The debate over futility is driven, in part, by physicians' desire to recover some measure of decision-making authority from their patients. The standard approach begins by noting that certain interventions are futile for certain patients and then asserts that doctors have no obligation to provide futile treatment. The concept of futility is a complex one, and many commentators find it useful to distinguish ‘physiological futility’ from ‘qualitative futility’. The assertion that physicians can decide to withhold physiologically futile treatment generates little (...) controversy. The claim that they can withhold qualitatively futile treatment runs afoul of standard objections to medical paternalism. There is reason to believe that the conceptual distinction will not be maintained in clinical practice. This paper contends that the scientific data which would support a physician's unilateral decision to withhold physiologically futile treatment also provide support for an institutional policy restricting access to the treatment. The data the doctor uses to take decision-making power out of the hands of the patient can be used by the administrator to take power out of the hands of the doctor. While this loss of power is unproblematic, there is reason to believe that the ambiguity in the term ‘futility’ will allow a much greater loss of physicians' power. Keywords: futility, physician authority CiteULike Connotea Del.icio.us What's this? (shrink)

Increasing evidence from psychology and neuroscience suggests that emotion plays an important and sometimes critical role in moral judgment and moral behavior. At the same time, there is increasing psychological and neuroscientific evidence that brain regions critical in emotional and moral capacity are impaired in psychopaths. We ask how the criminal law should accommodate these two streams of research, in light of a new normative and legal account of the criminal responsibility of psychopaths.

In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concernsmay vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many (...) have some and a few have sweeping clinical powers in hospitals. (shrink)

The Seraphic Doctrine: love and knowledge in the Dionysian hierarchy -- Affect, cognition, and the natural motion of the will -- Elemental motion and the force of union -- Hierarchy and excess in the Itinerarium Mentis in Deum -- The exemplary bodies of the Legenda Maior.

The Toulmin diagram layout is very familiar and widely used, particularly in the teaching of critical thinking skills. The conventional box-and-arrow diagram is equally familiar and widespread. Translation between the two throws up a number of interesting challenges. Some of these challenges represent slightly different ways of looking at old and deep theoretical questions. Others are diagrammatic versions of questions that have already been addressed in artificial intelligence models of argument. But there are further questions that are posed as a (...) specific result of examining the diagram inter-translation problem. These three classes of problems are discussed. To the first class are addressed solutions based on engineering pragmatism; to the second class are addressed solutions drawn from the appropriate literature; and to the third class, fuller exploration is offered justifying the approaches taken in developing solutions that offer both pragmatic utility and theoretical interest. Finally, these solutions are explored briefly in the context of the Araucaria system, showing the ways in which analysts can tackle arguments either using one diagrammatic style or another, or even a combination of the two. (shrink)

_Dreams of a Spirit-Seer_, Immanuel Kant's book on Emanuel Swedenborg, has mystified readers since its publication in 1766 during Swedenborg's lifetime. The unusual style and content of _Dreams_ have given rise to two opposing interpretations. Most Kant scholars regard the work as a skeptical attack on Swedenborg's mysticism. Other critics, however, believe that Kant regarded Swedenborg as a serious philosopher and visionary, and that _Dreams_ both reveals Kant's profound debt to Swedenborg and coneals that debt behind the mask of irony. (...) In addition, Dr. Gregory R. Johnson provides selections from other Kantian writings that mention Swedenborg and also contemporary reviews of _Dreams_, showing that Kant himself was ambivalent about Swedenborg's claims and that readers of his day questioned his position. With its extensive notes, this work is an invaluable resource for students of Kant and of Swedenborg. (shrink)

There is at this point no shortage of testimonials regarding the practice of philosophy for children. In addition, there have been a number of studies which give further support to the claim that philosophy for children is a valuable classroom practice. The idea that pre-college instruction in philosophy is beneficial is no longer in doubt, nor is there a significant lack of materials for use in philosophy for children programs. From Lewis Carroll to Matthew Lipman authors constructed texts that go (...) far in engaging children's philosophical inclinations. If there is any weakness in the practice of philosophy for children it is usually found in the individual classroom. (shrink)

Historians of Reformational philosophy often claim that Abraham Kuyper obtained the idea of sovereignty in its own sphere from Guillaume Groen van Prinsterer. But very little historical research has been done on Groen’s sources for and development of this idea. The first use of the Dutch phrase souvereiniteit in eigen sfeer is much earlier than previously thought; it was used in 1853 by J.I. Doedes, an associate of the “ethical theologian” Daniël Chantepie de la Saussaye. Groen became aware of the (...) ideas of Franz von Baader through journals founded by them, and by reading and corresponding with them and others, such as J.H. Gunning Jr. and Friedrich Fabri. Groen himself owned some of Baader’s books. He also relied strongly on the work of the jurist Friedrich Julius Stahl, who was 37 years younger than Baader but taught for a while at the same Munich university and shared Baader’s anti-revolutionary ideas. (shrink)

This volume brings together critical review papers, many specially commissioned, on key themes and questions in the work of the political scientist, philosopher and religious thinker Eric Voegelin (1901-1985). Areas covered include: (1) Political science: 'Political Religions': manifestations in Nazi Germany and in contemporary European and North American nationalism; (2) International relations: the 'Cold War' in critical perspective; (3) Philosophy: Plato and Aristotle in the reading of Eric Voegelin: contemporary assessments; (4) Sociology: Correspondence of Voegelin and Alfred Schütz; (5) New (...) Testament studies and Christology: questions and developments for Voegelin's interpretations; (6) Old Testament studies: questions and developments from Voegelin's Israel and Revelation; (7) Historical sociology: Revelation and order in axial-age societies; (8) Philosophy of history: Voegelin and Toynbee in contrast; (9) Literary studies: Voegelin in contrast with contemporary literary theory; critical readings of Milton, Greek tragedy. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 46-48, March 2012.

The liver was used widely in early studies of polarised transport but has been largely overlooked in recent years, mostly because of the development of epithelial cell lines which provide more tractable experimental systems. The majority of membrane proteins and lipids reach the hepatocyte apical membrane by transcytosis and it remains unclear whether there is a direct route for apical targeting, although the pathways present have yet to be fully characterised. The recent development of systems that allow hepatocyte transport processes (...) to be studied in culture and the observation that transcytosis can be significantly stimulated under physiological conditions suggest that hepatocytes have a role to play in future studies of polarised transport. This review discusses the known features of polarised membrane traffic in hepatocytes and contrasts them with the characteristics of vesicular transport in other epithelial cell types. (shrink)

Originally published in 1968, this volume raises perennial questions about the purposes of education, authority and freedom in the classroom, and the structure of the curriculum. The educational vision proposed in these pages seeks ultimately to help "reconcile the individual and his world.".

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

When one examines the emerging debate about genetic patenting, it becomes clear that those who oppose so-called misunderstand genetics or apply inappropriate moral and jurisprudential theory. In this brief essay I examine some arguments against gene patents of the variety, and conclude that patents on methods for detecting the presence of a genetic correlation with disease-related (and other) phenotypes can be appropriate, and that with several precautions the U.S. Patent and Trademark Office should continue granting patent protection to investigators who (...) generate genetic disease diagnostic innovations. (shrink)

Hospital ethics committees must be knowledgeable if they are to perform consultations, advise administrators on policy, or offer educational programs. Because the membership of the committee is interdisciplinary, with most drawn from the healthcare professions, the individuals who join cannot be expected to bring knowledge of bioethies with them. Therefore, a new committee must spend time developing expertise before it can appropriately serve the hospital community. Although the need for committee self-education is generally recognized, it is seldom discussed in any (...) detail. When discussed at all, expertise in bioethies is usually described as composed of a familiarity with an identifiable body of knowledge and mastery over techniques of moral reasoning. It is assumed that a committee can develop this expertise early in its life through a short course of study. (shrink)

Nietzsche's harsh attacks on modernity suggest a problem: if the modern age is so diseased, can we overcome it and move on to something higher? Or is the disease too severe? I examine the question by studying Nietzsche's view of spiritual health. Spiritual illness, even in the highest man, is nothing unusual or necessarily debilitating. Even the strongest have been infected since the earliest days of civilization. Indeed, infection with slave morality and bad conscience are requirements for spiritual elevation. And (...) the disease serves life by giving the strong something to struggle against, as well as making possible the spiritual greatness required to revalue all values. The higher man, then, is a mixture of health and disease. The revaluation of values is extraordinarily dangerous, but not impossible. Key Words: great politics • Nietzsche's revaluation of all values • On the Genealogy of Morals • spiritual health. (shrink)

Albert Einstein insists that his epistemology made his discovery of relativity possible. He believed it was his understanding of the relationship of experience and reason that allowed him to reconsider certain “truths” of physics. Specifically, he believed that reality and thought were independent but related, and that conceptual systems are independent of but conditioned by experience. Failure to understand the relation between experience and reason had, Einstein believed, limited progress in science. His understanding of the relation, on the other hand, (...) enabled him to formulate relativity theory and therefore provides one example of the relevance of philosophy to scientific inquiry. When Albert Einstein discussed his discoveries in physics, particularly the theory of relativity, he often began with an explanation of his epistemology and referred to thinkers like Hume and Kant. Einstein may have been a physicist, but he had definite ideas about how we know and regarded epistemological theories as crucial to science, especially to physics. Indeed, he placed such importance on the question of how we know that the discussion of his work in his “Autobiographical Notes” begins with the question, “What, precisely, is ‘thinking?'” (1951, 7). The correct answer to this philosophical question, he believed, makes progress in science possible. The present article focuses on the relationship of the two elements, experience and reason, in Einstein's epistemology. Einstein himself frequently concentrates on what he characterizes as “the eternal antithesis between the two inseparable components of our knowledge, the empirical and the rational” (1934b, 271) in his papers and lectures on physics, for he regards them as independent in origin but related in scientific truth. His insistence that experience and reason do not determine one another yet must be related proved, for him, to be a necessary but not sufficient condition for the formulation of relativity theory and for scientific progress in general. The discussion of the relationship has four parts. First, experience and reason are explained; included in this explanation are Einstein's reasons for maintaining that the two are independent. The second section discusses the connection between the two that produces truth and knowledge. The third section follows with discussion of the way that Einstein believes reason can be both conditioned by and independent of experience. Finally, the significance of this understanding of the relation for relativity theory is examined. (shrink)

The role of the healer is expanding. Attempts by physicians to enhance human capacity are but one among many new medical projects. The twentieth century ushered in significant changes in therapeutic modalities, and the past two decades have seen the role of the physician reshaped by economic, political, and dramatic new social mores. People ask new and different things of their clinicians. Under managed care, the primary care clinician is expected to have much more skill than was traditionally expected of (...) a general internist, and new incentives force physicians to much more explicitly ration the care they provide to patients and to patient populations. But perhaps no change in the contemporary world of health portends more long-term effects than the introduction of enhancement technologies. (shrink)