Clinical decisionmaking includes reasoning from prescientific or scientific theories, reasoning from uncontrolled or controlled experience, and reasoning based on empathic understanding and moral beliefe. The development of contemporary clinical thinking is discussed, and it is found that successive generations of medical practitioners have had different views of the rationality and relative importance of these modes of reasoning: that which is considered rational by one generation of doctors is sometimes denounced by the next. The author's book, Rational Diagnosis and Treatment , (...) which is an example of clinical thinking in the 1960s and early 70s, is used to illustrate one particular view of clinical decisionmaking. Keywords: rational, clinical decisionmaking, biological theory, controlled clinical studies, empathic understanding, ethical reasoning CiteULike Connotea Del.icio.us What's this? (shrink)

In this commentary on the article by Arthur L. Caplan [1] the philosophy of medicine is viewed from a medical perspective. Philosophical studies have a long tradition in medicine, especially during periods of paradigmatic unrest, and they serve the same goal as other medical activities: the prevention and treatment of disease. The medical profession needs the help of professional philosophers in much the same way as it needs the cooperation of basic scientists. Philosophy of medicine may not deserve the status (...) of a philosophical subspecialty or field, but it so closely linked to the main trends of contemporary medical thinking that it must be regarded as an emerging (or reemerging) medical subdiscipline. (shrink)

It is sometimes suggested that the physician should offer the patient “just the facts,” preferably in a “value-free manner,” explain the different options, and then leave it to the patient to make the choice. This paper explores the extent to which this adviser model is realistic. The clinical decision process and the various components of clinical reasoning are discussed, and a distinction is made between the biological, empirical, empathic/hermeneutic and ethical components. The discussion is based on the ethical norms of (...) the public health services in the Nordic countries, and the problems are illustrated by a clinical example. It is concluded that the adviser model is unrealistic. Patient information is important, but the complexity of clinical reasoning makes it impossible to separate facts and value judgments. It is claimed that there is an inherent element of paternalism in clinical decision-making and that clinical practice presupposes a mutual trust between physician and patient. (shrink)

In this paper, we pause to assess a long-standing and ongoing outreach programme by King’s College London and The Philosophy Foundation. In it, philosophy students at university are recruited and trained to facilitate philosophy sessions for pupils who go to schools with high rates of free school meals. This paper describes every stage of that programme, from the recruitment and training of students to the difficulties that can accrue along the way. It also argues that the programme has a benefit (...) which is underappreciated and understudied in the literature on philosophy in schools, which is that it fosters cultural capital among the pupils who participate in it. As such, the paper serves both as a proof of concept for a high-quality, cost-effective philosophical outreach programme and as an impetus for further research into the effects of such programmes. (shrink)

The aim of the present investigation was to describe and to classify significant ethical problems encountered by the members of the staff during the daily clinical work at a hospital medical department. A set of definitions was prepared for the purpose, including the definition of a 'significant ethical problem'. During a three month period 426 inpatients and 173 outpatients were admitted. Significant ethical problems were encountered during the management of 106 in-patients (25 per cent) and 9 out-patients (5 per cent). (...) No significant difference was found between the frequency of ethical problems in female and male patients, but a positive correlation was noted between the number of problems and the patients' age. The problem types were classified according to a problem list. The results of this investigation suggest that greater attention must be paid to discussions about ethical problems among doctors and other categories of health personnel and that, among others, medical students ought to be taught the analysis of ethical problems. (shrink)

In this article, drawing on the discursive psychology of Rom Harré, we show how mapping the exchange of words among people might disclose a complex reality; not merely that which farmers explicitly talk ‘about’ but the reality implicitly at stake within the communication. More specifically, we show how discourses involving modern farmers reveal an underlying placing in an abstract space, having sub-spaces defined by the life-orientation, sense of self and according self-positioning of modern people. In this way, we construct a (...) road map of a set of ‘individualities’ characterizing the life of modern farmers: an individuality of citizenship, an individuality of geographies and an individuality of experience. Consequently, farmers face the problem that this multiplicity of individuality prevents them from communicating, as we will call it, univocally in the public by contrast to the univocal voices of other established social groups. We will analyse the structure of that problem by viewing diverse relations between the authority and the authenticity of different partners in the conversation on land use. (shrink)

© Ginn et al. 2016.The indexing methods currently used for serial femtosecond crystallography were originally developed for experiments in which crystals are rotated in the X-ray beam, providing significant three-dimensional information. On the other hand, shots from both X-ray free-electron lasers and serial synchrotron crystallography experiments are still images, in which the few three-dimensional data available arise only from the curvature of the Ewald sphere. Traditional synchrotron crystallography methods are thus less well suited to still image data processing. Here, a (...) new indexing method is presented with the aim of maximizing information use from a still image given the known unit-cell dimensions and space group. Efficacy for cubic, hexagonal and orthorhombic space groups is shown, and for those showing some evidence of diffraction the indexing rate ranged from 90% to 151%. Here, the indexing rate refers to the number of lattices indexed per image. (shrink)

ABSTRACT Nietzsche's texts invite perplexing questions about the justification and objectivity of his ethical views. According to the interpretation suggested here, Nietzsche does not advance a substantive normative ethics, but proposes, based on his ontological idea of will to power, an instrumentalist theory of value. He is not a realist about value—according to him, nothing is intrinsically valuable. However, things, actions, beliefs, and values can be evaluated with reference to their capacities in serving our fundamental quest for power. The central (...) advantage of this interpretation against competing readings is that it attempts to make sense of how an “objective” evaluation fits together with antirealism or nihilism about value, including how the “ethics” of will to power is to be understood alongside the metaphysical and ethical doctrine of eternal recurrence. (shrink)

In this article, the author studies some central concepts in Avicenna's and sī's modal logics as presented in Avicenna's Al-Ish r t wa'l Tan īh t ( Pointers and Reminders ) and in sī's commentary. In this work, Avicenna introduces some remarkable distinctions in order to interpret Aristotle's modal syllogistic in the Prior Analytics . The author outlines a new interpretation of absolute sentences as temporally indefinite sentences and argues on the basis of this that Avicenna seems to subscribe to (...) the Principle of Plenitude. He also shows that he has no valid proof of the modal conversion rules and that he uses some rather ad hoc distinctions to show that Aristotle's modal syllogistic is correct. The author also notes some interesting differences between Avicenna's and sī's approaches to modal logic. (shrink)

Systems theory is proposed as a major resource for reconceptualizing a Christian theology of creation. Section I outlines the principles of the theory of autopoietic systems and discusses in particular Manfred Eigen's and Stuart Kauffman's differing views of the emergence of life. Section II shows how biblical texts conceive of God's “blessing” as a divine installment and reshaping of spatio‐temporal fields for creaturely self‐productivity. On this double basis, Section III undertakes a constructive attempt to formulate a theology of self‐productivity within (...) a Trinitarian framework. The unity of divine self‐consistency and capacity for self‐relativization is seen as the clue for understanding how God not only sustains the world in general but also influences particular processes by changing the overall probability pattern of evolving systems. (shrink)

Carl Henrik Koch har i denne bog samlet en række af sine artikler om fremtrædende danske filosoffer. Med start ved Holberg i 1700-tallet arbejder Koch sig op gennem den danske filosofihistorie og strejfer blandt andre Eilchov, Sibbern, A.P. Adler, Brøchner og naturligvis mastodonterne Søren Kierkegaard og Georg Brandes. Bogen giver en hurtig, men spændende indførsel i en vigtig del af den danske kulturhistorie, som gennem de sidste 250 år har haft stor indflydelse både herhjemme og i udlandet.

In lieu of an abstract, here is a brief excerpt of the content:Protestant Responses to Darwinism in Denmark, 1859–1914Hans Henrik HjermitslevFrom the 1870s onwards, Charles Darwin’s theory of evolution, published in On the Origin of Species (1859) and Descent of Man (1871), was an important topic among the followers of the influential Danish theologian N.F.S. Grundtvig (1783–1872). The Grundtvigians constituted a major faction within the Danish Evangelical-Lutheran Established Church, which included more than ninety percent of the population in the (...) period 1859–1914.This article demonstrates the influence of local contexts on the reception of scientific ideas by analyzing how specific aspects of Danish intellectual culture made the Grundtvigian reactions to Darwin’s theory different from Protestant denominations in America and Britain. Firstly, Grundtvig’s critique of Lutheran scriptural theology and his preference for the living word to the letters of the Bible legitimized liberal interpretations of Scripture. Secondly the philosophy of the Søren Kierkegaard protagonist, Rasmus Nielsen, made it possible for Grundtvigians to draw radical distinctions between science and faith. This specific “Danish Protestantism,” as the clergyman Frederik Jungersen phrased it in 1873, led the way for liberal Grundtvigians in coming to terms with Darwinism in the first decades of the twentieth century.1 [End Page 279]Protestant Responses to EvolutionIn recent decades historians have paid considerable attention to religious responses to Darwinism. Studies have revealed a variety of reactions to evolution depending on local contingencies, which has made it impossible to uphold any grand narrative of the dissemination of Darwinism.2 In his study of Calvinist attitudes toward Darwinism in Princeton, Belfast, and Edinburgh, David N. Livingstone thus emphasizes the importance of place in the reception of evolution.3 The historical complexities shaped by local contexts have been further demonstrated by scholars, who have explored the responses to Darwinism in a wide range of Protestant denominations in Britain and America.4 From the 1870s, when evolution was generally accepted among British and American scientists, liberal and even some orthodox theologians advocated various kinds of theistic evolutionism. It was not until the 1920s that creationists, who rejected evolution in general and human evolution in particular, took center stage in American Protestant answers to the Darwinian challenge. While many Protestant theologians in the decades around 1900 accepted that God had created the living world, including man, through evolution, very few embraced the specific Darwinian mechanism of natural selection that was often said to have atheistic implications. Instead liberal theologians, in line with many naturalists, often applied Lamarckian concepts of use-inheritance and teleological [End Page 280] development and prevalent ideas of progress that were seen as consistent with viewing evolution as a meaningful process and the unfolding of the Creator’s plan. According to James R. Moore, Peter J. Bowler, and Frederick Gregory this was the common way for liberal Christians to respond to organic evolution at least in the English-speaking world. It offered an acceptable compromise between science and faith. However, this article demonstrates that this strategy did not dominate in Denmark, where a separation model of science and faith was a more widespread approach when embracing the theory of evolution.5While studies by Jon H. Roberts and Ronald L. Numbers reveal considerable differences within the leading Protestant denominations such as Calvinists, Baptists, Lutherans, Episcopalians, and Methodists in their attitudes toward evolution, they detect no significant differences among the groups. Numbers notes however that “distinctive theological convictions sometimes influenced how people viewed Darwin’s theory.”6 This was especially the case when we move from the Protestant mainstream into distinctive groups such as the Seventh-day Adventists and the Pentecostals. In the case of the Adventists, their hyper-literalism and strong support for young-earth creationism owed much to the inspired writings of their founding prophetess Ellen G. White, while the relative indifference to evolution among Pentecostals can be explained by their Wesleyan-Methodist focus on religious experience over the study of Scripture.7 Likewise, in a study of attitudes toward evolution within the British Quaker community, Geoffrey Cantor has shown how discussions of Darwinism between evangelicals and moderates centred on the relative importance that should be paid to the Bible versus the doctrine of the Inner Light. Emphasizing... (shrink)

Henrike Jansen’s “The strategic formulation of abductive arguments in everyday reasoning” insightfully explores the terrain of abductive argumentation. The purpose of this note is to continue the exploration along lines marked out by her paper. This further exploration proceeds in two stages. Section 2 of the paper addresses the nature of abductive inference by distinguishing two types of abduction, identifying some of abduction’s formal and nonformal properties, and relating abduction to enthymematic inference. Section 3 focuses on some of Jansen’s examples, (...) paying particular attention to the distinction between abduction and argument from sign. Whereas Jansen maintains that some arguments from sign are not abductive, the paper suggests an alternative perspective from which arguments from sign can generally be viewed as one sort of abductive inference. (shrink)

The concept of ‘causal powers’ as principles of necessary change, once derided by mainstream philosophers in the thrall of David Hume, has made a dramatic comeback and seems to be here to stay. The...

Pragmatism gained considerable attention in bioethical discussions in the early 21st century. However, some dimensions and contributions of pragmatism to bioethics remain underexplored in both research and practice. It is argued that pragmatism can make a distinctive contribution to bioethics through its concept, developed by Charles S. Peirce and John Dewey, that ethical issues can be resolved through experimental inquiry. Dewey’s proposal that policies can be confirmed or disconfirmed through experimentation is developed by comparing it to the confirmation of scientific (...) hypotheses, with a focus on the objection that the consequences of following a moral view or policy do not provide guidance on choosing among competing ethical perspectives. As confirmation of scientific hypotheses typically relies on evidence gathered from observation, the possibility of ethically relevant observation is then explored based on Peirce’s views on feelings as emotional interpretants. Finally, the connection between Dewey’s experimental ethics and democracy is outlined and compared to unfettered ethical progressivism. (shrink)

In this book we present the first study of all of his philosophical works from logic and grammar to metaphysics and ethics. It contains a substantial introduction about Kilwardby's life and work as well as a comprehensive bibliography.