Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

New dimensions in different ethical scenarios following genetic information require new medical-ethical Action Guides for physician-patient interaction. This paper discusses the ambiguity in moral choice between a “right not to know” and “a duty to know”, regarding parental decisionmaking pro or contra selective abortion following prenatal screening for autosomal dominant polycystic kidney disease (Potter III) and related public policy issues.

We start this issue of Journal of Military Ethics with a recent address on military ethics given by one of the US ARMY's leading officers.Brigadier General H. R. McMaster graduated from the United...

Open peer commentary on the article “The Autopoiesis of Social Systems and its Criticisms” by Hugo Cadenas & Marcelo Arnold. Upshot: I discuss the foundations of what I have said in my work as a biologist on autopoiesis, molecular autopoietic systems and social systems. I argue that the theme of sociology should be to understand how is it that we come out of the social manner of living that is the foundation of our origin as languaging and reflecting human beings.

Mole's (2008 [this issue]) argument that consciousness is a necessary concomitant of attention rests on the question of what is being attended in spatial attention. His answer is space. Some authors, including ourselves, claim that the fact that the processing of unseen objects can be modulated by spatial attention (e.g. Kentridge et al., 1999; 2004; 2008; Marzouki et al., 2007; Sumner et al., 2006) demonstrates that visual attention is not a sufficient precondition for visual awareness. Mole, however, contends that as (...) space, rather than any object that might occupy that space, is what is being attended, these experiments do not constitute evidence for a dissociation between attention and consciousness. We disagree. To understand the source of this disagreement we need to understand the various processes encompassed by the term 'attention' and to consider experimental evidence illustrating how these processes operate. We review evidence that spatial attention can be deployed with the specific goal of determining the properties of objects occupying the attended region of space. One might, for example, attend to a location with the goal of determining the colour of objects occupying that space as efficiently as possible. Mole's assumption that all that is attended in spatial attention is space is not consistent with this evidence. We conclude that attention can be directed at objects by mechanisms of so- called 'spatial attention' without those objects necessarily eliciting conscious visual experience and hence that attention is not a sufficient precondition for visual awareness. (shrink)

Hadith, authorities, early works to 1800.

Secularism; Arab countries; Islam and state.

Classical treatise on the fundamentals of Nyaya philosophy with commentaries; critical edition.

Properties sometimes attributed to the “particle” aspect of a neutron, e.g., mass and magnetic moment, cannot straightforwardly be regarded in the Bohm interpretation of quantum mechanics as localized at the hypothetical position of the particle. This is shown by examining a series of effects in neutron interferometry. A related thought-experiment also provides a variation of a recent demonstration that which-way detectors can appear to behave anomolously in the Bohm theory.