For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

Twentieth-century developments in quantum physics, together with an emerging science of consciousness, have created the need for a new cosmology, or model of the universe. The theory of process contained in THE REFLEXIVE UNIVERSE places consciousness within the context of contemporary science. One of the central themes of this extraordinary work is that each successive organization of matter, from fundamental particles in physics to living organisms, expresses a particular stage in the evolution of mind. Starting with the photon, the basic (...) unit of light, and moving through atomic physics, molecular chemistry, the morphology of plants and animals and finally to levels of human evolution, Young develops his theory in vivid step-by-step detail. Consciousness, in his point of view, is not isolated from the material universe. It exists in a continuum, one in which physical and nonphysical realms can be linked and the teachings of mythology and religion can be integrated. To order: FAX: 415-883-9280; e-mail: [email protected]; or write: Anodos Foundation, c/o Publishers Services, P.O. Box 2510, Novato, CA 94948. Visa and MasterCard only. Trade STOP orders 40% plus postage. (shrink)

First published in 1818, The World as Will and Representation contains Schopenhauer's entire philosophy, ranging through epistemology, metaphysics, philosophy of mind and action, aesthetics and philosophy of art, to ethics, the meaning of life and the philosophy of religion, in an attempt to account for the world in all its significant aspects. It gives a unique and influential account of what is and is not of value in existence, the striving and pain of the human condition and the possibility of (...) deliverance from it. This new translation of the first volume of what later became a two-volume work reflects the eloquence and power of Schopenhauer's prose and renders philosophical terms accurately and consistently. It offers an introduction, glossary of names and bibliography, and succinct editorial notes, including notes on the revisions of the text which Schopenhauer made in 1844 and 1859. (shrink)

Death is the destiny we all share, and this will not change. Yet the way we die, which had remained the same for many generations, has changed drastically in a relatively short time for those in developed countries with access to healthcare. For generations, if people were lucky enough to reach old age, not having died in infancy or childhood, in childbirth, in war, or by accident, they would take to bed, surrounded by loved ones who cared for them, and (...) fade into death. Most likely, they would have seen their parents and grandparents die the same way, and so this manner of dying would be familiar: it was part of the natural cycle of life. Now less than 25 per cent of Americans die at home, having reached much older ages than people would have dreamed of in past generations, often after surviving many illnesses and even diseases that would have been terminal for their grandparents. We are fortunate to live (and die) today, supported by myriad scientific, medical, and technological advancements, however we also face new problems as a result of the new way in which we die. We can no longer anticipate a peaceful waning at home with family. We know our lives will likely end in hospitals likely after we have endured grueling treatments to prolong life. We have to decide what decisions we want our loved ones, or care-givers, to make when we cannot choose for ourselves. We have to think about whether in any circumstances we would seek physician-assisted death. We know we face other questions as well, but we may not even know where to start. In the face of these decisions, we can feel daunted and afraid. The best remedy is information and planning. In this book, Gregory Eastwood - a physician who has cared for dying patients, served as an ethics consultant, and taught end of life issues to medical and other health profession students - draws from his substantial experience with patients and families to provide the information that will help us think clearly about the choices and issues we will face at the end of our own lives, and when faced with the deaths of our loved ones. With sensitivity and profound insight, Eastwood guides us through all the important questions about death and dying in straightforward, clear language, enhanced by real-life stories. Throughout, he shows us how we can take ownership of the way we want to die, when we must die, and feel more in control as death approaches. (shrink)

Arthur Waley's brilliant and definitive translation of one of the foremost of all mystical books, Lao Tzu's Tao Te Ching, has become a modern classic in its own right. Unlike previous translations, it is founded not on the medieval commentaries but on a close study of all the early Chinese literature, and it provides a singular example of authoritative scholarship skillfully blended with brilliant, precise writing. In his introduction, Dr. Waley gives an extensive scholarly account of Chinese thought down (...) to the end of the third century B.C. Here, the author presents a full picture of Chinese prehistory, early philosophy, and literature, showing the original, lofty conception of Taoism before the gradual corruption through the course of centuries, tracing this conflict of philosophies and its background of politics. (shrink)

One of the more interesting developments in recent historical writing has been a reconsideration of the debates over poor law reform. In the sharply-demarcated world of post-war scholarship, the poor law fell clearly, if somewhat problematically, into the domain of social history. For obvious contemporary reasons, post-war social history devoted a good deal of scholarly energy to constructing a history of social policy. Much of this work was problematized in terms of the then orthodox agenda of the welfare state. The (...) dominant questions concerned modes of assessing entitlements, mechanisms for delivering welfare, and the bureaucratic characteristics of the old and new poor laws. Despite its considerable empirical merits, this kind of social history was inhibited by its methodological and problematic certainties. To a large extent this was a social history which defined itself against traditional political history, offering a narrative of social policy formation which, whilst not eliminating political processes from its account, tended to marginalize their normative significance. One extreme formulation was Sydney Checkland's ‘socially innocent state’. Here the loss of ‘social innocence’ on the part of the British state is evaluated directly in terms of its willingness to develop the kind of social agenda and administrative machinery characteristic of modern wellfarism. For Checkland in particular, social policy was conceived almost exclusively in terms of state-driven programmes of ‘social improvement’. The old poor law, with its pattern of local management, discretionary administration, and paternalist social vision flatly contracted the statutorily-articulated welfarism which Checkland took to be axiomatic to a coherently-conceived social policy. In terms of statutory authority and administrative machinery, Checkland saw the new poor law as a critical move towards a more coherently-constructed state social policy. (shrink)

John Broome argues that fairness requires that claims are satisfied in proportion to their strength. Broome holds that, when distributing indivisible goods, fairness requires the use of weighted lotteries as a surrogate to satisfy proportionally each candidate's claims. In this article, we present two arguments against Broome's account of fairness. First, we argue that it is almost impossible to calculate the weights of the lotteries in accordance with the requirements of fairness. Second, we argue that Broome rules out those methods (...) whose use might provide some resolution to this problem. From these arguments, we conclude that, contra Broome, fairness does not require the proportional satisfaction of claims. (shrink)

1929. The course of Gifford Lectures that Eddington delivered in the University of Edinburgh in January to March 1927.

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases (...) into stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

"Popular summaries of existentialism and Sartre's ideas have ensured a wide currency for such words as 'absurdity', 'nothingness', 'engagement', 'shame', and 'anguish'. But for Sartre, each of these words embodies a precise philosophical concept which he applies and explores further in his fiction and plays. Synthesized in 'Being and Nothingness' and 'Critique of Dialectical Reason', these concepts comprise a fully articulated philosophical system which, as Arthur C. Danto argues, in its vision and scope, logical responsibility and human relevance, takes (...) its place among the greatest of philosophical achievements. This book offers a synoptic and sympathetic reconstruction of the Sartrean system and in particular Sartre's analysis of the nature of language, consciousness, knowledge, self, and values." --Descripción del editor. (shrink)

Asl. Atthasalinl of Buddhaghosa, ed. PTS. 1897. BB. Bibliotheca Buddhica, Petrograd. BC. Buddhacarita, ed. Cowell, Oxford, 1893. BCA. ...

The English Franciscan, William of Ockham (c. 1285-1349), was one of the most important thinkers of the later middle ages. Summoned to Avignon in 1324 to answer charges of heresy, Ockham became convinced that Pope John XXII was himself a heretic in denying the complete poverty of Christ and the apostles and a tyrant in claiming supremacy over the Roman empire. Ockham's political writings were a result of these personal convictions, but also include systematic discourses on the basis and functions (...) of spiritual and secular power as well as exhaustive discussions of Franciscan poverty and the general problem of papal heresy. Ockham emerges in this study as a man deeply committed to natural and Christian human rights, who found these fundamental values so seriously menaced in his time that their survival could be assured only by radical, even revolutionary, personal action and by a basic reworking of traditional political thought. (shrink)

The U.S. rejected isolationism during the standoff with the Soviet Union during the Cold War because of the perceived direct threat to U.S. security. Schlesinger argues that we must now both reexamine the Wilsonian doctrine of collective security and focus on preventive diplomacy.

General rules.--Our relation to ourselves.--Our relation to others.--Worldly fortune.--The ages of life.

This is arguably the seminal work in historical andphilosophical analysis of the twentieth century.

This is a revised and expanded edition of a seminal work in the logic and philosophy of time, originally published in 1968. Arthur N. Prior was the founding father of temporal logic, and his book offers an excellent introduction to the fundamental questions in the field. Several important papers have been added to the original selection, as well as a comprehensive bibliography of Prior's work and an illuminating interview with his widow, Mary Prior. In addition, the Polish logic which (...) made Prior's writings difficult for many readers has been replaced by standard logical notation. This new edition will secure the classic status of the book. (shrink)