ḥeleḳ 1. Oraḥ ḥayim. Mikhtavim -- ḥeleḳ 2. Hadrakhot be-ʻinyene Talmud-Torah ṿe-ḥinukh ... -- ḥeleḳ 3. Liḳuṭim, mikhtavim --.

Breaking off the ordinary flow of experience, the passions create a state of exception. In their suddenness and intensity, they map a personal world, fix and qualify our attention, and impel our actions. Outraged anger drives us to write laws that will later be enforced by impersonal justice. Intense grief at the death of someone in our life discloses the contours of that life to us. Wonder spurs scientific inquiry. The strong current of Western thought that idealizes a dispassionate world (...) has ostracized the passions as quaint, even dangerous. Intense states have come to be seen as symptoms of pathology. A fondness for irony along with our civic ideal of tolerance lead us to prefer the diluted emotional life of feelings and moods. Demonstrating enormous intellectual originality and generosity, Philip Fisher meditates on whether this victory is permanent-and how it might diminish us. From Aristotle to Hume to contemporary biology, Fisher finds evidence that the passions have defined a core of human nature no less important than reason or desire. Traversing the Iliad, King Lear, Moby Dick, and other great works, he discerns the properties of the high-spirited states we call the passions. Are vehement states compatible with a culture that values private, selectively shared experiences? How do passions differ from emotions? Does anger have an opposite? Do the passions give scale, shape, and significance to our experience of time? Is a person incapable of anger more dangerous than someone who is irascible? In reintroducing us to our own vehemence, Fisher reminds us that it is only through our strongest passions that we feel the contours of injustice, mortality, loss, and knowledge. It is only through our personal worlds that we can know the world. (shrink)

ḥeleḳ 1. Maʼamar rishon -- ḥeleḳ 2. Maʼamar sheni -- ḥeleḳ 3. Maʼamar shelishi -- ḥeleḳ 4. Maʼamar reviʻi-ḥamishi.

In this paper, we review recent neuroimaging investigations of disorders of consciousness and different disciplines' understanding of consciousness itself. We consider potential tests of consciousness, their legal significance, and how they map onto broader themes in U.S. statutory law pertaining to advance directives and surrogate decision-making. In the process, we outline a taxonomy of themes to illustrate and clarify the variance in state-law definitions of consciousness. Finally, we discuss broader scientific, ethical, and legal issues associated with the advent of neuroimaging (...) for disorders of consciousness and conclude with policy recommendations that could help to mitigate confusion in this realm. (shrink)

Background: Recent research demonstrates that people sometimes make different medical decisions for others than they would make for themselves. This finding is particularly relevant to end-of-life decisions, which are often made by surrogates and require a trade-off between prolonging life and maintaining quality of life. We examine the impact of decision role, patient age, decision maker age and multiple individual differences on these treatment decisions. Methods: Participants read a scenario about a terminally ill cancer patient faced with a choice between (...) an aggressive chemotherapy regimen that will extend life by two years and palliative treatments to control discomfort for one remaining month. Participants were randomly assigned to one of three decision roles (patient, physician, or an abstract other) and the scenario randomly varied whether the patient was described as 25 or 65-years old. Results: When deciding for a 65-year old patient, approximately 60% of participants selected aggressive chemotherapy regardless of decision role. When deciding for a 25-year old patient, however, participants were more likely to select chemotherapy for a patient (physician role) or another person (abstract other) than for themselves (70%, 67%, and 59%, respectively). In addition, confidence that powerful others (eg, physicians) control one’s health, as well as respondents’ age and race, consistently predicted treatment choices. Conclusions: Patient age appears to influence medical decisions made for others but not those that we make for ourselves. These findings may help to explain the discord that often occurs when younger cancer patients refuse life-extending treatments. (shrink)

What is the fruit of a searching dialogue between faith and reason? This book collects theological and philosophical perspectives on the richness of the faith-reason dialogue, including examples from literature, continental and analytic philosophy, worship and liturgy, and radical approaches to issues of racism and prejudice. The authors strongly resist the temptations to either disregard the faith-reason dialogue or take it for granted. Through their explorations and reflections they open up new vistas and horizons on a topic more necessary than (...) ever. (shrink)

[1] ʻAl ʻinyene ḥinukh ha-banim ṿeha-banot ṿi-yeme ha-baḥarut-- [2] ʻAl ʻinyene derekh ha-Ḥasidut lesayeaʻ le-zulato be-ruḥaniyut ṿe-nilṿeh elaṿ mikhteve ḳodesh be-ʻinyan zeh.

Torat Yesharim -- Tehilat Yesharim -- Avot Yesharim -- Sheʼelat Yesharim.

BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

Objective: To audit doctors’ knowledge of informed consent.Design: 10 consent scenarios with “true”, “false”, or “don’t know” answers were completed by doctors who care for children at a large district general hospital. These questions tested clinicians’ knowledge of who could give consent in different clinical situations.Setting: Royal United Hospital, Bath, UK.Results: 51 doctors participated . Paediatricians scored higher than other clinicians . Only 36% of paediatricians and 8% of other clinicians realised that the biological father of a child born before (...) 1 December 2003 needed a court order or a parental responsibility agreement to acquire parental responsibility, and thus be able to consent on behalf of his child, if he was not married to the child’s mother. Non-paediatric clinicians were unsure or incorrect when tested on situations where people with parental responsibility do not agree, or where young people , who are Fraser competent do not want to consult their parents. Most clinicians did not know that the parents of a 20-year-old man with severe learning difficulties are unable to consent to surgery on his behalf, and many non-paediatricians were unclear on who could give consent when a child lived with foster parents.Conclusion: Clinicians who obtain consent for the treatment of children need to increase their knowledge on who is able to give informed consent to ensure best practice. (shrink)