Spain is one of the most advanced European countries in terms of the legislative and administrative development of ADs. Article 11 of Law 41/2002, concerning Patient Autonomy, regulates ‘advance directives’ and has prompted various Autonomous Regions to develop legislation in this area. Nevertheless, whilst the variety of legislations in different territories presents advantages, the disparity of criteria also presents problems.Despite significant legislative development, only 23,000 Spanish citizens have filled in an AD. Clearly, AD use is confined to a minority. Several (...) surveys, however, show that the Spanish population views these documents in a positive light. Thus, we must analyse this discrepancy between attitude and practice. A similar situation exists amongst health professionals. Whilst they generally feel that the use of ADs is positive and necessary, they are frequently unwilling to employ them.Bioethical literature and research on ADs has significantly increased in Spain over the last six years. It is likely that this trend will continue in the foreseeable future; but more resources and effort are required if ADs are to become consolidated. (shrink)

This paper evaluates the content of the syllabi of postgraduate courses on public health ethics within accredited schools and programs of public health in the United States in order to gain an awareness of the topics addressed within these courses. Methods: Data was gathered via the analysis of syllabi of courses on PHE. In 2012, information was requested by e-mail from the 48 schools and 86 PH programs accredited by the U.S. Council on Education for Public Health for 2012. The (...) “Epidemiology and PHE Syllabi” project of the University of Miami also was consulted. A table of topics was drawn up in order to carry out content analysis of the documents. Results: Data was obtained from 25 schools and 36 accredited programs ; 36 syllabi were gathered and 75 different topics were found. Of these, 38 topics were addressed in six or more syllabi and can be grouped as follows: foundations of PHE; autonomy and its limits; infectious disease control; justice; research ethics; health education and promotion; environmental and occupational health; screening; genetics; privacy and confidentiality; and community-based practice and vulnerable populations. Conclusions: The analyzed syllabi show high variability in curricular content. The debate with regard to whether a core curriculum on PHE should be established is ongoing. The results of this work might be of interest for schools and programs of PH in other countries or regions of the world in order to develop or ameliorate their own PHE syllabi. (shrink)

Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had (...) occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken. (shrink)

Cancer is a singular cellular state, the emergence of which destabilises the homeostasis reached through the evolution to multicellularity. We present the idea that the onset of the cellular disobedience to the metazoan functional and structural architecture, known as the cancer phenotype, is triggered by changes in the cell's external environment that occur with ageing: what ensues is a breach of the social contract of multicellular life characteristic of metazoans. By integrating old ideas with new evidence, we propose that with (...) ageing the environmental information that maintains a multicellular organisation is eroded, rewiring internal processes of the cell, and resulting in an internal shift towards an ancestral condition resulting in the pseudo‐multicellular cancer phenotype. Once that phenotype emerges, a new local social contract is built, different from the homeostatic one, leading to tumour formation and the foundation of a novel local ecosystem. (shrink)

This study compares the balance of newspaper and television news coverage about migration in two countries that were differently affected by the so-called “refugee crisis” in 2015 in terms of the geopolitical involvement and numbers of migrants being admitted. Based on a broad consensus among political elites, Germany left its borders open and received about one million migrants mainly from Syria during 2015. In contrast, the conservative British government was heavily attacked by oppositional parties for closing Britain’s borders and, thus, (...) restricting immigration. These different initial situations led to remarkable differences between the news coverage in both countries. In line with news value theory, German media outlets reported much more on migration than did their British counterparts. In line with indexing theory, German news coverage consonantly reflected the consensual view of German political elites, while British news media reported along their general editorial lines. (shrink)

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when (...) a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”. (shrink)

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain “on the loop,” by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes “reflection machines” (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible (...) with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM’s functionality and the experiences of users working with it. (shrink)

Un tipo de prolepsis, utilizado frecuentemente en Argonáuticas, es el discurso-programa en el cual un personaje anticipa la narración posterior. De esta manera funciona el relato de Fineo como guía de navegación para los Argonautas. Con el ineludible modelo de los relatos de viajes de Odisea, esta narración interna guarda una relación especular con la obra que la contiene y conlleva una cuasi-identificación entre narrador interno y narrador principal. Este artículo tiene como objetivo el análisis de los niveles narrativos en (...) este relato, para mostrar el modo en que esa técnica anticipatoria funciona en el poema en un nivel metaliterario. One type of prolepsis, frequently used in the Argonautica, is the programmatic speech in which a character anticipates the subsequent story. In this manner works the story of Phineus as navigation guidance for the Argonauts. With the inevitable model of travel stories of Odyssey, this internal narrative keeps a mirror-relationship with the work that contains it and carries a quasi-identification between internal narrator and main narrator. This article aims to analyze the narrative levels in this story, to show how this anticipatory technique works in the poem on a metaliterary level. (shrink)

El presente artículo aborda las connotaciones y los fundamentos de la paráfrasis cum canere vellem en Serv. Ecl. 6. 3. El análisis del sentido del verbo volo en este contexto y la confrontación del pasaje con Serv. Ecl. 6. 5 revelan que Servio interpreta la frase cum canerem reges et proelia como referencia a un temprano empeño de Virgilio en componer poesía épica, del que pronto desistió. Esta interpretación está condicionada por la idea de que la secuencia cronológica Églogas - (...) Geórgicas - Eneida tiene un correlato jerárquico, idea que se funda en noticias biográficas y en la teoría de la tripertita varietas. This paper focuses on the connotations and grounds of the paraphrase cum canere vellem in Serv. Ecl. 6. 3. The analysis of the sense of verb volo within this context, as well as the confrontation between that passage and Serv. Ecl. 6. 5, show that Servius interprets the clause cum canerem reges et proelia as a reference to Virgil's early endeavor to compose an epic poem, from which he shortly desisted. This interpretation is conditioned by the idea that the chronological sequence Eclogues - Georgics - Aeneid has a hierarchical correlate, an idea which is founded on biographical information and the theory of tripertita varietas. (shrink)

En el marco de una investigación mayor acerca de la duración en el arte, el cine y la literatura en Colombia, en este trabajo realizamos un estudio de caso de un corpus conformado por la videoinstalación El caballero de la fe, de José Alejandro Restrepo (2011), y los ensayos fílmicos Pirotecnia (2019), de Federico Atehortúa, y Bicentenario, de Pablo Álvarez (2020). La hipótesis que desarrollamos afirma que estas piezas audiovisuales colombianas contemporáneas, mediante un uso de los recursos técnicos disponibles (...) puestos sobre la materialidad de lo visual, transforman, reescriben, subvierten y sublevan el sentido de las imágenes. Son obras que, por un lado, dislocan el tiempo registrado de las imágenes al intervenir en sus tiempos, en las gradaciones de su intensidad y en los movimientos de sus elementos y, a su vez, los recolocan en el tiempo proyectado como parte del proceso de sublevación de la imagen. (shrink)

El presente artículo pretende invitar al estudio del impacto que tuvo _El Evangelio en Triumpho_ de Olavide sobre el pensamiento decimonónico. Con ese fin propone, en primer lugar, leerlo captando en sus rasgos esenciales el valor alegórico de sus personajes en sus relaciones. A continuación, señala qué aspectos de esa lectura habrían influido de manera más marcada en las obras de Maistre y Saint-Simon, con las que abarca las dos tendencias post-revolucionarias de entender la historia, catecóntica y quiliástica. Finalmente, (...) presenta la unidad milenarista de la obra de Olavide, ajena a aquellas interpretaciones precisamente por su ortodoxia, apuntando, como lectura alternativa a la francesa, la que sugiere Dostoyevski en _El Gran Inquisidor_. (shrink)

Deconstruction and pragmatism constitute two of the major intellectual influences on the contemporary theoretical scene; influences personified in the work of Jacques Derrida and Richard Rorty. Both Rortian pragmatism, which draws the consequences of post-war developments in Anglo-American philosophy, and Derridian deconstruction, which extends and troubles the phonomenological and Heideggerian influence on the Continental tradition, have hitherto generally been viewed as mutually exclusive philosophical language games. The purpose of this volume is to bring deconstruction and pragmatism into critical confrontation with (...) one another through staging a debate between Derrida and Rorty, itself based on discussions that took place at the College International de Philosophie in Paris in 1993. The ground for this debate is layed out in introductory papers by Simon Critchley and Ernesto Laclau, and the remainder of the volume records Derrida's and Rorty's responses to each other's work. Chantal Mouffe gives an overview of the stakes of this debate in a helpful preface. (shrink)

What can reason do for us and what can't it do? This is the question examined by Herbert A. Simon, who received the 1978 Nobel Prize in Economic Sciences "for his pioneering work on decision-making processes in economic organizations." The ability to apply reason to the choice of actions is supposed to be one of the defining characteristics of our species. In the first two chapters, the author explores the nature and limits of human reason, comparing and evaluating the (...) major theoretical frameworks that have been erected to explain reasoning processes. He also discusses the interaction of thinking and emotion in the choice of our actions. In the third and final chapter, the author applies the theory of bounded rationality to social institutions and human behavior, and points out the problems created by limited attention span human inability to deal with more than one difficult problem at a time. He concludes that we must recognize the limitations on our capabilities for rational choice and pursue goals that, in their tentativeness and flexibility, are compatible with those limits. (shrink)

I explore the interrelations between the ontological and aesthetic issues raised by ready-mades such as Duchamp’s Fountain. I outline a hylomorphic metaphysics which has two central features. First, hylomorphically complex objects have matter to which they are not identical. Secondly, when such objects are artefacts (including artworks), it is essential to them that they are the products of creative work on their matter. Against this background, I suggest that ready-mades are of aesthetic interest because they pose a dilemma. Is there (...) really an object, a sculpture, that is distinct from its matter, a urinal, which object is created merely by the artist’s choice of the urinal? Or are we dealing with a case in which an artist passes off something, a urinal, as if it were a sculpture, even though it is not one? (shrink)

An original study of the philosophical problems associated with inductive reasoning. Like most of the main questions in epistemology, the classical problem of induction arises from doubts about a mode of inference used to justify some of our most familiar and pervasive beliefs. The experience of each individual is limited and fragmentary, yet the scope of our beliefs is much wider; and it is the relation between belief and experience, in particular the belief that the future will in some respects (...) resemble the past and the unobserved the observed, which forms the subject of this book. Dr Blackburn's first aim is to state the problem of induction properly, to show that there does exist a genuine problem immune to the solutions in vogue at present, yet no tin principle insoluble. He gives an extended and original account of the concept of a reason and goes on to discuss prediction. In the end Dr Blackburn produces a rationale for belief in certain short-term predictions based on his reinterpretation of the classical principle of indifference. He claims that a justification for induction can be found along the lines he has suggested and must indeed be found there if anywhere. (shrink)

We study one way in which stable phenomena can exist in an NIP theory. We start by defining a notion of ‘pure instability’ that we call ‘distality’ in which no such phenomenon occurs. O-minimal theories and the p-adics for example are distal. Next, we try to understand what happens when distality fails. Given a type p over a sufficiently saturated model, we extract, in some sense, the stable part of p and define a notion of stable independence which is implied (...) by non-forking and has bounded weight. (shrink)

Gilles Deleuze’s engagements with mathematics, replete in his work, rely upon the construction of alternative lineages in the history of mathematics, which challenge some of the self imposed limits that regulate the canonical concepts of the discipline. For Deleuze, these challenges provide an opportunity to reconfigure particular philosophical problems – for example, the problem of individuation – and to develop new concepts in response to them. The highly original research presented in this book explores the mathematical construction of Deleuze’s philosophy, (...) as well as addressing the undervalued and often neglected question of the mathematical thinkers who influenced his work. -/- In the wake of Alain Badiou’s recent and seemingly devastating attack on the way the relation between mathematics and philosophy is configured in Deleuze’s work, Simon Duffy offers a robust defence of the structure of Deleuze’s philosophy and, in particular, the adequacy of the mathematical problems used in its construction. By reconciling Badiou and Deleuze’s seeming incompatible engagements with mathematics, Duffy succeeds in presenting a solid foundation for Deleuze’s philosophy, rebuffing the recent challenges against it. -/- Simon B. Duffy is a Senior Lecturer in Philosophy at Yale-NUS College, Singapore, and Honorary Research Associate in the Department of Philosophy at the University of Sydney, Australia. He is the author of The Logic of Expression: Quality, Quantity, and Intensity in Spinoza, Hegel and Deleuze (2006). (shrink)

Simon Glendinning explores both the difficulty and significance of the work of Derrida, arguing that his challenging ideas make a significant contribution to philosophy."--P. [2] of cover.

This is a book about the religious life of the Greeks from the eighth century BC to the fifth century AD, looked at in the context of a variety of different cities and periods. Simon Price does not describe some abstract and self-contained system of religion or myths but examines local practices and ideas in the light of general Greek ideas, relating them for example, to gender roles and to cultural and political life (including Attic tragedy and the trial (...) of Socrates). He also lays emphasis on the reactions to Greek religions of ancient thinkers - Greek, Roman, Jewish and Christian. The evidence drawn on is of all kinds: literary texts, which are translated throughout; inscriptions, including an appendix of newly translated Greek inscriptions; and archaeology, which is highlighted in the numerous illustrations. (shrink)

Practical philosophy and ethics -- Practical tortise raising -- Truth, beauty, and goodness -- Dilemmas: dithering, plumping, and grief -- Group minds and expressive harm -- Trust, cooperation, and human psychology -- Must we weep for sentimentalism? -- Through thick and thin -- Perspectives, fictions, errors, play -- The steps from doing to saying -- Success semantics -- Wittgenstein's irrealism -- Circles, finks, smells, and biconditionals -- The absolute conception: Putnam vs. Williams -- Julius Caesar and George Berkeley play leapfrog (...) -- The majesty of reason -- Fiction and conviction. (shrink)

A philosophical introduction to and interrogation of the work of Gilbert Simondon and its relation to contemporary media technology, communication and information.

Book synopsis: On the Genealogy of Morality is Nietzsche's most influential, provocative, and challenging work of ethics. In this volume of newly commissioned essays, fourteen leading philosophers offer fresh insights into many of the work's central questions: How did our dominant values originate and what functions do they really serve? What future does the concept of 'evil' have - and can it be revalued? What sorts of virtues and ideals does Nietzsche advocate, and are they necessarily incompatible with aspirations to (...) democracy and a free society? What are the nature, role, and scope of genealogy in his critique of morality - and why doesn't his own evaluative standard receive a genealogical critique? Taken together, this superb collection illuminates what a post-Christian and indeed post-moral life might look like, and asks to what extent Nietzsche's Genealogy manages to move beyond morality. (shrink)

This book is the first treatment at length of negative, or apophatic, theology within the analytic tradition. Apophatic theology holds that there is a significant sense in which we cannot say what God is. Important negative theological elements are present in a host of Christian thinkers, from Gregory of Nyssa to Aquinas, and yet apophaticism is neglected in philosophical theology as practiced within the analytic tradition. By contrast, Hewitt shows how apophatic theology is integral to how Christians have thought about (...) God, and how it can be defended against standard attacks in the philosophical literature. Hewitt diagnoses the unease with apophaticism amongst contempory philosophical theologicans as rooted in a certain picture of how language functions, here called referentialism. Arguing that this picture is not compulsory, an account of language which sits more comfortably with negative theology (originating from work of later Wittgenstein) is invoked, and applied to key themes in philosophical theology including divine personhood, the Trinity, the Incarnation and the afterlife. (shrink)

This paper contrasts two ways of understanding the function of human thought and language. According to representationalism, the function of thought and language is to refer to entities in the world and assert truths about them. By contrast, pragmatism seeks to understand the function of thought and language without any such appeal, at the most fundamental level, to the concepts of truth or reference.

In recent times, realism in economic methodology has increasingly gained importance. Uskali Mäki and Tony Lawson are the best-known realists within the discipline and even though their approaches are fundamentally different, both provide pragmatic defences of realism by claiming anti-realism to be the reason for the low quality of economic models. My paper will show that a pragmatic defence of realism is untenable and furthermore, I will show that for both Mäki's and Lawson's normative ideas there is no need for (...) realism. (shrink)

Maimon’s theory of the differential has proved to be a rather enigmatic aspect of his philosophy. By drawing upon mathematical developments that had occurred earlier in the century and that, by virtue of the arguments presented in the Essay and comments elsewhere in his writing, I suggest Maimon would have been aware of, what I propose to offer in this paper is a study of the differential and the role that it plays in the Essay on Transcendental Philosophy (1790). In (...) order to do so, this paper focuses upon Maimon’s criticism of the role played by mathematics in Kant’s philosophy, to which Maimon offers a Leibnizian solution based on the infinitesimal calculus. The main difficulties that Maimon has with Kant’s system, the second of which will be the focus of this paper, include the presumption of the existence of synthetic a priori judgments, i.e. the question quid facti, and the question of whether the fact of our use of a priori concepts in experience is justified, i.e. the question quid juris. Maimon deploys mathematics, specifically arithmetic, against Kant to show how it is possible to understand objects as having been constituted by the very relations between them, and he proposes an alternative solution to the question quid juris, which relies on the concept of the differential. However, despite these arguments, Maimon remains sceptical with respect to the question quid facti. (shrink)

For each k 1, let Γk be the countable universal homogeneous k-hypergraph. In this paper, we shall classify the closed permutation groups G such that Aut G Sym. In particular, we shall show that there exist only finitely many such groups G for each k 1. We shall also show that each of the associated reducts of Γk is homogeneous with respect to a finite relational language.

We formulate a Borel version of a corollary of Furman's superrigidity theorem for orbit equivalence and present a number of applications to the theory of countable Borel equivalence relations. In particular, we prove that the orbit equivalence relations arising from the natural actions of on the projective planes over the various p-adic fields are pairwise incomparable with respect to Borel reducibility.