The paper addresses the tension in Wittgenstein’s work between an absolute and a more contextual approach to values. It argues that both are relevant, but that from a systematic point of view the contextual perspective has priority. The consequent commitment to a form of moral realism is discussed, and an analogy with normativity in the domain of language is adduced to provide further support.

Unrecognized presuppositions about patient appearance have become increasingly important in medicine, medical ethics and medical law. Symptoms of these historically conditioned assumptions include common ageism, aesthetic surgery, and litigation about ‘wrongful life’. These phenomena suggest a societal intolerance for what is considered an ‘abnormal’ appearance. Among others, eighteenth-century artists and anatomists helped to set these twentieth-century precedents, actually measuring deviations of external traits to analogous deformations of the soul, and drawing moral conclusions from physiognomic measurements. Other eighteenth-century artists countered with (...) pathognomy, recognizing that uneven physical features may indicate humanity, instead of character flaws. We suggest that there is an important and as yet unrecognized role played by visual and perceptual preferences in our judgments concerning normalcy and anomaly. We further suggest a shift away from our current fashion-magazine, youth-oriented aesthetic, and towards an aesthetic of imperfection. Physicians and medical students can be made aware of their historically conditioned reactions to ‘abnormal’ appearing patients by studying the understandings and methods with which artists have portrayed those who are considered deformed in appearance. (shrink)

The 1995 Encyclopedia of Bioethics is an almost complete reworking of the original 1978 edition, due to the expanding nature of the field. The following article focuses on how the second edition of the Encyclopedia deals with the topic of “clinical ethics” and three related topics: “nursing ethics”, “trust”, and “conflict of interest”. We assess their relevance to the current developments in these fields and the Encyclopedia's usefulness as a resource to ethics consultants, researchers and clinicians. We emphasize the heterogeneity (...) of clinical ethics as a still new and evolving field. (shrink)

We consider the desirability, or otherwise, of various forms of induction in the light of certain principles and inductive methods within predicate uncertain reasoning. Our general conclusion is that there remain conflicts within the area whose resolution will require a deeper understanding of the fundamental relationship between individuals and properties.

It is generally believed that the uncertainty relation Δq Δp≥1/2ħ, where Δq and Δp are standard deviations, is the precise mathematical expression of the uncertainty principle for position and momentum in quantum mechanics. We show that actually it is not possible to derive from this relation two central claims of the uncertainty principle, namely, the impossibility of an arbitrarily sharp specification of both position and momentum (as in the single-slit diffraction experiment), and the impossibility of the determination of the path (...) of a particle in an interference experiment (such as the double-slit experiment). (shrink)

The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.

In his foreword, Brand Blanshard provides the suitable justification for publishing yet one more book on Berkeley: Berkeley is "curiously modern," and philosophically acute. Twelve competent essays, contributed by as many scholars, testify to the accuracy of Blanshard's judgment. These twelve scholars, all of whom rely on the Luce-Jessop definitive edition, touch upon the major issues of Berkeley's philosophy: perception, substance, spirit, and God. Differences in interpretation are everywhere evident, but Berkeley is nowhere given facile treatment or quick dismissal. Of (...) the many good essays, Ian T. Ramsey's on "Berkeley and the Possibility of an Empirical Metaphysics" deserves close attention. Ramsey argues that Berkeley's doctrine of will, soul, mind, etc., should be viewed as forms of personal activity and not on the analogy of Locke's ideas. T. E. Jessop contributes a useful bibliography as well as an essay on "Berkeley as Religious Apologist." The only, very minor, flaw in this distinguished volume is that the editor's own essay, the twelfth, "Berkeley and his Modern Critics" might have been better placed immediately following the foreward.--D. J. M. B. (shrink)

We present a general derivation of the Duffin-Kemmer-Petiau (D.K.P) equation on the relativistic phase space proposed by Bohm and Hiley. We consider geometric algebras and the idea of algebraic spinors due to Riesz and Cartan. The generators βμ (p) of the D.K.P algebras are constructed in the standard fashion used to construct Clifford algebras out of bilinear forms. Free D.K.P particles and D.K.P particles in a prescribed external electromagnetic field are analized and general Liouville type equations for these cases are (...) obtained. Choosing particular values for the label p we classify the different types of the D.K.P Liouville operators. (shrink)

Large-scale genetic databases are being developed in several countries around the world. However, these databases depend on public participation and acquiescence. In the past, information campaigns have been waged and little attention has been paid to dialogue. Nowadays, it is important to include the public in the development of scientific research and to encourage a free, open and useful dialogue among those involved. This paper is a review of community consultation strategies as part of four proposed large-scale genetic databases in (...) Iceland, Estonia, United Kingdom and Quebec. The Iceland Health Sector Database and Estonian Genome Project have followed a “communication approach” in order to address public concerns, whereas, UK Biobank and Quebec CARTaGENE have chosen a “partnership approach” to involve the public in decision-making processes. (shrink)

The "Dutch Book" argument, tracing back to Ramsey and to deFinetti, offers prudential grounds for action in conformity with personal probability. Under several structural assumptions about combinations of stakes, your betting policy is coherent only if your fair odds are probabilities. The central question posed here is the following one: Besides providing an operational test of coherent betting, does the "Book" argument also provide for adequate measurement of the agents degrees of beliefs? That is, are an agent's fair odds also (...) his/her personal probabilities for those events? We argue the answer is "No!" The problem is caused by the possibility of state dependent utilities. (shrink)

Bulang He,1,2 Jeffrey M Hamdorf2 1Liver and Kidney Transplant Unit, Sir Charles Gairdner Hospital, Perth, WA, Australia; 2School of Surgery, The University of Western Australia, Perth, WA, Australia Aims: The aim of this paper was to review the current status of laparoscopic/robotic kidney transplant and evaluate its feasibility and safety in comparison with conventional standard "open" kidney transplant. Methods: An electronic search of PubMed, Embase, and the Cochrane library database was performed to identify the papers between January 1980 and June (...) 2013 that reported on laparoscopic/robotic kidney transplantation. The terms "laparoscopic kidney/renal transplant" and "robotic kidney/renal transplant " were used. Cross-referencing was also used to find the further publications. Only English language reports were selected and accepted for descriptive analysis. Results: A total of 17 papers and abstracts were retrieved. There were two case-control studies of small volume. High-level evidence comparing the safety and efficacy of laparoscopic/robotic kidney transplant with conventional open kidney transplant was not available at the time of this review. Conclusion: The limited published data have suggested that laparoscopic/robotic kidney transplant may offer the advantages of less pain, better cosmesis, possible shorter hospital stay, and fewer wound complications, without compromising graft function. Accordingly, some immunosuppressive agents, such as sirolimus, might be able to be commenced earlier, after laparoscopic/robotic kidney transplant. The techniques are various at this early stage. A uniformed operative technique may be established in the near future. With refinement of laparoscopic devices, this technique may be widely employed. Further studies will be needed to demonstrate the advantages of laparoscopic/robotic kidney transplant over the conventional open kidney transplant. Keywords: laparoscopic surgery, robotic surgery. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)