logic, to PM ([15]), to subjunctive (including contrary-to-fact) implication and to the “paradoxes” of material and strict implication are developed. Apart from any intrinsic merit it possesses, its chief significance lies in demonstrating the feasibility of a general logic containing theprinciple of subjunctive contrariety, i.e., the principle that ‘Ifpwere true thenqwould be true’ and ‘Ifpwere true thenqwould be false’ are incompatible.

In lieu of an abstract, here is a brief excerpt of the content:69 WILLIAM ROBERTSON AND DAVID HUME: THREE LETTERS The relationship between David Hume and his fellow Scottish historian William Robertson has always seemed one-sided. Despite the existence of fifteen letters to Robertson in the standard volumes of Hume's correspondence,1 Hume scholars have long had reason to regret the lack of a single extant letter from Robertson to Hume. None are to be found, for example, where one would most (...) expect them to be — in the Royal Society of Edinburgh, alongside the letters to Hume from various other Moderate clergymen and literati in Robertson's circle, such as Hugh Blair and Adam Ferguson. Fortunately, however, two of Robertson's letters to Hume (numbered II and III below) have now turned up where one would not expect them to be — among Robertson's own correspondence in the Robertson2 Macdonald Papers, National Library of Scotland. They are not mere drafts, such as one is accustomed to find among an author's private papers; rather, they are autograph signed letters that appear to have actually been posted. How and when they found their way back to Robertson's personal papers, and what became of the rest of Robertson's letters to Hume, are questions open to speculation. For the moment we are grateful for the letters we now have, neither of which is known to have been published before in whole or in part. Nor has Hume been identified before as the recipient of either of these letters, though internal evidence makes it clear that he was. Both letters date from the late 1760s, when Hume was living in London and Robertson was at the peak of his multi-faceted career in Edinburgh as university principal, parish minister, ecclesiastical leader, and man of letters. The first of them, dated 27 March 1767, was sent to Hume in his capacity as under- 70 secretary of state in the Northern Department (an office he held from February 1767 to January 1768). It is plainly a reply to a letter of 19 March, in which Hume had discussed three topics to which Robertson was 5 responding: Robertson's efforts to secure a military chaplaincy for a certain Scottish minister (evidently named Brodie); Conway's role in the famous dispute between Hume and Rousseau; and the public response to Adam Ferguson's newly published Essay on the History of Civil Society. In addition Robertson addresses a matter that Hume had apparently broached with him at some earlier time: the attempt to find a suitable Scottish church to which Hume might obtain a crown presentation for his nephews' tutor, the Rev. Christopher Tait. The letter concludes on a note of admiration that is characteristic not only of Robertson but of most of Hume's other "Protestant Pastors" in Scotland. The second letter to Hume, dated 31 January 1769, is chiefly concerned with the forthcoming publication of Robertson's History of Charles V and the French translation of it by J.-B.-A. Suard — subjects that had been treated in two letters from Hume to 7 Robertson of autumn 1768. It also contains a strong recommendation for a bright young Scottish writer (in both the legal and literary senses of that term) who would one day become Robertson's most vitriolic critic: Gilbert Stuart. On the personal side, there is encouragement for the now unemployed Hume to return to Edinburgh, as he was then threatening to do, after his "great glut of society" at Paris and London, and there are allusions in the closing paragraph to Hume's part in introducing his friend to polite society when Robertson had visited London to arrange the publication of Charles V in the spring of 1768. 71 To these two letters from Robertson we have prefixed a third from earlier in the same decade, one Q not actually addressed to Hume but largely about him. Robertson wrote it to their common friend Gilbert Elliot (later Sir Gilbert Elliot) on 8 March 1762, two days before the Town Council elected Robertson principal of Edinburgh University. The first paragraph deals with the principalship and relates to Hume only indirectly, as we point out in a footnote. The second paragraph, however, contains interesting... (shrink)

In this basically expository paper we discuss the role of logic and mathematics in researches concerning the ontology of scientific theories, and we consider the particular case of quantum mechanics. We argue that systems of logic in general, and classical logic in particular, may contribute substantially with the ontology of any theory that has this logic in its base. In the case of quantum mechanics, however, from the point of view of philosophical discussions concerning identity and individuality, those contributions may (...) not be welcome for a specific interpretation, and an alternative system of logic perhaps could be used instead of a classical system. In this sense, we argue that the logic and ontology of a scientific theory may be seen as mutually influencing each other. On the one hand, logic contributes to shape the general features of the ontology of a theory; on the other hand, the theory also puts constraints on the possible understanding of ontology and, respectively, on possible systems of logic that may be the underlying logic of the theory. (shrink)