The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.

We conducted focus groups with 47 potential jurors who were presented with diferent scenarios in a hypothetical malpractice case involving failure to order a PSA test. Better documentation that a patient made an informed decision to decline a PSA test appeared to provide more medical-legal protection for physicians, especially with the use of a decision aid.

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

Intuitionists and classical logicians use in common a large number of the logical axioms, even though they supposedly mean different things by the logical connectives and quantifiers — conquans for short. But Wittgenstein says The meaning of a word is its use in the language. We prove that in a definite sense the intuitionistic axioms do indeed characterize the logical conquans, both for the intuitionist and the classical logician.

Myles Burnyeat maintains that Aristotelian epistêmê, in so far as it deals with explanations, is properly identified as understanding rather than as knowledge. Although Burnyeat is right in thinking that the cognitive achievement Aristotle typically has in mind is not justified true belief, Aristotelian epistêmê cannot be equated with understanding. On some occasions in Aristotle's writings (e.g. Apo 71a4), the term designates a particular science such as mathematics; on others (e.g. Apo 72b18-20), it designates the grasp of a first principle; (...) on others (e.g. Apo 94a20) it is a systematic grasp of fact and explanation that is properly termed understanding; and on still others (e.g. N. Ethics 1147a22) it is that combination of factual knowledge and competency in demonstration that qualifies as expertise or disciplinary mastery. (shrink)

Orestes has returned to Argos, . For him to brandish at his father's murderers is natural there, where he is delivering a sort of general manifesto as to his aims, and where the strong word is justified and alleviated by the jingle with juxtaposed . But there is no reason for Orestes to go on insisting on the bloodthirstiness of these aims, and reads oddly in 100, where he is explaining soberly his plan of campaign.

State of nature theories have a long history and play a lively role in contemporary work. Theories of this kind share certain nontrivial commitments. Among these are commitments to inclusion of a Lockean proviso among the principles of justice and to an assumption of invariance of political principles across changes of circumstances. In this article I want to look at those two commitments and bring to light what I believe are some important difficulties they engender. For nonpattern state of nature (...) theories, the justness of a society is marked by the conformance of the society to procedural principles. Distributions of resources and the like have no particular import for questions of justice. Whatever may later result, so long as it came about in accordance with the rules determined by the principles of justice, is itself just. The Lockean proviso is one of the principles of justice governing property and other rights of nonpattern theories of justice. The proviso hangs as a "shadow" over the results of the operation of the other (usual) principles of justice. It is intended to remedy a complaint which arises when the positions of those no longer at liberty to use some resource are worsened (1) by no longer being able to use freely what they previously were free to use and (2) in such a way that they fall below a "baseline." Following Locke, a traditional formulation of the proviso is to allow acquisition just so long as there is "enough and as good" left over for others. Section I concerns the relation of the Lockean proviso to pattern and nonpattern principles of justice, demonstrating that a Lockean proviso turns a nonpattern into a pattern theory of justice. Section II is about the relation of the Lockean proviso to the ideas revealed by an examination of a state of nature, suggesting reasons to reject ideal theories of justice. (shrink)

This lecture is divided, roughly, into three parts. First, there is a general and perhaps rather simple-minded discussion of what are the ‘facts’ that social anthropologists study; is there anything special about these ‘facts’ which makes them different from other kinds of facts? It will be useful to start with the common-sense distinction between two kinds or, better, aspects of social facts; first—though neither is analytically prior to the other—and putting it very crudely, ‘what people do’, the aspect of social (...) interaction, and second, ‘what—and how—people think’, the conceptual, classifying, cognitive component of human culture. Now in reality, of course (and perhaps not so ‘of course’; people do tend to think of them as separate ‘things’), these two aspects are inextricably intertwined. But it is essential to distinguish them analytically, because each aspect gives rise to quite different kinds of problems of understanding for the social anthropologist. We shall see that the problem of how to be ‘objective’, and so to avoid ethnographic error, arises in both contexts, but in rather different forms in each. (shrink)

Professor Richmond's reply t o m y article on Palatine Apollo is argued with his usual enthusiasm and cogency. This reply to him, which has been delayed by my departure for Australia, must begin with an expression of the respect that I feel for an antagonist far more able and experienced than I can claim to be. Indeed, it was while lecturing on Ovid, Tristia 3 that I first met Professor Richmond's masterly article on the Augustan Palatium . From this (...) article my enthusiasm for the subject began, and I know that Professor Richmond has always welcomed discussion and argument about the famous Augustan temple of Apollo on the Palatine. I can but join him in urging any who may have been interested by our discussion to study his original article which contains much more besides a discussion of the site of Apollo's temple. (shrink)

Fragment B 18 of Xenophanes is widely regarded as an early expression of a faith in human progress. I believe, however, that we should reconsider this 'progressivist' interpretation. Not only does it lack a firm foothold in the language of Fr. 18, its optimism is out of keeping with virtually everything else Xenophanes is known to have said or thought on the topic of human intelligence. If we had no viable alternative to the 'hymn to progress' reading we might be (...) justified (on the basis of its similarities with later expressions of pride in human achievement) in regarding it as his singular and otherwise inexplicable surge of optimism. But since there is an alternative reading that can be firmly and systematically grounded in Xenophanes' own teachings, then we ought to prefer it over one which fits the fragment only inexactly and fails to correspond with other aspects of his teachings. -/- . (shrink)

Is there a place in scientific inquiry for guessing? Jonathan Cohen has recently argued that resorting to guesswork entails a loss of objectivity and regard for evidence which are essential to proper scientific investigation. I assess the merits of Cohen’s view first by taking as a test case Aristotle’s positive view of the role of guesswork (anchinoia) and conjecture (eustochia) in the search for the connections essential to the construction of scientific demonstrations. I then argue contra Cohen that one can (...) usefully employ guesswork while also employing reason; that it is possible to guess either intelligently or mindlessly; and consequently, that the use of guesswork need not represent a diminution in respect for the objectivity essential to scientific investigation. Although I would not claim that guesswork has a role to play in all scientific inquiry, there appear to be some datable instances of the useful and respectable scientific guess. (shrink)

All commentators on these lines make two assumptions about the first clause, that means ‘sitting in judgement’, ‘punishing’, or the like, that the which is its subject as well as that of is the second in a series of two: the subsequent slaying punishes or sits in judgement on the previous; thus the slaying of Cly taemnestra herself will sit in judgement upon that of Agamemnon, just as that had sat in judgement upon the of Iphigenia. Then opinions differ as (...) to whether is to be taken as the object of both verbs, or of one but not the other. (shrink)

Fragment B 1 of Parmenides describes a youth's journey to the house of a goddess who enlightens him as to the nature of all things. The task of translating Parmenides' Greek text is beset with many difficulties, most notably the phrase kata pant' atê at B 1.3. There, the neuter accusative plural panta ('all things') combines with the feminine nominative singular atê (heavenly sent blindness') to render translation impossible. Some have proposed emending the text to read a<s>tê ('down to all (...) cities'), understood in connection with the pathway of divine inspiration. Others reject the emendation in so far as the youth is said at B 1.27 to travel 'far from the beaten path of men.' I argue in defense of the reading kata pant' a<s>tê in so far as references to pathways of inspiration and poetic journeys to the cities of men occur frequently in the poetry of Parmenides' era. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)