Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)
Context: Constructivist approaches to cognition have mostly been descriptive, and now face the challenge of specifying the mechanisms that may support the acquisition of knowledge. Departing from cognitivism, however, requires the development of a new functional framework that will support causal, powerful and goal-directed behavior in the context of the interaction between the organism and the environment. Problem: The properties affecting the computational power of this interaction are, however, unclear, and may include partial information from the environment, exploration, distributed processing (...) and aggregation of information, emergence of knowledge and directedness towards relevant information. Method: We posit that one path towards such a framework may be grounded in these properties, supported by dynamical systems. To assess this hypothesis, we describe computational models inspired from swarm intelligence, which we use as a metaphor to explore the practical implications of the properties highlighted. Results: Our results demonstrate that these properties may serve as the basis for complex operations, yielding the elaboration of knowledge and goal-directed behavior. Implications: This work highlights aspects of interaction that we believe ought to be taken into account when characterizing the possible mechanisms underlying cognition. The scope of the models we describe cannot go beyond that of a metaphor, however, and future work, theoretical and experimental, is required for further insight into the functional role of interaction with the environment for the elaboration of complex behavior. Constructivist content: Inspiration for this work stems from the constructivist impetus to account for knowledge acquisition based on interaction. (shrink)
Upshot: Albeit mostly supportive of our work, the commentaries we received highlighted a few points that deserve additional explanation, with regard to the notion of learning in our model, the relationship between our model and the brain, as well as the notion of anticipation. This open discussion emphasizes the need for toy computer models, to fuel theoretical discussion and prevent business-as-usual from getting in the way of new ideas.
Evidence coming from several studies into memory and awareness during general anesthesia suggests that in surgical patients who seem to be adequately anesthetized , some form of cognitive functioning is preserved. This finding has important implications both for clinical practice and for memory research. In order to give the methodological background of the present situation in this field of research, this article deals, on the basis of recent experiments, with important methodological aspects of studies into perception and memory during general (...) anesthesia. (shrink)
The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)
Articles by Castelli, Dempf, de Corte, del Noce, Garin, Gigon, Gouhier, Guéroult, Husserl, Lombardi, Valori, and Wagner on a variety of topics pertinent to the philosophy of history, such as myth and history, legitimacy of the philosophy of history, and historic intention. Of special interest is a commentary and French translation by M. Valori of two unpublished manuscripts of Husserl. In these manuscripts one can see how Husserl views the place of phenomenological study in the history of philosophy since Descartes.--J. (...) E. B. (shrink)
In his foreword, Brand Blanshard provides the suitable justification for publishing yet one more book on Berkeley: Berkeley is "curiously modern," and philosophically acute. Twelve competent essays, contributed by as many scholars, testify to the accuracy of Blanshard's judgment. These twelve scholars, all of whom rely on the Luce-Jessop definitive edition, touch upon the major issues of Berkeley's philosophy: perception, substance, spirit, and God. Differences in interpretation are everywhere evident, but Berkeley is nowhere given facile treatment or quick dismissal. Of (...) the many good essays, Ian T. Ramsey's on "Berkeley and the Possibility of an Empirical Metaphysics" deserves close attention. Ramsey argues that Berkeley's doctrine of will, soul, mind, etc., should be viewed as forms of personal activity and not on the analogy of Locke's ideas. T. E. Jessop contributes a useful bibliography as well as an essay on "Berkeley as Religious Apologist." The only, very minor, flaw in this distinguished volume is that the editor's own essay, the twelfth, "Berkeley and his Modern Critics" might have been better placed immediately following the foreward.--D. J. M. B. (shrink)