On August 29, 1995, the United States District Court for the Northern District of Ohio ruled that certain practices of Blue Cross and Blue Shield of Ohio relating to the calculation of copayments on insurance claims violated provisions of ERISA, and thus BCBSO could be liable for unpaid benefits and breach of fiduciary duty ). According to BCBSO's Explanation of Benefits and Schedule of Benefits, beneficiaries were responsible for a 20 percent copayment for hospital charges, and the remaining 80 percent (...) of the Provider's Reasonable Charges would be paid by BCBSO. BCBSO negotiated with the hospitals to create discount agreements whereby the actual charge to BCBSO was less than 80 percent of the total amount of the hospital's charges. By this arrangement, BCBSO paid less than 80 percent of what patients were billed; concurrently, patients paid more than 20 percent of the amount ultimately paid to hospitals for their services. (shrink)

The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (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)

This volume is a collection of the Lullian contributions to the 2012 Congress of the Societe Internationale pour l'Etude de la Philosophie Medievale (SIEPM), held in Freising, Germany, 20-25 August. The Lullian Opera constitute a philosophical mirror of the medieval tradition. The questions and interests of medieval masters played a role in the Renaissance and Early Modern period through the Lullian Art. The three parts of this volume-Knowledge, Contemplation and Lullism- are intended to show that influence, collecting the contributions of (...) well-known specialists on the Lullian works, conceived of as Opera philosophica, in different areas such as geometry, logic, methodology, or Early Modern law. The results of Lullian studies in the past 20th century and the revival of Lullian discussions at present also hold an important place. The Raimundus-Lullus-Institut in Freiburg supports this edition, and in the introduction its members place the volume in the great tradition of Lullian studies. The celebration of a Lullian meeting devoted to the relationship between medieval philosophy and the Lullian Opus at the 2012 SIEPM Congress, the recent constitution of a Lullian Section by the SIEPM-Bureau to develop projects about Llull's works as a vehicle of medieval philosophical concerns and the history of its reception, and the results collected in this volume, are a good example of the increasing relevance of Llull-studies today. (shrink)

Following Fine [3], p. 20, we say that a normal propositional modal logic is canonical i all its theorems are valid on the frame of its canonical model . In this paper we prove that K1:1, i.e. S4+ J1 L p) p is not canonical y . We say that two points x and y in a frame are co-accessible i xRy; yRx, but x =6 y. Our proof proceeds by showing that A. The canonical model for K1:1 contains a (...) pair of co-accessible points; and B. J1 is not valid on any frame with a pair of co-accessible points. Clearly our result follows immediately from A and B. (shrink)

In 1992, the Walloon Region modified its investment incentive legislation. The new legislation applies the notion of SME to any business employing up to 250 people and which turnover does not exceed 20 million ECU, and replaces the former interest subsidies and capital premiums by a grant calculated as a percentage of investment. According to the size of the business, the activity sector and the area, the maximum aid may vary from 13 to 21 %. The grant total percentage is (...) calculated by summing up the percentage of aid obtained for five criteria under which job creation is by far the most important. The new legislation gives a partial answer to traditional criticisms against investment incentives. First of all it aims at reducing the risk of accelerated substitution of capital for Labour. Besides, it simplifies adminsitrative procedures and reduces the "sprinkling". It should also reduce the risk of inefficient allocation of resources thatarises when grants go to loss-making entreprises. But the question of whether investment incentives actually increase the level of investment remains largely unanswered. Evidence suggests that investment incentives might have contributed to attract foreign investments hut have little impact on thelevel of domestic investment. Nevertheless, as far as SMEs are concerned, public grants might contribute to increased investment not by reducing the cost or increasing the profitability of the project but rather by increasing the means available in the business. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Theologian's Doubts:Natural Philosophy and the Skeptical Games of GhazālīLeor HaleviIn the history of skeptical thought, which normally leaps from the Pyrrhonists to the rediscovery of Sextus Empiricus in the sixteenth century, Abū Ḥāmid Muḥammad al-Ghazālī (1058-1111) figures as a medieval curiosity. Skeptical enough to merit passing acknowledgment, he has proven too baffling to be treated fully alongside pagan, atheist, or materialist philosophers. As a theologian defending certain Muslim (...) dogmas, Ghazālī has not met what historians consider the mark of the true skeptic, a mind doubting the possibility of all systems of knowledge. But what is fascinating about him is that he brought into practical operation the tools of what I call "functional skepticism."1He denied the claims to truth of Aristotelian physics—whose basis he showed to rest on groundless belief—then turned and argued for the possibility of the Resurrection tooth and nail. The scholarly debate on The Incoherence of the Philosophers (Tahāfut al-falāsifa) has concentrated on the extent to which Ghazālī qua Ashcarite theologian was seduced into Aristotelian philosophy despite himself.2 In my view this debate has been misguided in the attempt to distill the [End Page 19] essence of Ghazālī from the book's eclectic theology; I will argue for a different view of Ghazālī on the basis of a close reading of key passages. In the unusual sections where Ghazālī applies Aristotelian language to a world not following the ordinary laws of physics, some have found Ghazālī slipping, unconsciously perhaps, into an Aristotelian frame of mind. I will show that, as a skeptical theologian with a dialogic imagination, he was rather deconstructing Aristotelian discourse while playing a Wittgensteinian sort of language game.Natural Philosopher or Speculative Theologian?The disagreement about the extent to which philosophy infected Ghazālī is ancient. Ghazālī might have studied philosophy only in order to refute it. He himself defended his philosophizing with the claim that one cannot deconstruct a system of thought until one has understood it so deeply as to elaborate upon its fundamental principles.3 His Maqāṣid al-falāsifa was in fact received, especially in trans-Pyrenean Europe, as a philosopher's genuine summary of the object of philosophy.4 The book strikes me as suspiciously creative in its representation of philosophical discourse, but it appears in any case as an expert and surprisingly unbiased treatment.5 Arabic readers knew that Ghazālī had also written a polemical treatise against philosophy, Tahāfut al-falāsifa, but they still wondered about his engagement with the ideas he challenged. Abū Bakr Ibn al-cArabī, for example, commented that Ghazālī had been unable to extricate himself from philosophy.6 Other philosophers pondered whether or not he had been a closeted member of their charmed circle and sought in his writings traces of esoteric philosophy.7Averroës's own sober sense of distance between philosophy and theology was partially a reaction to what he perceived as Ghazālī's dangerous and carefree mixture of the two sciences.8 He attacked Ghazālī's book in The Incoherence [End Page 20] of the Incoherence to restore philosophy's sense of purity, an aim he sought to accomplish by separating religious concerns from the philosopher's field of inquiry.9 Ironically, such a separation is precisely what Ghazālī might have wished to provoke by crisscrossing and blurring the line between religion and philosophy.The modern debate on chapter 17 of Tahāfut al-falāsifa has concentrated on defining Ghazālī as either a natural philosopher or an occasionalist theologian. In his defense of the possibility of miracles Ghazālī presented two theories of causation, one denying the logical basis of Aristotelian notions of natural causality, and the other more or less adopting these notions. Jointly, the two theories have seemed incompatible, and for this reason scholars have attempted to sort Ghazālī out of the apparent confusion. In 1978 L. E. Goodman argued persuasively that Ghazālī exploited rather than denied the philosophers' ideas of causality. In two articles Michael Marmura challenged Goodman, contending... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Refusals of Treatment and Requests for DeathTom L. Beauchamp (bio)It would be hard to overestimate the importance of two decisions on physician-assisted suicide delivered recently by the Ninth and Second Circuit Courts (Compassion in Dying v. State of Washington, 79 F.3d 790 (9th Cir. 1996) (en banc), aff’g 850 F.Supp. 1454 (W.D. Wash. 1994), rev’g 49 F.3d 586 (9th Cir. 1995); Quill v. Vacco, 80 F.3d 716 (2nd Cir. (...) 1996). They are the highest courts yet to render an opinion on this subject, and their decisions have set the stage for the U.S. Supreme Court to take one of two paths: It will either say that (1) all citizens have a liberty interest in physician-assisted suicide, or that (2) each state may set its own policy on such matters. Whichever path is elected, a right to request physician-assisted suicide is a virtual certainty, at least in some states.These opinions are later segments of an evolving legal history in which courts have held that no criminal liability exists for withholding or withdrawing a life-sustaining treatment when physicians are directed to do so by a patient or an authorized surrogate (see Alan Meisel 1992). The decriminalization of suicide and the right to refuse a life-sustaining treatment now appear to be evolving into a rule that a patient has a legal right to control his or her death, or at least to obtain a lethal prescription. We are at a delicate point in this evolving history. Neither in law nor in bioethics is the justification of physician assistance in suicide the received opinion at the present time, but support for physician assistance in dying could soon become the received opinion in both disciplines.The leading edge of the wedge producing these changes has been widespread acceptance of an extensive right to refuse treatment. This right is today axiomatic in even conservative quarters of bioethics, but 20 years ago it was far from axiomatic that all patients have a right to refuse treatment. Few at that time judged that it would be both immoral and illegal for a physician not to forgo treatment in the face of a competent, authoritative refusal of any form of medical service or treatment.The justification for assistance in bringing about death in medicine is an extension of the justification for letting patients die. Letting a patient die by accepting a valid refusal to continue in life is directly analogous to helping a patient die by accepting a valid request for help. The high value we place on [End Page 371] rights of autonomy thereby spills over from the right to refuse to the underexplored right to request active assistance. 1 As the autonomy interest in this choice increases, denial of help to the patient becomes more burdensome.Those who defend the view that euthanasia and physician-assisted suicide are morally prohibited typically assume that assistance involves an act of killing, that acts of killing are impermissible, and that a defensible distinction exists between killing and letting die. However, this distinction has proved difficult to explicate, and the category of killing often seems distant from the problem at hand. For example, it is an eccentric view that a physician who prescribes a lethal medication to a patient thereby kills the patient (or, for that matter, lets the patient die) when the patient voluntarily ingests the medication and dies. So poor are the conceptual understandings of “killing” and “letting die” that conceptual confusion abounds as to which term to use in almost all morally difficult and controversial cases.A common view is that “letting die” is a matter of “ceasing useless treatments” after which patients die (Gaylin, Kass, Pellegrino, and Siegler 1988). This account is attractive, but too narrow. “Letting die” occurs in medicine under at least two circumstances: cessation of treatment because it is useless and cessation of treatment because it has been refused (which can occur even with useful treatments). Neither conceptually nor morally is “ceasing useless treatment” the proper way to state the condition under which many “letting-die” cases occur. It follows that the type of action—killing or letting... (shrink)

The following suggestions for the interpretation of Parmenides and Melissus can be grouped for convenience about one problem. This is the problem whether, as Aristotle thought and as most commentators still assume, Parmenides wrote his poem in the broad tradition of Ionian and Italian cosmology. The details of Aristotle's interpretation have been challenged over and again, but those who agree with his general assumptions take comfort from some or all of the following major arguments. First, the cosmogony which formed the (...) last part of Parmenides' poem is expressly claimed by the goddess who expounds it to have some measure of truth or reliability in its own right, and indeed the very greatest measure possible for such an attempt. Second, the earlier arguments of the goddess prepare the ground for such a cosmogony in two ways. For in the first place these arguments themselves start from assumptions derived from earlier cosmologists, and are concerned merely to work out the implications of this traditional material. And, in the second place, they end by establishing the existence of a spherical universe: the framework of the physical world can be secured by logic even if the subsequent introduction of sensible qualities or ‘powers’ into this world marks some decline in logical rigour. (shrink)