Recently, commentators close to and within the UK government have claimed that patient choice can increase equity in the context of the National Health Service. This article critically examines the basis for this claim through analysis of recent speeches and publications authored by secretaries of state for health and their policy advisers. It is concluded that this claim has not developed prospectively from an analysis of the causes of healthcare inequity, or even with a consistent normative definition of equity. The (...) limited justification that is “framed in causal explanations” of inequity has suffered from an apparent disregard of the available evidence. (shrink)

Heisenberg'sgendanken experiments in quantum mechanics have given rise to a widespread belief that the indeterminacy relations holding for the variables of a quantal system can be explained quasiclassically in terms of a disturbance suffered by the system in interaction with a quantal measurement, or state preparation, agent. There are a number of criticisms of this doctrine in the literature, which are critically examined in this article and found to be ininconclusive, the chief error being the conflation of this disturbance with (...) the projection postulate. We present a critique of the disturbance theory based on the fact that the required disturbance will in general depend on the interaction time of the system and state-preparer. This point is exploited in the construction of a spin-interaction model which acts as a counterexample to the disturbance doctrine, while remaining faithful to the spirit of Heisenberg'sgedanken experiments. Several consequences of this result are discussed. (shrink)

Two countable well orderings are weakly comparable if there is an order preserving injection of one into the other. We say the well orderings are strongly comparable if the injection is an isomorphism between one ordering and an initial segment of the other. In [5], Friedman announced that the statement “any two countable well orderings are strongly comparable” is equivalent to ATR 0 . Simpson provides a detailed proof of this result in Chapter 5 of [13]. More recently, Friedman has (...) proved that the statement “any two countable well orderings are weakly comparable” is equivalent to ATR 0 . The main goal of this paper is to give a detailed exposition of this result. (shrink)

In this article we examine the specific contributions Native American thought can make to the ongoing search for a Western ecological consciousness. We begin with a review of the influence of Native American beliefs on the different branches of the modem environmental movement and some initial comparisons of Western and Native American ways of seeing. We then review Native American thought on the natural world, highlighting beliefs in the need for reciprocity and balance, the world as a living being, and (...) relationships with animals. We conclude that Native American ideas are important, can prove inspirational in the search for a modem environmental consciousness, and affirm the arguments of both deep ecologists and ecofeminists. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

Linkage of population-based administrative data is a valuable tool for combining detailed individual-level information from different sources for research. While not a substitute for classical studies based on primary data collection, analyses of linked administrative data can answer questions that require large sample sizes or detailed data on hard-to-reach populations, and generate evidence with a high level of external validity and applicability for policy making. There are unique challenges in the appropriate research use of linked administrative data, for example with (...) respect to bias from linkage errors where records cannot be linked or are linked together incorrectly. For confidentiality and other reasons, the separation of data linkage processes and analysis of linked data is generally regarded as best practice. However, the ‘black box’ of data linkage can make it difficult for researchers to judge the reliability of the resulting linked data for their required purposes. This article aims to provide an overview of challenges in linking administrative data for research. We aim to increase understanding of the implications of the data linkage environment and privacy preservation; the linkage process itself and linkage quality and potential bias in linked data. We draw on examples from a number of countries to illustrate a range of approaches for data linkage in different contexts. (shrink)

Extrapolating from the work of Mahlo , one can prove that given any pair of countable closed totally bounded subsets of complete separable metric spaces, one subset can be homeomorphically embedded in the other. This sort of topological comparability is reminiscent of the statements concerning comparability of well orderings which Friedman has shown to be equivalent to ATR0 over the weak base system RCA0. The main result of this paper states that topological comparability is also equivalent to ATR0. In Section (...) 1, the pertinent subsystems of second-order arithmetic and results on well orderings are reviewed. Sections 2 and 3 overview the encoding of metric spaces and homeomorphisms in second-order arithmetic. Section 4 contains a proof of the topological comparability result in ATR0. Section 5 contains the reversal, a derivation of ATR0 from the topological comparability result. In Section 6, additional information about the structure of the embeddings is obtained, culminating in an application to closed subsets of the real numbers. (shrink)

The rapid advancement from single-gene testing to whole genome sequencing has significantly broadened the type and amount of information available to researchers, physicians, patients, and the public in general. Much debate has ensued about whether genomic test results should be reported to research participants, patients and consumers, and at what stage we can be sure that existing evidence justifies their use in clinical settings. Courts and judges evaluating the utility of these results will not be immune to this uncertainty. As (...) scholars increasingly explore the duty of care standards related to reporting genomic test results, it is timely to provide a framework for understanding how uncertainty about genetic and genomic tests influences evidentiary considerations in the court room. Here, we explore the subtleties and nuances of interpreting genetic data in an environment of substantial discord related to the value that individuals should place on genetic and genomic tests. In conjunction, we discuss the roles courts should play in qualifying experts, expert testimony, and genetic and genomic tests given the intricate and complex nature of genetic and genomic information. (shrink)

In this article we examine the specific contributions Native American thought can make to the ongoing search for a Western ecological consciousness. We begin with a review of the influence of Native American beliefs on the different branches of the modem environmental movement and some initial comparisons of Western and Native American ways of seeing. We then review Native American thought on the natural world, highlighting beliefs in the need for reciprocity and balance, the world as a living being, and (...) relationships with animals. We conclude that Native American ideas are important, can prove inspirational in the search for a modem environmental consciousness, and affirm the arguments of both deep ecologists and ecofeminists. (shrink)

The paper is written in response to those who fail to recognize the relation between a patient's mental competency and her state of pain. Some clinicians claim that a proper diagnosis can only be made in the absent of analgesia. Rather, the patient's state of pain directly affects her mental competency and thus her ability to give valid consent. Clinicians should rethink their approach to diagnosis when the patient is in pain.

This article advances, for the first time, a framework for situating public health law interventions as occurring in a predictable four-stage process. Whether the intervention is related to mandatory seat-belt laws, HIV prevention through needle-exchanges, or distracted-driving laws, these public health law interventions have generally been characterized by the following four stages. First, a series of publicized incidents, observances, or outcomes generate significant media attention, and are framed as public health harms. Then, a few select states evaluate such harms and (...) proactively seek testimony or evidence designed to support a law-based intervention. After this initial public engagement, states enact legal frameworks designed to minimize or reduce the harm, often in the absence of full information about the scope of harm or potential effectiveness of the intervention. In contrast, scholars have proposed that at these early stages, lawmaking should be evidence-based and “developed through a continuous process that uses the best available quantitative and qualitative evidence.”5 Our experience evaluating youth sports traumatic brain injury lawmaking suggests that, like other public health issues with sudden and intense media attention, an evidence-based approach was lacking during these early stages. (shrink)

Ranging from ancient Greek thought to contemporary quantum mechanics, Mastery of Nature investigates to what extent nature can be conquered to further human ends and to what extent such mastery is compatible with human flourishing.

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

In this article we examine the specific contributions Native American thought can make to the ongoing search for a Western ecological consciousness. We begin with a review of the influence of Native American beliefs on the different branches of the modem environmental movement and some initial comparisons of Western and Native American ways of seeing. We then review Native American thought on the natural world, highlighting beliefs in the need for reciprocity and balance, the world as a living being, and (...) relationships with animals. We conclude that Native American ideas are important, can prove inspirational in the search for a modem environmental consciousness, and affirm the arguments of both deep ecologists and ecofeminists. (shrink)

The cognitive and behavioral functions of the frontal lobes have been of great interest to neuroscientists, neurologists, psychologists and psychiatrists. Recent technical advances have made it possible to trace their neuroanatomical connections more precisely and to conduct evoked potential and neuroimaging studies in patients. This book presents a broad and authoritative synthesis of research progress in this field. It encompasses neuroanatomical studies; experiments involving temporal organization and working memory tasks in non-human primates; clinical studies of patients following frontal lobe excisions (...) for intractable epilepsy; metabolic imaging in schizophrenia and affective disorder; neurobehavioral studies of patients with dementia, frontal lobe tumors, and head injuries; magnetic resonance imaging methods for studying human frontal lobe anatomy; theoretical approaches to describing frontal lobe functions; and rehabilitation of patients with frontal lobe damage including their core problem of diminished awareness. Written by a distinguished group of neuroscientists, psychologists and clinicians, Frontal Lobe Function and Dysfunction provides the best current source of information on this region of the brain and its role in cognition, behavior and clinical disorders. (shrink)

For half a century, Ernest Fortin's scholarship has charmed and educated theologians and philosophers with its intellectual search for the best way to live. Written by friends, colleagues, and students of Fortin, this book pays tribute to a remarkable thinker in a series of essays that bear eloquent testimony to Fortin's influence and his legacy. A formidable commentator on Catholic philosophical and political thought, Ernest Fortin inspired others with his restless inquiries beyond the boundaries of conventional scholarship. With essays on (...) subjects ranging across philosophy, political science, literature, and theology Gladly to Learn and Gladly to Teach reflects the astonishing depth and breadth of Fortin's contribution to contemporary thought. (shrink)

For half a century, Ernest Fortin's scholarship has charmed and educated theologians and philosophers with its intellectual search for the best way to live. Written by friends, colleagues, and students of Fortin, this book pays tribute to a remarkable thinker in a series of essays that bear eloquent testimony to Fortin's influence and his legacy. A formidable commentator on Catholic philosophical and political thought, Ernest Fortin inspired others with his restless inquiries beyond the boundaries of conventional scholarship. With essays on (...) subjects ranging across philosophy, political science, literature, and theology Gladly to Learn and Gladly to Teach reflects the astonishing depth and breadth of Fortin's contribution to contemporary thought. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

Although workplace bullying is common and has universally harmful effects on employees’ outcomes, little is known about workplace bullies. To address this gap in knowledge, we draw from the tenets of social exchange and displaced aggression theories in order to develop and test a model of workplace bullying that incorporates the effects of employees’ individual differences, perceptions of their work environments, and perceptions of supervisory treatment on their tendencies to bully coworkers. The results of mediated moderation analyses that examine responses (...) from two samples of working adults support our hypotheses. Specifically, we find evidence of an indirect relationship between entitlement and coworker bullying through perceptions of abusive supervision that is stronger for employees who report lower levels of felt accountability than employees who report higher levels of felt accountability. This study makes important theoretical and practical contributions to abusive supervision research, bullying research, and organizational efforts to promote ethical work environments devoid of interpersonal mistreatment by providing novel insight into how employees’ entitlement and felt accountability combine to influence their tendencies to perceive themselves as victims of abusive supervision and culprits of coworker bullying. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Citation and Modernity: Derrida, Joyce, and BrechtHarvey L. HixCitation and Modernity: Derrida, Joyce, and Brecht, by Claudette Sartiliot; xiii & 173 pp. Norman: University of Oklahoma Press, 1993, $15.95 paper.Claudette Sartiliot argues that “the traditional definition of citation” is “inadequate and outmoded” (p. 15). It no longer applies to modernist and postmodernist writers, for whom “quotation represents a definite break with the tradition as well as a means (...) of questioning the nature of the literary text” (p. 3). The traditional definition, derived from classical rhetoric, limits quotation to the purpose of illustration and ornament. In contrast, modernist and postmodernist citational practices, having abandoned the typographical separation of the quotation from the “main” text, question “the concept of text as an autonomous entity” and replace the idea of a book “by the more unbounded word discourse” (p. 20).To illustrate her point, Sartiliot appeals first to Derrida’s Glas, which “relies on citation to such an extent that it can serve as a paradigm for a theory of quotation” (p. 35). By juxtaposing two columns of text and by extensive quotation, Derrida (a) links quotation with violence and with sexual penetration, (b) stages “a game of appearance and disappearance” through which he evades the reader’s attempts to “pin him down” (p. 42), (c) reveals that words contain within themselves other words, (d) blurs boundaries between languages and disciplines, and (e) “demonstrates how meaning is generated through an aleatory scattering of semes” (p. 57).Sartiliot also attends to Joyce and Brecht, who achieve similar ends through their citational practices: “both have elevated ‘plagiarism’ to the level of originality” and both “have shown that writing is always and inevitably quoting” (p. 75). Because everything in Finnegans Wake is a quotation—even the characters—Joyce undercuts meaning: a text without boundaries cannot be ingested. Finnegans Wake is like quantum physics: “neither intimated that God was dead, but both confronted the world with a model of representation that intimated that ‘God played dice’” (p. 84).Brecht’s characters, like those of Finnegans Wake, are quotations rather than originals: “empty signifiers” whose very names are not their own, they challenge “the bourgeois myth of the identity and continuity of the subject” (p. 130). [End Page 367] As Copernicus removes humanity from the center of the universe and Marx removes humanity from the center of history, so Brecht removes humanity from the center of theatrical representation, revealing that “the subject as a fully present identity and entity” is delusory, and humanity is “a linguistic (and thus political) construct” (p. 124). In sum, by their citational practices Derrida, Joyce, and Brecht question “the notions of origin, closure, and authorship associated with the conception of the book” (p. 124).Citation and Modernity contains moments of insight. For instance, Sartiliot says of Finnegans Wake that “while Joyce was doing away with quotation marks in his own texts, he was forcing his critics to surround most of their critical terms with quotation marks, as a sore sign [sic] of their inability to find the right word to describe what he was doing” (p. 75). In other respects, however, her book is not satisfying. The most obvious problem is that her own citational practices contradict her thesis. After writers like Derrida, Joyce, and Brecht, she says, we can no longer return to traditional quotation based on classical rhetoric, yet her own quotation is strictly traditional: it illustrates and ornaments, and maintains a clear distinction between her own words and those belonging to someone else.There are other failures to live up to the book’s own standards. Sartiliot claims that the chief purpose of quotation is to attack the authority of the quoted father, to “subvert the notions of filiation and tradition” (p. 149) and “eclipse the precursor” (p. 8), yet her own book steadfastly upholds filiation and tradition. From the cover, which makes much of her having been a student of Derrida, to the pervasive jargon (totalization, hymen, logocentrism, dissemination, etc.), the book defers all too consistently to the authority of its father, and consequently fails to challenge its readers.Harvey L. HixKansas City Art InstituteCopyright © 1995 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Poetics of PerspectiveHarvey L. HixThe Poetics of Perspective, by James Elkins; xv & 324 pp. Ithaca: Cornell University Press, 1994, $39.95.The Poetics of Perspective does not mention that Leonardo was born more than 100 years before Galileo and nearly 200 before Newton, but doing so would underscore its thesis. According to James Elkins, our anachronistic view of perspective, invented in the Enlightenment, systematically distorts our understanding of (...) Renaissance art. Instead of “tracing the outline” of the real nature of Renaissance art, our discussions (to borrow Wittgenstein’s metaphor) merely trace “the frame through which we look at it.” The actual Renaissance view, unlike the modern idée fixe, involved no concept of a unified pictorial space. In the absence of such a concept, “Renaissance authors and artists [End Page 368] thought there were many compatible perspectives, so that their writing and painting evince a ‘pluralist’ approach in strict contrast to the monolithic mathematical perspective we imagine today” (p. xi). The Poetics of Perspective attempts, in six substantial chapters and a brief envoi, to unearth this pluralistic Renaissance approach to perspective buried beneath modern preconceptions.Elkins identifies a number of differences between the Renaissance view of perspective and modern views. For instance, no longer is perspective “charged with the religious and social meanings it had for the early Renaissance” (p. 2). Why? “Renaissance artists and writers saw many techniques where we see a single discovery” (p. 8). Renaissance artists thought of perspective as a series of rules and techniques for constructing images; modern art historians, in contrast, think of perspective on analogy with tracing a scene on a pane of glass. In contrast to the “object oriented” Renaissance notion of perspective, the modern concept is “space oriented.” For the Renaissance, perspective was “a strategy for making pictures,” but for us it has become “a sign signifying a mental state, a culture, or an expressive language” (p. 17). Renaissance perspective originated as “a construction, an intellectual accomplishment rather than as a transcription of appearances” or a “revelation of optical reality” (pp. 136–38). To its contemporaries, Renaissance perspective suggested “the complicated, unfinished, and partial” rather than “the harmonious, balanced, and whole” (p. 170). We expect a uniform accuracy of perspective through an entire painting, but Renaissance practitioners were selective in their applications of perspective to passages of particular interest or significance. All these differences taken together, Elkins says, imply that our insistence on attributing to Renaissance paintings an isotropic application of perspective based on an ideal geometry is a mistake: “we are looking for something the Renaissance artists did not supply” (p. 226).Elkins’s excellent book is a corrective for the sort of thing Lillian Schwartz does in the April 1995 Scientific American. In the middle of a series of ill-substantiated conjectures, based on computer manipulations of images and ranging from the claim that Leonardo himself was a model for the Mona Lisa to the assertion that Piero della Francesca’s Resurrection of Christ, plastered over during the seventeenth century, must have been painted “in sunset colors,” she suggests that Leonardo intended The Last Supper to “appear as an extension of the refectory” in which it was painted. She explains the quirks of the painting’s perspective (“Leonardo placed Christ and the apostles up front, tilted the floor and table, designed side walls of uneven lengths and tapestries of different sizes and spacing”) by constructing a computer simulation to show that a person entering the room from what was then the main door “would perceive the supper as taking place in the refectory.” Schwartz’s conjecture may or may not be right, but comparison with her article reveals the major strengths of Elkins’s book. In contrast to Schwartz’s hasty manipulations, The Poetics of Perspective is encyclopedic; it takes scrupulous care to meet on their own ground the many [End Page 369] texts and paintings it examines, and it follows the Wittgensteinian imperative to stop thinking and look. Whatever the promise of the new technologies available to art historians, they can never replace the sort of patient attention Elkins lavishes on the works he studies.Harvey L. HixKansas City Art InstituteCopyright... (shrink)