Showcasing American music and music making during the Great Depression, Hard Luck Blues presents more than two hundred photographs created by the New Deal's Farm Security Administration photography program. With an appreciation for the amateur and the local, FSA photographers depicted a range of musicians sharing the regular music of everyday life, from informal songs in migrant work camps, farmers' homes, barn dances, and on street corners to organized performances at church revivals, dance halls, and community festivals. Captured across the (...) nation from the northeast to the southwest, the images document the last generation of musicians who learned to play without the influence of recorded sound, as well as some of the pioneers of Chicago's R & B scene and the first years of amplified instruments. The best visual representation of American roots music performance during the Depression era, Hard Luck Blues features photographs by Jack Delano, Dorothea Lange, Russell Lee, Arthur Rothstein, Ben Shahn, Marion Post Wolcott, and others. Photographer and image researcher Rich Remsberg breathes life into the images by providing contextual details about the persons and events captured, in some cases drawing on interviews with the photographers' subjects. Also included are a foreword by author Nicholas Dawidoff and an afterword by music historian Henry Sapoznik. Published in association with the Library of Congress. (shrink)

The Jubilee Centre’s new report, Virtuous Medical Practice, examines the place of character and values in the medical profession in Britain today. Its findings are drawn from a UK-focused multi-methods study of 549 doctors and aspiring doctors at three career stages, first and final year students and experienced doctors.

The majority of people show persistent poor performance in reasoning about “stock-flow problems” in the laboratory. An important example is the failure to understand the relationship between the “stock” of CO2 in the atmosphere, the “inflow” via anthropogenic CO2 emissions, and the “outflow” via natural CO2 absorption. This study addresses potential causes of reasoning failures in the CO2 accumulation problem and reports two experiments involving a simple re-framing of the task as managing an analogous financial budget. In Experiment 1 a (...) financial version of the task that required participants to think in terms of controlling debt demonstrated significant improvements compared to a standard CO2 accumulation problem. Experiment 2, in which participants were invited to think about managing savings, suggested that this improvement was fortuitous and coincidental rather than due to a fundamental change in understanding the stock-flow relationships. The role of graphical information in aiding or abetting stock-flow reasoning was also explored in both experiments, with the results suggesting that graphs do not always assist understanding. The potential for leveraging the kind of reasoning exhibited in such tasks in an effort to change people's willingness to reduce CO2 emissions is briefly discussed. (shrink)

Abstract:The specialty of psychiatry has a long-standing, virtually monolithic view that a desire to die, even a desire for a hastened death among the terminally ill, is a manifestation of mental illness. Recently, psychiatry has made significant inroads into hospice and palliative care, and in doing so brings with it the conviction that dying patients who seek to end their suffering by asserting control over the time and manner of their inevitable death should be provided with psychotherapeutic measures rather than (...) having their expressed wishes respected as though their desire for an earlier death were the rational choice of someone with decisional capacity. This article reviews and critiques this approach from the perspective of recent clinical data indicating that patients who secure and utilize a lethal prescription are generally exercising an autonomous choice unencumbered by clinical depression or other forms of incapacitating mental illness. (shrink)

Abstract:Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result. With the exponential increase in the penetration of Catholic-affiliated healthcare across the country, physicians and nurses who are not practicing Catholics are nevertheless required to execute documents pledging to conform their patient care to the Ethical (...) and Religious Directives for Health Care Services as a condition of employment or medical staff privileges. In some instances, doing so may result in patient morbidity or mortality or violate professional standards for respecting advance directives or surrogate decisionmaking. This article challenges the ethical propriety of such institutional mandates and argues that legal protections for conscientious refusal must provide redress for patients who are harmed by care that falls below the prevailing clinical standards. (shrink)

In a recent special supplement to the Hastings Center Report entitled “Improving End-of-Life Care—Why Has It Been So Difficult?” Robert Burt wrote the following in an essay ominously entitled “The End of Autonomy”: No one should be socially authorized to engage in conduct that directly, purposefully, and unambiguously inflicts death, whether on another person or on oneself. Decisions that indirectly lead to death should be acted upon only after a consensus is reached among many people. No single individual should be (...) socially authorized to exercise exclusive control over decisions that might lead to death, whether that individual is the dying person, the attending physician, or a family member acting as health care proxy. (shrink)

Continuous first-order logic has found interest among model theorists who wish to extend the classical analysis of “algebraic” structures to various natural classes of complete metric structures. With research in continuous first-order logic preoccupied with studying the model theory of this framework, we find a natural question calls for attention. Is there an interesting set of axioms yielding a completeness result?The primary purpose of this article is to show that a certain, interesting set of axioms does indeed yield a completeness (...) result for continuous first-order logic. In particular, we show that in continuous first-order logic a set of formulae is satisfiable if it is consistent. From this result it follows that continuous first-order logic also satisfies an approximated form of strong completeness, whereby Σ⊨φ only if Σ⊢φ∸ 2-n for all n < ω. This approximated form of strong completeness asserts that if Σ⊨φ, then proofs from Σ, being finite, can provide arbitrarily better approximations of the truth of φ.Additionally, we consider a different kind of question traditionally arising in model theory—that of decidability. When is the set of all consequences of a theory recursive? Say that a complete theory T is decidable if for every sentence φ, the value φT is a recursive real, and moreover, uniformly computable from φ. If T is incomplete, we say it is decidable if for every sentence φ the real number φT∘ is uniformly recursive from φ, where φT∘is the maximal value of φ consistent with T. As in classical first-order logic, it follows from the completeness theorem of continuous first-order logic that if a complete theory admits a recursive axiomatization then it is decidable. (shrink)

(2013). Distinguishing Difficult Patients From Difficult Maladies. The American Journal of Bioethics: Vol. 13, No. 4, pp. 24-26. doi: 10.1080/15265161.2013.767957.

The concept of person is integral to bioethical discourse because persons are the proper subject of the moral domain. Nevertheless, the concept of person has played no role in the prevailing formulation of human death because of a purported lack of consensus concerning the essential attributes of a person. Beginning with John Locke's fundamental proposition that person is a ‘forensic term’, I argue that in Western society we do have a consensus on at least one necessary condition for personhood, and (...) that is the capacity for conscious experience. When we consider the whole brain formulation of death, and the most prominent defense of it by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, we can readily identify the flaws that grow out of the failure to define human death as the permanent loss of the capacity for conscious experience. Most fundamental among these flaws is a definition of human death that reduces persons to the capacity of the brain to regulate purely physiological functioning. Such a formulation would, in theory, apply to any member of the animal kingdom. I suggest that an appropriate concept of death should capture what it is about a particular living being that is so essential to it that the permanent loss of that thing constitutes death. What is essential to being a human being is living the life of a person, which derives from the capacity for conscious experience. (shrink)

Prognostication, the process offormulating and communicating a prognosis, isno longer considered by most physicians to bean essential task in caring for patients withserious illness. Because of this fact, it isnot surprising to find that when physiciansattempt to engage in prognostication, they doit poorly. What may be surprising to thoseoutside the medical community is the extent towhich professional norms have developed whichactively discourage physicians from engaging inprognostication. This article explores thecauses of this state of affairs and thejustifications offered for it. The (...) conclusionis reached that physicians have a professionalresponsibility to competently engage inprognostication based upon the doctrine ofinformed consent, and that a failure or refusalto do so has not only potential legalramifications, but serious negativeimplications for many of the core issues inbioethics, such as the use of advancedirectives, palliative medicine, and medicalfutility. (shrink)

Abstract:Recent contributions to the medical literature have raised yet again the issue of whether the term “terminal” is an intelligible one and whether there is a consensus view of its meaning that is sufficient to justify or even require its use in discussing end-of-life care and treatment options with patients. Following a review of the history and development of informed consent, persistent problems with the communication of prognosis and the breaking of bad news are analyzed. The author argues that candid (...) but compassionate communication between physicians and patients about prognosis is essential to informed decisions about both disease-directed (curative) and palliative therapies. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 52-53, June 2011.

This book is a fundamental and unique masterpiece which reflects the discussions on business and economic ethics over decades in German-speaking countries, and ...

Until quite recently bioethicists have had little of depth and probity to say about the duty of healthcare professionals in general and physicians in particular to relieve pain and suffering associated with disease and/or its treatment.

In the mid to late 1980s a debate arose over the moral and legal authority of advance medical directives. At the center of this debate were two point-counterpoint law journal articles by Rebecca Dresser and Nancy Rhoden. What appeared to have the makings of an ongoing critical dialogue ended with the untimely death of Nancy Rhoden. Rebecca Dresser, however, has continued her challenge of advance directives in numerous publications, most recently in a critique of Ronald Dworkin's Life's Dominion. Like Rhoden, (...) Dworkin has been a staunch advocate of advance directives as an exercise of what has come to be referred to as prospective or precedent autonomy. In this paper I will consider a number of the issues that Dresser has repeatedly raised about the infirmities of advance directives, and suggest that it is from an understanding of and appreciation for the narrative dimension of the life of a person that advanced directives draw one of their most powerful justifications. (shrink)

1. Theologische Grundlegung.--2. Wirtschaftsethik. 2 v.--3. Politische Ethik (Staat und Revolution).

[Bd. 1.] Grundlagen in theologischer Perspektive -- Bd. 2. Marktwirtschaft, Planwirtschaft, Weltwirtschaft aus sozialethischer Sicht.

Among the most significant findings of SUPPORT was that 50% of ICU patients suffered from moderate to severe pain during the last days of life. At the time of its publication late in 1995, SUPPORT was merely the latest in a long series of articles in the medical literature documenting the widespread and significant undertreatment of pain, beginning with a 1973 study of hospital inpatients. Much has been written about the phenomenon of undertreated pain and inadequate care of patients at (...) the end of life, and many positive suggestions for reform of clinical education and clinical practice have been iterated and reiterated in the two decades separating the studies. Proposals for modifying clinician behaviors in this aspect of patient care have tended to focus on particular barriers to effective pain management and palliative care. (shrink)

-/- Continuous first-order logic has found interest among model theorists who wish to extend the classical analysis of “algebraic” structures (such as fields, group, and graphs) to various natural classes of complete metric structures (such as probability algebras, Hilbert spaces, and Banach spaces). With research in continuous first-order logic preoccupied with studying the model theory of this framework, we find a natural question calls for attention. Is there an interesting set of axioms yielding a completeness result? -/- The primary purpose (...) of this article is to show that a certain, interesting set of axioms does indeed yield a completeness result for continuous first-order logic. In particular, we show that in continuous first-order logic a set of formulae is (completely) satisfiable if (and only if) it is consistent. From this result it follows that continuous first-order logic also satisfies an approximated form of strong completeness, whereby Σ⊧φ (if and) only if Σ⊢φ ∸2−n for all n < ω. This approximated form of strong completeness asserts that if Σ⊧φ, then proofs from Σ, being finite, can provide arbitrarily better approximations of the truth of φ. -/- Additionally, we consider a different kind of question traditionally arising in model theory—that of decidability. When is the set of all consequences of a theory (in a countable, recursive language) recursive? Say that a complete theory T is decidable if for every sentence φ, the value φ T is a recursive real, and moreover, uniformly computable from φ. If T is incomplete, we say it is decidable if for every sentence φ the real number φ T o is uniformly recursive from φ, where φ T o is the maximal value of φ consistent with T. As in classical first-order logic, it follows from the completeness theorem of continuous first-order logic that if a complete theory admits a recursive (or even recursively enumerable) axiomatization then it is decidable. (shrink)

In the mid to late 1980s a debate arose over the moral and legal authority of advance medical directives. At the center of this debate were two point-counterpoint law journal articles by Rebecca Dresser and Nancy Rhoden. What appeared to have the makings of an ongoing critical dialogue ended with the untimely death of Nancy Rhoden. Rebecca Dresser, however, has continued her challenge of advance directives in numerous publications, most recently in a critique of Ronald Dworkin's Life's Dominion. Like Rhoden, (...) Dworkin has been a staunch advocate of advance directives as an exercise of what has come to be referred to as prospective or precedent autonomy. In this paper I will consider a number of the issues that Dresser has repeatedly raised about the infirmities of advance directives, and suggest that it is from an understanding of and appreciation for the narrative dimension of the life of a person that advanced directives draw one of their most powerful justifications. (shrink)

Charles Dickens began one of his many great works of literature with this seemingly paradoxical, self-contradictory statement. Reflecting on a jury verdict in Northern California in June of 2001, in the context of what has transpired during the decade of the 1990s with regard to the care of dying patients, observations in the genre of Dickens come readily to mind. In 1991, two of the most compelling books on the subject of pain, medicine, and society were published: Eric Cassell's The (...) Nature of Suffering and the Goals of Medicine and David Morris's The Culture of Pain. Both works unflinchingly recognized and explored the implications of the vast clinical literature documenting the failure of modern medicine to respond compassionately and effectively to what had by then become an epidemic of undertreated pain. (shrink)

When one considers the protracted and continuing struggle of the citizens of Oregon to include physician-assisted suicide among the panoply of measures available to dying patients and the physicians who care for them, the depth and breadth of the issue becomes inescapable. The potential intractability of the dispute is illustrated by the very fact, noted in the preceding parenthetical phrase, that consensus eludes us on even the most basic of semantic points—how we are to most aptly characterize the conduct in (...) question? The case featured in this issue's The Caduceus in Court must be examined as the latest battle in a long war of attrition waged by opponents of physician-assisted suicide against the Oregon Death with Dignity Act. After briefly reviewing that history, I will then consider the details of Oregon v. Ashcroft and the implications of the litigation not only for the care of dying patients but also for the regulation of medical practice in the United States and, more broadly still, the search for resolution of serious medical disputes in a democratic society. (shrink)

In the regime of Anglo-American tort law, every person has a responsibility to comport him- or herself with “due care” in going about day-to-day activities so as not to imperil the health, safety, or general welfare of others. The gold standard for determining what constitutes due care in any particular situation is what a reasonable person, similarly situated, would do. Determinations of due care are necessarily fact specific. Nevertheless, the general objective is to strike an appropriate balance between an unrealistically (...) high standard of caution and one that fails to take into account the known or foreseeable risks of any human endeavor. The same standard applies to individuals regardless of their age, gender, race, and level of education or economic status. The standard also applies to fictional “persons” such as corporations. The usual or prevailing custom and practice in an industry or occupation may provide relevant evidence of what constitutes “due care” in the activities common to it, but that evidence can be effectively overcome or rebutted by competent, credible evidence that the custom and practice either diverges from what it has been asserted to be or that the custom and practice is itself unsafe or otherwise poses an unreasonable risk of harm to others. Until quite recently, a singular exception to this general principle of tort law was made for the medical profession. We will consider this exception in the next section. (shrink)