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)

Objectives: to assess physicians’ and patients’ views in Saudi Arabia towards involving the patient versus the family in the process of diagnosis disclosure and decision-making, and to compare them with views from the USA and Japan.Design: A self-completion questionnaire was translated to Arabic and validated.Participants: Physicians from different specialties and ranks and patients in a hospital or attending outpatient clinics from 6 different regions in KSA.Results: In the case of a patient with incurable cancer, 67% of doctors and 51% of (...) patients indicated that they would inform the patient in preference to the family of the diagnosis . Assuming the family already knew, 56% of doctors and 49% of patients would tell the patient even if family objected . However, in the case of HIV infection, 59% of physicians and 81% of patients would inform the family about HIV status without the patient’s consent . With regards to withholding ventilatory support, about 50% of doctors and over 60% of patients supported the use of mechanical ventilation in a patient with advanced cancer, regardless of the wishes of the patient or the family. Finally, the majority of doctors and patients were against assisted suicide.Conclusions: Although there was more recognition for a patient’s autonomy amongst physicians, most patients preferred a family centred model of care. Views towards information disclosure were midway between those of the USA and Japan. Distinctively, however, decisions regarding life prolonging therapy and assisted suicide were not influenced to a great extent by wishes of the patient or family, but more likely by religious beliefs. (shrink)

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

A new theory of particles proposed in an earlier paper is now applied to explain energy. Having earlier derived the Rydberg formula for atomic spectra without using the Pauli principle, the authors now derive the photoelectric effect, deflection of light by gravitation, and Planck's law for blackbody radiation without using Planck's assumption on energy quanta or Einstein's theory of general relativity.

Without a doubt, one of the main reasons Platonsim remains such a strong contender in the Foundations of Mathematics debate is because of the prima facie plausibility of the claim that objectivity needs objects. It seems like nothing else but the existence of external referents for the terms of our mathematical theories and calculations can guarantee the objectivity of our mathematical knowledge. The reason why Frege – and most Platonists ever since – could not adhere to the idea that mathematical (...) objects were mental, conventional or in any other way dependent on our faculties, will or other historical contingencies was that objects whose properties of existence depended on such contingencies could not warrant the objectivity required for scientific knowledge. This idea gained currency in the second half of the 19th Century and remains current for the most part today. However, it was not always like that. Objectivity, after all, has a history, and according to its historians (Daston 2001), the view that scientific knowledge need be objective is a fairly recent one. Up until mid-19th Century, science was not so much concerned with objectivity, as it was concerned with truth. Before the rise of the modern university and the professional scientist, science had the discovery of truths as its ultimate goal. In contrast, modern science now aims at the production and acquisition of objective knowledge. The difference might seem.. (shrink)

An attempt is made to show that Wittgenstein's later philosophy of logic is not the kind of conventionalism which is often ascribed to him. On the contrary, Wittgenstein gives expression to a “mixed” theory which is not only interesting but tends to resolve the perplexities usually associated with the question of the a priori character of logical truth. I try to show that Wittgenstein is better understood not as denying that there are such things as “logical rules” nor as denying (...) that the results of applying such rules are “logically necessary,” but as trying to understand what it is to appeal to a logical rule and what it means to say that the results of applying such a rule are “necessary.” He is not so much overthrowing standard accounts of logical necessity as discovering the limits of the concept. (shrink)

William of Malmesbury's Regesta Regum Anglorum is one of the great histories of England, and one of the most important historical works of the European Middle Ages. Although its focus is national, its scope encompasses most of Western Europe and beyond, providing a full-scale account of the First Crusade. Apart from its formidable learning, it is characterized by narrative skill and entertainment value - with topics including unpowered flight and Henry I's zoo. This edition in the Oxford Medieval Texts series (...) is the first modern translation and edition. A full historical introduction is supplied in Volume II. (shrink)

William of Malmesbury's Regesta Regum Anglorum is one of the great histories of England, and one of the most important historical works of the European Middle Ages. Although its focus is national, its scope encompasses most of Western Europe and beyond, providing a full-scale account of the First Crusade. Apart from its formidable learning, it is characterized by narrative skill and entertainment value - with topics including unpowered flight and Henry I's zoo. This edition in the Oxford Medieval Texts series (...) is the first modern translation and edition. A full historical introduction is supplied in Volume II. (shrink)

Fifteen families cooperated in this study. Each consisted of father, mother and two or more children over 14 years of age. The recording of potentials was made by means of standard amplifiers and a Westinghouse oscillograph. An analysis of the records leads the author to conclude that, while no data which indicate a certain relationship between any members of a family on the basis of their electro-encephalographic patterns can be offered, it is justifiable to assume that the resemblances in the (...) patterns, if any exist, are not marked. The problem of whether or not patterns in brain potentials are inherited is not a closed one. Davis' work would definitely indicate that a hereditary factor does exist. Investigations of possible relationships between grandparents and grandchildren are indicated. (PsycINFO Database Record (c) 2016 APA, all rights reserved). (shrink)

This book is a study of the second-edition version of the 'Transcendental Deduction', which is one of the most important and obscure sections of Kant's Critique of Pure Reason. By way of a close analysis of the B-Deduction, Adam Dickerson makes the distinctive claim that the Deduction is crucially concerned with the problem of making intelligible the unity possessed by complex representations - a problem that is the representationalist parallel of the semantic problem of the unity of the proposition. Along (...) the way he discusses most of the key themes in Kant's theory of knowledge, including the nature of thought and representation, the notion of objectivity, and the way in which the mind structures our experience of the world. (shrink)

Following lesions to the primary visual cortex, some patients maintain visual capacities within areas of the visual field in which they are defined as clinically blind by static field perimetry. Blindsight describes the ability to discriminate visual stimuli in the absence of awareness of the stimuli in such patients. Some patients exhibit blindsight, but others are aware of the stimuli with which they are presented, a response mode that has been referred to as residual vision. The two response modes are (...) of great interest as they are capable of providing us with information concerning the conscious and unconscious processing of visual signals in humans. However, determining consciousness in these patients is a difficult task and relies on the patient assessing and then reporting on his awareness. In this paper, an experiment is described which is capable of demonstrating conscious visual processing of motion under conditions where the observer is not required to assess his level of awareness. In applying this technique to a human hemianope, GY, it is demonstrated that GY has veridical and conscious perception of visual motion presented to his blind hemifield. Although previously reported, this result can be derived without any reference to GY's commentary on his blind field perception. (shrink)