As a patient approaches death, family members often are asked about their loved one’s preferences regarding treatment at the end of life. Advance care directives may provide information for families and surrogate decision makers; however, less than one-third of Americans have completed such documents. As the U.S. population continues to age, many surrogate decision makers likely will rely on other means to discern or interpret a loved one’s preferences. While many surrogates indicate that they have some knowledge of their loved (...) one’s preferences, how surrogates obtain such knowledge is not well understood. Additionally, although research indicates that the emotional burden of end-of-life decision making is diminished when surrogates have knowledge that a loved one’s preferences are honored, it remains unclear how surrogates come to know these preferences were carried out. The current study examined the ways that next of kin knew veterans’ end-of-life preferences, and their ways of knowing whether those preferences were honored in Veteran Affairs Medical Center inpatient settings. (shrink)

To controlforceaccurately under a wide range of behavioral conditions, the central nervous system would either require a detailed, continuously updated representation of the state of each muscle (and the load against which each is acting) or else force feedback with sufficient gain to cope with variations in the properties of the muscles and loads. The evidence for force feedback with adequate gain or for an appropriate central representation is not sufficient to conclude that force is the major controlled variable in (...) normal limb movements.Morton's hypothesis, thatlengthis controlled by a follow-up servo, has a number of difficulties related to the delays, gains, variability, and specificity in feedback pathways comprising potential servo loops. However, experimental evidence is consistent with these pathways providing servo assistance for some movements produced by coactivation of α- and static γ-motoneurons. Dynamic γ-motoneurons may provide an additional input for adaptive control of different types of movements.The idea that feedback is used to compensate for changes in musclestiffnesshas received experimental support under static postural conditions. However, reflexes tend to increase rather than decrease the range of variation in muscle stiffness during some cyclic movements. Theoretical problems associated with the regulation of stiffness are also discussed. The possibilities of separate control systems forvelocityorviscosityare considered, but the evidence is either negative or lacking. I conclude that different physical variables can be controlled depending on the type of limb movement required. The concept of stiffness regulation is also useful under some conditions, but should probably be extended to the regulation of the visco-elastic properties (i.e., the mechanical impedance) of a muscle or joint. (shrink)

In this basically expository paper we discuss the role oflogic and mathematics in researches concerning the ontology of scientific theories, and we consider the particular case of quantum mechanics. We argue that systems of logic in general, and classical logic in particular, may contribute substantially with the ontology of any theory that has this logic in its base. In the case of quantum mechanics, however, from the point of view of philosophical discussions conceming identity and individuality, those contributions may not (...) be welcome for a specific interpretation, and an altemative system of logic perhaps could be used instead of a classical system. In this sense, we argue that the logic and ontology of a scientific theory may be seen as mutually inftuencing each other. On the one hand, logic contributes to shape the general features of the ontology of a theory; on the other hand, the theory also puts constraints on the possible understanding of ontology and, respectively, on possible systems of logic that may be the underlying logic ofthe theory. (shrink)

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

It is a common complaint against moral philosophers that their abstract theorising bears little relation to the practical problems of everyday life. Professor Braithwaite believes that this criticism need not be inevitable. With the help of the Theory of Games he shows how arbitration is possible between two neighbours, a jazz trumpeter and a classical pianist, whose performances are a source of mutual discord. The solution of the problem in the lecture is geometrical, and is based on the formal analogy (...) between the logic of the situation and the geometry of a parabola. But an appendix provides the alternative algebraic treatment of a general two-person collaboration situation. (shrink)

This article is in a larger textbook of articles on Medical Ethics. It identifies a number of values that underlie professional commitments to confidentiality that are involved in protecting or promoting the client's (1) privacy, (2)social status, (3) economic advantages, (4) openness of communications, (5) seeking professional help, (6) trust in professionals, (7) autonomous control over personal information. The problem of making exceptions to confidentiality commitments is also examined.

A formal Ethics Consultation Service (ECS) can provide significant help to patients, families and hospital staff. As with any other form of clinical consultation, documentation of the process and the advice rendered is very important. Upon review of the published consult documentation practices of other ECSs, we judged that none of them were sufficiently detailed or structured to meet the needs and purposes of a clinical ethics consultation. Thus, we decided to share our method in order to advance the practice (...) of ethics consultation. Here, we describe a method of ECS documentation practice, including use of a formal consult report template, as well as a log for maintaining a chronological record of the consultations performed. These two documents facilitate order and organisation of the ECS. They also enable the ECS to keep an account of professional time and experience, enable quick consult trend assessments (by consult theme or ward, for example) and establish a potential registry of consults for future research study. This method of documentation, we believe, not only contributes significantly to the primary purpose of the consultation—namely, the evincing and sharing of ethical opinion about a case—but also enables consultants to improve their practice and to pursue research on clinical ethics consultation. (shrink)

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In this paper a formalized logic of propositions, PA1, is presented. It is proven consistent and its relationships to traditional logic, to PM ([15]), to subjunctive (including contrary-to-fact) implication and to the “paradoxes” of material and strict implication are developed. Apart from any intrinsic merit it possesses, its chief significance lies in demonstrating the feasibility of a general logic containing theprinciple of subjunctive contrariety, i.e., the principle that ‘Ifpwere true thenqwould be true’ and ‘Ifpwere true thenqwould be false’ are incompatible.

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)