This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

This article looks at the late John Paul II's allocution on artificial nutrition and hydration (ANH) and the implications his statement will have on the ordinary-extraordinary care distinction. The purpose of this article is threefold: first, to examine the medical condition of a persistent vegetative state (PVS); second, to examine and analyze the Catholic Church's tradition on the ordinary-extraordinary means distinction; and third, to analyze the ethics behind the pope's recent allocution in regards to PVS patients as a matter of (...) conscience. Rather than providing clarification, I argue that the papal allocution has raised many difficult questions. People in situations where decisions must be made about withdrawal or continued ANH are in need of guidance. Moreover, additional analysis is needed to determine whether the papal allocution is in conflict with the traditional Catholic medical ethics understanding of the ordinary-extraordinary care distinction. (shrink)

The common thread running through the logicism of Frege, Dedekind, and Russell is their opposition to the Kantian thesis that our knowledge of arithmetic rests on spatio-temporal intuition. Our critical exposition of the view proceeds by tracing its answers to three fundamental questions: What is the basis for our knowledge of the infinity of the numbers? How is arithmetic applicable to reality? Why is reasoning by induction justified?

From the philosophy of mind and language, through physics and mathematics, to the philosophy of the human sciences, morality and religion, there is almost no area of philosophy to which Hilary Putnam has not made highly original and influential contributions. This wide-ranging collection of papers provides a critical assessment and exploration of Putnam's Seminal Work. Written by Philosophers themselves well known for their work in the field, each essay bears witness to the continuing influence and importance of Putnam's thought. Putnam's (...) reply constitutes an extensive new essay which clarifies, and develops further, central themes in his philosophy. This volume includes papers by Simon Blackburn, George Boolos, Michael Hallett, Michael Redhead, Thomas Ricketts, David Wiggins and Crispin Wright. (shrink)

In April 1999, Dr. Curt Freed of the University of Colorado in Denver and Dr. Stanley Fahn of Columbia Presbyterian Center in New York presented the results of a four-year, $5.7 million government-financed study using tissue from aborted fetuses to treat Parkinson’s disease at a conference of the American Academy of Neurology. The results of the first government-financed, placebo-controlled clinical study using fetal tissue showed that the symptoms of some Parkinson’s patients had been relieved. This research study involved forty subjects, (...) nineteen women and twenty-one men; all suffered from Parkinson’s disease for an average of 13.5 years. In the study, each subject underwent neurosurgery: “four tiny burr holes, drilled through the wrinkle lines above the eyebrows into the skull, to clear a pathway to the brain. But only half received injections of fetal cells into the putamen, the region of the brain that controls movement; the other half received nothing. One year later, three members of the placebo group said their symptoms had improved.” In two-thirds of the transplant recipients, the fetal tissue took hold and seemed to establish a new network to produce the missing neurochemical dopamine. (shrink)

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation, or signs of torture. Mounting information from many sources, including Pentagon documents, the International Committee of the Red Cross, Amnesty International, Human Rights Watch, etc., indicate that medical personnel failed to maintain medical records, (...) conduct routine medical examinations, provide proper care of disabled and injured detainees, accurately report illnesses and injuries, and falsified medical records and death certificates. Medical personnel and medical information was also used to design and implement psychologically and physically coercive interrogations. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism. (shrink)

ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)

A little over one hundred years ago , Frege wrote to Russell in the following terms1: I myself was long reluctant to recognize ranges of values and hence classes; but I saw no other possibility of placing arithmetic on a logical foundation. But the question is how do we apprehend logical objects? And I have found no other answer to it than this, We apprehend them as extensions of concepts, or more generally, as ranges of values of functions. I have (...) always been aware that there are difficulties connected with this, and your discovery of the contradiction has added to them; but what other way is there? (shrink)

To circumvent objections that the death penalty was “cruel and unusual punishment” and therefore a violation of the Eighth Amendment to the Constitution, advocates proposed lethal injection and the involvement of physicians to overcome the negative perceptions associated with the death penalty, and to increase public acceptability of the practice. Initiated in 1982, lethal injection is now the primary method of execution in 37 of the 38 states with the death penalty. “To be exact, this method has been used to (...) kill 788 of the 956 men and women who have been executed in the United States since 1976, when the death penalty was reinstated by the Supreme Court.” More recently, of the 191 executions performed in the United States since 2001, 189 have been by lethal injection.This “medicalization” of the death penalty has ignited a debate, by those within the medical profession and by others outside it, about the appropriateness of physicians participating in executions. (shrink)

The paper examines Dummett's argument for the indefinite extensibility of the concepts set, ordinal, real number, set of natural numbers, and natural number. In particular it investigates how the indefinite extensibility of the concept set affects our understanding of the notion of real number and whether the argument to the indefinite extensibility of the reals is cogent. It claims that Dummett is right to think of the universe of sets as an indefinitely extensible domain but questions the cogency of the (...) further claim that this fact raises an issue as to what sets or real numbers there are. (shrink)

The paper examines Dummett's argument for the indefinite extensibility of the concepts set, ordinal, real number, set of natural numbers, and natural number. In particular it investigates how the indefinite extensibility of the concept set affects our understanding of the notion of real number and whether the argument to the indefinite extensibility of the reals is cogent. It claims that Dummett is right to think of the universe of sets as an indefinitely extensible domain but questions the cogency of the (...) further claim that this fact raises an issue as to what sets or real numbers there are. (shrink)

ABSTRACT Mother‐to‐child transmission (MTCT) of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age (...) infected with HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)

The volume includes twenty-five research papers presented as gifts to John L. Bell to celebrate his 60th birthday by colleagues, former students, friends and admirers. Like Bell’s own work, the contributions cross boundaries into several inter-related fields. The contributions are new work by highly respected figures, several of whom are among the key figures in their fields. Some examples: in foundations of maths and logic ; analytical philosophy, philosophy of science, philosophy of mathematics and decision theory and foundations of economics. (...) Most articles are contributions to current philosophical debates, but contributions also include some new mathematical results, important historical surveys, and a translation by Wilfrid Hodges of a key work of arabic logic. (shrink)

Frege famously claimed that logic is the science of truth: “To discover truths is the task of all science; it falls to logic to discern the laws of truth” (Frege, 1956, p. 289). But just like the other foundational concept of set, truth at that time was intimately associated with paradox; in the case of truth, the Liar paradox. The set-theoretical paradoxes had their teeth drawn by being recognised as reductio proofs of assumptions that had seemed too obvious to warrant (...) stating explicitly, but were now seen to be substantive, and more importantly inconsistent. Tarski includes the Liar paradox in his classic discussion of the concept of truth (Tarski, 1956), and developed it, in the form of his famous theorem on the undefinability of truth, as a reductio of the assumption that a language could be semantically closed, in the sense of being able to contain its own truth-predicate.Frege famously claimed that logic is the science of truth: “To discover truths is the task of all science; it falls to logic to discern the laws of truth” (Frege, 1956, p. 289). But just like the other foundational concept of set, truth at that time was intimately associated with paradox; in the case of truth, the Liar paradox. The set-theoretical paradoxes had their teeth drawn by being recognised as reductio proofs of assumptions that had seemed too obvious to warrant stating explicitly, but were now seen to be substantive, and more importantly inconsistent. Tarski includes the Liar paradox in his classic discussion of the concept of truth (Tarski, 1956), and developed it, in the form of his famous theorem on the undefinability of truth, as a reductio of the assumption that a language could be semantically closed, in the sense of being able to contain its own truth-predicate. (shrink)

Mr. A's physician recommends immediate dialysis. However, Mr. A is in the United States illegally, has no family living in the area, and is unemployed. The Emergency Medical Treatment and Labor Act requires the hospital not only to examine Mr. A, but to provide him with any needed stabilizing treatment without considering his lack of insurance coverage or ability to pay. The needed treatment to stabilize Mr. A is dialysis. Therefore, the physician admits him and starts dialysis. But Mr. A (...) will need to continue dialysis indefinitely. Because he has no insurance and is an illegal immigrant, he is not eligible for any outpatient dialysis units. He is also unable to afford any medical treatments. Once Mr. A is stabilized, should he be discharged? His physician and social worker turn to the hospital ethics committee for help. What should Mercy Hospital do? (shrink)

According to the World Health Organization cardiovascular disease is the leading cause of death globally. Over 80% of CVD deaths take place in low- and middle-income countries. It is estimated that 1 million to 2 million people worldwide die each year due to lack of access to an implantable cardiac defibrillator or a pacemaker. Despite the medical, legal, cultural and ethical controversies surrounding the pacemaker reutilization, studies done so far on the reuse of postmortem pacemakers show it to be safe (...) and effective with an infection rate of 1.97% and device malfunction rate of 0.68%. Pacemaker reutilization can be effectively and safely done and does not pose significant additional risk to the recipient. Heart patients with reused pacemakers have an improved quality of life compared to those without pacemakers. The thesis of this paper is that pacemaker reutilization is a life-saving initiative in LMICs of Nigeria and Ghana. It is cost effective; consistent with the principles of beneficence, nonmaleficence, and justice with a commitment to stewardship of resources and the Common Good. Used pacemakers with adequate battery life can be properly sterilized for use by patients in LMICs who cannot afford the cost of a new pacemaker. (shrink)

There is no doubt at all that the issue of determinism versus indeterminism was a central, dominating theme of Popper's thought. By his own account he saw his criticism of the thesis of determinism as crucial to his defence not only of the reality of human freedom, moral responsibility and creativity but also as equally fundamental to his account of human rationality and to his theory of the content and growth of science as an objective, rational and most importantly demonstrably (...) rational enterprise. Consequently a great deal of his writings discussing both the content and methodology of the natural and the social sciences alternately bear upon and presuppose his defence of indeterminism. (shrink)

Over the past decades the mortality rate in the United States has decreased and life expectancy has increased. Yet a number of recent studies have drawn Americans attention to the fact that racial and ethnic disparities persist in health care. It is clear that the U.S. health care system is not only flawed for many reasons including basic injustices, but may be the cause of both injury and death for members of racial and ethnic minorities.In 2002, an Institute of Medicine (...) report requested by Congress listed more than 100 studies documenting a wide range of disparities in the United States health care system. This report found that people belonging to racial and ethnic minorities often receive lower quality of health care than do people of European descent, even when their medical insurance coverage and income levels are the same as that of the latter. (shrink)

End-of-life issues and questions are complex and frequently cause confusion and anxiety. In _Death with Dignity_,_ _theologian, medical ethicist, and pastoral caregiver Peter A. Clark examines numerous issues that are pertinent to patients, family members, and health care professionals, including physiology, consciousness, the definition of death, the distinction between extraordinary and ordinary means, medical futility, “Do Not Resuscitate” orders, living wills, power of attorney, pain assessment and pain management, palliative and hospice care, the role of spirituality in end-of-life care, (...) and physicians’ communication with terminal patients. Patients, family members, medical students, and health care professionals will find in _Death with Dignity _the_ _practical and ethical knowledge they need to capably and confidently cope with end-of-life challenges. (shrink)

Accountants confronted with ethical dilemmas are expected to comply with their ethical guide or seek advice from their professional body. This study of Chartered Accountants in Ireland records their views on the usefulness of a Code of Ethics, the efficacy of their professional Institute and the need for ethics courses in Continuing Professional Development. Peter Clarke is a lecturer in the Department of Accountancy, University College Dublin, Dublin 4; Nancy Hill and Kevin Stevens are members of the School (...) of Accountancy, DePaul University, Chicago. (shrink)

The main strength of this book is the international exchange of ideas that will not only highlight many of these crucial bioethical issues but will strengthen the discipline of bioethics both nationally and globally. A critical exchange of ideas allows everyone to learn and benefit from the insights gained through others experiences. Analyzing and understanding real medical-ethical issues and cases and how they are resolved is the basis of education in bioethics for those who will have to make these decisions (...) in the future. The more we examine, analyze, and debate these bioethical issues and cases, the more knowledge will be gained and hopefully, we will all gain more practical wisdom. (shrink)

Perspectives on recent business scandals and the current debate.

Perspectives on recent business scandals and the current debate.