BackgroundAn analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.MethodsIn order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These statements (...) were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.ResultsOf 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).ConclusionsFew US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS. (shrink)

Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

For most observers of economics from both inside and outside the science, the term ‘economics’ is synonymous with neoclassical economics. It is the methodology of neoclassical economics that defines the discipline of economics. ‘Mainstream economics’ is neoclassical economics and anyone entering the discipline today who wishes to obtain an appointment at one of the leading universities of the world is well advised to master its techniques. The fact that virtually every winner of a Nobel prize from Paul Samuelson up to (...) his student Joseph Stiglitz has been a practitioner of neoclassical economics is ample proof of the methodology’s triumph. Despite the dominance of this methodology, however, neoclassical economics has been subject to a steady stream of criticisms and proposals for alternative methodological approaches throughout its life. This article focuses on two relatively recent challenges to the neoclassical orthodoxy that seem to have taken hold of a non-negligible minority of the profession, some of whom can be found at leading universities. These two challenges come from behavioural economics and evolutionary economics. The article describes the strengths and weaknesses of both of these methodological approaches and contrasts them with that of neoclassical economics. It concludes that all three methodologies have something positive to contribute to the study of human behaviour. Key Words: neoclassical economics • behavioural economics • evolutionary economics. (shrink)

Though we agree with their argument that language is shaped by domain-general learning processes, Christiansen & Chater (C&C) neglect to detail how the development of these processes shapes language change. We discuss a number of examples that show how developmental processes at multiple levels and timescales are critical to understanding the origin of domain-general mechanisms that shape language evolution.

Amartya Sen has demonstrated a possible inconsistency between a (liberal) right and Pareto optimality. Neither Sen nor the subsequent literature have discussed the origin of the rights that lead to the liberal paradox. In this article I examine one possible origin of rights definitions-a constitutional contract agreed to by all members of the community. Constitutional rights are show to be vulnerable to a similar paradox as with liberal rights, but if the writers of the constitution were correct in their choice (...) of actions to protect, such paradoxes will be unlikely and involve small welfare losses when they do occur. The article demonstrates that both the origin of rights and their potential role in advancing the interests of citizens can be explained using a utilitarian/welfarist methodology. (shrink)

Starting with The Calculus of Consent James M. Buchanan published many books and articles emphasizing the importance of constitutional institutions and the promise of constitutional reforms. In this chapter I review some of these publications. The review begins with The Calculus, and then goes on to The Limits of Liberty, The Power to Tax, The Reason of Rules, Politics by Principle, Not Reason, and essays about the importance of constitutions in the European Union. The chapter closes with discussions of the (...) prospects of and impediments to constitutional reform in the United States and the European Union. (shrink)

This article employs the methodology of public choice, or constitutional political economy, to the question of how citizenship should be defined in a constitution. All members of a community or an assembly representative of all members writes a constitution. Each participant in the constitution-drafting process is uncertain of his or her future identity under the constitution and thus chooses a constitution that maximizes the expected utility of all future citizens. The article describes the optimal conditions within this framework for: granting (...) citizenship to those born and raised in the country; granting citizenship to those immigrating into the country; and withdrawing citizenship from those who emigrate from the country. The article also discusses why it might be desirable to require that people pass certain tests and take a loyalty oath to the constitution before being awarded the privilege of voting. (shrink)

The present paper is a survey of the economics of survival, a branch of ecological economics that stresses the preservation of the opportunities of future generations over an extended time horizon. It outlines the main analytical foundation of the branch – in which the concept of entropy is a major building block –, and its analysis of the interaction between the economic system and the environment. Regarding its outlook of the future, we see that the founders of the branch were (...) mainly concerned with the consequences of a serious depletion of natural resources – particularly the energetic capital of the earth. More recently, however, emphasis is being placed on problems that stem from the fragility of the global ecosystem in face of the disturbances caused by the entropic acceleration imposed by mankind. It is feared that the ongoing expansion of the scale of the economy may bring about irreversible damages to vital environmental functions, such as protection against undesirable consequences of solar radiation, maintenance of temperature within a range that will support life, and preservation of ecosystem resiliency. (shrink)

ABSTRACT In its attempt to prove that voters, politicians, and bureaucrats are motivated by the public interest, Self-Interest and Public Interest in Western Politics overlooks a great deal of public-choice research, to which much has been added during the two decades since it was published. The importance of self-interest at both the micro and macro levels of politics becomes clear once one looks not simply at the ?inputs? of a democracy but at its ?outputs? as well. The prevalence of interest (...) groups, the dysfunction of the United States tax code, the lobbying by unions for their members? self-interest, the earmarks in the Patriot Act, the numerous cases of corruption in Western democracies, and the dissatisfaction of citizens with their governments? failings all point to the importance of self-interest in politics. (shrink)

In its attempt to prove that voters, politicians, and bureaucrats are motivated by the public interest, Self-Interest and Public Interest in Western Politics overlooks a great deal of public-choice research, to which much has been added during the two decades since it was published. The importance of self-interest at both the micro and macro levels of politics becomes clear once one looks not simply at the “inputs” of a democracy but at its “outputs” as well. The prevalence of interest groups, (...) the dysfunction of the United States tax code, the lobbying by unions for their members’ self-interest, the earmarks in the Patriot Act, the numerous cases of corruption in Western democracies, and the dissatisfaction of citizens with their governments’ failings all point to the importance of self-interest in politics. (shrink)

This book also emphasizes the difference between religion and science as means for understanding causal relationships, but it focuses much more heavily on the challenge religious extremism poses for liberal democratic institutions. The treatment contains a discussion of human psychology, describes the salient characteristics of all religions, and contrasts religion and science as systems of thought. Historical sketches are used to establish a link between modernity and the use of the human capacity for reasoning to advance human welfare. The book (...) describes the conditions under which democratic institutions can advance human welfare, and the nature of constitutional rights as protectors of individual freedoms. Extremist religions are shown to pose a threat to liberal democracy, a threat that has implications for immigration and education policies and the definition of citizenship. (shrink)

Public choice or rational politics differs from other approaches to the study of political behavior in that it builds on models in which rational individuals seek to advance their own interests. This five-part volume surveys the main ideas and contributions of the field. It contains twenty-five essays written by thirty scholars, both economists and political scientists, from North America and Europe. Part I discusses the nature and justification for the existence of government and various forms it can take, including mixed, (...) private, and public institutions, international organizations, federalisms, and constitutional governments. Part II examines the properties of different voting rules and preference aggregation procedures. Part III explores multiparty systems, interest groups, logrolling and political business cycles. The individual decisionmaker is the focus of Part IV, with surveys of the experimental literature on individual behavior, and why people vote as they do. The final section applies public-choice reasoning to bureaucracy, taxation, and the size of government. (shrink)

The present paper is a survey of the economics of survival, a branch of ecological economics that stresses the preservation of the opportunities of future generations over an extended time horizon. It outlines the main analytical foundation of the branch - in which the concept of entropy is a major building block -, and its analysis of the interaction between the economic system and the environment. Regarding its outlook of the future, we see that the founders of the branch were (...) mainly concerned with the consequences of a serious depletion of natural resources - particularly the energetic capital of the earth. More recently, however, emphasis is being placed on problems that stem from the fragility of the global ecosystem in face of the disturbances caused by the entropic acceleration imposed by mankind. It is feared that the ongoing expansion of the scale of the economy may bring about irreversible damages to vital environmental functions, such as protection against undesirable consequences of solar radiation, maintenance of temperature within a range that will support life, and preservation of ecosystem resiliency. (shrink)

Is it possible that all of the social sciences could employ a common methodology? If so, what would it be? This article adresses these questions. It takes off from James Coleman’s recent book, The Foundations of Social Theory. Coleman’s social theory is built on the postulate that individuals are rational actors, the same postulate that most of modern economics is built upon. This article critiques the use of this postulate in economics, and thus questions whether it is a useful building (...) block for the methodological foundations of social science research. It proposes an adaptive view of human behavior as an alternative in which preferences are conditioned by past experience. The work of Joseph Schumpeter is discussed as an exemplar of the methodology advocated here. (shrink)

Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients’ ability to comprehend (...) complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17%) would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician’s decision as to whether to comply with a patient’s AD. Conclusions Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient’s initial wishes and preferences expressed by the AD. (shrink)

Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

Violent conflicts in emerging democracies or societies in transition threaten the stability of state governance institutions, which brings about insecurity of lives, property and deepens the vicious cycle of poverty and criminality in Africa. The first responsibility of any government is to provide security of lives and property. At no time since Nigeria’s civil war has the country witnessed the resurgence of violence and insecurity that claims hundreds of lives weekly. It is a sectarian insurgence of multiple dimensions. This article (...) makes the case that Boko Haram is not just a religious phenomenon but a reflection of a so- cio-political, economic and ethnic problem caused by bad governance. As a result, Boko Haram has witnessed a cross-border influence and impact which has expanded its frontiers beyondNigeriato neighboring countries in the West African region. The theoretical framework employed in this article posits that Boko Haram has its roots fundamentally in poverty caused by bad governance in the Northern Moslem bend, in Nigeria and the West African Region where corruption, human rights violations, marginalization of cultural, political and religious groups have created the situation whereby weak state structures have abysmally failed to deliver on the development promises made during elections. So the emergence of Nigeria’s Boko Haram violence, as a result of the street poverty and the rise of unemployed street beggars, popularly known as Almajiris, and their use for electoral and party violence, was encouraged by the neglect and abandonment of the masses by the governors and other elected leaders. The expansion and consolidation of the Boko Haram insurgence to other parts of the country and neighboring West African nations was made possible by the already existing failed state institutions, bad governance and corruption and the existing band of small criminal sectarian groups that depend upon their survival on aids from Al Quaeda, drug gangs and sea piracy. The religious dimension is a marginal factor fueled by fundamental socio-economic and political variables which have been thrown up in the first place by bad governance and leadership in Nigeria. (shrink)

Introduction au Numéro spécial de la Revue Philosophique de Louvain.