This article focuses on emergency medical care in black urban populations, suggesting that the classification of a "community" within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between "autonomy" and "community." The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines (...) a clinical trial for the blood substitute PolyHeme® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of "community." The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment. (shrink)

Narrative analysis is well established as a means of examining the subjective experience of those who suffer chronic illness and cancer. In a study of perceptions of the outcomes of treatment of cancer of the colon, we have been struck by the consistency with which patients record three particular observations of their subjective experience: the immediate impact of the cancer diagnosis and a persisting identification as a cancer patient, regardless of the time since treatment and of the presence or absence (...) of persistent or recurrent disease; a state of variable alienation from social familiars, expressed as an inability to communicate the nature of the experience of the illness, its diagnosis and treatment; and a persistent sense of boundedness, an awareness of limits to space, empowerment and available time. These subjectivities were experienced in varying degree by all patients in our study. Individual responses to these experiences were complex and variable. The experiences are best understood under the rubric of a category we call “liminality”. We believe that all cancer patients enter and experience liminality as a process which begins with the first manifestations of their malignancy. An initial acute phase of liminality is marked by disorientation, a sense of loss and of loss of control, and a sense of uncertainty. An adaptive, enduring phase of suspended liminality supervenes, in which each patient constructs and reconstructs meaning for their experience by means of narrative. This phase persists, probably for the rest of the cancer patient’s life. The experience of liminality is firmly grounded in the changing and experiencing body that houses both the disease and the self. Insights into the nature of the experience can be gained from the Existentialist philosophers and from the history of attitudes to death. Understanding liminality helps us to understand what it is that patients with cancer seek from the system to which they turn for help. Its explication should therefore be important for those who provide health care, those who educate health care workers and those concerned to study and use outcomes as administrative and policy making instruments. (shrink)

High-dose chemotherapy and autologous stem cell transplantation is used to treat some advanced malignancies. It is a traumatic procedure, with a high complication rate and significant mortality. ASCT patients and their carers draw on many sources of information as they seek to understand the procedure and its consequences. Some seek information from beyond orthodox medicine. Alternative beliefs and practices may conflict with conventional understanding of the theory and practice of ASCT, and ‘contested understandings’ might interfere with patient adherence to the (...) strict and demanding protocols required for successful ASCT.The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant.Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the ‘transplant’, of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox informationPatients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur. (shrink)

Western societies today are coming unmoored in the face of an earth-shaking ethical and cultural paradigm shift. At its core is the question of what it means to be human and how we are meant to live. The old answers are no longer accepted; a dizzying array of options are offered in their stead. Underpinning this smorgasbord of lifestyles is a thicket of unquestioned assumptions, such as the separation of gender from biological sex, which not so long ago would have (...) been universally rejected as radical notions. In the spring of 2019, a group of Orthodox Christian scholars drawn from a wide variety of academic disciplines met together to offer responses to the moral crisis our generation faces, elaborating upon its various forms and facilitating a fuller understanding of some of its theological and philosophical foundations. In doing so they offer support to all those who question the claims that are so forcefully insisted upon today--a clarity that will aid them in standing up and resisting trends that have already shown to be the cause of great suffering and unhappiness. (shrink)

laudationem ferculum est insecutum plane non pro expectatione magnum: novitas tamen omnium convertit oculos. rotundum enim repositoriurr duodecim habebat signa in orbe disposita, super quae proprium convenien. temque materiae structor imposuerat cibum: super arietem cicer arietinum, super taurum bubulae frustum, super geminos testiculos ac rienes, supei cancrum coronam, super leonem ficum Africanam, super virginem steriliculam super libram stateram in cuius altera parte scriblita erat, in altera placenta super scorpionem † pisciculum marinum, super sagittarium oclopetam, supei capricornum locustam marinam,† super pisces (...) duos mullos. in medio autem caespes cum herbis excisus favum sustinebat. (shrink)

In the autumn of 1912, C. G. Jung, then president of the International Psychoanalytic Association, set out his critique and reformulation of the theory of psychoanalysis in a series of lectures in New York, ideas that were to prove unacceptable to Freud, thus creating a schism in the Freudian school. Jung challenged Freud's understandings of sexuality, the origins of neuroses, dream interpretation, and the unconscious, and Jung also became the first to argue that every analyst should themselves be analyzed. Seen (...) in the light of the subsequent reception and development of psychoanalysis, Jung's critiques appear to be strikingly prescient, while also laying the basis for his own school of analytical psychology. This volume of Jung's lectures includes an introduction by Sonu Shamdasani, Philemon Professor of Jung History at University College London, and editor of Jung's Red Book. (shrink)

laudationem ferculum est insecutum plane non pro expectatione magnum: novitas tamen omnium convertit oculos. rotundum enim repositoriurr duodecim habebat signa in orbe disposita, super quae proprium convenien. temque materiae structor imposuerat cibum: super arietem cicer arietinum, super taurum bubulae frustum, super geminos testiculos ac rienes, supei cancrum coronam, super leonem ficum Africanam, super virginem steriliculam super libram stateram in cuius altera parte scriblita erat, in altera placenta super scorpionem † pisciculum marinum, super sagittarium oclopetam, supei capricornum locustam marinam,† super pisces (...) duos mullos. in medio autem caespes cum herbis excisus favum sustinebat. (shrink)

We will show that there is a strong form of emergence in cell biology. Beginning with C.D. Broad's classic discussion of emergence, we distinguish two conditions sufficient for emergence. Emergence in biology must be compatible with the thought that all explanations of systemic properties are mechanistic explanations and with their sufficiency. Explanations of systemic properties are always in terms of the properties of the parts within the system. Nonetheless, systemic properties can still be emergent. If the properties of the components (...) within the system cannot be predicted, even in principle, from the behavior of the system's parts within simpler wholes then there also will be systemic properties which cannot be predicted, even in principle, on basis of the behavior of these parts. We show in an explicit case study drawn from molecular cell physiology that biochemical networks display this kind of emergence, even though they deploy only mechanistic explanations. This illustrates emergence and its place in nature. (shrink)

In this paper I want to do the following things. First I want to show that in the part of the Theaetetus where the relationship between knowledge and perception is examined, the concept of knowledge that is in question is very clearly characterized. We are left in no doubt as to what is to count as knowing. Secondly I want to unravel in some detail the case that Socrates puts on Protagoras’ behalf where he draws on what Protagoras actually wrote (...) ; as opposed to what he may have taught secretly to his pupils. Thirdly I wish to argue that if we let the dialogue speak for itself, it is manifest that this case put up on Protagoras’ behalf at 151 E-152C is not overthrown; it is not even shaken.In that part of the dialogue where the question is under examination whether or not knowledge and perception are the same, Socrates uses an idealized concept of knowledge. That is, he restricts the use of the word by setting down what he will consider to be the essential characteristics of knowledge, the sufficient and necessary conditions of its being instantiated. An excellent piece of philosophical procedure. (shrink)

In this paper I want to do the following things. First I want to show that in the part of the Theaetetus where the relationship between knowledge and perception is examined, the concept of knowledge that is in question is very clearly characterized. We are left in no doubt as to what is to count as knowing. Secondly I want to unravel in some detail the case that Socrates puts on Protagoras’ behalf where he draws on what Protagoras actually wrote (...) (151 E-152C); as opposed to what he may have taught secretly to his pupils (152C-160D). Thirdly I wish to argue that if we let the dialogue speak for itself, it is manifest that this case put up on Protagoras’ behalf at 151 E-152C is not overthrown; it is not even shaken. (shrink)

This is a book about the philosophy of Henri Bergson which shows how relevant Bergson is to much contemporary philosophy. The book takes as its point of departure Bergson's insistence on precision in philosophy. It then discusses a variety of topics including laughter, the nature of time as experienced, how intelligence and language should be construed as a pragmatic product of evolution, and the antinomies of reason represented by magic and religion. This is not just another exposition of Bergson's work. (...) It offers an account of why Bergson commanded such a massive reading public in his own day and why he deserves to be read now. Written in a terse and clear style, this book will prove appealing to teachers and students of philosophy, cognitive science, psychology, religious studies and literature. (shrink)

In this paper there are two claims that I wish to defend. One is that in Socrates’ much discussed “causal” theory concrete particulars are more central than Forms. The other is that these concrete particulars are held by Plato to be not simply bundles of characteristics, not mere meeting-points of Forms, but independent individuals, existing in their own right.It will not, I believe, be questioned that from one point of view the prime concern of the Phaedo is with concrete particulars; (...) not with Forms, characteristics, or anything else. For, the overriding aim of the dialogue is, surely, to persuade us each to care for his own soul; it is for this reason that arguments are put forward to show that souls are indestructible. But there is no doubt that these souls are particulars. (shrink)

This book is a philosophical commentary on Schopenhauer's "Fourfold Root of the Principle of Sufficient Reason," dealing with each of Schopenhauer's principal ...

Mild and massive DNA damage are differentially integrated into the cellular signaling networks and, in consequence, provoke different cell fate decisions. After mild damage, the tumor suppressor p53 directs the cellular response to cell cycle arrest, DNA repair, and cell survival, whereas upon severe damage, p53 drives the cell death response. One posttranslational modification of p53, phosphorylation at Serine 46, selectively occurs after severe DNA damage and is envisioned as a marker of the cell death response. However, the molecular mechanism (...) of action of the p53 Ser46 phospho‐isomer, the molecular timing of this phosphorylation event, and its activating effects on apoptosis and ferroptosis still await exploration. In this essay, the current body of evidence on the molecular function of this deadly p53 mark, its evolutionary conservation, and the regulation of the key players of this response, the p53 Serine 46 kinases, are reviewed and dissected. (shrink)