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)

OBJECTIVES: To study and report the attitudes and practices of physicians in a former Soviet republic regarding issues pertaining to patients' rights, physician negligence and the acceptance of gratuities from patients. DESIGN: Survey questionnaire administered to physicians in 1991 at the time of the Soviet breakup. SETTING: Estonia, formerly a Soviet republic, now an independent state. SURVEY SAMPLE: A stratified, random sample of 1,000 physicians, representing approximately 20 per cent of practicing physicians under the age of 65. RESULTS: Most physicians (...) shared information with patients about treatment risks and alternatives, with the exception of cancer patients: only a third of physicians tell the patient when cancer is suspected. Current practice at the time of the survey left patients few options when physician negligence occurred; most physicians feel that under a reformed system physician negligence should be handled within the local facility rather than by the government. It was common practice for physicians to receive gifts, tips, or preferential access to scarce consumer goods from their patients. Responses varied somewhat by facility and physician nationality. CONCLUSION: The ethics of Soviet medical practice were different in a number of ways from generally accepted norms in Western countries. Physicians' attitudes about the need for ethical reform suggest that there will be movement in Estonia towards a system of medical ethics that more closely approximates those in the West. (shrink)

Marie-Frédérique Pellegrin | : Poulain de la Barre fait un usage original des procédés d’inversion tels qu’on les trouve en littérature et en philosophie, afin de démontrer l’égalité des sexes. Chez lui, l’inversion des valeurs ne vise pas seulement à remettre en cause le bien-fondé de la domination masculine et à louer une supériorité féminine en matière de moeurs et d’intelligence. Cette inversion entend abolir toute hiérarchisation entre les sexes. Tout d’abord l’auteur émancipe le genre du sexe. Ensuite il prône (...) un efféminage de tous les êtres humains. Le concept d’efféminage que nous forgeons est à distinguer de celui d’efféminement, qui implique l’idée d’une féminisation au sens d’une inclination vers des valeurs considérées comme féminines d’un point de vue culturel. L’efféminage est une prescription morale et sociale à devenir femme au sens d’un retour à l’état prélapsaire parfait dont les femmes sont plus héritières que les hommes car elles ont moins été touchées par le péché originel. L’efféminage ne consiste donc pas à devenir femme au sens d’une simple féminisation — sociale — des moeurs. L’efféminage fait signe vers l’égalité et non vers une supériorité féminine que sous-entend l’impératif d’efféminement. Le concept d’efféminage permet donc de penser, de manière explicite, le genre contre le sexe, non pas comme inversion mais comme construction ou plutôt reconstruction d’une autre nature humaine. | : Poulain de la Barre made original use of methods of inversion such as are found in literature and in philosophy, in order to demonstrate the equality of the sexes. In his work, the inversion of values is aimed not only at calling into question the legitimacy of male dominance and at praising feminine superiority in matters of morals and intelligence. It is an attempt to abolish any organization of the sexes into a hierarchy. In the first place, the author liberates gender from sex. Next, he advocates the “efféminage” of all human beings. The concept of “efféminage” that we are constructing here is to be distinguished from that of “efféminement”, which implies the idea of feminization in the sense of an inclination toward values considered feminine from a cultural perspective. “Efféminage” is a moral and social prescription to become a woman in the sense of a return to the perfect prelapsarian state of which women are more properly the inheritors because they have been less affected by original sin. “Efféminage” does not then consist in becoming a woman in the sense of a simple social feminization of morals. “Efféminage” gestures toward equality and not toward the feminine superiority implied by the imperative of “efféminement”. The concept of “efféminage” allows us then to think explicitly about gender in distinction with sex, not as an inversion but as a construction or rather a reconstruction of another human nature. (shrink)

A brief discussion is offered of what it means to say that a set of statements provides D-N explanation with special emphasis given to approximative D-N explanation. An idealized theory is seen to provide approximative D-N explanation. An ideal case provides explanation only if postulates are offered which connect the ideal antecedent condition with actual conditions. Such postulates will help in accounting for deviations between what the consequent of the ideal case entails and what actually occurs. Three ways are presented (...) for deciding on the acceptability of idealizations: (i) as actual conditions more closely approximate the ideal antecedent conditions specified in an ideal case, the more closely actual cases ought to approximate the consequent of the ideal case; (ii) the additional postulates connecting ideal antecedent conditions with actual conditions ought to account for deviations between what is entailed by an idealized theory and what actually occurs; and (iii) an idealized theory is explained by a more general theory when certain state variables in the more general theory are given extreme values. It is argued that (iii) is not a necessary condition for the acceptability of idealizations. (shrink)

Pourquoi continue-t-on à dénigrer le féminisme malgré l'amélioration notable de la condition des femmes grâce à ses revendications ? On peut invoquer le sens péjoratif persistant du mot « féminisme », la récupération des thèses féministes par les politicien-nes, ou encore les divergences au sein des tendances féministes. Mais ces motifs ne devraient pas empêcher la prise de conscience du fait que le féminisme ne recherche que la construction d'une société nouvelle juste pour les deux sexes.Why is feminism still denigrated (...) in spite of notable improvements in the condition of women due to its claims ? One can invoke the lasting pejorative meaning of the word "feminism", the politicians' recovery of feminist propositions, or the diverse stands of the main feminist trends. But these reasons should not prevent us to see that feminism only wants a new and just society for both women and men. (shrink)

Le philosophe François Poulain de La Barre réfléchit aux conditions nécessaires pour fonder une nouvelle science d'inspiration cartésienne. Parfaite et universelle, celle-ci s'oppose au savoir de type scolastique en remettant en question la distinction traditionnelle entre le savant et le vulgaire. Poulain entend démontrer que la véritable réforme de la science suppose une féminisation de ses acteurs. Les femmes se caractérisent en effet par le désir naturel de se comprendre elles-mêmes, or la véritable science se définit justement comme connaissance de (...) soi-même. Elles ont, de plus, une capacité tout aussi naturelle de la diffuser autour d'elles, capacité qui manque à la plupart des hommes. Avec l'émergence de savantes aux côtés des savants, le sage pourra enfin sortir de son statut ambigu d' « esprit fort ». The philosopher François Poulain de La Barre discussed the conditions that are necessary to found a new science that is inspired by Cartesianism. Since it would be perfect and universal, such a science would contrast with knowing in a scholastic manner by challenging the traditional distinction between the learned and the uneducated. Poulain wished to show that a genuine reform of science presupposes the feminization of its contributors. Women are characterized by a natural desire for self-understanding, and genuine science or knowledge is defined precisely as self-knowledge. Women also have a completely natural capacity for disseminating knowledge -a capacity that is lacking in most men. If learned women appeared sideby-side with learned men, the concept of a wise person would eventually be liberated from its ambiguous association with a 'strong mind'. (shrink)

BackgroundHeavy media use has been linked to sleep problems in children, which may also extend to the infancy period. While international parent-advisory agencies, such as the American Academy of Pediatrics, advise no screen time before 18 months, parents often do not follow this recommendation. Research on Italian infants’ early access to media is sparse, and only very few studies have investigated links with sleeping habits.MethodTo address this gap, we examined concurrent associations between parent-reported surveys of child technology use and sleeping (...) patterns. The Italian version of the 60 item Comprehensive Assessment of Family Media Exposure Survey, developed as part of a larger international study,, the Brief Screening Questionnaire for Infant Sleep Problems Sadeh, 2004) were completed online by 264 Italian parents of 8- to 36-month-olds and a subset completed the Parenting Stress Index Abidin, 1995) between April 2017 and April 2018.ResultsMore devices located in the child’s room and the more time spent watching TV or using an iPad were associated with less hours of sleep at night. Furthermore, more time spent watching TV or using a smartphone, as well as the number of devices in the room was associated with going to sleep later at night. Instrumental media use was associated with less sleep.ConclusionLike other countries, Italian infants have high levels of exposure to media, and differences in media patterns were associated with sleep patterns. Cultural factors influence both instrumental reasons for media use and sleep practices. Further research should explore how media use may serve to regulate emotion as a function of both contextual factors and individual differences. (shrink)

L’objet du cycle de colloques était de mettre en débat et d’enrichir une réflexion qui avait donné lieu à la publication du manifeste Pour une recherche scientifique responsable. Le chercheur est-il un rouage impuissant ou un acteur pleinement responsable? Et si oui, à quelles conditions? Le premier colloque visait à identifier le rôle du contexte institutionnel, économique et politique. Le deuxième colloque avait pour point d’entrée la responsabilité du chercheur lui-même. Le troisième colloque a posé la question de comment envisager (...) une autre recherche : quels contre-modèles existent ou émergent? Il s’agit maintenant de passer à la vitesse supérieure par le développement d’une communauté d’acteurs-chercheurs se reconnaissant dans ces nouvelles pratiques. D’où l’appel à la mise en mouvement des imaginations et la déclaration « qu’une autre science est possible ». Partie prenante d’un nouveau contrat science-société pour une transition écologique et sociale, une recherche scientifique responsable pourrait alors émerger. The purpose of the seminar was to debate and enrich the manifesto For a responsible scientific research. Is the researcher a helpless cog or a fully responsible actor? And if yes, at what conditions? The first conference aimed at identifying the role of the institutional, economic and political context. The second conference was centered on the responsibility of the researcher himself/herself. The third conference addressed the question of how to envision another type of research: which alternative models actually exist or are emerging? Time has come now to go up a gear through the development of a community of actors – researchers recognizing themselves in these new practices. Hence the call for moving forward and the declaration that “another science is possible”. Stakeholder of a new science-society contract for an ecological and social transition, a responsible scientific research could therefore emerge. (shrink)

The aim of this article is to present a medieval Arabic report regarding six animals from the Gulf of Aden, to provide a zoological identification of five of the animals in question, which may be identified, and to comment on the biological data provided by the report in the light of both contemporary and modern zoological knowledge and, thus, to evaluate the scientific standard of the report.RésuméLe but de cet article est de présenter un rapport d'origine arabe médiévale concernant six (...) animaux du Golfe d'Aden, de fournir une identification zoologique des cinq parmi ces animaux qui peuvent être identifiés, et d'analyser les informations biologiques fournies par ce rapport à la lumière des connaissances zoologiques à la fois contemporaines au rapport et modernes, afin d'évaluer ainsi le niveau scientifique de celui-ci. (shrink)

Justice will once take the place which the Magians are keeping now, for it is they who lord it over the world.

David Bohm, Emeritus Professor of Theoretical Physics at Birkbeck College of the University of London and Fellow of the Royal Society, died of a heart attack on October 29, 1992 at the age of 74. Professor Bohm had been one of the world’s leading authorities on quantum theory and its interpretation for more than four decades. His contributions have been critical to all aspects of the field. He also made seminal contributions to plasma physics. His name appears prominently in the (...) modern physics literature, through the Aharonov- Bohm effect , the Bohm-EPR experiment , the Bohm-Pines collective description of particle interactions (random phase approximation), Bohm diffusion and the Bohm causal interpretation of quantum mechanics, also sometimes called the de Broglie-Bohm pilot wave theory. David Bohm was born in Wilkes-Barre, Pennsylvania on December 20, 1917. A student of J. Robert Oppenheimer, Bohm received his Ph.D. from the University of California at Berkeley in 1943. In 1950 he completed the first of his six books, Quantum Theory, which became the definitive exposition of the orthodox (Copenhagen) interpretation of quantum mechanics. Here Bohm presented his reformulation of the paradox of Einstein, Podolsky, and Rosen. It is this Bohm version of EPR which has provided the basis for the enormous expansion of research on the foundations of quantum theory, focusing on nonlocality and the possible incompleteness of the quantum description (the question of “hidden variables”), which has occurred during the past several decades. (shrink)

In this essay an ‘objective’ account of intrinsic value is proposed and partly defended. It is claimed that a kind of value exists which is, or may reasonably be supposed to be, a property of certain objects. The presence of such value is not to be wholly accounted for as the ‘projection’ of certain human feelings elicited by the object thought to be of value, nor by the object's meeting certain operative human conventions prescribing what is to be admired, nor (...) by its being conformable, in some way, to human needs or desires. Hume, of course, would have none of this. It is hoped to show that if one adopts Hume's account, then his attempt to show that there nevertheless will be convergence in the long run as to what is of aesthetic value is forced and unsuccessful. By contrast, on the ‘objective’ account convergence is to be expected. This, of course, only shows the superiority of the ‘objective’ account so long as there is an expectation of long-term convergence. This is not an expectation of most contemporary value ‘subjectivists’, and therefore the argument will not be directly relevant to their positions. (shrink)

If the world were wholly just, the following inductive definition would exhaustively cover the subject of justice in holdings. 1. A person who acquires a holding in accordance with the principle of justice in acquisition is entitled to that holding. 2. A person who acquires a holding in accordance with the principle of justice in transfer, from someone else entitled to the holding, is entitled to the holding. 3. No one is entitled to a holding except by applications of i (...) and 2. The complete principle of distributive justice would say simply that a distribution is just if everyone is entitled to the holdings they possess under the distribution. (shrink)

Revisiting African philosophy’s classic questions, D. A. Masolo advances understandings of what it means to be human—whether of African or other origin. Masolo reframes indigenous knowledge as diversity: How are we to understand the place and structure of consciousness? How does the everyday color the world we know? Where are the boundaries between self and other, universal and particular, and individual and community? From here, he takes a dramatic turn toward Africa’s current political situation and considers why individual rights and (...) freedoms have not been recognized, respected, demanded, or enforced. Masolo offers solutions for containing socially destructive conduct and antisocial tendencies by engaging community. His unique thinking about community and the role of the individual extends African philosophy in new, global directions. (shrink)

Mill says that the object of his essay On Liberty is to defend a certain principle, which I will call the ‘liberty principle’, and will take to say the following: ‘It is permissible, in principle, for the state or society to control the actions of individuals “only in respect to those actions of each, which concern the interest of other people”’. The liberty principle is a prescription of intermediate generality. Mill intends it to support more specific political prescriptions, such as (...) liberty of conscience, of expressing and publishing opinions, of framing a plan of life to suit our own character, and of combination for any purpose not involving harm to others. The liberty principle is more general than these prescriptions but less general than its possible moral foundations, such as utilitarianism. My concern will be with attempts to defend the liberty principle by showing it to be supported by an acceptable moral position. (shrink)

A three-valued propositional logic is presented, within which the three values are read as ?true?, ?false? and ?nonsense?. A three-valued extended functional calculus, unrestricted by the theory of types, is then developed. Within the latter system, Bochvar analyzes the Russell paradox and the Grelling-Weyl paradox, formally demonstrating the meaninglessness of both.

In debates about criteria for human death, several camps have emerged, the main two focusing on either loss of the "organism as a whole" (the mainstream view) or loss of consciousness or "personhood." Controversies also rage over the proper definition of "irreversible" in criteria for death. The situation is reminiscent of the proverbial blind men palpating an elephant; each describes the creature according to the part he can touch. Similarly, each camp grasps some aspect of the complex reality of death. (...) The personhood camp, in contrast to the mainstream "organism" camp, recognizes that a human organism can still be a biological living whole even without brain function. The mainstream camp, in contrast to the personhood camp, recognizes that a person can be permanently, even irreversibly unconscious, and still be a living person so long as his/her body is alive. The author proposes that hylomorphic dualism incorporates both these key insights. But to complete the picture of the entire "death elephant," a fundamental paradigm shift is needed to make sense of other seemingly conflicting insights. The author proposes a "semantic bisection" of the concept of death, analogous to the traditional distinction at the beginning of life between "conception" and "birth." To avoid the semantic baggage associated with the term "death," the two new death-related concepts are referred to as "passing away" (or "deceased") and "deanimation," corresponding, respectively, to sociolegal ceasing-to-be (mirror image of birth) and ontological/theological ceasing-to-be of the bodily organism (mirror image of conception). Regarding criteria, the distinguishing feature is whether the cessation of function is permanent (passing away) or irreversible (deanimation). If the "dead donor rule" were renamed the "deceased donor rule" (both acronyms felicitously being "DDR"), the ethics of organ transplantation from non–heart-beating donors could, in principle, be validly governed by the DDR, even though the donors are not yet ontologically "deanimated." Thus, the paradigm shift satisfies both those who insist on maintaining the DDR and those who claim that it has all along been receiving only lip service and should be explicitly loosened to include those who are "as good as dead." Even so, a number of practical caveats remain to be worked out for non–heart-beating protocols. (shrink)

Physicians have developed a number of implicit and explicit approaches to complex medical decisions. Decision analysis is an explicit, quantitative method of clinical decision making that involves the separation of the probabilities of events from their relative values, or utilities. Its use can help physicians make difficult choices in a manner that promotes true patient participation. Decision analysis also provides a framework for the incorporation of data from multiple sources and for the assessment of the impact of uncertain data on (...) the final decision. Although this approach is imperfect, it represents a significant advance in clinical decision making. (shrink)

Lexical Semantics is about the meaning of words. Although obviously a central concern of linguistics, the semantic behaviour of words has been unduly neglected in the current literature, which has tended to emphasize sentential semantics and its relation to formal systems of logic. In this textbook D. A. Cruse establishes in a principled and disciplined way the descriptive and generalizable facts about lexical relations that any formal theory of semantics will have to encompass. Among the topics covered in depth are (...) idiomaticity, lexical ambiguity, synonymy, hierarchical relations such as hyponymy and meronymy, and various types of oppositeness. Syntagmatic relations are also treated in some detail. The discussions are richly illustrated by examples drawn almost entirely from English. Although a familiarity with traditional grammar is assumed, readers with no technical linguistic background will find the exposition always accessible. All readers with an interest in semantics will find in this original text not only essential background but a stimulating new perspective on the field. (shrink)

Signals to the brain from the flows of energy around the body, varied primarily by declining amounts of food energy in the stomach, can explain the pattern of meals in the laboratory rat, the differences between dark and light phases, and the development of obesity ion the rat wioth VMH lesions but normal sating.

In some languages every statement must contain a specification of the type of evidence on which it is based: for example, whether the speaker saw it, or heard it, or inferred it from indirect evidence, or learnt it from someone else. This grammatical reference to information source is called 'evidentiality', and is one of the least described grammatical categories. Evidentiality systems differ in how complex they are: some distinguish just two terms (eyewitness and noneyewitness, or reported and everything else), while (...) others have six or even more terms. Evidentiality is a category in its own right, and not a subcategory of epistemic or some other modality, nor of tense-aspect. Every language has some way of referring to the source of information, but not every language has grammatical evidentiality. In English expressions such as I guess, they say, I hear that, the alleged are not obligatory and do not constitute a grammatical system. Similar expressions in other languages may provide historical sources for evidentials. True evidentials, by contrast, form a grammatical system. In the North Arawak language Tariana an expression such as "the dog bit the man" must be augmented by a grammatical suffix indicating whether the event was seen, or heard, or assumed, or reported. This book provides the first exhaustive cross-linguistic typological study of how languages deal with the marking of information source. Examples are drawn from over 500 languages from all over the world, several of them based on the author's original fieldwork. Professor Aikhenvald also considers the role evidentiality plays in human cognition, and the ways in which evidentiality influences human perception of the world.. This is an important book on an intriguing subject. It will interest anthropologists, cognitive psychologists and philosophers, as well as linguists. (shrink)

This paper presents a new formal model for D–N explanation that gives intuitive criteria of acceptability, avoids the known trivializations, and links explanation with confirmation theory. Although set in the twenty-five year tradition of attempts to formalize D–N explanation, it proposes a new direction for the model that is to be distinguished from the syntactical and informational approaches by its introduction of restrictions which derive from the use which the D–N model can have in hypothesis testing. This model, illustrating the (...) verificational approach, revises the classic H–O requirements and amends the notion of partial self-explanation to meet a criticism to which the H–O notion is vulnerable. (shrink)

The sport industry is an extremely diverse industry, including segments such as professional sport, intercollegiate athletics, health and fitness, recreational sport and facility management. The industry is currently experiencing rapid growth and development, and as it grows, sport managers in the different segments encounter ethical issues which are often unique to each segment. This article examines the professional sport, intercollegiate athletics, health and fitness, recreational sport and facility management segments of the sport industry and discusses the various ethical issues facing (...) managers in each of these segments. (shrink)

The ethical standard for informed consent is fostered within a shared decision-making process. SDM has become a recognized and needed approach in health care decision-making. Based on an ethical foundation, the approach fosters the active engagement of patients, where the clinician presents evidence-based treatment information and options and openly elicits the patient’s values and preferences. The SDM process is affected by the context in which the information exchange occurs. Rural settings are one context that impacts the delivery of health care (...) and SDM. Rural health care is significantly influenced by economic, geographical and social characteristics. Several specific distinctive features influence rural health care decision-making—poverty, access to health care, isolation, over-lapping relationships, and a shared culture. The rural context creates challenges as well as fosters opportunities for the application of SDM as a natural dynamic within the rural provider–patient relationship. To fulfill the ethical requirements of informed consent through SDM, it is necessary to understand its inherent challenges and opportunities. Therefore, rural clinicians and ethicists need to be cognizant of the impact of the rural setting on SDM and use the insights as an opportunity to achieve SDM. (shrink)