The field of clinical ethics consultation has matured into a multidisciplinary profession, with clinical ethics consultants (CECs) being trained in bioethics, philosophy, theology, law, medicine, n...

Reflection in medical education is becoming more widespread. Drawing on our Jesuit Catholic heritage, the Loyola University Chicago Stritch School of Medicine incorporates reflection in its formal curriculum and co–curricular programs. The aim of this type of reflection is to help students in their formation as they learn to step back and analyze their experiences in medical education and their impact on the student. Although reflection is incorporated through all four years of our undergraduate medical curriculum, this essay will focus (...) on three areas where bioethics faculty and medical educators have purposefully integrated reflection in the medical school, specifically within our bioethics education and professional development efforts: 1) in our three–year longitudinal clinical skills course Patient Centered Medicine (PCM), 2) in our co–curricular Bioethics and Professionalism Honors Program, and 3) in our newly created Physician’s Vocation Program (PVP). (shrink)

SETTING: Previous health policies in South Africa neglected the teaching of ethics and human rights to health professionals. In April 1995, a pilot course was run at the University of Cape Town in which the ethical dimensions of human rights issues in South Africa were explored. OBJECTIVES: To compare knowledge and attitudes of participating students with a group of control students. DESIGN: Retrospective cohort study. SUBJECTS: Seventeen fourth-year medical students who participated in the course and 13 control students from the (...) same class, matched for gender. INTERVENTIONS: Students participated in a one-week module on ethics and human rights. Five months after the course had been run, students completed a semi-structured questionnaire exploring their knowledge and attitudes with regards to ethics and human rights issues. MAIN OUTCOME MEASURES: Knowledge scores, attitude scores and various individual indicators of attitude. RESULTS: Clear benefits for overall knowledge score, for four out of five individual knowledge questions and for one of the attitude questions, were demonstrated. Participating students also appeared to be more convinced of the need for teaching on the ethical dimensions of human rights at postgraduate level and that such teaching should also be integrated in the curriculum. The low response rate amongst controls may have selected students who were more socially conscious, thereby leading to an underestimate of the true impact of the course. CONCLUSION: The evaluation indicates clear benefits of the course for undergraduate students, and supports arguments for the inclusion of such courses in the training of health professionals. This is particularly important given the challenges posed by the Truth and Reconciliation Commission to the health professions to address past complicity in human rights abuses through reorientation of medical training in South Africa. (shrink)

A persistent complaint about modal forms of the ontological argument is that the characteristic modalized existence assumptions of these arguments are simply too close to the conclusion to be of much probative value in establish­ing it. I present an abstract form of the ontological argument in which the properties imputed to the divine nature by these assumptions are replaced by any of a wide class of properties of a sort I call “actualizing.” These include basic theistic attributes such as authorship, (...) sovereignty and omniscience. The import of these arguments is to show that the metaphysical coherence of some of the most familiar conceptions of the divine nature ensures their actual realization. (shrink)

This clear reference to unlimited freedom in values despite limited freedom in causality pictures quite accurately the theme of this article. Lord Russell made the statement in the closing eloquent paragraph of a 1927 volume he wrote to outline the problems of philosophy. He evidently feels that, prescinding from determinism or non-determinism in the causal sphere, freedom can still be meaningfully discussed in the ethical sphere, the realm of human values, though obviously in a special sense of the word ‘freedom’. (...) In other words, regardless of man’s psychological freedom or nonfreedom, Russell asserts that in the moral order man has perfect ‘freedom’ to decide for himself what shall be good or evil, right or wrong. (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The study examined the influence of the Pond Report on the teaching of medical ethics in the London medical schools. A questionnaire was given to both medical students and college officers. All medical colleges reported that ethics was included in the curriculum. However, from students' replies, it seems that attendance of optional courses is low and that not all current final year medical students have had any formal teaching in medical ethics. Stronger guidelines are necessary to ensure appropriate ethical training (...) in London medical schools. (shrink)

This study offers a systematic reconstruction of the theoretical foundations and framework of critical social theory. It is Habermas' "magnum opus", and it is regarded as one of the most important works of modern social thought. In this second and final volume of the work, Habermas examines the relations between action concepts and systems theory and elaborates a framework for analyzing the developmental tendencies of modern societies. He discusses in detail the work of Marx, Durkheim, G.H. Mead and Talcott Parsons, (...) among others. By distinguishing between social systems and what he calls the "life-world", Habermas is able to analyze the ways in which the development of social systems impinges upon the symbolic and subjective dimensions of social life, resulting in the kind of crises, conflicts and protest movements which are characteristic of advanced capitalist societies in the late-20th century. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale – a 'Good Samaritan' story – which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and (...) moral agency. I then consider this relationship from the perspectives of two twentieth century philosophers: Emmanuel Levinas and Michel Foucault. Levinas' basic point is that the experience of ethical subjectivity is made possible through others: the demand to respond to the existence of others is the basic social structure that precedes individual freedom. If Levinas posits intersubjectivity as a fundamental or primitive feature of the moral realm, Foucault poses an even more basic question: how have moral subjects and relations of obligation been constituted? The aim of ethical inquiry, for Foucault, is to describe the network of discourses, institutions, relations, and practices through which certain kinds of subjects are constituted and constitute themselves, e.g. as a kind of person who can act morally. Finally, I consider some recent research in philosophy of nursing which illustrates how Levinasian and/or Foucauldian perspectives can deepen understanding of nurses' moral practices, specifically, the work of Norwegian public health nurses, Canadian pediatric nurses, and Irish midwives. I suggest that in spite of the instability of morality in general and the particular ethical challenges that face nurses, there are grounds for hope and possible strategies for living in unstable times. (shrink)

internal events that happen spontaneously from external events (actions). It also treats processes, e.g. a buzzer, that do not settle down. The non-monotonic reasoning is circumscription done situation by situation.

Catholic sexual ethics proposes a number of exceptionless moral norms. This distinguishes it from theories which deny the possibility of any exceptionless moral norms (e.g. the proportionalist approach proposed in the aftermath of "Humanae Vitae" and condemned in "Veritatis Splendor"). I argue that Catholic teaching on sexual ethics refers to chosen physical structures in such a way as to make ‘new natural law’ theory inherently unstable. I outline a theory of “the moral act” (Veritatis Splendor 78) which emphasises the place (...) which chosen physical features – in particular, chosen sexual structures – play in specifying human actions. I conclude that this account, involving what I term UMDAs, is needed to make sense of the Church’s teaching in these areas. (shrink)

Beginning with an overview of the knowledge claims proposed by John Locke and David Hume, this essay first explores the respective responses of Newman and W. G. Ward and then updates the discussion by bringing Newman into dialogue with the thoughtof Alasdair MacIntyre.

• substantially overlaps XML and ICE • used Lisp data format, e.g. (PRICE $1.00 ) instead of $5.00 (...) semantic features of natural language will needed for business communication than have so far considered in the XML literature or in ICE. • Generalized Chomsky principle: Any position ma occupied by an expression designating Error: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapError: Illegal entry in bfrange block in ToUnicode CMapsomething of right semantics, e.g. a price. • Description (ι) and operators—“the” and “a”. (IOT X)(P X) and (EPSILON X)(P X). The work of the cians may be useful. Principle: Humans use “the” and “a”. Inter-computer will therefore need the equivalent of the these words. • Adjectives and other modifiers. (shrink)

• Conventional data mining infers relations among e.g. the fraction of supermarket baskets with diapers also contain beer. • Phenomenal data mining concerns relations between data and the phenomena underlying the data, e.g. y married couples keeping old friends buy diapers and • Example: The sales receipts of a supermarket usually not identify the customers. Grouping baskets by customer is possible and useful but requires new techniques.

This article addresses salient conceptual issues in social organisational psychology in probing change in organisational systems, e.g., culture, innovation and implementation, reflective practice and change models. Insights from chaos–complexity research in the natural sciences which underpin the dynamics of flux and change to unravel the hidden, the unexplained, the disordered will be built on to explore the phenomena of change from a social psychological perspective. The concept of nano-psychology is introduced to open up a creative debate in the social psychological (...) field on creative change which builds on the nano-insights evolving in the natural science field. (shrink)

One of the most important developments over the last twenty years both in logic and in Artificial Intelligence is the emergence of so-called non-monotonic logics. These logics were initially developed by McCarthy [10], McDermott & Doyle [13], and Reiter [17]. Part of the original motivation was to provide a formal framework within which to model cognitive phenomena such as defeasible inference and defeasible knowledge representation, i.e., to provide a formal account of the fact that reasoners can reach conclusions tentatively, (...) reserving the right to retract them in the light of further information. (shrink)

It has frequently been argued that Marxism is a secular offshoot of the Judeo-Christian tradition. Both traditions share many themes and categories, e.g., alienation, redemption, messianism, prophecy, a “providential” ordering of history, and an eschatological vision. Such thematic similarities provide the organization for Nicholas Lash’s theological reflections on the thought of Karl Marx. Lash, a distinguished theologian and Newman scholar, claims no special competence in Marx’s thought or in the history of the Marxist intellectual tradition. Rather, what he offers is (...) a series of theological reflections on Marx, a comparison and contrast of Marxist and Christian world views, and an assessment of their critiques of each other. (shrink)

It has frequently been argued that Marxism is a secular offshoot of the Judeo-Christian tradition. Both traditions share many themes and categories, e.g., alienation, redemption, messianism, prophecy, a “providential” ordering of history, and an eschatological vision. Such thematic similarities provide the organization for Nicholas Lash’s theological reflections on the thought of Karl Marx. Lash, a distinguished theologian and Newman scholar, claims no special competence in Marx’s thought or in the history of the Marxist intellectual tradition. Rather, what he offers is (...) a series of theological reflections on Marx, a comparison and contrast of Marxist and Christian world views, and an assessment of their critiques of each other. (shrink)

McCarthy begins this first systematic review of the development of Habermas's thought with general accounts of the relation of theory and practice and of the reduction of praxis to techne in positivist conceptions of reason. We learn how the communication structures presupposed by the community of natural scientists cannot be grasped within the framework of empirical-analytic science and the technological cognitive interests on which it is based. He then goes on to explain clearly the practical interest supposedly underlying the (...) historical-hermeneutic sciences and the emancipatory interests said to be the basis of critical theory. McCarthy shows how the perceived weaknesses in the initial attempt to elucidate this view by incorporating some of Freud's insights into a revised historical materialism set the program for most of Habermas's subsequent work. He examines in some detail the central points at issue between hermeneutics and critical theory and shows how the existence of systematically distorted communication structures and the tendency of the hermeneutical sciences to reduce inquiry to the interpretation of transmitted meanings force Habermas to a critique of ideology. Having shown the importance of psychoanalysis to this critique and to social theory as conceived by the Frankfurt School, McCarthy proceeds to outline Habermas's project for the general theory of communicative competence presupposed by a consistent theoretical development of psychoanalysis. Since critical theory regards the reflexive application of science to social structures as a process of enlightenment, Habermas must also take seriously the challenge laid down by functional analysis, which understands life processes of the human species not a quest for liberation, but as a drive for the self-maintenance of social systems. In concretizing the critique of systems theory, McCarthy shows how Habermas is driven to project a theory of social evolution, a reconstructed historical materialism which goes beyond explaining historical development through changes in the forces of production to include the learning processes that take place in the dimension of moral insight, practical knowledge, communicative action and the consensual regulation of conflicts. This brings us to Habermas's most recent work on communication theory, and one of the considerable merits of McCarthy's book is that it brings together the widely scattered publications which bear on this matter. He shows how Habermas's universal pragmatics, his theory of communicative competence, is an attempt to rework the normative-theoretical foundations of critical theory. Since speech is seen as the distinctive medium of human life, a theory of communication becomes the foundation for the human sciences by disclosing the universal infrastructure of socio-cultural life. Since Habermas is particularly concerned with a theory of social action, his work in universal pragmatics focuses on speech acts and the interpersonal relations which underlie them. McCarthy argues that the theory of communicative competence can be seen as an attempt to make good the claim Habermas made some thirteen years ago in his inaugural lecture at Frankfurt: that the human interest in autonomy and responsibility can be apprehended a priori since it lies at the root of language. Habermas attempts to reconstruct the normative basis of speech as a system of universal and necessary validity claims, and McCarthy provides a clear account of the "logics" of truth and morality, as well as Habermas's argument for their inseparability. McCarthy concludes by examining the crisis tendencies Habermas perceives in advanced capitalism and the correlative question of legitimizing the private appropriation of public wealth. No such legitimization can withstand discursive examination or rational consensus since it must suppress generalizable interests by treating them as particular. Thus, a repoliticization of the public sphere becomes the "new conflict zone" in organized capitalism.--G.E. (shrink)

Thomas McCarthy, the general editor of the series of “Studies in Contemporary German Social Thought,” and Richard Dien Winfield, the translator and introducer of this volume, deserve signal praise for making Joachim Ritter’s essays on Hegel’s Philosophy of Right available in a fine and accurate English translation. Despite the book’s narrow title, these essays address in cogent and far-reaching ways major issues in Hegel’s political philosophy and in modernity generally.

This paper, starting from the awareness of the anthropological finitude, aims to investigate the symbolic meaning of the catastrophe in today's society. With reference to E. De Martino’s and G. Anders’s anthropo - philosophical theses, the paper analyzes the representation of present catastrophes as Apocalypses without eskaton , in which the "blindness" of man and his inability to react is manifested. Both technological catastrophes directly caused by man and environmental disasters indirectly produced by anthropic neglect causes a widespread sense of (...) powerlessness, leaving man devoid of theoretical and practical means to guide his action. This implies, however, the necessity to widen human "feel" and the ability to understand the "meaning" of our actions in the world. This paper aims to examine all these issues through an ecocritic analysis of the novel The Road by C. McCarthy, in order to show that there is still a deeply human way to experience the fragility and to represent the catastrophe. (shrink)

The moth snowstorm, a phenomenon Michael McCarthy remembers from his boyhood when moths 'would pack a car's headlight beams like snowflakes in a blizzard,' is a distant memory. Wildlife is being lost, not only in the wholesale extinctions of species but also in the dwindling of those species that still exist. The Moth Snowstorm records in painful detail this rapid dissolution of nature's abundance and proposes a radical solution: that we recognize our capacity to love the natural world. Arguing (...) that neither sustainable development nor ecosystem services have proven adequate as defenses against pollution, habitat destruction, species degradation, and climate change, McCarthy asks us to consider nature as an intrinsic good and an emotional and spiritual resource, capable of inspiring joy, wonder, and even love. An award-winning environmental journalist, McCarthy presents a clear, well-documented picture of what he calls 'the great thinning' around the world, while interweaving the story of his own early discovery of wilderness and a childhood saved by nature. Drawing on the truths of poets, the studies of scientists, and the author's long experience in the field, The Moth Snowstorm is part elegy, part ode, and part argument, resulting in a passionate call to action. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)