The main thesis of this excellent little book is that "contrary to widespread misapprehensions, two formally different kinds of utilitarianism, simple and general, and along with the latter one kind of rule-utilitarianism, are extensionally equivalent; that is, analogous principles of the various kinds necessarily yield equivalent judgments in all cases; or, in other words, it makes no difference in theory whether the simple or generalization test is applied to acts or—within limits—whether an appeal is made to rules grounded in utility." (...) The "misapprehension" is dispelled in the particularly valuable third chapter, "Extensional Equivalence," by means of an a priori causal analysis of action situations and an exacting consideration of action descriptions. Furthermore, Lyons argues that other rule-utilitarian theories not extensionally equivalent to the simple utilitarianism of tradition differ from it in the wrong ways. As a result of these two findings the author holds that "any appeal to generalization or to rules consequently fails to escape the force of traditional arguments against utilitarianism." Utilitarian readers who accept Lyons' argument and particularly his interspersed but incisive criticisms of the works of Broad, Harrison, Singer, Harrod, Brandt, and Rawls, are likely to feel that it is best to go back to Mill! But in his final chapter Lyons' analysis of promising and fairness throws doubt on the adequacy of any purely utilitarian moral theory. However this may be, to read Lyons' book is to follow a precise and rigorous intellect, free of current dogmas about value statements, while it threads its way through a maze of conceptual complexities toward substantive philosophic conclusions.—R. B. C. (shrink)

This study explored drug users’ attitudes toward and understanding of randomized controlled trials testing addiction therapies. A video portraying a fictional consent conference for a randomized controlled trial with placebo arm was shown to poor male and female drug users of diverse ethnic status and sexual orientation. The video stimulated focus group discussion in which participants’ comments often reflected “experimental realism”—a realistic view of the trial—and adequate understanding of the uncertain efficacy of the treatment being tested, as well as the (...) concepts of randomization and placebo control. However, participants’ comprehension of the nature of placebos was compromised by the widespread view that placebos are a way of testing a subject’s willpower and personal control over his or her addiction. Comments also showed a mistrust of the video investigator’s integrity and competence and signs of therapeutic misconception and misestimation. The study’s findings underscore the importance of tailoring informed consent encounters to the personal and sociohistorical context of participants’ lived experiences. (shrink)

This manual presents a carefully researched, detailed psychodynamic treatment program for the alleviation of a transdiagnostic range of primary Axis I anxiety disorders, including panic disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, and related psychological problems. First exploring the principles of psychodynamic theory and formulation, the authors then present a three-phased process of Panic Focused Psychodynamic Psychotherapy-Extended Range : initial evaluation, interpretation of central conflicts and defense mechanisms, and termination. Each phase is discussed in depth and relies (...) on central case illustrations to demonstrate techniques and results. A subsequent chapter explores how to address complex issues that may arise during the course of treatment. Altogether, this manual not only provides a demonstrated, adaptable approach for anxiety disorders, but also clearly embodies a spirit of research and empiricism heretofore rare in psychodynamic psychotherapies, with an eye toward future development. (shrink)

In dealing with an objection to the view of abortion presented in Chapter 6, we have already looked beyond abortion to infanticide. In so doing we will have confirmed the suspicion of supporters of the sanctity of human life that once abortion is accepted, euthanasia lurks around the next comer - and for them, euthanasia is an unequivocal evil. It has, they point out, been rejected by doctors since the fifth century B.C., when physicians first took the Oath of Hippocrates (...) and swore 'to give no deadly medicine to anyone if asked, nor suggest any such counsel'. Moreover, they argue, the Nazi extermination programme is a recent and terrible example of what can happen once we give the state the power to MI innocent human beings. (shrink)

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Hume and Hume’s Connexions ed. by M. A. Stewart, John P. WrightIra SingerM. A. Stewart and John P. Wright, eds. Hume and Hume’s Connexions. University Park, PA: Penn State Press, 1995. Pp. xvi + 266. Cloth, $40.00. Paper, $18.95.This collection is organized around the theme of Hume’s connections with his philosophical predecessors, contemporaries, and successors.In a historical prelude, Roger Emerson meticulously describes the factions that supported and opposed (...) Hume’s efforts to gain a professorship. Emerson attributes Hume’s failure not only to the charges of impiety leveled against him, but also to the intricate workings of a political patronage system.Four essays about moral theory follow. James Moore attacks the conventional view that Hume’s moral theory is deeply similar to Hutcheson’s. In fact, Moore argues, surface similarities here mask systematic disagreements about justice, self-interest, teleology, theology, reason’s role within a sentimentalist framework, and about whether morality is, fundamentally, justified approbation for benevolence (Hutcheson) or sympathy’s merely natural tendency to generate feelings of approbation (Hume). These differences make sense, Moore notes, in light of Hutcheson’s debts to Stoicism, and Hume’s debts to Epicureanism. Stephen Darwall argues that, by parting company with Hutcheson on one crucial point, Hume opens up a logical space for Bentham’s Utilitarianism. Hutcheson explains the goodness of natural [End Page 141] goods, such as happiness, in terms of our distinctively moral approval of benevolence: happiness is good because a benevolent person wills general happiness. Hume instead explains our moral approval of qualities of character in terms of natural goods and the psychological mechanism of sympathy: a benevolent person receives moral approval because she produces happiness for herself and others, including sympathetic spectators. Darwall claims that Hume thus foreshadows Bentham’s efforts to set our moral judgments on an uncontroversial nonmoral foundation. Pauline C. Westerman discusses the relation between Hume and the natural lawyers. Hume shares some of their characteristic concerns, such as accounting for the origin of private property, and employs some of their terminology. Still, Westerman argues, while Grotius and Pufendorff wanted to justify morality, Hume wants only to explain it. Finally, John P. Wright invokes Butler’s account of habit to illuminate Hume’s notion of a calm passion. Butler argues that, as a habit develops, repetition weakens feelings while strengthening the tendency to act: distress will seldom shock someone habituated into generosity, who will reliably act to relieve that distress. Citing this psychological dynamic, Wright argues, helps to explain what a calm passion is, and how it can prevail over a violent passion.Two essays concern philosophy of mind and epistemology. P. B. Wood uses Thomas Kuhn’s concept of texts that are “exemplars” for working scientists to illuminate the “science of mind” as Hume and Reid practiced it. David Owen puts “inductive skepticism” into historical context, arguing that in that context, Hume appears as neither the victim nor the opponent of deductivism about rationality. Instead, Hume’s focus is Locke’s account of probable reasoning, according to which such reasoning involves a chain of associated ideas (not a formal structure of propositions). Hume’s argument is that our causal thinking proceeds differently than Locke requires, because in it we do not follow an unbroken series of associated perceptions, but rather leap over the gap between our impressions up to now and the general causal idea.The book’s centerpiece is a fragmentary Hume manuscript, discovered in 1993, about the problem of evil. The manuscript appears in both facsimile and transcription. In introducing the manuscript, M. A. Stewart argues plausibly that it is one of the “nobler parts” that Hume cut from the Treatise to avoid offending Bishop Butler.Four essays discuss philosophy of religion. Reflecting on miracles, Stewart traces a tradition of critically examining religious testimony back to the Port-Royal Logic and to Locke; moreover, Stewart emphasizes that Hume’s method in “Of Miracles” is similar to his method in debunking the Ossian poems. Michel Malherbe, taking as his point of departure those remarks by “Pamphilus” that preface the Dialogues, and reviewing in detail Shaftesbury’s pronouncements about the art of philosophical dialogue, discusses... (shrink)

The social, educational and political writings of Jean-Jacques Rousseau have become enormously influential in the 200 years since his death. But the breadth as well as the depth of Rousseau's achievement - he was amongst other things a creative writer and musical composer as well as a philosopher - is not always appreciated. In around 100 articles, alphabetically arranged and fully cross-referenced, N. J. H. Dent explores all facets of Rousseau's work and thoughts, while his subject's remarkable life is summarized (...) in a biographical introduction. Details of works by and about Rousseau are listed in an extensive bibliography. For students or general readers seeking an introduction to Rousseau's work, and for those already familiar with the material who require a convenient reference source, this dictionary is essential reading. (shrink)

Opening an entirely new dimension of Platonic studies, this volume addresses major themes: the nature of law, property, and acquisitiveness; Socrates' famous "demonic voice"; the poetic claim to inspiration; and the psychology of the...

Bradford C Bemiss, Chad A WittDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA: Chronic rejection is a major cause of death after the first year following lung transplantation. Bronchiolitis obliterans is the most common pathologic finding on biopsy, characterized by fibrous granulation tissue, which obliterates the lumen of the bronchiole. Clinically, in the absence of tissue for pathology, BO syndrome refers to a progressive irreversible drop in the forced (...) expiratory volume in 1 second. Recently, a broader definition of chronic rejection, termed "chronic lung allograft dysfunction", has been used to encompass a more inclusive definition of posttransplant dysfunction. Recently, the lung transplant community has come to realize that chronic rejection may be the final common result after repetitive epithelial insults. Acute rejection, infection, and alloreactivity to mismatched HLA antigens are a few of these insults that damage the surface of the bronchioles. Recent evidence of autoimmunity to the normally hidden structural proteins collagen V and K-α1 tubulin have been correlated with a BO phenotype as well, perhaps correlating the epithelial damage with a mechanism for developing BO lesions. Many immunomodulatory medications and treatments have been studied for effectiveness for the treatment of chronic lung allograft dysfunction. New drugs, which more precisely target the immune system, are being developed and tested. Further study is required, but recent advances have improved our understanding of the pathogenesis and potential intervention for this common and deadly complication of lung transplantation.Keywords: lung transplant, bronchiolitis obliterans syndrome, rejection. (shrink)

The United Nations Convention on the Rights of the Child risks harm to adolescents insofar as it encourages not only poor decision making by adolescents but also parenting styles that will have an adverse impact on the development of mature decision-making capacities in them. The empirical psychological and neurophysiological data weigh against augmenting and expression of the rights of children. Indeed, the data suggest grounds for expanding parental authority, not limiting its scope. At the very least, any adequate appreciation of (...) the moral claims regarding the authority of parents with respect to the decision-making capacity of adolescents needs to be set within an understanding of the psychological and neurophysiological facts regarding the development of adolescent decision-making capacity. (shrink)

This volume brings together 14 classic papers by interpersonal pioneers. Collectively, these papers not only demonstrate the coherence and explanatory richness of interpersonal psychoanalysis; they anticipate the emphasis on relational patterns and analyst-analysand interaction that typifies much recent theorizing. Each paper receives a substantial introduction from a leading contemporary interpersonalist. The pioneers of interpersonal psychoanalysis are: H. Sullivan, F. Fromm-Reichmann, J. Rioch, C. Thompson, R. Crowley, E. Schachtel, E. Tauber, E. Fromm, H. Bone, E. Singer, D. Schecter, J. Barnett, (...) S. Arieti, and J.Schimel. (shrink)

Contributed articles, with reference to India.

Aristotle, great Greek philosopher, researcher, reasoner, and writer, born at Stagirus in 384 BCE, was the son of Nicomachus, a physician, and Phaestis. He studied under Plato at Athens and taught there ; subsequently he spent three years at the court of a former pupil, Hermeias, in Asia Minor and at this time married Pythias, one of Hermeias's relations. After some time at Mitylene, in 343?2 he was appointed by King Philip of Macedon to be tutor of his teen-aged son (...) Alexander. After Philip's death in 336, Aristotle became head of his own school, the Lyceum at Athens. Because of anti-Macedonian feeling there after Alexander's death in 323, he withdrew to Chalcis in Euboea, where he died in 322. Nearly all the works Aristotle prepared for publication are lost; the priceless ones extant are lecture-materials, notes, and memoranda. They can be categorized as follows: I Practical: Nicomachean Ethics; Great Ethics ; Eudemian Ethics; Politics; Economics ; On Virtues and Vices. II Logical: Categories; Analytics ; Interpretation; Refutations used by Sophists; Topica. III Physical: Twenty-six works including astronomy, generation and destruction, the senses, memory, sleep, dreams, life, facts about animals, etc. IV Metaphysics: on being as being. V Art: Rhetoric and Poetics. VI Other works including the Constitution of Athens; more works also of doubtful authorship. VII Fragments of various works such as dialogues on philosophy and literature; and of treatises on rhetoric, politics and metaphysics. The Loeb Classical Library edition of Aristotle is in twenty-three volumes. (shrink)

The systems approach to niche presented herein stands as an example of the unifying potential of mathematical system theory when applied to concepts and principles of ecology. Beginning with subjective concepts from the naturalistic tradition, the niche was framed in the formalism of general system theory. So modeled, it appeared as a restriction of a more general construct, the environ. Both niches and environs are implementable in the context of ecosystem models, and with the growing ability of ecologists to construct (...) such models, system theoretic niches and environs both should serve in the future to clarify old problems of ecology, and make it possible to raise new classes of problems. The nature of niches, always difficult conceptually for the ecologist, may now give way to further development, both theoretical and empirical. (shrink)

It is often taken for granted that there is a crucial dichotomy between positive science, with its interest in what is the case, and morality, with its supposed interest in what ought to be the case. This assumption takes its departure from a belief in the notion of unconditional or categorical obligation or ?the moral? as ?that whose nature it is to be required or demanded?. The notion of unconditional or categorical obligation, together with the assumption that there is a (...) dichotomy between considerations of what is the case and what ought to be the case, however widespread and entrenched this notion and assumption might be, are logically confused. But to demonstrate this logical confusion is not the only task confronting ethical theory. Another, and often neglected task, is to draw attention to the ethical origins of this confusion in a particular way of life. Hegel's distinction between Moralität (Moral Life) and Sittlichkeit (Ethical Life) is of critical importance here. The obstacle to the development of ethical theory, then, is not some abstract ?logical confusion?, but is, rather, the way of life (Moral Life) of which this confusion is a natural expression. (shrink)

The paper is an attempt to make sense of Hegel's notion of aufheben. The double meaning of aufheben and its alleged ?rise above the mere ?either?or?; of understanding? have been taken, by some, to constitute a criticism of the logic of either?or. It is argued, on the contrary, that Hegel's notion of aufheben, explicated in its primary and philosophical context, turns out to be a substantiation of that logic. The intelligibility of the formula of either?or depends, for example, on the (...) categories of Being and Not?Being. But if these categories are regarded as particular finite determinations themselves subject to the formula of either?or, then the formula, far from being intelligible, ?falls apart?. Hegel is arguing, in other words, that if we are to substantiate the logic of either?or, we must, at the same time, ?rise above? that logic. The role of aufheben is then considered in the special sciences. Here it is argued that we must distinguish between empirical transitions, governed by the finite determinations of things, and logical or dialectical transitions, governed by considerations of the intelligibility of the notions involved. Applying the notion of aufheben to the former transitions suggests wrongly that empirical transitions have an objective or philosophic necessity. Finally, the place of ?immanent transformation? in the context of aufheben is examined. It is concluded that if there is to be a transformation, then a distinction must be drawn between thought and its content, but then the transformation cannot be regarded as immanent. (shrink)