Mr. Galanas, an eighty‐six‐year‐old man, intentionally shot himself in the chest and abdomen. Surprisingly, the bullet damaged only his distal pancreas and part of his colon, requiring a diverting colostomy to prevent leakage of bowel fluids into his abdomen. After being admitted, he lies intubated in the intensive care unit awaiting surgery to repair his colon. He is responsive but does not demonstrate clear decision‐making capacity. He grudgingly accepts pain medications but refuses antibiotics and antidepressants. He has a living will (...) that gives his wife durable power of attorney and also explicitly states a desire to refuse all medical interventions if he is permanently unconscious or in an end‐stage condition. Mrs. Galanas reports frequent conversations in which her husband said he would not want to be sustained on life support. She also says that he often mentioned he would not want an ostomy bag—a likely, albeit temporary, outcome of the proposed surgery. His physicians are nervous about withholding medical interventions when Mr. Galanas's injury is the result of a suicide attempt and his prognosis is good. Should the care team surgically repair his injured colon, regardless of the patient's capacity, his advance directive, and his wife's statement that he would not want surgery or other life‐sustaining treatment? (shrink)

The adage “an ounce of prevention is worth a pound of cure” is widely used in healthcare settings and can be applied to the work of institutional clinical ethics committees. The model of clinical ethics consultation, however, is inherently reactive: a crisis or question emerges, and ethics experts are called to help. In an effort to employ a proactive component to the model of clinical ethics consultation (as well as to standardize our educational interventions), we developed ethics pocket cards. The (...) purpose of this article is to: (1) describe the rationale for using ethics pocket cards, (2) provide examples of our cards, and (3) begin a dialogue about the potential uses of ethics pocket cards. In doing so, we hope to explore how such portable, economical devices can advance the goals of ethics consultation as well as the educational aims of ethics committees. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

THE SELF, THE INDIVIDUAL AND THE COMMUNITY: LIBERALISM IN THE POLITICAL THOUGHT OF F. A. HAYEK AND SIDNEY AND BEATRICE WEBB by Brian Lee Crowley New York: Oxford University Press, 1987. 310 pp., $59.00.

Disorders of volition are often accompanied by, and may even be caused by, disruptions in the phenomenology of agency. Yet the phenomenology of agency is at present little explored. In this paper we attempt to describe the experience of normal agency, in order to uncover its representational content.

This paper responds to the issues raised by D. Chalmers by offering a research direction which is quite radical because of the way in which methodological principles are linked to scientific studies of consciousness. Neuro-phenomenology is the name I use here to designate a quest to marry modern cognitive science and a disciplined approach to human experience, thereby placing myself in the lineage of the continental tradition of Phenomenology. My claim is that the so-called hard problem that animates these Special (...) Issues can only be addressed productively by gathering a research community armed with new pragmatic tools for the development of a science of consciousness. I will claim that no piecemeal empirical correlates, nor purely theoretical principles, will really help us at this stage. We need to turn to a systematic exploration of the only link between mind and consciousness that seems both obvious and natural: the structure of human experience itself. In what follows I motivate my choice by briefly examining the current debate about consciousness at the light of Chalmer’s hard problem. Next, I outline the phenomenological strategy. Finally I conclude by discussing some of the main difficulties and consequences of this strategy. (shrink)

One of a handful of truly pioneering figures in visual semiotics, Jean-Marie Floch elaborated an approach that combined an analysis of the basic perceptual qualities and compositional strategies of the image, with a study of the cultural and historical significance of its representational dimension. A key collaborator of A. J. Greimas, Floch situated his project within the theoretical framework of Paris semiotics, which he helped to develop. He positioned his visual studies of familiar cultural objects in proximity to cultural anthropology (...) and the work of Claude Lévi-Strauss. His five published monographs explore abstract painting, art photography, Russian icons, magazine advertisements, and comic books. (shrink)

One of a handful of truly pioneering figures in visual semiotics, Jean-Marie Floch elaborated an approach that combined an analysis of the basic perceptual qualities and compositional strategies of the image, with a study of the cultural and historical significance of its representational dimension. A key collaborator of A. J. Greimas, Floch situated his project within the theoretical framework of Paris semiotics, which he helped to develop. He positioned his visual studies of familiar cultural objects in proximity to cultural anthropology (...) and the work of Claude Lévi-Strauss. His five published monographs explore abstract painting, art photography, Russian icons, magazine advertisements, and comic books. (shrink)

Timothy Williamson, in various places, has put forward an argument that is supposed to show that denying bivalence is absurd. This paper is an examination of the logical force of this argument, which is found wanting.

The Epistles of the Brethren of Purity' is an encyclopedic compendium, probably composed in tenth-century Iraq by a society of adepts with Platonic, Pythagorean, and Shi'i tendencies. Its 52 sections ('epistles') are divided into four parts (Mathematics, Natural Philosophy, Sciences of the Soul and Intellect, and Theology). The current volume provides an edition, translation, and notes to Epistle 3 ('On Astronomia'), which forms one of the 14 sections on Mathematics. The content is a mixture of elementary astronomy and astrology, but (...) it is not a beginner's textbook. Rather, the purpose is to use examples from those disciplines to provide spiritual, moral, and soteriological guidance. Thus the Epistle uses the argument from design to show the necessity for a Creator who made the harmonious universe; this wondrous design is then employed by the authors as a model, providing humans with a paradigm for proper ethical, political, and even economic conduct; and the study of Astronomia helps the soul achieve ultimate happiness as it seeks to throw off the shackles of this mundane world and oppressive body in favour of the purity of the celestial realm.0Although by no means typical of Islamic astronomical literature, Epistle 3 of the Brethren of Purity gives a window into a fascinating and intriguing group operating during the early period of Islam who sought to continue and adopt one of the esoteric strands of Hellenistic philosophy within an Islamic context, meshing astronomy, astrology, Platonic-Pythagorean philosophy, Quranic and Biblical quotations, and anecdotes from the lives of the Abrahamic prophets. (shrink)

The biological sciences study (bio)complex living systems. Research directed at the mechanistic explanation of the "live" state truly requires a pluralist research program, i.e. BioComplexity research. The program should apply multiple intra-level and inter-level theories and methodologies. We substantiate this thesis with analysis of BioComplexity: metabolic and modular control analysis of metabolic pathways, emergence of oscillations, and the analysis of the functioning of glycolysis.

Recent articles in Religious Studies have underscored the questions of whether Buddhism presents any empirical doctrines, and whether, if it does, such doctrines are false or vacuous. In what follows I want to sketch an interpretation of Buddhism according to which it does not offer doctrines which are empirically false, on the one hand, or trivially true on the other. In doing so I take my cue from an earlier, and by now classic, paper by H. H. Price. For the (...) exposition of Buddhism I take the Pali Nikāyas, the single most significant collection of texts in the Buddhist tradition. The particular doctrine which is the focus of discussion here is the kammavāda or ‘karma view’ of early Indian Buddhism, for it is the focus of much of the recent literature cited above and a doctrine which some have thought amenable to statement in empirical terms. (shrink)