The white coat ceremony is a common practice at many American and European medical schools. Current justification for the ceremony is mainly based on the good will felt by participants and an assumed connection between the ceremony and encouraging humanistic values in medicine. Recent critiques of the ceremony faults its use of oaths, premature alignment of students and faculty, and the selective appropriation of meaning to the white coat itself. This paper responds to recent critiques by addressing their misconceptions and (...) arguing that the white coat ceremony is a contemporary medical ritual with a key role for students and faculty in developing a professional identity.Since its inception in 1993, the white coat ceremony has become a national and international phenomenon. It is now practised at the beginning of the year at more than 100 American medical schools and is supported by foundation grants dedicated to endorsing and encouraging professional development and humanism in medicine.1 While some literature addresses the symbolism and history of the white coat itself, few sources consider the meaning of the ceremony.2–4 A common appeal is to the emotion and good will felt at the event.1,5 Although feelings are important, a deeper justification is called for.Criticism of the WCC is more explicit, charging that the ceremony: uses the Hippocratic Oath inappropriately or, at best, prematurely; fosters improper student faculty relationships, and; interprets the meaning of the white coat selectively.6,7 Critics suggest either that students not be asked to swear an oath together because it might conflict with personally held beliefs, or that students not be allowed to take the oath until they have demonstrated competence as physicians.6 Some also say that the WCC aligns students with faculty and against patients.6 The third …. (shrink)

Background: In Switzerland, non-medical right-to-die organisations such as Exit Deutsche Schweiz and Dignitas offer suicide assistance to members suffering from incurable diseases. Objectives: First, to determine whether differences exist between the members who received assistance in suicide from Exit Deutsche Schweiz and Dignitas. Second, to investigate whether the practices of Exit Deutsche Schweiz have changed since the 1990s. Methods: This study analysed all cases of assisted suicide facilitated by Exit Deutsche Schweiz (E) and Dignitas (D) between 2001 and 2004 and (...) investigated by the University of Zurich’s Institute of Legal Medicine (E: n = 147; D: n = 274, total: 421). Furthermore, data from the Exit Deutsche Schweiz study which investigated all cases of assisted suicide during the period 1990–2000 (n = 149) were compared with the data of the present study. Results: More women than men were assisted in both organisations (D: 64%; E: 65%). Dignitas provided more assistance to non-residents (D: 91%; E: 3%; p = 0.000), younger persons (mean age in years (SD): D: 64.5 (14.1); E: 76.6 (13.3); p = 0.001), and people suffering from fatal diseases such as multiple sclerosis and amyotrophic lateral sclerosis (D: 79%; E: 67%; p = 0.013). Lethal medications were more often taken orally in cases assisted by Dignitas (D: 91%; E: 76%; p = 0.000). The number of women and the proportion of older people suffering from non-fatal diseases among suicides assisted by Exit Deutsche Schweiz has increased since the 1990s (women: 52% to 65%, p = 0.031; mean age in years (SD): 69.3 (17.0) to 76.9 (13.3), p = 0.000), non-fatal diseases: 22% to 34%, p = 0.026). Conclusions: Weariness of life rather than a fatal or hopeless medical condition may be a more common reason for older members of Exit Deutsche Schweiz to commit suicide. The strong over-representation of women in both Exit Deutsche Schweiz and Dignitas suicides is an important phenomenon so far largely overlooked and in need of further study. (shrink)

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public (...) came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism. (shrink)

Tool use research has suffered from a lack of consistent theoretical frameworks. There is a plethora of tool use definitions and the most widespread ones are so inclusive that the behaviors that fall under them arguably do not have much in common. The situation is aggravated by the prevalence of anecdotes, which have played an undue role in the literature. In order to provide a more rigorous foundation for research and to advance our understanding of the interrelation between tool use (...) and cognition, we suggest the adoption of Fragaszy and Mangalam's (2018) tooling framework, which is characterized by the creation of a body-plus-object system that manages a mechanical interface between tool and surface. Tooling is limited to a narrower suite of behaviors than tool use, which might facilitate its neurocognitive investigation. Indeed, evidence in the literature indicates that tooling has distinct neurocognitive underpinnings not shared by other activities typically classified as tool use, at least in primates. In order to understand the extent of tooling incidences in previous research, we systematically surveyed the comprehensive tool use catalog by Shumaker et al. (2011). We identified 201 tool use submodes, of which only 81 could be classified as tooling, and the majority of the tool use examples across species were poorly supported by evidence. Furthermore, tooling appears to be phylogenetically less widespread than tool use, with the greatest variability found in the primate order. However, in order to confirm these findings and to understand the evolution and neurocognitive mechanisms of tooling, more systematic research will be required in the future, particularly with currently underrepresented taxa. (shrink)

There is an increasing interest in how managers describe and respond to what they regard as moral versus nonmoral problems in organizations. In this study, forty managers described a moral problem and a nonmoral problem that they had encountered in their organization, each of which had been resolved. Analyses indicated that: (1) the two types of problems could be significantly differentiated using four of Jones' (1991) components of moral intensity; (2) the labels managers used to describe problems varied systematically between (...) the two types of problems and according to the problem's moral intensity; and (3) problem management processes varied according to the problem's type and moral intensity. (shrink)

The problem addressed in this paper is “the main epistemic problem concerning science”, viz. “the explication of how we compare and evaluate theories [...] in the light of the available evidence” (van Fraassen, BC, 1983, Theory comparison and relevant Evidence. In J. Earman (Ed.), Testing scientific theories (pp. 27–42). Minneapolis: University of Minnesota Press). Sections 1– 3 contain the general plausibility-informativeness theory of theory assessment. In a nutshell, the message is (1) that there are two values a theory should exhibit: (...) truth and informativeness—measured respectively by a truth indicator and a strength indicator; (2) that these two values are conflicting in the sense that the former is a decreasing and the latter an increasing function of the logical strength of the theory to be assessed; and (3) that in assessing a given theory by the available data one should weigh between these two conflicting aspects in such a way that any surplus in informativeness succeeds, if the shortfall in plausibility is small enough. Particular accounts of this general theory arise by inserting particular strength indicators and truth indicators. In Section 4 the theory is spelt out for the Bayesian paradigm of subjective probabilities. It is then compared to incremental Bayesian confirmation theory. Section 4 closes by asking whether it is likely to be lovely. Section 5 discusses a few problems of confirmation theory in the light of the present approach. In particular, it is briefly indicated how the present account gives rise to a new analysis of Hempel’s conditions of adequacy for any relation of confirmation (Hempel, CG, 1945, Studies in the logic of comfirmation. Mind, 54, 1–26, 97–121.), differing from the one Carnap gave in § 87 of his Logical foundations of probability (1962, Chicago: University of Chicago Press). Section 6 adresses the question of justification any theory of theory assessment has to face: why should one stick to theories given high assessment values rather than to any other theories? The answer given by the Bayesian version of the account presented in section 4 is that one should accept theories given high assessment values, because, in the medium run, theory assessment almost surely takes one to the most informative among all true theories when presented separating data. The concluding section 7 continues the comparison between the present account and incremental Bayesian confirmation theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Vessel of Honor: The Virgin Birth and the Ecclesiology of Vatican II by Brian A. GraebeAaron Pidel S.J.Vessel of Honor: The Virgin Birth and the Ecclesiology of Vatican II. By Brian A. Graebe (Steubenville, OH: Emmaus Academic, 2021), 351 pp.Though Mary's undiminished virginity in giving birth (virginitas in partu) was long understood to be an event as miraculous and a teaching as authoritative as her virginity in conceiving (...) (virginitas ante partum), virginitas in partu underwent a kind of existential reinterpretation in the middle of the twentieth century. Authors such as Albert Mitterer and Karl Rahner suggested that, physically speaking, Jesus's birth might have happened like any other, rupturing the hymen, distending the birth canal, and causing Mary pain, albeit not in the spiritually disintegrating way common to postlapsarian humanity. These arguments effectively "unsettled" the traditional understanding of virginitas in partu, leading theologians of the highest stature to distinguish between the doctrine itself and the anatomical aspects attached to it over time. Fr. Brian Graebe has written a fine book arguing that the bodily dimensions of the virgin birth, including the physical "seal" of virginity, belong to the substance of the doctrine. This more inclusive understanding not only does better justice to the data of tradition, he argues, but illuminates the ecclesiology of the Second Vatican Council. The book impresses by its theologically reflective method, its clarity of exposition, [End Page 1106] and its depth of research—especially into the archival and antepreparatory sources of Vatican II.Vessel of Honor responds in effect to Rahner's argument that physical intactness is peripheral to the dogmatic core of Mary's virginity in partu. To show otherwise, Rahner contended, one would need to show that such a doctrine can be found directly in the apostolic teaching, or that it, "being implicitly contained therein, has grown out of the apostolic doctrine, by a legitimate historical, logical, and theological process, as its authentic development" (68–69). If the bodily aspects of this doctrine really belonged to the deposit of faith, in other words, one would need to show how they are implied in the traditio divino-apostolica, as well as how they cohere organically with the rest of the deposit. The two major parts of Vessel of Honor respond in turn to each aspect of Rahner's challenge.The first three chapters argue that Mary's bodily integrity in parturition belongs at least implicitly to the traditio divino-apostolica. Turning first to the postapostolic tradition, Fr. Graebe shows that—apart from the early exceptions of Origen and Tertullian—patristic sources either affirm or strongly imply a miraculous delivery. This constant witness culminates in the Lateran Council (649 AD), which, while not itself an ecumenical council, was received into the magisterium of Pope Martin and affirmed by the Third Council of Constantinople (680 AD). Its teaching that Mary "gave birth without corruption" (incorruptibiliter... genuisse) would be defended by Paschasius, Ratramnus, Thomas Aquinas, and others. This consensus remained undisturbed until the eve of Vatican II.Even at Vatican II, Fr. Graebe argues in the next chapter, the Council Fathers intended to reaffirm the more inclusive idea of virginitas in partu against those who would marginalize its bodily dimensions. Here he really breaks new ground, delving deep into the antepreparatory, preparatory, and conciliar drafting history. He shows convincingly that many of the chief drafters of the final formula—"Our Lord, who did not diminish his mother's virginal integrity but sanctified it..." (Lumen Gentium §57)—saw it as excluding Rahner's and Mitterer's minimalizing interpretations. Drawing on material from the Vatican Apostolic Archives, Fr. Graebe shows that some of the very theologians who voted to omit the pointed phrase "in the birth itself" (in ipsomet partu) did so for tonal rather than substantive reasons.The third chapter argues that Mary's physical integrity in birth is to be believed with divine and Catholic faith, despite the ongoing confusion introduced by Rahner and others. Admittedly, Vatican II did not define but merely reaffirmed the traditional understanding of virginitas in partu. But there are other reasons for including it in the traditio divino-apostolica. [End Page 1107] Drawing heavily... (shrink)

Examines the political significance of ideas about happiness through the work of utilitarian philosophers William Thompson and Jeremy Bentham. Happiness is political. The way we think about happiness affects what we do, how we relate to other people and the world around us, our moral principles, and even our ideas about how society should be organized. Utilitarianism, a political theory based on hedonistic and individualistic ideas of happiness, has been dominated for more than two-hundred years by its founder, Jeremy Bentham. (...) In Happiness, Democracy, and the Cooperative Movement, Mark J. Kaswan examines the work of William Thompson, a friend of Bentham’s who nonetheless offers a very different utilitarian philosophy and political theory based on a different conception of happiness, but whose work has been largely overlooked. Kaswan reveals the importance of our ideas about happiness for our understanding of the basic principles and nature of democracy, its role in society and its character as a social institution. In what is the closest examination of Thompson’s political theory to date, Kaswan moves from philosophy to theory to practice, starting with conceptions of happiness before moving to theories of utility, then to democratic theory, and finally to practice in the first detailed account of how Thompson’s ideas laid the foundations for the cooperative movement, which is now the world’s largest democratic social movement. Mark J. Kaswan is Assistant Professor of Government at the University of Texas at Brownsville and J. Robert Beyster and Michael W. Huber Fellow, Rutgers University School of Management and Labor Relations. (shrink)

Introduction -- Tending the dark fire: the Boehmian notion of drive -- The night-side of nature: the early Schellingian unconscious -- The speculative psychology of dissociation: the later Schellingian unconscious -- Schellingian libido theory.

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

The early Schelling and the romantics constructed the unconscious in order to overcome the modern split between subjectivity and nature, mind and body, a split legislated by Cartesian representationalism. Influenced by Boehme and Kabbalah, the later Schelling modified his notion of the unconscious to include the decision to be oneself, which must sink beneath consciousness so that it might serve as the ground of one's creative and personal acts. Slavoj Zizek has read the later Schelling's unconscious as a prototype of (...) Lacan's reactive unconscious, an unconscious that only exists as the excluded other of consciousness. This reading, though close to the text of Schelling, misses something essential: the unconscious for Schelling is not a repression but a condition of the possibility of life and love. (shrink)

How do we know that our own actions belong to us? How are we able to distinguish self-generated sensory events from those that arise externally? In this paper, I will briefly discuss experiments that were designed to investigate these questions. In particularly, I will review psychophysical and neuroimaging studies that have investigated how we recognise the consequences of our own actions, and why patients with delusions of control confuse self-produced and externally produced actions and sensations. Studies investigating the failure of (...) this 'self-monitoring' mechanism in patients with delusions of control will be discussed in the context of the hypothesis that overactivity in the parietal cortex and the cerebellum contribute to the misattribution of an action to an external source (). (shrink)

Context: Philosophical debates in recent decades have developed new ways of dealing with old philosophical problems such as reality, truth, knowledge, language, communication, and action. These new approaches deserve serious consideration because they can improve the discourse of radical constructivism. Problem: This paper discusses the following problem: How can we overcome dualistic and ontological approaches to basic philosophical problems – problems that are relevant to all scientific domains? Method: The method applied here can be roughly described as a transition from (...) entities/substantives/identities to actions and processes, the actions and processes from which so-called entities result. Action-orientation – or an actor-based process – is necessarily combined with sense-orientation as provided by culture and society. Results: The paper demonstrates how the problems mentioned above can be reformulated in a non-dualistic and non-ontological way. Implications: Opening up constructivist thinking to insights provided by neighbouring philosophical approaches facilitates interdisciplinary cooperation and helps overcome dualistic remnants – as well as the cognitive one-sidedness of traditional constructivism. (shrink)

In this paper the authors argue that research ethics committees should not be paternalistic by rejecting research that poses risk to people competent to decide for themselves. However it is important they help to ensure valid consent is sought from potential recruits and protect vulnerable people who cannot look after their own best interests. The authors first describe the tragic deaths of Jesse Gelsinger and Ellen Roche. They then discuss the following claims to support their case: competent individuals are epistemologically (...) and ethically in the best position to say which risks are reasonable for them, so RECs should be no more restrictive than the “normal” constraints on people taking risks with themselves; RECs do not judge individual competence ; individual liberty is mostly limited by what serves the public interest, and RECs do not determine public interest; RECs may have a paternalistic role in preventing exploitation of competent people vulnerable to the use of incentives, and in protecting the interests of incompetent people; however, the moral and political authority of RECs has not been established in this respect. (shrink)

Increasingly, medical students are required to face up to ethical issues in their training and practice. At the same time, there is growing interest in philosophy courses in the ethical issues raised by medical practice. This textbook, designed primarily for students of medicine, develops the issues to a philosophical level complex enough to be satisfying to students of philosophy as well as MA students on applied ethics courses. The author advocates an approach to medical ethics which breaks out of the (...) straitjacket of the narrow choice between utilitarian or deontological theory, and contains a valuable discussion of practical wisdom. It maintains a balance between case studies and philosophical arguments - which are developed in a historical context, and will be of interest at all levels of the medical profession. (shrink)

Increasingly, medical students are required to face up to ethical issues in their training and practice. At the same time, there is growing interest in philosophy courses in the ethical issues raised by medical practice. This textbook, designed primarily for students of medicine, develops the issues to a philosophical level complex enough to be satisfying to students of philosophy as well as MA students on applied ethics courses. The author advocates an approach to medical ethics which breaks out of the (...) straitjacket of the narrow choice between utilitarian or deontological theory, and contains a valuable discussion of practical wisdom. It maintains a balance between case studies and philosophical arguments - which are developed in a historical context, and will be of interest at all levels of the medical profession. (shrink)

In the academic year 1920-1921 at the University of Freiburg, Martin Heidegger gave a series of extraordinary lectures on the phenomenological significance of the religious thought of St. Paul and St. Augustine. The publication of these lectures in 1995 settled a long disputed question, the decisive role played by Christian theology in the development of Heidegger’s philosophy. The lectures present a special challenge to readers of Heidegger and theology alike. Experimenting with language and drawing upon a wide range of now (...) obscure authors, Heidegger is finding his way to Being and Time through the labyrinth of his Catholic past and his increasing fascination with Protestant theology. A Companion to Heidegger's Phenomenology of Religious Life is written by an international team of Heidegger specialists. (shrink)

The purported failures of ergodic theory (seen in its often proved ineptitude to ground a mechanical explanation of thermodynamics) are shown to arise from misconception of the functions served by scientific explanation. In fact, the predictive failures of ergodic theory are precisely its points of greatest physical utility, where genuinely new knowledge about actual physical systems can be obtained, once the links between explanation and reconstructive estimation are recognized.

Cora Diamond has recently criticised as mere legend the interpretation of a quip of Ramsey's, contained in the epigraph below, which takes him to be objecting to or rejecting Wittgenstein's Tractarian distinction between saying and showing. Whilst I agree with Diamond's discussion of the legend, I argue that her interpretation of the quip has little evidential support, and runs foul of a criticism sometimes made against intuitionism. Rather than seeing Ramsey as making a claim about the nature of propositions, as (...) Diamond does, we should understand him as making a claim about the grammar of the logical connectives. Such a view coheres with the extant evidence of the nature of Wittgenstein's and Ramsey's 1929 philosophical encounters. It is also compatible with attributing to Ramsey a recognition of Wittgenstein's distinction and with denying that criticising it is the lesson of the quip. (shrink)