Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

I have Crohn's disease. This essay is about how my experiences with this disease have shaped my perceptions of boundaries in medicine, particularly around the issue of self‐disclosure. I became a pediatrician first, then a parent, and now a patient, and with each new role, I have become increasingly confused on where boundaries regarding self‐disclosures in medicine lie. I'd like to make the case for more of a reframing and a blurring of personal and professional boundaries regarding physicians’ disclosures about (...) their own health. Although historically thought of as a way to strengthen the physician‐patient relationship and therefore encouraged, physician disclosure has recently become more controversial, and boundary discussions that include it seem to increasingly begin from the edict, “Don't do it.” But why not capitalize on the shared experience of physicians and patients? It offers an opportunity to deepen our therapeutic relationship with our patients, to build trust, to help understanding, and maybe even to improve patient outcomes. (shrink)

D. J. Allan; XV—Aristotle's Criticism of Platonic Doctrine Concerning Goodness and The Good, Proceedings of the Aristotelian Society, Volume 64, Issue 1, 1 June.

Multiple -conclusion logic extends formal logic by allowing arguments to have a set of conclusions instead of a single one, the truth lying somewhere among the conclusions if all the premises are true. The extension opens up interesting possibilities based on the symmetry between premises and conclusions, and can also be used to throw fresh light on the conventional logic and its limitations. This is a sustained study of the subject and is certain to stimulate further research. Part I reworks (...) the fundamental ideas of logic to take account of multiple conclusions, and investigates the connections between multiple - and single - conclusion calculi. Part II draws on graph theory to discuss the form and validity of arguments independently of particular logical systems. Part III contrasts the multiple - and the single - conclusion treatment of one and the same subject, using many-valued logic as the example; and Part IV shows how the methods of 'natural deduction' can be matched by direct proofs using multiple conclusions. (shrink)

I present an annotated development of the basic ideas of the Geneva School approach to the foundations of physics and the structures which emerge as mathematical representations of the physically dual notions of state and property.

Does South Africa need a common moral language? Many people are of the opinion that South Africa finds itself 'after Babel’ and needs a common moral language (1). The author considers some of the arguments of people who disagree with this analysis, because they do not define the problem in this way (2); because they find the language- or Babel-methaphor confusing (3); because they agree with the description of the problem, but not with the suggested solution, namely a common moral (...) language (4); or because they accept the solution, but do not regard it as the proper task of the Christian church to be involved in this search for a common moral language (5). (shrink)

The effects in a quantum-mechanical system form a partial algebra and a partially ordered set which is the prototypical example of the effect algebras discussed in this paper. The relationships among effect algebras and such structures as orthoalgebras and orthomodular posets are investigated, as are morphisms and group- valued measures (or charges) on effect algebras. It is proved that there is a universal group for every effect algebra, as well as a universal vector space over an arbitrary field.

An appropriate kind of curved Hilbert space is developed in such a manner that it admits operators of $\mathcal{C}$ - and $\mathfrak{D}$ -differentiation, which are the analogues of the familiar covariant and D-differentiation available in a manifold. These tools are then employed to shed light on the space-time structure of Quantum Mechanics, from the points of view of the Feynman ‘path integral’ and of canonical quantisation. (The latter contains, as a special case, quantisation in arbitrary curvilinear coordinates when space is (...) flat.) The influence of curvature is emphasised throughout, with an illustration provided by the Aharonov-Bohm effect. (shrink)

In this chapter we will investigate the nature of abstraction in detail, its entwinement with logical thinking, and the general role it plays for the mind. We find that non-logical capabilities are not only important for input processing, but also for output processing. Human beings jointly use analytic and embodied capacities for thinking and acting, where analytic thinking mirrors reflection and logic, and where abstraction is the form in which embodied thinking is revealed to us. We will follow the philosophical (...) analyses of Heidegger and Polanyi to elaborate the fundamental difference between abstraction and logics and how they come together in the mind. If computational approaches to mind are to be successful, they must be able to recognize meaningful and salient elements of a context and engage in abstraction. Computational minds must be able to imagine and volitionally blend abstractions as a way of recognizing gestalt contexts. And it must be able to discern the validity of these blendings in ways that, in humans, arise from a sensus communis. (shrink)