Context: Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives: To explore the decision-making process among women invited to a mammography screening programme.Setting: Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program in 2003.Methods: Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged (...) 50–69 years.Results: The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion: In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine. (shrink)

New arguments against Bayesian regularity and an otherwise plausible domination principle are offered on the basis of rotational symmetry. The arguments against Bayesian regularity work in very general settings.

Informed consent is reviewed as it applies to psychiatric patients. Although new legislation, such as the Mental Health Act 1983, provides a useful safeguard for the protection of the civil rights of patients, it could actually reduce their humane care unless applied with sensitivity for the nature of their unique difficulties. In order to guard against this possibility, we suggest that legal requirements should be considered in light of the ethical principles which underlie them. Three principles are considered: those of (...) autonomy (freedom); beneficence (paternalism); and the fiduciary principle (partnership). Psychotherapy is offered as a model for informed consent, which might be generalised to other clinical situations. (shrink)

The cosmological and teleological argument both start with some contingent feature of the actual world and argue that the best or only explanation of that feature is that it was produced by an intelligent and powerful supernatural being. The cosmological argument starts with a general feature, such as the existence of contingent being or the presence of motion and uses some version of the Principle of Sufficient Reason to conclude that this feature must have an explanation. The debate then focuses (...) on two points: first, whether the PSR in question is true, and second, whether the explanation must involve God or at least some God-like being. The teleological argument begins with a general feature of the cosmos judged to have value, such as the existence of intelligent life or the presence of order in the universe, and argues, usually inductively but sometimes deductively, that this feature is to be explained by the agency of a powerful supernatural being. Here, the debate tends to focus on whether there are alternate naturalistic explanations, such as Darwinian evolution. (shrink)

A simple argument is given that shows that conditional probabilities do not supervene on unconditional probabilities. In particular, one cannot in general define conditional probabilities using the ratio formula P ( U | V ) = P ( U & V )/ P ( U ), or using any more sophisticated method based on unconditional probabilities.

'The world is tragically splendid in its fragmentedness. Its harmony lies in its disharmony, its unity in its enmity. Such is the paradoxical doctrine of Heraclitus, subsequently paradoxically developed by Friedrich Nietzsche into the theory of 'tragic optimism."'.

In lieu of an abstract, here is a brief excerpt of the content:154, DAVID HUME'S PRACTICAL ECONOMICS As Professor Eugene Rotwein emphasized in his introduction to David Hume: Writings on Economics (Madison, 1955), the philosopher made his observations on the eve of the industrial revolution in a period of accelerating change. Very often — as in the latter half of the seventeenth century — times of flux and turmoil call forth Utopian thinkers, who propose the creation of hierarchical, communal, authoritarian (...) societies, often patterned after a supposed golden 2 age. Hume emphatically rejected Utopian schemes of this kind. "All plans of government which suppose great reformation in the manners of mankind," he said, 3 "are plainly imaginary." He repeatedly warned as well that "projectors" and visionaries would disrupt the balance in government between liberty and authority. Thus he could speak of or make reference to "the visionary system or ravings of Plato" (in The Republic), the ultimate impracticality of More's Utopia and James Harrington's The Commonwealth of Oceana, and the absurdity of Robert Wallace's theories on 4 population and the paper money schemes of John Law. Even the Utopian republics of Andrew Fletcher of Saltoun, the Scottish patriot whom Hume admired as "a man of undaunted courage and inflexible principles," were dismissed with the others on practical grounds. The key word we have extracted from Hume's economics is practicality. Much as Hume would have liked to have designed an empirical "science of man" — which, incidentally, would have permitted him to propose his own infallible scheme of political economy — he realized that his own attempts had fallen far short of his goal. Thus his nine essays devoted especially to economics: "Of Commerce," "Of Refinement 155. in the Arts," "Of Money," "Of Interest," "Of the Balance of Trade," "Of the Jealousy of Trade," "Of Taxes," "Of Public Credit," and "Of the Populousness of Ancient Nations," are cautious in approach and pragmatic in spirit. Most of these essays were specifically designed to challenge prevailing assumptions and Utopian grand schemes of one sort or another. In "Of Commerce," for example, Hume rejects the idea that a nation can achieve greatness as an agricultural utopia. In "Of Refinement in the Arts" he takes issue with certain religious thinkers who 7 denote luxury as evil. In "Of Money" he is critical of those who believe that an injection of money into O the economy will work long-term wonders, and in "Of Interest" he argues with those who reason that the 9 plenty of money leads to low interest rates. "Of the Balance of Trade" and "Of the Jealousy of Trade" are directed against the protectionist policies of the mercantilists, "Of Taxes" rejects the French physiocratic single tax on land, and "Of Public Credit" deplores the expedients of Lord Oxford's partisans to draw bills on posterity and imprudently 12 use public credit to create paper riches. Finally, he addressed his essay, "Of the Populousness of Ancient Nations" to a refutation of the doomsday thinking of 13 the Reverend Robert Wallace of Edinburgh. This is not to imply, however, that Hume's economic thought was merely negative, or that he believed governments could safely entrust their powers over the economy to an "invisible hand." Even Hume's advocacy of free trade (which his friend and pupil Adam Smith, of course, applied with less caution) left the government with room to maneuver. Hume was willing to employ both the market and authority in designs for human progress. In seeking his mix of "action, 156. consumption, liveliness and indolence," a contradictory, counter-poised economic actor, the individual, was not a simple pleasure maximizer, nor did the acquisition of wealth and luxury make him a villain. He was a person in whom the complex springs of action, the causes of labour, needed first one, now another counter-weight. Society benefited from both 14 free trade and from tariff. Hume believed that industrial development and the advancement of commerce were the springboards to progress and happiness. Less is less and more is more; Hume never got these simple verities mixed up. "The same age," he said, "which produces great philosophers and politicians, renowned generals and poets, usually abounds with skillful weavers, and ship-carpenters.... The spirit of the age... (shrink)