Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of 1502 (...) French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)
We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)
The analysis of the Helmholtz equation is shown to lead to an exact Hamiltonian system describing in terms of ray trajectories, for a stationary refractive medium, a very wide family of wave-like phenomena (including diffraction and interference) going much beyond the limits of the geometrical optics (“eikonal”) approximation, which is contained as a simple limiting case. Due to the fact, moreover, that the time independent Schrödinger equation is itself a Helmholtz-like equation, the same mathematics holding for a classical optical beam (...) turns out to apply to a quantum particle beam moving in a stationary force field, and leads to a system of Hamiltonian equations providing exact and deterministic particle trajectories and dynamical laws, and containing the laws of Classical Mechanics in the eikonal limit. (shrink)
We construct a nonlow2 r.e. degree d such that every positive extension of embeddings property that holds below every low2 degree holds below d. Indeed, we can also guarantee the converse so that there is a low r.e. degree c such that that the extension of embeddings properties true below c are exactly the ones true belowd.Moreover, we can also guarantee that no b ≤ d is the base of a nonsplitting pair.
Ship design needs to respond to and attract an ever more design conscious society. However, little research has been conducted into perceptions of beauty and pleasure and how such perceptions can be usefully absorbed into ship design. Aesthetic consideration, is seen as a distraction from the bespoke nature of the ship design process and is often avoided, second guessed or left for external consultancy. The ship design discipline requires the nurturing of its own aesthetic methods, for future development, and to (...) adapt some of the aesthetic ideals found in architecture, art and design. This paper argues that philosophy can be effective in interpreting what the passenger finds attractive and pleasurable. To illustrate the philosophical approach proposed, the `Elbe SWATH’ and the `Oasis of the Seas’ are investigated and compared using theoretical resources from the culturally focused philosophy of `Functional Beauty’. Conclusions suggest that the interpretation of the end users most valued appreciations can lead to design directives that deliver subjective qualities of beauty - beauty similar to those seen in the pure aims of the Elbe SWATH’s purposeful work craft, or comparable to nature’s beauty and purity in aim. (shrink)
We investigate an approach for drawing logical inference from inconsistent premisses. The main idea in this approach is that the inconsistencies in the premisses should be interpreted as uncertainty of the information. We propose a mechanism, based on Kinght’s  study of inconsistency, for revising an inconsistent set of premisses to a minimally uncertain, probabilistically consistent one. We will then generalise the probabilistic entailment relation introduced in  for propositional languages to the first order case to draw logical inference from (...) a probabilistic set of premisses. We will show how this combination can allow us to limit the effect of uncertainty introduced by inconsistent premisses to only the reasoning on the part of the premise set that is relevant to the inconsistency. (shrink)