Advancements in fetal assessment and therapeutic intervention in medical practice and clinical research call for corresponding progress in regulatory and ethical guidance. In “A new ethical framewo...

Sextus Empiricus does not reveal anything of himself as distinct from ‘the Sceptic’ except in a passing and incidental way. He does not refer to his contemporaries, nor to his country, nor to any personal experiences, in such a way as to provide a definite picture of his life and times. The few references he makes to his involvement in the medical profession are as perplexing as they are enlightening. The only attachments which Sextus strongly identifies with in his extant (...) writings are the demands of the Pyrrhonean philosophy. (shrink)

The paper attempts to show that Aristotle's critique of Plato's teachings provides an exemplary model of sound, scientific, philosophical commentary. This view has been vigorously opposed by one of the most brilliant Platonist in our century. J.N. Findlay sharply distinguishes between the Aristotle whom he regards as a faithful recorder of his master's teachings, and the Aristotle whom he condemns as a thoroughly misguided and incompetent Platonic commentator. I join Findlay in giving first authority to Aristotle's evidence against Cherniss and (...) others, but maintain against Findlay that the most philosophically insightful and accurate exposition of Plato's philosophy is to be found in the works of Aristotle. In arguing this thesis I attempt to support J.A. Doull's account of the relation of Aristotle to Plato. (shrink)

"Without God or His Doubles" offers a sympathetic but critical interpretation of the philosophy of Richard Rorty.

Deciding whether to grant an expanded access request for a child whose sibling is enrolled in a gene therapy trial involves a number of complex factors: considering the best interests of the child, the psychosocial and economic impact on the family, and the concerns and obligations of researchers. Despite the challenges in coming to a substantively fair outcome in cases of discordant eligibility, creating a procedurally fair decision-making process to adjudicate requests is essential.

Volume 19, Issue 6, June 2019, Page 22-25.

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Thousands of youth suffering from acquired brain injury or other early-life neurological disease live, mature, and learn with only limited communication and interaction with their world. Such cognitively capable children are ideal candidates for brain-computer interfaces. While BCI systems are rapidly evolving, a fundamental gap exists between technological innovators and the patients and families who stand to benefit. Forays into translating BCI systems to children in recent years have revealed that kids can learn to operate simple BCI with proficiency akin (...) to adults. BCI could bring significant boons to the lives of many children with severe physical impairment, supporting their complex physical and social needs. However, children have been neglected in BCI research and a collaborative BCI research community is required to unite and push pediatric BCI development forward. To this end, the pediatric BCI Canada collaborative network was formed, under a unified goal to cooperatively drive forward pediatric BCI innovation and impact. This article reflects on the topics and discussions raised in the foundational BCI-CAN meeting held in Toronto, ON, Canada in November 2019 and suggests the next steps required to see BCI impact the lives of children with severe neurological disease and their families. (shrink)

This festschrift collects a number of insightful essays by a group of accomplished Christian scholars, all of who have either worked with or studied under Hendrik Hart during his 35-year tenure as Senior Member in Systematic Philosophy at the Institute for Christian Studies, Toronto, Canada.

When surveying recent philosophical work on the nature and status of collective intentionality and we-intentions, it is striking how much effort is spent on analysing the structure of joint action and on establishing whether or not the intention to, say, go for a walk or paint a house together is reducible to some form of I-intentionality. Much less work has been devoted to an analysis of shared affects and emotions. This is regrettable, not only because emotional sharing in all (...) likelihood is developmentally prior to and logically more basic than joint action, but also because it might constitute a way of being together with others, which we need to study if we wish to better understand the nature of the we. In the present contribution, my primary aim will be to offer an answer to the following question: does the we-experience, the experience of being part of a we, presuppose, precede, preserve, or abolish the difference between self- and other-experience? In pursuing this task, I will take a closer look at emotional sharing and draw on resources that are too frequently ignored in current social ontology, namely insights found in classical phenomenology and in contemporary research on social cognition. (shrink)

OBJECTIVE: To examine the long-term effects of an innovative curriculum on medical house officers' (HOs') knowledge, confidence, and attitudes regarding medical ethics. DESIGN: Long term cohort study. The two-year curriculum, implemented by a single physician ethicist with assistance from other faculty, was fully integrated into the programme. It consisted of monthly sessions: ethics morning report alternating with didactic conferences. The content included topics such as ethics vocabulary and principles, withdrawing life support, informed consent, and justice. Identical content was offered (...) simultaneously at the largest affiliated community hospital. SETTING: A multi-hospital university training programme from July, 1992 to June, 1994. PARTICIPANTS: Thirty-nine HOs responded in 92. Thirty HOs from the same cohort responded in 94 (response rates = 83% v 71%; P = 0.19). RESULTS: The curriculum was well received, with 96% of HOs finding the sessions stimulating. Previously validated scales of knowledge and confidence were administered at baseline and at follow-up. The average knowledge score improved 14% (P < 0.001). Confidence also improved, rising from 3.3 to 3.8 on a 5-point Likert scale (P < 0.001). These findings were independent of age, gender, religion, and prior education. The only attitudinal change was an increase in the proportion of residents who thought that ethics should be a required part of residency training (57% v 80%, P = 0.05). CONCLUSION: This curriculum appears practical, popular, and effective. It should be readily transferable to other institutions. (shrink)

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge (...) scores did not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)

Background Retraction is a mechanism for alerting readers to unreliable material and other problems in the published scientific and scholarly record. Retracted publications generally remain visible and searchable, but the intention of retraction is to mark them as “removed” from the citable record of scholarship. However, in practice, some retracted articles continue to be treated by researchers and the public as valid content as they are often unaware of the retraction. Research over the past decade has identified a number of (...) factors contributing to the unintentional spread of retracted research. The goal of the Reducing the Inadvertent Spread of Retracted Science: Shaping a Research and Implementation Agenda (RISRS) project was to develop an actionable agenda for reducing the inadvertent spread of retracted science. This included identifying how retraction status could be more thoroughly disseminated, and determining what actions are feasible and relevant for particular stakeholders who play a role in the distribution of knowledge. -/- Methods These recommendations were developed as part of a year-long process that included a scoping review of empirical literature and successive rounds of stakeholder consultation, culminating in a three-part online workshop that brought together a diverse body of 65 stakeholders in October–November 2020 to engage in collaborative problem solving and dialogue. Stakeholders held roles such as publishers, editors, researchers, librarians, standards developers, funding program officers, and technologists and worked for institutions such as universities, governmental agencies, funding organizations, publishing houses, libraries, standards organizations, and technology providers. Workshop discussions were seeded by materials derived from stakeholder interviews (N = 47) and short original discussion pieces contributed by stakeholders. The online workshop resulted in a set of recommendations to address the complexities of retracted research throughout the scholarly communications ecosystem. -/- Results The RISRS recommendations are: (1) Develop a systematic cross-industry approach to ensure the public availability of consistent, standardized, interoperable, and timely information about retractions; (2) Recommend a taxonomy of retraction categories/classifications and corresponding retraction metadata that can be adopted by all stakeholders; (3) Develop best practices for coordinating the retraction process to enable timely, fair, unbiased outcomes; and (4) Educate stakeholders about pre- and post-publication stewardship, including retraction and correction of the scholarly record. -/- Conclusions Our stakeholder engagement study led to 4 recommendations to address inadvertent citation of retracted research, and formation of a working group to develop the Communication of Retractions, Removals, and Expressions of Concern (CORREC) Recommended Practice. Further work will be needed to determine how well retractions are currently documented, how retraction of code and datasets impacts related publications, and to identify if retraction metadata (fails to) propagate. Outcomes of all this work should lead to ensuring retracted papers are never cited without awareness of the retraction, and that, in public fora outside of science, retracted papers are not treated as valid scientific outputs. (shrink)

For many years the damages available to an employee in a wrongful dismissal action have been somewhat limited. A conservative approach to the question of measure of damages has prevailed and the recoverable heads of damage have been restricted. In particular, damages for injury to feelings and reputation have not been available. The House of Lords decision in Malik v BCCI [1998] AC 20, where the plaintiffs were held to be entitled to compensation for the damage the dismissals caused (...) to future employment prospects, has resulted in a significant change in the law. The decision in Malik comes at a time when the law of the employment contract is undergoing significant change. Perhaps the most notable instance of this has been the emergence of the implied obligation of mutual trust and confidence; that obligation being central to the plaintiffs case in Malik. Against that background this article considers whether further reform of the damages available in a wrongful dismissal action might usefully take place. It is argued that, for reasons of public policy, the law should aim to compensate fully an employee who has been wrongfully dismissed. This would involve a radical re-thinking on the approach to measure of damages. It would also require a change in the position on compensation for injury to feelings. (shrink)

Much effort and many resources have been expended in enacting smoking bans for private businesses catering to adult-only clientele. Although the arguments in favor of bans leave much to be desired, many people believe that banning smoking in the hospitality industry is justified.What is puzzling is the lack of attention on banning smoking around children in cars, houses, and other private property. After all, if such prohibitions are justified for autonomous adults, then they must be for non-autonomous minors as well. (...) A good case can be made out for banning smoking around children in the best interests of their health. (shrink)

The twenty‐six‐year‐old patient requested a prophylactic bilateral mastectomy with reconstruction because of an extensive family history of cancer. She reported that she had developed melanoma at twenty‐five; that her mother, sister, aunts, and a cousin all had breast cancer; that a cousin had ovarian cancer at nineteen; and that a brother was treated for esophageal cancer at fifteen. The treating team was skeptical about this history, and they could find no documentation of the patient's reported melanoma. The surgeon wrote the (...) patient's primary care physician, explaining that he had seen the patient and planned to proceed with the bilateral mastectomy and reconstruction. The primary care physician responded that he was unable to substantiate several of the patient's claims; some of his colleagues believed the family history to be fabricated. Trying to make sense of the discrepancies, the genetic counselor called a counselor colleague who had met with this patient. The colleague suggested that the in‐house genetic counselor “google” the patient. The search revealed two Facebook pages linked to the patient. In one, apparently a personal profile, the patient stated that in addition to battling stage four melanoma, she had recently been diagnosed with breast cancer. She provided a link to a site where she solicited donations to attend a summit for young cancer patients. The other Facebook page featured numerous pictures of her with a bald head, as though she has been through chemotherapy. The genetic counselor showed the Facebook pages to the surgeon, who then decided not to operate. Should health care professionals “google” their patients? (shrink)

Between 1234 and 1258 King Henry III, having emerged from the tutelage of ministers inherited from his father, controlled the government of England himself. Looking at this period of personal rule, it would be easy to gain the impression that Henry's kingship, in its theory, and also to some extent its practice, challenged the position of the magnates. M. T. Clanchy, for example, in a justly famous article has suggested that in the 1240s and 1250s Henry III evolved a theory (...) of royal absolutism, a theory which had threatening implications for the magnates. He has also stressed the extent to which Henry was “the initiator both of the methods and of the theory” behind Edward I's quo warranto campaign, which questioned the liberties possessed by the magnates in the field of local government. As for Henry's court, the impression has been given by R. F. Treharne that few English barons were present there, and that the king was largely surrounded by officials and foreign relatives — the latter being his wife's Savoyard uncles and his own Poitevin half-brothers of the house of Lusignan. G. W. S. Barrow has written that Henry “appeared to be excluding the barons as a class from membership of his royal council.” The question whether Henry, like his father John, was pressing magnates to pay their debts has never been investigated; but Matthew Paris's picture of the king as a “vigilant and indefatigable searcher after money” might indicate that the revolution of 1258, like that of 1215, was a “rebellion of the king's debtors.”. (shrink)

OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, consultant physician, (...) class='Hi'>house officer, and primary nurse and compared the ward notes with the understandings of these staff members. SETTING: The medical service of an urban university medical centre. RESULTS: The average number of documented CCCs addressed per DNR order was 1.1. The ward notes generally agreed with the perceptions of patients, house officers, and nurses (% agreement with notes = 79%, 77%, and 82%; kappa = 0.43, 0.40, 0.50). Consultant physicians' understandings were poorly reflected in the ward notes (% agreement = 59%; kappa = 0.18). They overestimated attention to CCCs compared with the notes (P < 0.0001) and with other observers (P < 0.0001). CONCLUSION: Chart review for attention to CCCs accurately reflects the understandings of patients, house officers, and nurses, but consultant physicians report more attention to CCCs than is recorded in the ward notes or understood by other observers. Better communication regarding end-of-life care plans should be encouraged. (shrink)

House of Lords authority in Tesco v Secretary of State for the Environment [1995] 1 WLR 759 has reinforced the well-established principle that judicial review will distinguish between relevant and irrelevant considerations pertaining to the exercise of a power, and leave the weighing of the relevant ones to the decision-maker. It has also problematized the principle by insisting that relevant factors may adequately be taken into account even where the decision-maker allows them no influence (subject to challenge for irrationality). (...) It is difficult to accept that a legislative identification of relevant factors need not influence the decision-maker, and the article begins by observing that this proposition would probably not have been accepted at the time of Roberts v Hopwood [1925] AC 578. It is argued in the article, however, that the proper influence of the relevant can be accommodated within the decision-making process while upholding the Tesco principle. The article therefore charts the activities which are logically implicit in a decision-making process including the consideration and weighing of relevant factors, and locates opportunities for legal challenge. The influence of the expressly relevant must be felt when the decision-maker has to decide whether other factors are impliedly relevant. It will equally be registered when a basis for the assessment of weight is established (weight being impossible to gauge without the prior formulation of criteria of influence). The process of weighing itself is shown to require two separate assessments; the first particular to each factor, the second comparative. This distinction allows explanation of those explanation of those authorities which require substantial weight to be given to certain protected factors, and helps to define the nature of irrationality challenges to absurd weighing. In summary, the article takes a rigorous look at what weight is, how it is assessed, how it differs from relevance, and to what extent a flawed assessment of it can be challenged. (shrink)

Euro Women's Independent Label Distribution (WILD) was a pan-European network of feminist music distributors active in the early 1980s. They were affiliated to WILD, the US-based Women's Music distribution network founded in 1979 to disseminate the growing corpus of Women's Music emerging from the US Women's Liberation Movement (WLM). This article presents an interpretation of archive materials that document Euro WILD's activities from the Women's Revolutions Per Minute archive, housed at the Women's Art Library, London. Constrained and enabled by the (...) archive materials on offer, I revisit some of the practical and political problems the network faced as European distributors of US Women's Music. Key issues explored include the perception of US cultural imperialism by women based in Europe and the affective politics that circulated transnationally between distributors. Finally, this article explores how the concept and practice of the Women's Music industry changed when women beyond the borders of the US engaged with it. (shrink)

Title: The Prison House of LanguagePublisher: Princeton University PressISBN: 0691013160Author: Frederic JamesonTitle: Russian Formalism: History, DoctrinePublisher: Mouton & Co.Author: Victor Erlich.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dogma and Ecumenism: Vatican II and Karl Barth's Ad Limina Apostolorum ed. by Matthew Levering, Bruce L. McCormack, and Thomas Joseph White, O.P.Gavin D'CostaDogma and Ecumenism: Vatican II and Karl Barth's Ad Limina Apostolorum edited by Matthew Levering, Bruce L. McCormack, and Thomas Joseph White, O.P. (Washington, DC: Catholic University Press of America Press, 2020), ix + 369 pp.In May 1966 Karl Barth visited Rome. He was invited (...) to reflect on the Second Vatican Council, to ask questions to leading curial figures, and peritus theologians, as well as Pope Paul VI. Barth's book Ad Limina Apostolorum: An Appraisal of Vatican II contains his questions and an account from Barth of his visit, along with some other important essays. It is still deeply challenging in its incisiveness, despite its brevity. I have always been struck by Barth's Marian criticisms that are so central to his viewpoint about divine agency and human cooperation. These give us an excellent insight into his ecclesiology. They represent the reasons for much of his questioning of various Roman Catholic positions on all sorts of matters. Eberhard Busch's diaries, while Barth's assistant during this period, form a fascinating complimentary account of the visit. These tell of the not-so-fruitful visit to Augustin Cardinal Bea and the great highpoint (for Barth) of his one-hour audience with Pope Paul VI. Barth was impressed by the Jesuits during his visit, but not so much by the Dominicans. He thought the latter had absorbed too many streams of liberal modernity. The two Dominicans participating in this book turn those tides. Indeed, all the authors could be located within the conserving wings of their ecclesial membership, which makes the volume all the stronger in raising serious unresolved disagreements and noting important common ground. It is testimony to Barth's enduring value that this volume seems so timely. The Barth Centre at Princeton and the Pontifical Faculty of the Dominican House in Washington were the sponsors of this collection.The volume is structured around five of the key documents commented on by Barth, with a Catholic and Reformed voice reflecting on both the particular document and Barth's input (with the exception of Francesca Aran Murphy, who deals with George Lindbeck rather than Barth), thereby simultaneously pushing forward the Catholic–Reformed engagement with the Council and with Barth. There is a preface with a penetrating introduction by Thomas Joseph White, O.P., and an irenic opening chapter by Matthew Levering on biblical renewal at Vatican II. Then follow the twin reflections on the five documents.First (and rightly so) comes the Dogmatic Constitution on Revelation, Dei Verbum. Katherine Sonderegger develops a nuanced reflection on the metaphor of Scripture as mirror of God (found in Dei Verbum), showing [End Page 971] a deep appreciation of currents within Dei Verbum that Barth had not detected, but which are more connective with his concerns and preoccupations. Lewis Ayres rather impishly takes what Barth saw as the main weakness of the text (its chapter 2: "Handing on Divine Revelation") and makes it the greatest strength. Ayers provides a deeply learned and original exploration of the concept of "tradition" as sacramental. In this duet, Barth comes out looking like he may have missed hearing the melodies while too closely studying the score.Then follow two profound essays on Lumen Gentium, the Dogmatic Constitution on the Church. Christoph Schwöbel builds up a strong Protestant case for the necessary visible ecclesial identity of the Church, thus showing a deep convergence without denying differences that remain. White, in a deeply insightful and probing essay, goes to the heart of the ecclesiological difference between Barth and Yves Congar (and some other key Catholics at the time): the relationship between uncreated divine agency and created human agency, especially within the context of the post-apostolic Church. White suggests that, without some stable ecclesial mediations, there can be no proper relationship envisaged between the transcendent causality of God operating in Christ and the created, active cooperative acts with this grace. While building up both a metaphysical and a theological case against Barth's criticisms... (shrink)

There you are at the opera house. The soprano has just hit her high note – a glassshattering high C that fills the hall – and she holds it. She holds it. She holds it. She holds it. She holds it. She holds the note for such a long time that after a while a funny thing happens: you no longer seem only to hear it, the note as it is currently sounding, that glass-shattering high C that is loud (...) and high and pure. In addition, you also seem to hear something more. It is difficult to express precisely what this extra feature is. One is tempted to say, however, that the note now sounds like it has been going on for a very long time. Perhaps it even sounds like a note that has been going on for too long. In any event, what you hear no longer seems to be limited to the pitch, timbre, loudness, and other strictly audible qualities of the note. You seem in addition to experience, even to hear, something about its temporal extent. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How Philosophers Trivialize Art: Bleak House, Oedipus Rex, "Leda and the Swan"Michael D. HurleyIIt is a Perverse but unsurprising irony that answers to the question of whether art can give us knowledge characteristically trivialize that which draws us to individual artworks in the first place. The experience of art is sidelined in favor of the apparent after-effect of that experience. Even those writing against each other tend to (...) converge on this. In an essay contesting Nelson Goodman's epistemic claims for art, Gordon Graham nonetheless agrees that, "The question to be asked of such a work is not, 'Does this effectively capture the scene portrayed?', but 'Does this make us see this sort of occasion differently?'"1 Even attempts to distinguish art as "gift" as opposed to commodity predictably figure its value in terms of what might be taken away: "I went to see a landscape painter's works, and that evening, walking among pine trees near my home, I could see the shapes and the colors I had not seen the day before."2This state of affairs is perversely ironic for two reasons. Firstly, because the possibility of art's cognitive content is only prompted at all by the immediate experience it offers: without this, art would not excite us the way it does and there would be no debate to be had. Secondly, and more significantly, because a defining part of what constitutes an interest in art is, I should like to suggest, an experience of knowledge; or, more accurately, an experience of knowing. This irony is unsurprising because it is merely another expression of a recalcitrant prejudice in western epistemology that idealizes knowledge as an objectively true, justified belief—perforce excluding the possibility of knowing as a subjective [End Page 107] experience of believing. No wonder the author of Theætetus elsewhere finds poets incapable of offering anything but lies.Plato's lingering legacy assures that the cognitive content of art be assized according to what might be extracted from the artwork—cashed in like so many casino chips—when we are done with our experience of it. This applies whether the knowledge-bearing being argued for, or against, is conceptual or propositional (e.g., Putnam, Novitz, John),3 or imaginative (e.g., Goodman, Robinson, Currie),4 as well as for the claim that art can offer us moral instruction (e.g., Beardsmore, Eldridge, Nussbaum, Sharpe, Kieran, John).5 There is less consensus as to whether the capacity of art to give us knowledge enriches the aesthetic value of that artwork, but those who would advance this position have been on the back-foot in recent years following a wave of criticisms from, among others, Beardsley, Lamarque and Olsen, Diffey, and Gaut.6This article addresses art's capacity to give us knowledge as well as the conjunct of whether such knowledge might inform its value qua art. In so doing, it presses a case that has already been disallowed by the terms in which the question of the relationship between art and knowledge is typically put. Whatever efferent knowledge art might offer, it also provides the conditions for a kind of knowing that cannot be translated beyond itself. Only such an experience of knowledge-as-knowing, which is realized through the untranslatable singularity of an artwork, may be considered constitutive of art's aesthetic value. Couched another way: epistemology meets aesthetics not where it has most often been located, in the perfective, at the congruence of the thought and the felt, but in the present continuous, in the engagement of thinking and feeling. Connecting the epistemic and the aesthetic in this way is, then, exactly the opposite proposition to that presented by Douglas Morgan, for whom, "although many words in many arts can and do give us knowledge of many kinds, nonetheless if this knowledge were the key and limit to the love of art, the world of art would be even sorrier than it now is."7IILiterature has generated by far the greatest volume of commentary in the debate on art and knowledge. This is to be expected given the bias towards categorizing knowledge as something like data... (shrink)

A scholarly, clearly written interpretation of the Oresteia, interweaving the aesthetic, moral, political and cosmic elements in the drama. The author gives a valuable assessment of Aeschylus' reaction to the then current ideas of Plato and Aristotle. In an excellent chapter on the meanings of catharsis, he shows how Aeschylus interpreted Aristotle's theory of tragedy.--A. B. D.

The second volume in the Random House History of Philosophy, under the general editorship of Etienne Gilson. Maurer covers a very wide ground, ending with Suarez and the early Renaissance. The relevant dates and events are mentioned, but it is the philosophical work itself that is treated rather than biography and cultural background. Each section is fairly self-contained; introductions and summaries tie them together very well. This excellent history is meant chiefly for laymen and undergraduates, but is certainly not (...) without interest for more advanced readers.--C. D. (shrink)

Purpose: Physicians are often reluctant to discuss “Do Not Resuscitate” orders with patients. Although perceived self-efficacy is a known prerequisite for behavioural change, little is understood about the confidence of physicians regarding DNR discussions.Subjects and methods: A survey of 217 internal medicine attendings and 132 housestaff at two teaching hospitals about their attitudes and confidence regarding DNR discussions.Results: Participants were significantly less confident about their ability to discuss DNR orders than to discuss consent for medical procedures , and this was (...) true for both attendings and housestaff . In a multivariate logistic model of confidence regarding DNR discussions, women were less confident than men ; house officers were less confident than attendings , those who were less confident of their ability to discuss medical procedures were less confident discussing DNR , and those who found talking to patients about DNR orders very difficult reported less confidence than those who did not .Conclusion: We conclude that physicians’ confidence regarding DNR discussions is low compared with their confidence regarding other medical discussions and that confidence varies by sex and perceived difficulty of the task. Efforts to improve DNR discussions should explore the need to tailor educational interventions to fit these characteristics. (shrink)

A scholarly, clearly written interpretation of the Oresteia, interweaving the aesthetic, moral, political and cosmic elements in the drama. The author gives a valuable assessment of Aeschylus' reaction to the then current ideas of Plato and Aristotle. In an excellent chapter on the meanings of catharsis, he shows how Aeschylus interpreted Aristotle's theory of tragedy.--A. B. D.

It is well known that today jails and prisons house many seriously mentally ill citizens who in prior decades have been treated in mental hospitals and community mental health programs. This paper begins with a brief review of the history of support for mental health programs at the federal level and then, using the State of Oregon as an example, describes the new state era of mental health services which is characterized by the increasing use of the criminal justice (...) system as a cornerstone of the treatment of many seriously and chronically mentally ill individuals. Are there any solutions to our current dilemma? The paper ends with this question, and the reader must determine if any of the suggestions posed in this discussion are realistic and/or feasible given the current fiscal and political climate. (shrink)

This piece, included in the drift special issue of continent. , was created as one step in a thread of inquiry. While each of the contributions to drift stand on their own, the project was an attempt to follow a line of theoretical inquiry as it passed through time and the postal service(s) from October 2012 until May 2013. This issue hosts two threads: between space & place and between intention & attention . The editors recommend that to experience the (...) drifiting thought that attention be paid to the contributions as they entered into conversation one after another. This particular piece is from the BETWEEN SPACE & PLACE thread: April Vannini, Those Between the Common * Laura Dean & Jesse McClelland, Ballard: A Portrait of Placemaking * Amara Hark Weber, Crossroad * Isaac Linder & Berit Soli-Holt, The Call of the Wild: Terro(i)r Modulations * Ashley D. Hairston, Momma taught us to keep a clean house * Sean Smith, The Garage (Take One) * * * * Momma taught us to keep a clean house. Dust the wood furniture every two weeks. Clean the bathrooms once a week. Wipe down the baseboards once a season (Those damn baseboards. I still got bruises on my knees from scrubbing those things). Sweep away the cobwebs—and pray that those spiders are either dead or delirious (Livin in the country don’t mean you like bugs, especially the ones with too many legs ). Didn’t matter that the house was full of stuff: Great-Grandma’s heirloom dresser, that weird Mammy salt shaker and matching Uncle Tom pepper grinder (Where the hell did Momma get those P.O.S.’s?), the outdated drapes from Belks, Dad’s favorite wooden TV tray, and that uuuuugly love seat that some crazy uncle thought was a glorious find from the Salvation Army (Momma tried to make it pretty with some pillows, but no amount of love could help that seat). Spring Cleaning meant pullin all that furniture away from the walls and holdin your breath to see what time collected in the crevices. Then you gotta be careful not to breathe out too heavy cause the dust would go flying fore you got a chance to catch it. If you didn’t, you’d quickly find out if you’re allergic to dust. Quarter cup of lemon Lysol in a bucket of steaming water and an old wash rag. Maybe two. A dust towel and citrus-scent Pledge. Me and my brothers would fight over who cleaned what. Somehow the twins always got the easy stuff: vacuuming or moving dirt around with the feather-duster. Finishing in enough time to fly down the street on their bikes with the neighborhood kids. Older sister never got off that easy. Each of my stubby fingers morphed into plump, lemon-fresh golden raisins by the time that whole damn house was done. I would finish just in time to sit with Nadine on the porch, counting the seconds til the sun turned off and the fireflies fluttered on. The craziest thing: despite all that cleaning, the house still smelled like Momma’s cookin. That Old House. Might have been some of Grandma’s and Great-Grandma’s cookin mixed in there too. Pork chops. Ham hock soaked in collards. Pinto beans and mustard greens. Corn bread and my Auntie’s famous macaroni and cheese. Didn’t matter if the oven was cold and the valve of the gas stove had been shut for days. A stranger woulda thought someone’d been slavin away in that kitchen for a week straight. No Sweet Citrus & Zest Fabreze back then. Lysol would mask the odors for a little while. Not long enough to overpower the 50 years of goodness marinated in buttermilk, kneaded with lard, and fried in Crisco that’d been embedded in the wallpaper and window treatments. All that grime—dead skin, hair follicles, Carolina clay, carpet lint, yippee-little-dog fur—was evidence of life. We were a socially-awkward newly-minted teenager, two rowdy twin boys, a multi-tasking mother, and a road-warrior father. Eventually a strangely-feline Yorkie was added to the mix. And don’t forget about the stray distant relative stopping by unannounced. No corner of that damn house was unmarked. Hand-sewn pillows in the living room that we were forbidden to breathe on somehow had tiny burnt orange paw prints on them (sneaky little dog). It drove Momma crazy. And tore up my fingernails. They still won’t grow back right. Wipe all that shit off just for it to build up again. But that house was inherited and fully paid for. No reason to move. I did move. I was ready to move on. Move up. Move out. Over that small town. Into the big city. Here the streets take on the smells of Momma’s house. Plus piss, shit, and unbathed skin. A hot day means everything cooks and stews in its own juices, making the stench 10x more intense. The apartment is another story. 11 floors up. Big, east-facing windows. Great view of the skyline dotted with some green foliage. And the great lake. Immaculate. Odorless. Not even a trace of tobacco from the previous tenant’s bad habits. No lingering scent of lemon Lysol. No street stench seeping through the window panes. No stray cat hairs. Or dog fur. Not a speck of dust. Futon. Throw pillows. Photos. Knickknacks. Bowls of fresh citrus. Cursedly-assembled desk set from IKEA. Yet the void is too big to fill. Too clean. (shrink)