Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient inclusion. Results Justifications were provided for 59% of DNAR orders and included (...) severe comorbidity, patients and families’ resuscitation preferences, patients’ age, or poor prognosis or quality of life. Reasons to include patients in CPR/DNAR decisions were provided in 96% and 84% of cases, and were based on respect for autonomy, clinical assessment of the situation as not too severe, and the view that such inclusion was required. Reasons for not including patients were offered in 84% of cases for CPR and in 70% for DNAR. They included absent decision-making capacity, a clinical situation viewed as good (CPR) or offering little hope of recovery (DNAR), barriers to communication, or concern that discussions could be emotionally difficult or superfluous. Decisions made earlier in the patient's management were infrequently viewed as requiring revision. Residents reported a variety of introductions to discussions with patients. Conclusions These results provide better understanding of reasons for CPR/DNAR decisions, reasons for patient inclusion or lack thereof, and ways in which such inclusion is initiated. They also point to potential side-effects of implementing CPR/DNAR recommendations without in-depth and practical training. This should be part of a regular audit and follow-up process for such recommendations. (shrink)

The vast expansion of research in human-robot interactions (HRI) these last decades has been accompanied by the design of increasingly skilled robots for engaging in joint actions with humans. However, these advances have encountered significant challenges to ensure fluent interactions and sustain human motivation through the different steps of joint action. After exploring current literature on joint action in HRI, leading to a more precise definition of these challenges, the present article proposes some perspectives borrowed from psychology and philosophy showing (...) the key role of communication in human interactions. From mutual recognition between individuals to the expression of commitment and social expectations, we argue that communicative cues can facilitate coordination, prediction, and motivation in the context of joint action. The description of several notions thus suggests that some communicative capacities can be implemented in the context of joint action for HRI, leading to an integrated perspective of robotic communication. (shrink)

In this paper we show how recent concepts from Dynamic Logic, and in particular from Dynamic Epistemic logic, can be used to model and interpret quantum behavior. Our main thesis is that all the non-classical properties of quantum systems are explainable in terms of the non-classical flow of quantum information. We give a logical analysis of quantum measurements (formalized using modal operators) as triggers for quantum information flow, and we compare them with other logical operators previously used to model various (...) forms of classical information flow: the “test” operator from Dynamic Logic, the “announcement” operator from Dynamic Epistemic Logic and the “revision” operator from Belief Revision theory. The main points stressed in our investigation are the following: (1) The perspective and the techniques of “logical dynamics” are useful for understanding quantum information flow. (2) Quantum mechanics does not require any modification of the classical laws of “static” propositional logic, but only a non-classical dynamics of information. (3) The main such non-classical feature is that, in a quantum world, all information-gathering actions have some ontic side-effects. (4) This ontic impact can affect in its turn the flow of information, leading to non-classical epistemic side-effects (e.g. a type of non-monotonicity) and to states of “objectively imperfect information”. (5) Moreover, the ontic impact is non-local: an information-gathering action on one part of a quantum system can have ontic side-effects on other, far-away parts of the system. (shrink)

Thomas Hobbes is recognized as one of the fathers of modern philosophy and political theory. In his own time he was as famous for his work in physics, geometry, and religion. He associated with some of the greatest writers, scientists, and politicians of his age. Martinich has written a complete and accessible biography of Hobbes. The book takes full account of the historical and cultural context in which Hobbes lived, drawing on both published and unpublished sources. It will be a (...) great resource for philosophers, political theorists and historians of ideas. The clear, crisp prose style will also ensure that the book appeals to general readers with an interest in the history of philosophy, the rise of modern science and the English Civil War. (shrink)

La filosofía de la historia se ha debatido durante siglos en una estéril lucha entre idealistas y materialistas. El libro de Ignacio Ellacuría es un intento de superar esa dicotomía clásica. Tomando como punto de partida algunos conceptos fundamentales de la filosofía de Zubiri, Ellacuría cree posible asumir y a la vez criticar ambos extremos, desde una actitud más realista. De ahí el título del libro. Es importante destacar que la historia, para Ignacio Ellacuría, es el lugar de realización de (...) la ética. La historia no está hecha, se construye, es un proceso de creación de posibilidades humanas, y, en tanto que tal, una labor ética. La tesis de Zubiri de que el hombre tiene que hacerse cargo de la realidad, en Ellacuría se transforma en esta otra: el ser humano está obligado a encargarse de la realidad, y a cargar con ella. Este es el imperativo ético. Imperativo que, por otra parte, no sólo le obliga individualmente al hombre, en el reducto de la propia conciencia, al modo del idealismo, ni tampoco sólo en tanto que miembro de una clase social, como en el marxismo, sino como sujeto a la vez individual y específico, como miembro a la vez solitario y solidario de la especie humana. La obra póstuma de Ignacio Ellacuría constituye sin duda su más ingente trabajo intelectual en el campo de la filosofía, y representa, por su calidad y contenido, una pieza clave para comprender no solamente su producción estrictamente filosófica, sino también su pensamiento teológico y socio-político. (shrink)

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, was sent to aneurysm (...) patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (shrink)

In The Idea of a Social Science Winch, argues that, sociology is more properly conceived as a branch of philosophy than of empirical science. Winch falls victim here to the Humean assimilation of the empirical to the generalizable. He notes that much of our talk about social practice is in terms of conventions, so that explanations of social action can be given without recourse to statistical or experimental findings. But such talk depends nonetheless on the accuracy and detail with which (...) the situations in which actions occur are? recorded, and this is surely an empirical enterprise. It is the misleading conception of sociology as a discipline, characterized by common procedures, that leads Winch to espouse the assimilation of sociology to conceptual inquiry. We need to see instead that sociology embraces a group of questions and subjects so loosely connected that it would be mistaken to speak of, and idle to project, a procedure common to all of them. (shrink)

Background This pilot study evaluated the speaking book ‘What it means to be part of a clinical trial’. The book aims at empowering populations with information on their rights and responsibilities when enrolled in clinical research. Wide publication of the book—at significant cost—is anticipated. It is important that the book is evaluated within the communities for whom it is intended, and the necessary changes (if any) are made, before translation and large-scale publication takes place. Objective The objective of the study (...) was to measure the efficacy and ease of use of the book. Methods Participants were recruited from a catering company. Participants were questioned on their knowledge of clinical trials and were then given the book. Instructions for use of the book were given to one group (‘experimental’ group). The other group (‘control’ group) was not given any instructions. A week later, the investigators returned, repeated the knowledge questions and asked ‘ease of use’ questions. Results A two-way repeated measure of covariants showed a statistically significant positive increase in knowledge of clinical trials among the intervention group (p=0.02). Results for the control group displayed trends that were not statistically significant. Percentage analysis of ‘ease of use’ questions proved that the book is easy to use, although some changes would be beneficial. Conclusion This study revealed that the speaking book is easy to use. It significantly increased knowledge of clinical trials among the study sample if instructions on use of the book were provided. (shrink)

v. 1. Edinyĭ i︠a︡zyk chelovechestva. --.

We investigate to what extent theorems about quantum mechanical or classical entropy can be generalized to functionals of the type ρ→Tr f(ρ), or ψ→∫f(ψ)dμ, respectively, wheref is an arbitrary concave function.

(1976). PROBABILITY, LIKELIHOOD AND SUPPORT: A METAMATHEMATICAL APPROACH TO A SYSTEM OF AXIOMS FOR UPPER AND LOWER DEGREES OF BELIEF. Philosophical Papers: Vol. 5, No. 2, pp. 153-161.

The nature of tragedy has always been felt to be a problem, not only by the philosopher, but also, and perhaps even more, by the ordinary man. The question so often asked is: why, if there is so much suffering already in the world, do we want to go to a theatre or read a story describing more suffering? Why indeed should the spectacle of suffering ever be pleasing to us? Yet it is obvious that olarge numbers of ordinary people (...) do like reading or seeing tragedies; and that there are some tragedies which are generally judged to be the most valuable works of literary art ever produced. What then is the nature of the value which we extract from these works? That is the question to which I would like to address myself. (shrink)

t. 1. Noosferizm : vvedenie v noosferizm, Noosferizm: dvizhenie, ideologii︠a︡ ili novai︠a︡ nauchno-mirovozzrecheskai︠a︡ sistema? -- t. 2. Noosferizm : Kapitalokratii︠a︡ mify liberizma ... -- t. 3. Noosferizm : Rossii︠a︡ v XXI veke v kontekste ... -- t. 4, kn. 1. Noosferizm : Noosfernoe ili neklassicheskoe chelovekovedeni; kn. 2. Noosfernoe ili neklassicheskoe chelovekovedenie: poisk osnovaniĭ -- t. 5, kn. 1. Noosfernoe ili neklassicheskoe chelovekovedenie: poisk osnovaniĭ; kn. 12. Noosfernoe ili neklassicheskoe chelovekovedenie: poisk osnovaniĭ -- t. 6. kn. 1. Obrazovanie--vysshiĭ imperativ noosfernogo (...) ili ustoĭchivogo razvitii︢a︡ Rossii v XXI veke; kn. 2 Obrazovanie--vysshiĭ imperativ noosfernogo ili ustoĭchivogo razvitii︢a︡ Rossii v XXI veke -- t. 7. Sistemologii︠a︡ obrazovanii︠a︡ i obrazovanievedenie. (shrink)

Israel Scheffler's ground-breaking essay, On Human Potential, deserves to be more widely known among educational policy analysts, especially in light of the popularity in educationist circles of W.E. Deming's organizational philosophy known as Total Quality Management . In what follows,I argue that the heuristical value of Deming's perscriptions are entailed in Scheffler's On Human Potential. More importantly, I argue, where Deming's work falls short, especially in being naive about the human condition, Scheffler's analysis provides a foundation for management theory in (...) education that insures the flourishing of an optimal number of contributing participants. In fashioning these ideas, Scheffler brings pioneering thinking to the emerging fields of management studies generally and educational policy specifically. (shrink)

It is commonly accepted by those who consider macroevolution as a process decoupled from microevolution that its apparent jerkiness (and, hence, incompatibility with principles of population genetics) results from the structural complexity of epigenetic systems, since all complex cybernetic systems are expected to behave discontinuously. To analyse the validity of this assumption, the process of self-improvement has been analysed in a complex cybernetic system by means of computer simulations. It turns out that the investigated system tends to develop by accumulation (...) of as small structural changes as possible, while larger changes are likely to result in the collapse of the system rather than in its persistence or improvement. This implies that cybernetic considerations alone cannot justify the claim that the very nature of epigenetic systems induces evolution by discrete steps rather than by gradual accumulation of small changes. (shrink)