Medical aid in dying (MAiD), despite being legal in many jurisdictions, remains controversial ethically. Existing surveys of physicians’ perceptions of MAiD tend to focus on the legal or moral permissibility of MAiD in general. Using a novel sampling strategy, we surveyed physicians likely to have engaged in MAiD-related activities in Colorado to assess their attitudes toward contemporary ethical issues in MAiD.

Introduction: The coronavirus disease 2019 pandemic has placed intensive care units (ICU) triage at the center of bioethical discussions. National and international triage guidelines emerged from professional and governmental bodies and have led to controversial discussions about which criteria—e.g. medical prognosis, age, life-expectancy or quality of life—are ethically acceptable. The paper presents the main points of agreement and disagreement in triage protocols and reviews the ethical debate surrounding them. Sources of data: Published articles, news articles, book chapters, ICU triage guidelines (...) set out by professional societies and health authorities. Areas of agreement: Points of agreement in the guidelines that are widely supported by ethical arguments are (i) to avoid using a first come, first served policy or quality-adjusted life-years and (ii) to rely on medical prognosis, maximizing lives saved, justice as fairness and non-discrimination. Areas of controversy: Points of disagreement in existing guidelines and the ethics literature more broadly regard the use of exclusion criteria, the role of life expectancy, the prioritization of healthcare workers and the reassessment of triage decisions. Growing points: Improve outcome predictions, possibly aided by Artificial intelligence (AI); develop participatory approaches to drafting, assessing and revising triaging protocols; learn from experiences with implementation of guidelines with a view to continuously improve decision-making. Areas timely for developing research: Examine the universality vs. context-dependence of triaging principles and criteria; empirically test the appropriateness of triaging guidelines, including impact on vulnerable groups and risk of discrimination; study the potential and challenges of AI for outcome and preference prediction and decision-support. (shrink)

A remarkable but little commented on feature of the various discourses on India circulating today is the near total absence of its metaphysical heritage as a source of illumination into our contemporary condition. On the few occasions that this heritage is explicitly invoked, it is either as a subsidiary aspect of some purportedly larger concept such as religion, civilization, history, tradition etc., or as a set of quaint speculations fit for study as a tertiary branch of history of philosophy or (...) religion but with little claim to political relevance. But is this neglect as innocent as it appears? Or might it be that the metaphysical heritage confronts us with the disavowed -- indeed the unthinkable that lurks behind our current obsessions: progress and development; modernity and tradition; faith and secularism; history and myth; fundamentalism and tolerance? The central claim of this book is that the metaphysical heritage has an autonomy and dignity of its own not subsumable under any other concept whatsoever; and that furthermore, our national self-understanding and its place in the current system of global knowledge are founded on a wholesale effacing of this heritage. The collective contention of the papers in this volume is that a full and proper understanding of our ever lengthening catalogue of social afflictions and pathologies demands that we squarely confront the consequences of this fateful evasion, no matter how unsettling it might be to our vaunted notions about ourselves. Only in and out of such a self-encounter can we hope to break out of our thralldom to the currently hegemonic vision of humanitys future -- a vision that is already bankrupt in every respect, but which nonetheless seems able to reproduce itself without end. (shrink)

The COVID-19 vaccine has been a miraculous, life-saving advance, offering staggering efficacy in adults, and was developed with astonishing speed. The time from sequencing the virus to authorizing the first COVID-19 vaccine was so brisk even the optimists appear close-minded. Yet, simultaneously, United States’ COVID-19 vaccination roll-out and related policies have contained missed opportunities, errors, run counter to evidence-based medicine, and revealed limitations in the judgment of public policymakers. Misplaced utilization, contradictory messaging, and poor deployment in those who would benefit (...) most—the elderly and high-risk—alongside unrealistic messaging, exaggeration, and coercion in those who benefit least—young, healthy Americans—is at the heart. It is important to consider the history of COVID-19 vaccines to identify where we succeeded and where we failed, and the effects that these errors may have more broadly on vaccination hesitancy and routine childhood immunization programs in the decades to come. (shrink)

Text document classification and clustering is an important learning task which fits to both data mining and machine learning areas. The learning task throws several challenges when it is required to process high dimensional text documents. Word distribution in text documents plays a very key role in learning process. Research related to high dimensional text document classification and clustering is usually limited to application of traditional distance functions and most of the research contributions in the existing literature did not consider (...) the word distribution in documents. In this research, we propose a novel similarity function for feature pattern clustering and high dimensional text classification. The similarity function proposed is used to carry supervised learning based dimensionality reduction. The important feature of this work is that the word distribution before and after dimensionality reduction is the same. Experiment results prove the proposed approach achieves dimensionality reduction, retains the word distribution and obtained better classification accuracies compared to other measures. (shrink)

In this paper a new technique of dual image watermarking is proposed for protection of ownership rights which utilizes salient properties of homomorphic transform (HT), discrete wavelet transform (DWT), singular value decomposition (SVD) and Arnold transform (AT). In embedding algorithm host image is splitted into reflectance and illumination components using HT, DWT is further applied to the reflectance component resulting in frequency subbands (HL and LH) which are transformed by SVD. Two image watermarks are selected for embedding process whereas security (...) of proposed algorithm is strengthen by performing scrambling of second watermark through AT. Both watermarks are transformed with DWT and SVD. Singular values (SVs) of both transformed watermark are embedded into SVs of host image. Simulation results clearly signifies for high robustness and imperceptibility of proposed algorithm as it is examined under various attacks. Superiority of proposed technique is illustrated by comparing it with other reported methods. (shrink)

Religion of the Rabaris of the Rajasthan, India; a study.

pt. 1. Character development -- pt. 2. Training at NDA, IMA & OTA -- pt. 3. Army pt tests -- pt. 4. Leadership development -- pt. 5. Positive development -- pt. 6. Author's reminiscences.

On March 11, 2020 the World Health Organization classified COVID‐19, caused by Sars‐CoV‐2, as a pandemic. Although not much was known about the new virus, the first outbreaks in China and Italy showed that potentially a large number of people worldwide could fall critically ill in a short period of time. A shortage of ventilators and intensive care resources was expected in many countries, leading to concerns about restrictions of medical care and preventable deaths. In order to be prepared for (...) this challenging situation, national triage guidance has been developed or adapted from former influenza pandemic guidelines in an increasing number of countries over the past few months. In this article, we provide a comparative analysis of triage recommendations from selected national and international professional societies, including Australia/New Zealand, Belgium, Canada, Germany, Great Britain, Italy, Pakistan, South Africa, Switzerland, the United States, and the International Society of Critical Care Medicine. We describe areas of consensus, including the importance of prognosis, patient will, transparency of the decision‐making process, and psychosocial support for staff, as well as the role of justice and benefit maximization as core principles. We then probe areas of disagreement, such as the role of survival versus outcome, long‐term versus short‐term prognosis, the use of age and comorbidities as triage criteria, priority groups and potential tiebreakers such as ‘lottery’ or ‘first come, first served’. Having explored a number of tensions in current guidance, we conclude with a suggestion for framework conditions that are clear, consistent and implementable. This analysis is intended to advance the ongoing debate regarding the fair allocation of limited resources and may be relevant for future policy‐making. (shrink)

This essay draws attention to some of the ideas and discussions in the classical Advaita Vedantic literature that have a direct bearing on contemporary debates concerning the existence of consciousness in the empirical world. Section 1 makes the case for pursuing a non-eliminativist reading of Advaita Vedanta by clarifying its position on the existence of the empirical world. The idea here is to lay the background for approaching Advaita Vedanta from a cosmopsychist perspective. Section 2 shows, first, how the position (...) of Advaita Vedanta that macro-level consciousnesses are reflections of the universal consciousness (Brahman) in the intellects ( buddhi ) of empirical selves sets it apart from the prevailing cosmopsychist theories. It then goes on to discuss how this idea of reflection can at once offer an elegant solution to the decombination/derivation problem, suggest a promising way to bridge "the explanatory gap" and explain the phenomena of mental causation. (shrink)

The Limits of Scripture: Vivekananda's Reinterpretation of the Vedas by Anantanand Rambachan has been a pathbreaking work for initiating a critical examination of Swami Vivekananda's epistemological teachings. Rambachan challenges the trend adopted by some modern commentators to equate the teachings of Śaṅkara and Vivekananda. He observes that they overlook the "[f]undamental differences" between the two and present the latter "merely as a reviver of the Advaita of Śaṅkara."1 Opposing the trend, Rambachan follows Paul Hacker in projecting Vivekananda as a proponent (...) of "neo-Hinduism"2 as distinct from the traditional Hinduism.3 He argues that while Śaṅkara regards the Vedas as a "unique and self-valid... (shrink)

I am thankful to Professor Rambachan for responding to my comments. First of all, I retract my statement where I call one of the author's remarks to be a mocking of Swami Vivekananda's view. I apologize for this or any other comment that might project the author to be hostile toward Vivekananda. Some words are due regarding Rambachan's objection to my comparison of his work with that of Paul Hacker. Rambachan's questioning of the "continuity between neo-Vedānta and its classical roots" (...) is the reason that led me to compare his study with Hacker's neo-Vedānta thesis, which makes a similar argument.1It is not unreasonable to think that according to Rambachan Vivekananda's deviation from Śaṅkara was effected by factors... (shrink)

This is a welcome reprint of a book that continues to grow in importance.

Résumé Après avoir dressé un historique de l’accession à la parentalité des patients séropositifs depuis le début de l’épidémie, l’article décline quelques situations spécifiques familiales. Le point commun de ces différents contextes est l’omniprésence du secret et de la honte de la contamination par le vih, qui infiltrent la relation entre parents et enfants. L’article tente d’en analyser les fonctions à la fois défensives et organisatrices au sein de la famille.

Music-Dance explores the identity of choreomusical work, its complex authorship and its modes of reception as well as the cognitive processes involved in the reception of dance performance. Scholars of dance and music analyse the ways in which a musical score changes its prescriptive status when it becomes part of a choreographic project, the encounter between sound and motion on stage, and the intersection of listening and seeing. As well as being of interest to musicologists and choreologists considering issues such (...) as notation, multimedia and the analysis of performance, this volume will appeal to scholars interested in applied research in the fields of cognition and neuroscience. The line-up of authors comprises representative figures of today's choreomusicology, dance historians, scholars of twentieth-century composition and specialists in cognitive science and performance studies. Among the topics covered are multimedia and the analysis of performance; the notational practice of choreographers and the parallel attempts of composers to find a graphic representation for musical gestures; and the experience of dance as a paradigm for a multimodal perception, which is investigated in terms of how the association of sound and movement triggers emotions and specific forms of cognition. (shrink)

This volume is the first attempt to engage with the work of one of the most exciting thinkers or our times. The essays in the first section by Nandy are either autobiographical in nature or provide insights into his unique sensibility. The later section offers some analytical perspectives on Nandy's work by contributors including leading scholars in the academy, as well as outside it.

Although recognized as one of the principal sources of inspiration for the Indian environmental movement, Gandhi would have been profoundly uneasy with many of the most radical strands of ecology in the West, such as social ecology, ecofeminism, and even deep ecology. He was in every respect an ecological thinker, indeed an ecological being: the brevity of his enormous writings, his everyday bodily practices, his observance of silence, his abhorrence of waste, and his cultivation of the small as much as (...) the big all equally point to an extraordinarily expansive notion of ecological awareness. (shrink)

India and Civilizational Futures consists of the deliberations of the Backwaters Collective on Metaphysics and Politics, a group comprised largely of Indian scholars, academics, and writers. The authors probe how the intellectual and cultural resources of Indic civilization might be deployed to introduce greater plurality into the world of modern knowledge systems. They offer perspectives on the country's intellectual traditions that suggest how we might liberate ourselves from the straightjackets of history, normal politics, the nation-state, and other verities of a (...) global 'common sense'. (shrink)

Though the resurgence of Hindu nationalism as a political phenomenon is well-understood, Meera Nanda is correct in suggesting that the ascendancy of Hindutva has other dimensions, such as the avent placed by cultural nationalist on 'Vedic science'. However, apart from this rudimentary insight, Nanda's contribution, far from being a resounding demonstration of potmodernism's complicity in the projects of Hindu nationalism, is a striking testament to her own commitment to a rigidly positivist, ferociously intolerant, and intellectually sterile conception of modern science (...) and the Enlightenment rationality which she views as the pinnacle of human achievement. Nanda displays an impoverished understanding of the scholarly contributions of the last three decades and is unable to countenance the idea of a plurality of sciences; at the same time, in veiw of her deliberate conflation of Hindutva with Hinduism, and her attempts to equate Hinduism as such with Nazism, it is clear that Hinduism itself stands condemned, and not merely resurgent Hindu nationalism. Nanda's book is an indiscriminate and uninteresting assault upon the innumerable enemies of reason, and it is, ironically, likely to have the result of further eroding confidence in self-proclaimed champions of rationality such as herself and the modern science of which she claims herself to be a true and peerless inheritor. (shrink)

Keynote address at the All India Consultation of Evangelicals in Social Concern from January 27-30 2002. Reprinted with permission from Drishtikone - the magazine of the Evangelical Fellowship of India Commission on Relief available from EFICOR, 308, B-Block Community Centre, Janakpuri, New Delhi 110058. E-mail [email protected]; website www.eficoronline.org.

Many physicians are involved in relationships that create tension between a physician's duty to work in her patients’ best interest at all times and her financial arrangement with a third party, most often a pharmaceutical manufacturer, whose primary goal is maximizing sales or profit. Despite the prevalence of this threat, in the United States and globally, the most common reaction to conflicts of interest in medicine is timid acceptance. There are few calls for conflicts of interest to be banned, and, (...) to our knowledge, no one calls for conflicted practitioners to be reprimanded. Contrast our attitudes in medicine with public attitudes toward financial conflicts among government employees. When enforcement of rules against conflict of interest slackens in the public sector, news organizations investigate and publish their criticism. Yet even when doctors are quoted in the media promoting specific drugs, their personal financial ties to the drug maker are rarely mentioned. Policies for governmental employees are strict, condemnation is strong, and criminal statutes exist. Yet the evidence that conflict is problematic is, if anything, stronger in medicine than in the public sector. Policies against conflicts of interest in medicine should be at least as strong as those already existing in the public sector. (shrink)

The U.S. Food and Drug Administration's drug advisory committees provide expert assessments of the safety and efficacy of new therapies considered for approval. A committee hears from a variety of speakers, from six groups, including voting members of the committee, FDA staff members, employees of the pharmaceutical company seeking approval of a therapy, patient and consumer representatives, expert speakers invited by the company, and public participants. The committees convene at the request of the FDA when the risks and harms of (...) novel products are not immediately clear, and their final decisions carry significant weight, as most therapies that receive advisory committee approval are subsequently approved by the FDA. In recent years, across a series of diverse publications, the financial conflicts of interest of each category of participants in the meetings have been investigated. Here, we summarize these findings and their ethical implications, focusing on the FDA Oncologic Drugs Advisory Committee, and we suggest ways to move toward more transparent and impartial advisory committee meetings. (shrink)

Following the Washington Conference held from June 28-30 2002 on The Bible and the Ballot Box, the final conference of the Study Programme of the International Fellowship of Evangelical Mission Theologians on Evangelicals and Politics in Africa, Asia and Latin America, supported by the Pew Charitable Trusts, the project director, Canon Dr Vinay Samuel shared these reflections at a chapel service at the Oxford Centre for Mission Studies. See www.evangelicalsandpolitics.org. Summaries of the regional studies follow this reflection.

Three traditions have influenced the idea of the state in India – the Hindu Rajah, the Islamic View and the European Secular State. From biblical and theological considerations, Christians must reject the totalism and ego-centrism of modern states and work for greater accountability and decentralised decision-making.

We need to renew a Christian social vision for the new millennium. By social vision is meant a view of society in all its dimensions which expresses a view of humanity rooted in an understanding of who human beings are and can become. There are many possible social visions. There is a weariness with social involvement. Quite a bit of involvement has not produced the expected results. Studies have shown that some of the Latin American church growth is a wish (...) of the pastors rather than a representation of reality. (shrink)