The Physician Orders for Life-Sustaining Treatment Paradigm is designed to improve end-of-life care by converting patients’ treatment preferences into medical orders that are transferable throughout the health care system. It was initially developed in Oregon, but is now implemented in multiple states with many others considering its use. Accordingly, an observational study was conducted in order to identify potential legal barriers to the implementation of a POLST Paradigm. Information was obtained from experts at state emergency medical services and long-term care (...) organizations/agencies in combination with a review of relevant state law. Legal analysis of survey responses and existing laws identified several potential state legal barriers to a POLST Paradigm implementation. The most potentially problematic barriers are detailed statutory specifications for out-of-hospital DNR protocols. Other potential barriers include limitations on the authority to consent to forgo life-sustaining treatments, medical preconditions, and witnessing requirements for out-of-hospital DNR protocols. (shrink)

To what extent do people attribute meanings to “nonsense” words? How general is such attribution of meaning? We used a set of words lacking conventional meanings to elicit drawings of made‐up creatures. Separate groups of participants rated the nonsense words and the drawings on several semantic dimensions and selected what name best corresponded to each creature. Despite lacking conventional meanings, “nonsense” words elicited a high level of consistency in the produced drawings. Meaning attributions made to nonsense words corresponded with meaning (...) attributions made by separate people to drawings that were inspired by the name. Naïve participants were able to recover the name that inspired the drawing with greater‐than‐chance accuracy. These results suggest that people make liberal and consistent use of non‐arbitrary relationships between forms and meanings.Open Research Badges This article has been awarded Open Materials and Open Data badges. All materials and data are publicly accessible via the Open Science Framework at https://osf.io/8juyc/. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki. (shrink)

Medical technology, specialization, and the corporatization of health delivery systems in the late twentieth century have all helped give birth to an unwelcome but unavoidable responsibility for individuals with family or friends—serving as a health care proxy. The responsibility comes without monetary compensation, is often involuntary, and lacks any real guidelines beyond the duty to make life-and-death decisions in circumstances over which the proxy has little control.The parameters of the proxy's job have evolved somewhat awkwardly in statutes and case law, (...) as lawmakers and judges have tried to apply conventional concepts to novel circumstances. This article examines the legal and functional status of the proxy, as well as the strengths and weaknesses of current public policy as reflected by state advance directive and surrogate decision-making laws. The first section of the article provides a historical perspective of our current notions of agency law as relevant to health care proxies. (shrink)

Medical technology, specialization, and the corporatization of health delivery systems in the late twentieth century have all helped give birth to an unwelcome but unavoidable responsibility for individuals with family or friends—serving as a health care proxy. The responsibility comes without monetary compensation, is often involuntary, and lacks any real guidelines beyond the duty to make life-and-death decisions in circumstances over which the proxy has little control.The parameters of the proxy's job have evolved somewhat awkwardly in statutes and case law, (...) as lawmakers and judges have tried to apply conventional concepts to novel circumstances. This article examines the legal and functional status of the proxy, as well as the strengths and weaknesses of current public policy as reflected by state advance directive and surrogate decision-making laws. The first section of the article provides a historical perspective of our current notions of agency law as relevant to health care proxies. (shrink)

The vector product method developed in previous articles for space rotations and Lorentz transformations is extended to the cases of four-vectors, anti-symmetric tensors, and their transformations in Minkowski space. The electromagnetic fields are expressed in “six-vector” form using the notationH +iE, and this vector form is shown to be relativistically invariant. The wave equations of electromagnetism are derived using these vector products. The following three equations are deduced, which summarize electrodynamics in a compact form: (1) Maxwell's four equations expressed as (...) one, (2) the scalar and vector potential wave equations combined into one relation, and (3) the wave equations for the electric and magnetic fields and the continuity equation combined together. Space inversion, time reversal, and magnetic monopoles are also treated. (shrink)

Calls for greater corporate responsibility have resulted in the creation of various extralegal mechanisms to shape corporate behavior. The number and popularity of corporate responsibility standards has grown tremendously in the last three decades. Current estimates suggest there may be over 300 standards that address various aspects of corporate behavior and responsibility (e. g., working conditions, human rights, protection of the natural environment, transparency, bribery). However, little is known about how these standards relate directly to the notion of peace through (...) commerce and the reduction of violent conflict in the world. This article explores the relationship between corporate responsibility standards and peace through commerce. After a summary of the current state of standards with respect to the creation of peace and the reduction of violent conflict, I explore concerns regarding the effectiveness of standards in shaping corporate behavior and the potential future role standards could have in creating peace through commerce. (shrink)

State law requirements for health care advance directive documents were reviewed in every state and the District of Columbia to determine whether they are consistent and/or flexible enough to permit the utilization by the public of “universal” advance directive forms, specifically a health care power of attorney, that would be valid under every state's advance directive statutes. Such documents would have to overcome the wide variability of state legal formalities for validity. If this could be accomplished, the public would benefit (...) from having a variety of multi-state or truly universal forms available that could be used with confidence in their validity.The review found that a basic, multi-state health care power of attorney appears to be feasible in 41 States and the District of Columbia, compared to 36 states and the District in 2005. Only nine states prevent recognition of a truly universal form. Some barriers were surmountable, including differing agent and witness requirements, execution requirements, and effectiveness triggers. Other barriers were insurmountable, including mandatory forms, mandatory disclosures, and decision-specific language requirements. The strategies identified for overcoming some barriers can be used by lawyers in drafting true multi-state directives. More importantly, states should simplify state advance directive laws to facilitate a more meaningful communication model of advance care planning. (shrink)

This article details the results of a national survey conducted in 1999 of statewide laws and protocols providing for the creation and recognition of donot- resuscitate orders effective in nonhospital settings. Applicable primarily to emergency medical services personnel, most of these laws and protocols have been in existence for less than ten years, and there is little current comparative information on them. Such policies are commonly called out-of-hospital or prehospital DNR orders, although one state-Virginia-recently amended its DNR law to establish (...) a durable DNR order applicable to all health care providers and all settings. I will refer to the laws and policies examined here interchangeably as out-of hospital DNR protocols or EMS-DNR protocols. The survey produced a descriptive snapshot of such laws and protocols in effect on a statewide basis as of March 1999. (shrink)

Dissipative systems are described by a Hamiltonian, combined with a “dynamical matrix” which generalizes the simplectic form of the equations of motion. Criteria for dissipation are given and the examples of a particle with friction and of the Lotka-Volterra model are presented. Quantization is first introduced by translating generalized Poisson brackets into commutators and anticommutators. Then a generalized Schrödinger equation expressed by a dynamical matrix is constructed and discussed.

This article presents a Pauli-Dirac matrix approach to Clifford Algebras. It is shown that the algebra C2 is generated by two Pauli matrices iσ2 and iσ3; C3 is generated by the three Pauli matrices σ1, σ2, σ3; C4 is generated by four Dirac matrices γ0, γ1, γ2, γ3 and C5 is generated by five Dirac matrices iγ0, iγ1, iγ2, iγ3, iγ5. The higher dimensional anticommuting matrices which generate arbitrarily high order Clifford algebras are given in closed form. The results obtained (...) with this Clifford algebra approach are compared with the vector product method which was described in a recent article [Found. Phys. 10, 531–553 (1980) by Poole, Farach and Aharonov] and with the Dirac, Rashevskii and Ramakrishnan methods of matrix generation. (shrink)

This article details the results of a national survey conducted in 1999 of statewide laws and protocols providing for the creation and recognition of donot- resuscitate orders effective in nonhospital settings. Applicable primarily to emergency medical services personnel, most of these laws and protocols have been in existence for less than ten years, and there is little current comparative information on them. Such policies are commonly called out-of-hospital or prehospital DNR orders, although one state-Virginia-recently amended its DNR law to establish (...) a durable DNR order applicable to all health care providers and all settings. I will refer to the laws and policies examined here interchangeably as out-of hospital DNR protocols or EMS-DNR protocols. The survey produced a descriptive snapshot of such laws and protocols in effect on a statewide basis as of March 1999. (shrink)

Gilead et al.'s approach to human cognition places abstraction and prediction at the heart of “mental travel” under a “representational diversity” perspective that embraces foundational concepts in cognitive science. But, it gives insufficient credit to the possibility that the process of abstraction produces a gradient, and underestimates the importance of a highly influential domain in predictive cognition: language, and related, the emergence of experientially based structure through time.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Nietzsche's Ecce Homo and the Revaluation of All Values: Dionysian Versus Christian Values by Thomas H. BrobjerCharles P. RodgerThomas H. Brobjer. Nietzsche's Ecce Homo and the Revaluation of All Values: Dionysian Versus Christian Values. London: Bloomsbury Academic, 2021. Pp. viii + 210. Hardback, $115.00.It is difficult to review a book so rich in consequences and seemingly sui generis. To categorize it as the work of a "lumper" or (...) "splitter," for example, would only confuse matters. Granted, Brobjer dismisses The Will to Power as the tendentious forgery of Nietzsche's sister. Methodologically, he also appears as a "moderate" splitter who provides a close textual reading and draws on the Nachlass only so far as this serves to elucidate the claims Nietzsche made in his published works. Nonetheless, Brobjer's central hypothesis might, albeit falsely, suggest that he is an old-fashioned lumper, for he holds that Mazzino Montinari was wrong to claim Nietzsche abandoned his plans for a Hauptwerk ("Nietzsches Nachlaß von 1885 bis 1888 oder Textkritik und Wille zur Macht," in Nietzsche Lesen [Berlin: Walter de Gruyter, 1982], 92–119).Granted, Montinari admitted that after abandoning plans for The Will to Power, Nietzsche did, in the fall of 1888, entertain a new plan for a four-volume Hauptwerk titled The Revaluation of All Values. According to these plans, The Antichrist would be its first volume, followed by The Free Spirit, containing a critique of philosophy as a nihilistic movement; The Immoralist, containing a critique of morality and its dangers; and Dionysos Philosophos. Nonetheless, Montinari claimed, these plans also collapsed when, sometime after mid-November 1888, Nietzsche decided to make The Antichrist into the whole of The Revaluation of All Values. Indeed, Montinari's hypothesis was that Nietzsche finally realized, at the last minute, that the work of the past five years and what he had previously regarded as his life task was untenable and, having published everything he could salvage from his failed Hauptwerk project, "Nietzsche's collapse in Turin came when he had literally finished with everything" (12, emphasis in the original). To Brobjer, however, "this claim seems both psychologically improbable and, in regard to Nietzsche's intention to write a Hauptwerk, simply wrong" (12). Yet despite Brobjer having demonstrated in a number of articles published over the past decades that the evidence is not only too thin and ambiguous to sustain Montinari's hypothesis, but that it contradicts his timeline (92–94), scholars continue to treat Montinari's conclusions as established fact, and moreover treat all "discussions and considerations of a magnum opus … as hypothetical and old-fashioned" (12). But if so, why should the present study, wherein Brobjer advances this same thesis, not also fall on deaf ears? The answer is surprising: Ecce Homo.The Druckmanuskript shows that both the final chapter headings and the majority of the final text of Ecce Homo were established prior to mid-November, and, while Nietzsche continued to make additions and alterations to Ecce Homo up until a day before his collapse, his revisions to the completed portions of the text were only "minor" (21). Since, even according to Montinari's timeline, the vast majority of Ecce Homo was thus written at a time when Nietzsche still incontrovertibly intended that The Antichrist would constitute only the first volume of The Revaluation of All Values (47), nothing can possibly speak against examining whether Ecce Homo might retain at least traces of Nietzsche's original plans for his Hauptwerk. To the contrary, a great deal speaks for it. After all, the conventional interpretation of Ecce Homo as a "backward-looking autobiography" (5) has hardly borne fruit; read as a summary of Nietzsche's life and writings, Ecce Homo is so "elliptic, paradoxical, absurd" (48), and so contorted by excessive self-praise and praise for Thus Spoke Zarathustra, that the text is incoherent and unusable for its supposed purpose. Yet Nietzsche explicitly told his publisher that his intention was merely to tell of his life and works "in snatches" (3), and that Ecce Homo was being composed with the "intention to give this work the same form and appearance which that magnum opus [Hauptwerk] will have, to... (shrink)

Few studies exist which look at psychological factors associated with physician sexual misconduct. In this study, we explore family dysfunction as a possible risk factor associated with physician sexual misconduct. Six hundred thirteen physicians referred to a continuing medical education (CME) course for sexual misconduct were administered the FACES-II survey, a validated and reliable measure of family dynamics. The survey was part of a self-learning activity. We collected data from February 2000 to February 2009. Participants were predominantly white, middle-aged males (...) who represented the full range of medical specialties. Their results were compared against a sample of 177 physicians. The FACES-II is a self-report test that measures family of origin (the family in which one was raised) dynamics on two dimensions (1) flexibility, ranging from too flexible (chaotic) to not flexible enough (rigid) and (2) cohesion ranging from too close (enmeshed) to not close enough (disengaged). The most common family pattern observed among physicians accused of sexual misconduct was rigid flexibility paired with disengaged cohesion, indicative of unhealthy family functioning. This pattern was significantly different than the pattern observed in the comparison group. Physicians who engage in sexual misconduct are more likely to have family of origin dysfunction. Ethics is developmental and learned in one’s family of origin. Family of origin dynamics may be one risk factor predisposing one to ethical violations. These findings have important implications for screening, education, and treatment across the medical education continuum. (shrink)

Why, since happiness is so universally sought after, are so many people so miserable? The answer can be found by unpacking the wisdom of two of history's intellectual giants who set out to answer the question that has confounded man from time immemorial: What makes us happy? Aristotle and Thomas Aquinas existed sixteen centuries apart, yet each reached similar understandings about what makes a person happy and what makes him miserable. In these enlightening pages, Dr. Charles Nemeth synthesizes the (...) judgments of history's two greatest thinkers to present for you a life plan that inevitably leads to a happy human existence, whatever your ethnicity, religion, or citizenship. You will explore what it means to be happy and will come to understand the limitations of happiness. You'll learn how to live in accordance with your basic nature so that your inclinations will not conflict with that which makes you flourish. And you'll calibrate your compass so that you will be able to navigate your way into a state of life that makes you truly happy. Moreover, you'll discover why happiness is obtained through action and not mere desire and why wealth and fame do not -- and cannot -- buy happiness. You'll also learn why the body, despite providing avenues for sensory and intellectual pleasure, is incapable of providing true happiness. Strikingly, none of the suggestions in this book have ever been shown to be flawed. These timeless recommendations for a happy life never go out of favor and never change. Instead, they remain a constant, permanent, universal set of criteria on how to achieve a happy existence. You'll also learn: The benefits of moderation, sensibility, and equilibrium The source of ultimate happiness and the means to attain it The formula for fostering contentment -- what to strive for and what to avoid The essence of true goodness, happiness, and beauty Human excellence and different levels of happiness With this Rosetta stone of a book, you will find solutions to fortify your soul and bring you peace. You will be equipped with a new sense of direction, hope, and healing that will guide you closer to lasting happiness. (shrink)

In this article, I limn the remarkable ascent of Albert Einstein and Wassily Kandinsky into our cultural pantheon. I depict how both figures mastered and transcended their respective fields, and how they called into question long-established disciplinary assumptions and practices. I also demonstrate how the creative works of Einstein and Kandinsky constructed, and were constructed by, the reality we now call "modern.".

Kant's revolution in methodology limited metaphysics to the conditions of possible experience. Since, following Hume, analysis—the “method of discovery” in early modern physics—could no longer ground itself in sense or in God's constituting reason a new arché, “origin” and “principle,” was required, which Kant found in the synthesis of the productive imagination, the common root of sensibility and understanding. Charles Bigger argues that this imaginative “between” recapitulates the ancient Gaia myth which, as used by Plato in the Timaeus, offers (...) a way into this originary arché. Since it depends on myth and the “likely story” rather than on a self-certain apprehension of Being, this facilitates an imaginative approach to the natural sciences which, through its synthetic a priori formations, can claim to be Kantian. Bigger explores Kant's ethics as an alternative to metaphysics that holds open the prospect of a Good beyond Being—and phenomenology—whose traces nevertheless appear in original synthesis. Though wary of its reductive implications, Bigger uses Derrida's difference, a medial, feminine arché, as a way into this creative and procreative metaxu. As Emmanuel Levinas suggests, this is Plato's gap [chaos] between being and becoming, whose possibility, beyond both, lies in chora and the Good. This Open also presents the possibility for a new, yet still Kantian, understanding of the formal and material conditions for the natural sciences. (shrink)

The myf5 and myoD genes are implicated in the specification of vertebrate skeletal muscle. These genes have been thought to be functionally redundant because neonatal mice bearing homozygous null mutations in either gene show grossly normal muscle development. By analyzing the early embryonic development of the mutants, Michael Rudnicki and coworkers show that trunk muscle development is retarded in embryos bearing myf5 null mutations, while early limb and branchial arch muscle development is retarded by myoD null mutations.1 These results indicate (...) that the myoD and myf5 genes are not redundant but that each controls the early specification of distinct muscle cell lineages. BioEssays 20:357–362, 1998.© 1998 John Wiley & Sons Inc. (shrink)