This chapter contains sections titled: The Epistemology of Murder Violence and Human Nature The Gestation of Terrorists and Serial Killers Conclusions.

With the earliest known reference to angling with a fly dating from the Chou Dynasty, more than 2,300 years ago, it should come as no surprise that when asked to justify their passionate devotion to fly fishing, many anglers will refer to the rich and venerable literature the sport has generated. Ranging from Plutarch's references to Nile fishing in the Life of Antonius, to Pliny the Elder's Historia Naturalis, to the fifteenth century classic, Dame Julian Berner's The Treatyse of Fysshynge (...) wyth an Angle, to the sport's bible, the 17th century The Compleat Angler by Izaak Walton, to literary treatments in the work of authors such as John Donne, Gerard Manley Hopkins, William Butler Yeats, Ezra Pound and Ernest Hemingway, the wealth of literature devoted to fly fishing appears to be out of proportion to what is, ultimately, just a way of seducing an animal with a brain the size of a pea into inhaling a hook upon which some feathers, furs and tinsels have been lashed. What then, one may legitimately ask, is it about this sport that creates fanatical devotion on the part of its practitioners, who tend to regard it with such zeal and passion as is commonly reserved for art and religion? (shrink)

Doping can be both of chemical and protein nature or may involve prohibited methods, such as illegal blood transfusions. The rapidly increasing number of genetic therapies as a promising new branch of regular medicine, has raised the issue whether these techniques might be abused in the field of sports. The risks involved in gene doping are several, and are related both to the vector protein used (DNA, chemical, viral) and to the encoded transgene. A concern in the athletic community (...) is that no one knows how easily gene doping can be detected. The DNA used for gene transfer is of human origin, and not different from that of the person applying gene doping. A combination of developing detection methods based on gene arrays or proteomics and a clear education program on the associated risks seems to be the most promising preventive method to counteract the possible application of gene doping. (shrink)

Article 3.4 of EC directive 89/381 requires member states to take "all necessary measures to promote Community self-sufficiency in human blood or human plasma" and, for this purpose, to "encourage the voluntary unpaid donation of blood and plasma". This paper presents an ethical case in support of the policy of voluntary, unpaid donation.

A story does more than recount events; it recounts events in a way that renders them intelligible, thus conveying not just information but also understanding. We might therefore be tempted to describe narrative as a genre of explanation. When the police invite a suspect to “tell his story,” they are asking him to explain the blood on his shirt or his absence from home on the night of the murder; and whether he is judged to have a “good story” (...) will depend on its adequacy as an explanation. Can we account for the explanatory force of narrative with the models of explanation available in the philosophy of science? Or does narrative convey a different kind of understanding, which requires a different model and perhaps even a term other than ‘explanation’? (shrink)

Applying critical rationalism, all criticism is to be welcomed. A response can help to elucidate matters even when the criticisms are poor, misconceived, and hostile. Thus, we turn to the review.

In The Gift Relationship, Richard Titmuss argued that the practice of altruistic blood donation fosters social solidarity while markets in blood erode it. This paper considers the implications of this line of argument for the organ market debate. I defend Titmuss’ arguments against a number of criticisms and respond to claims that Titmuss’ work is not relevant to the context of live donor organ transplantation. I conclude that Titmuss’ arguments are more resilient than many advocates of organ markets (...) suggest, and more relevant to the debate than is commonly appreciated. (shrink)

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information (...) regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences. (shrink)

A story does more than recount events; it recounts events in a way that renders them intelligible, thus conveying not just information but also understanding. We might therefore be tempted to describe narrative as a genre of explanation. When the police invite a suspect to “tell his story,” they are asking him to explain the blood on his shirt or his absence from home on the night of the murder; and whether he is judged to have a “good story” (...) will depend on its adequacy as an explanation. Can we account for the explanatory force of narrative with the models of explanation available in the philosophy of science? Or does narrative convey a different kind of understanding, which requires a different model and perhaps even a term other than ‘explanation’? (shrink)

Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood (...) glucose to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

The Indiana Court of Appeals, in JKB, Sr. v. Armour Pharmaceutical Co. ), held that the state's Blood Shield Act does not protect pharmaceutical companies that produce blood-derived products from product liability suits based on injuries attributable to tainted blood supplies. Blood shield statutes help to guarantee adequate blood supplies by limiting the liability of blood banks. This holding limits the defenses available to pharmaceutical companies sued under product liability theory.The defendant, Armour Pharmaceutical, produces (...) and sells clotting factor agents, which are derived through plasmapheresis. Plasmapheresis is a costly and complex donation process through which the plasma and red blood cells of a donor's blood are separated. After separation, the process returns the red blood cells to the donor but retains the plasma. (shrink)

The purpose of this article is to highlight ways in which institutional policymakers tend to insufficiently conceptualise their role as ethics practitioners. We use the case of blood product recall notification as a means of raising questions about the way in which, as we have observed it, discourse for those who make institutional ethics policies is constrained by routine balancing of simplified principles to the exclusion of reflexive practices—those that turn ethics reasoning back on itself. The latter allows ethics (...) practitioners with comparatively little formal training to take ownership of traditional parameters, which define their discussions and ultimately ought to make them more insightful when doing ethics. Thus, in the midst of calls for more training to increase the competency of ethics committees, we suggest that an additional problem of how these lay ethicists conceive of their roles also needs to be addressed. (shrink)

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is (...) based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care. (shrink)

This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women's powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care (...) to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously‐based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of ‘reproductive health’ as one that supports women's reproductive self‐determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone‐marrow or blood donations for their children's survival. Women's unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity. (shrink)

We need to rethink our attitudes to the bodies of the dead in order to increase our willingness to donate organs and tissuesMy father died aged 87 on January 20, 1998. It was the day of his 42nd wedding anniversary. He been admitted to a major teaching hospital with jaundice of unknown origin. He died after a medical procedure and a delay in diagnosis and management of bleeding after the procedure. I believed it was important to understand why he had (...) died and what the underlying cause of his jaundice had been. I requested an autopsy.My father was not only the best father a person could have had, but my closest friend. The circumstances of his death were especially sad for me. I was on a plane while he was allowed to die of blood loss in intensive care over a period of hours, becoming progressively more delirious and experiencing the slow motion throes of death. I was told he had died while I was still in the air. My first thought was that I would never again see him or hear his deep chuckle. I would never again feel the gentle touch of his large hands. He would never see my daughter grow up as he had wanted to, playing, and laughing on the beach.I have witnessed many autopsies. As medical students, we had to attend autopsy each morning at 8.30 am as a part of pathology in fourth year medicine. Before this, we had two years of anatomy dissection, probing every crevice of the formalin fixed human body. I learnt an immense amount from these activities. But I also knew how gruesome the autopsy is. I knew that an autopsy would mean that my father would be dismembered. But I had no hesitation in requesting …. (shrink)

Moral conflicts occur in theories that involve more than one principle. I examine basic ways of dealing with moral dilemmas in medical ethics and in ethics generally, and propose a different approach based on a principle I call the "mutuality principle". It is offered as an addition to Tom Beauchamp and James Childress' principlism. The principle calls for the mutual enhancement of basic moral values. After explaining the principle and its strengths, I test it by way of an examination of (...) three responses—in the recent Festschrift for Dr Raanon Gillon—to a case involving parental refusal of a blood transfusion. The strongest response is the one that comes closest to the requirements of the mutuality principle but yet falls short. I argue that the mutuality principle provides an explicit future orientation in principlism and gives it greater moral coherence. (shrink)

Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral NS3/4A (...) protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Being and Freedom: On Late Modern Ethics in Europe by John SkorupskiJ. P. MessinaJohn Skorupski. Being and Freedom: On Late Modern Ethics in Europe. Oxford: Oxford University Press, 2021. Pp. 560. Hardcover, $130.00.John Skorupski's Being and Freedom traces the development of modern ethics in France, Germany, and England, as set in motion by two great revolutions: the French Revolution and Kant's methodological revolution in the Critique of Pure (...) Reason. I begin this review by offering [End Page 714] a brief summary of the book (which consists of eight lengthy chapters, an introduction, and a brief conclusion). I then raise some interpretive worries and offer an overall assessment.In chapter 1, Skorupski reminds us that the French Revolution, a physical struggle between opposing factions, was also a battleground of ideas. In opposing the ancien régime, revolutionaries took aim at the "Catholic-feudal order" (27). Underlying this order was an ethical view, "holism," according to which a person lives well through excellent performance of community roles assigned by family, state, and church. When individual interests conflict with these social roles, the latter take precedence. Revolutionaries (partially inspired by Rousseau) railed against this. On their view, persons were born for freedom, not the chains of traditional life. To realize such freedom demanded a radical democratic state. Here, too, fidelity to the ethical whole (the Republic) sometimes required sacrifices on the part of individuals. But in a properly constituted republic, these sacrifices would be self-imposed requirements of the general will.As revolution turned to terror and blood became the regular currency of sacrifice, critics like Guizot saw the ancien régime's parochialism as a symptom of a larger problem with its underlying ethics, one it shared with the radicals aligned against it: its commitment to holism. Holism says that some social entities have a good not reducible to the good of their members. Additionally, these social wholes have their own rights that sometimes override individual rights (28, 59). These features make it easy for holist orders to justify sacrificing individuals for collective goods. If this is the disease, individualism of the sort associated with Kantian ethics can seem to be the cure.Chapter 2 argues that the new critical philosophy resulting from Kant's "Copernican" Revolution is a mixed bag. On the one hand, Kant offers no good reason for positing a noumenal world and locating freedom there (77–79). On the other hand, there is lasting promise in the idea that morality follows from each person's individual autonomy. And yet, in the end, Kant's arguments fail here, too. For deriving morality from autonomy requires an explicit commitment to impartiality, which does not follow from autonomy (83–102). And, even when suitably modified, Kant's ethical principles risk emptiness if they fail to take content from our relationships and social roles (112, 148). Unfortunately, Kant suggests that doing so would perpetrate heteronomy, making such emptiness inevitable (102).By chapter 3, the tension between holist and individualist conceptions of ethics has become Skorupski's central leitmotif. On the one hand, individualists are well positioned to resist oppression and terror. On the other hand, individualism risks atomism and alienation from our attachments and feelings. Such alienation leads Schiller to reject Kant's views on freedom and virtue (161). For our author, this is as it should be.Skorupski next turns to Fichte. Although Fichte takes a step away from transcendental idealism by making intellectual intuition the hallmark of our subjectivity (173), he agrees with Kant that morality follows from autonomy. Indeed, for Fichte, autonomy commits us to striving for full self-sufficiency, which appears to court a similar atomism. Yet this impression is corrected when Fichte turns to politics. There, Fichte grounds rights (as permissible demands) in mutual recognition (182–83). This positions him to see the state and the family as ethical wholes (187–88), pointing away from Kantian individualism back toward holism.Hegel takes these steps away from Kant to their logical conclusion. As Skorupski explains in chapter 4, Hegel argues that the individualist systems grounded in autonomy and abstract right (Moralität) mark but stages on the way to moral... (shrink)

Death of a normal volunteer highlights problems with research review and protection of subjectsHealthy volunteer dies in asthma studyOn July 19, after investigating the death of a previously healthy volunteer, the United States Office for Human Research Protections suspended nearly all federally funded medical research involving human subjects at Johns Hopkins University. The death has been described as “particularly disturbing” because 24 year old Ellen Roche was a healthy volunteer who had nothing to gain by taking part in the study.1 (...) Her death has revived debate about the adequacy of oversight of medical research that followed the death of 18 year old Jesse Gelsinger who volunteered for a gene therapy experiment.Ellen Roche was a 24 year old technician from the Johns Hopkins Asthma and Allergy Centre who volunteered to take part in a study designed to provoke a mild asthma attack in order to help doctors discover the reflex that protects the lungs of healthy people against asthma attacks. After inhaling hexamethonium, a medication used for treating high blood pressure in the 1950s and 60s, Ms Roche became ill. She developed a cough and her condition worsened over the next week until she was put on a ventilator. With her lung tissue breaking down, blood pressure falling and her kidneys beginning to fail, nothing could be done to save her.2 She died on June 2, about a month after entering the study.The Office for Human Research Protections investigated the circumstances of Ms Roche's death and accused the Hopkins Institutional Review Board of failing to take proper precautions. It also evaluated the human subject protection system at Hopkins. The OHRP found that prior to approving the study, Hopkins researcher …. (shrink)

Romantic Naturphilosophie has been at the centre of almost every account of early nineteenth-century sciences, be it as an obstacle or as an aid for scientific advancement. The following paper suggests a change of perspective. I seek to read Naturphilosophie as one manifestation among others of a more general concern with the question of how experience enables the subject to acquire knowledge about objects. To illustrate such an approach, I focus on Johannes Muller's early work. Here one finds two contrasting (...) images of microscopical observation, its set-up, and the observer: the embryological study of 1830 demands a 'philosophical grasp' of the appearances. In contrast, the investigations of blood of 1832 are presented as a series of controlled experiments. I argue that an interpretation of this contrast in terms of an appropriation and casting aside of Naturphilosophie is not altogether convincing. Instead, both images of microscopy are manifestations of a more general problem, namely, the problem of exactly how subject and object came together in experience. I show how this concern not only shaped the methodological sensibilities particular to Muller's embryology and the investigation of bodily liquids but also provided the epistemological principles and the target for his sense-physiological experiments. It bound Muller's work together with Naturphilosophie and linked Naturphilosophie with other contemporaneous projects in philosophy. All of these enterprises sought to contribute to ongoing debates about how experience allowed the subject to acquire knowledge about the world. (shrink)

High blood pressure is a disease of unknown cause. Family history of the disease indicates higher risk, but it is not known which genes are involved or how they interact with environmental influences to produce the disorder. Molecular biology offers an approach to problems that have not so far been solved by classical physiology or biochemistry. By analysing polymorphic variation in chromosome markers such as minisatellite sequences, or by restriction fragment polymorphism analysis of candidate genes, attempts are being made (...) to link genetic variations with hypertension. In genetically hypertensive rats, hypertension is associated with a polymorphism of the renin gene and with other loci on chromosomes 10 and 18. The role of these loci in human hypertension remains to be determined. Other genes such as sodium‐lithium countertransport may be involved. Environmental factors such as stress or salt intake could influence the rate or timing of expression of certain genes and thus result in hypertension. (shrink)

The numerous researches devoted to 'jaundice' during the Second World War have brought to light the existence of an infectious type of hepatic jaundice or 'homologous serum jaundice' following parenteral injection of vaccines containing human serum and blood transfusions, which were carried out on a large scale at the time. This type of serum jaundice was then gradually differentiated from 'catarrhal', contagious or epidemic jaundice by clinical trials along with large series of animal studies. Finally, the epidemiological, clinical and (...) biological data obtained made it possible to establish, between 1944 and 1954, the viral etiology of these two types of jaundice: the A virus, present in the patients' blood and stools, was considered to be the agent responsible for epidemic hepatitis; the B virus, present primarily in the blood, was held to be responsible for serum hepatitis. (shrink)

Robert F. is an eighty-five-year-old who suffered a heart attack at home in a rural location some thirty minutes from any major hospital. By the time the paramedics arrived, he was unconscious and nonresponsive. After spontaneous return of circulation, they began their standard procedure of therapeutic hypothermia. Robert's core temperature was lowered using ice packs, and cold intravenous fluids were initiated. Soon afterward, Robert started to shiver when his body temperature reached 35.6° Celsius. He was then given a bolus of (...) vecuronium as a neuromuscular blockade, sedated, and intubated. He was also given a low-dose vasopressin for blood-pressure control. Shortly after Robert arrived in the emergency room, his daughter, his medical decision-maker, produced an advance directive documenting that her father has a do-not-resuscitate order, and she demanded that the breathing tube and any other life-sustaining treatments be withdrawn immediately. The medical staff is very reluctant to comply with this demand for immediate action. Until the neuromuscular blockade wears off, removing the ventilator will prevent Robert from breathing. Furthermore, it may take some time to reverse the therapeutic hypothermia procedure to the point that the patient is at normal temperature. In addition, therapeutic hypothermia itself often causes arrest, so the patient may need to be resuscitated again. Should the staff wait until the patient is warm or honor the decision of his daughter, who holds his medical power of attorney? (shrink)

In the second Nekyia Hermes conducts to Hades the souls of the suitors slain by Odysseus: Even in antiquity the identification of the Λευκς πέτρη was a conundrum. It would seem that no ancient Greek scholar could plausibly locate this rock. According to the scholion in the codex Venetus Marcianus 613, one of the many reasons Aristarchos gave for athetising the whole of the second Nekyia was λλ' οδ οικεν ες Ἅιδου λευκν εναι πέτραν. Certainly Hades had πέτραι, but traditionally (...) they were ‘black-hearted’ or ‘blood-red’, not λευκαί. As an example of the lengths to which scholiasts were driven to justify the epithet Λευκάς, the scholion in the British Library codex Harley 5674 has the unhelpful explanation ο γρ νεκροί κλείψαντος το αματος λευκοειδες ρνται. Eustathios' attempt is not much better; he writes στέον δ τι Λευκάδα μέν πέτραν μθος πρς τ Ἅιδπλάττει ἢ κατ ντίρασιν, μλας γρ κε σκότος, ἢ κα δι τούς σχάτους τς κε γς τόπους, ος εκς τν ᾓλιον τι διαλευκαίνειν δυόμενον. At Od. 10.515, in commenting on the πέτρη where the Pyriphlegethôn and the Kôkytos flow into the Acherôn, he ventures the suggestion σως δ εη ν ατη ν τος μετ τατα λεχθησομένη Λευκς πέτρα, which is obviously a mere guess. It would be a waste of time to record the conjectural attempts of modern scholars to locate the Λευκς πέτρη in Hades, for if the ‘Rock Leukas’ was across the Ocean, near the ‘Gates of the Sun’ and the ‘Land of Dreams’, we cannot reasonably hope to identify it. (shrink)

In the second Nekyia Hermes conducts to Hades the souls of the suitors slain by Odysseus: Even in antiquity the identification of the Λευκς πέτρη was a conundrum. It would seem that no ancient Greek scholar could plausibly locate this rock. According to the scholion in the codex Venetus Marcianus 613, one of the many reasons Aristarchos gave for athetising the whole of the second Nekyia was λλ' οδ οικεν ες Ἅιδου λευκν εναι πέτραν. Certainly Hades had πέτραι, but traditionally (...) they were ‘black-hearted’ or ‘blood-red’, not λευκαί. As an example of the lengths to which scholiasts were driven to justify the epithet Λευκάς, the scholion in the British Library codex Harley 5674 has the unhelpful explanation ο γρ νεκροί κλείψαντος το αματος λευκοειδες ρνται. Eustathios' attempt is not much better; he writes στέον δ τι Λευκάδα μέν πέτραν μθος πρς τ Ἅιδπλάττει ἢ κατ ντίρασιν, μλας γρ κε σκότος, ἢ κα δι τούς σχάτους τς κε γς τόπους, ος εκς τν ᾓλιον τι διαλευκαίνειν δυόμενον. At Od. 10.515, in commenting on the πέτρη where the Pyriphlegethôn and the Kôkytos flow into the Acherôn, he ventures the suggestion σως δ εη ν ατη ν τος μετ τατα λεχθησομένη Λευκς πέτρα, which is obviously a mere guess. It would be a waste of time to record the conjectural attempts of modern scholars to locate the Λευκς πέτρη in Hades, for if the ‘Rock Leukas’ was across the Ocean, near the ‘Gates of the Sun’ and the ‘Land of Dreams’, we cannot reasonably hope to identify it. (shrink)

Second in importance only to the question raised by the short editorial in the last number of Philosophy : Why are we at War? is that on which there is at present a lively discussion going on in The Times and elsewhere under the title of “German Rulers and People”: With Whom are we at War? On one point there is no difference of opinion: we are at war with the blood- and crimestained group that, with Hitler at their (...) head, hold the reins of government. Difference begins when it is asked what share the people of Germany as a whole has in their crimes. On the one side are those who hold that, as you cannot, in historical words, “bring an indictment against a whole nation,” neither can you be at war with a whole people, and that the main problem we have before us is the discovery of the means to appeal to the intelligence and hearts of the mass of the nation in order to enlist it against its Government as a common enemy. On the other side are those who quote the equally historic words that “every nation gets the kind of government it deserves,” from which “it follows that it deserves no immunity for the acts of the Government by which it chooses, or allows itself, to be governed.” This argument is reinforced first by a general philosophy of war as the “natural” order of things from which man is only gradually emerging into an exceptional and precarious condition of peace; and secondly, with regard to Germany in particular, that “the lust for dominance through force is, and will be for generations, at the root of the German character.” The importance of the issue as thus stated requires no emphasis. (shrink)

In Barrett v. Danbury Hospital ), the Supreme Court of Connecticut held that the fear of contracting or transmitting HIV or any other blood-borne pathogens is not a compensable injury and does not give rise to a negligence or a medical malpractice claim. The court's decision affirmed the holding of a Connecticut trial court.In June 1990, Allen Barrett was admitted to Danbury Hospital complaining of abdominal pain. He had a history of gall bladder trouble. Barrett was placed on a (...) stretcher in the emergency room. The attending physician diagnosed Barrett's pain as a gallstone condition. During the course of his examination, the doctor noticed that Barrett was sitting in blood. The physician subsequently performed a rectal examination of Barrett to locate the source of the blood. The physician determined that the patient was not bleeding, but that the blood was in fact coming from two slits in the vinyl pad that covered the stretcher on which Barrett sat. (shrink)

William Harvey's famous quantitative argument fromDe motu cordis about the circulation of blood explained how a small amount of blood could recirculate and nourish the entire body, upending the Galenic conception of the blood's motion. This paper argues that the quantitative argument drew on the calculative and rhetorical skills of merchants, including Harvey's own brothers. Modern translations ofDe motu cordisobscure the language of accountancy that Harvey himself used. Like a merchant accounting for credits and debits, intake and (...) output, goods and moneys, Harvey treated venous and arterial blood as essentially commensurate, quantifiable and fungible. For Harvey, the circulation of blood was an arithmetical necessity. The development of Harvey's circulatory model followed shifts in the epistemic value of mercantile forms of knowledge, including accounting and arithmetic, also drawing on an Aristotelian language of reciprocity and balance that Harvey shared with mercantile advisers to the royal court. This paper places Harvey's calculations in a previously underappreciated context of economic crisis, whose debates focused largely on questions of circulation. (shrink)

A model is proposed which implicates molecular recognition systems as the major controlling factors in life cycle expression. It is envisaged that such systems are important in immune functioning and catabolic, metabolic molecule recognition at both inter- and intea-cellular level. These recognition systems have the following characteristics: Specific recognition molecules , e.g. vertebrate antibodies, invertebrate agglutinins and plant agglutinins may recognise specific substances, e.g. antigens, catabolic and metabolic molecules. The range of possible recognisable substances is very wide and variable. The (...) recognisers may themselves be recognised by other recognisers. Recognisers are usually produced in large amounts only on presentation of the appropriate recognisable molecule. The progressive introduction of new recognisable molecules increases the recogniser interaction, this interaction causing depression of some recogniser types and facilitation of other types among which may be recognisers specific for self components . Low juvenile viability is associated with a restricted range of available recognisers, high adult viability with increasing recogniser range and some auto-immunity/immune depression, senescence with a wide range of available recognisers and extensive auto-immunity/immune depression.Life cycle patterns and their control are discussed. It is suggested control mechanisms may include: Dietary restriction and in some periods complete nutritional abstinence. Specific recogniser depression, genes implicated here are the various antigens found on cell surfaces, in the serum and in various body fluids of vertebrates, e.g. ABO, MNSs, P, Rh, Le and other blood groups, the ABO and Le secretor antigens and the HL-A antigens. In addition the immune response and mixed lymphocyte culture loci are implicated. Finally life cycle control is discussed with relation to sexual selection. (shrink)

A study was undertaken of the views of users of two genitourinary medicine (GUM) clinics in England on unlinked anonymous testing (UAT) for HIV. The UAT programme measures the prevalence of HIV in the population, including undiagnosed prevalence, by testing residual blood (from samples taken for clinical purposes) which is anonymised and irreversibly unlinked from the source. 424 clinic users completed an anonymous questionnaire about their knowledge of, and attitudes towards, UAT. Only 1/7 (14%) were aware that blood (...) left over from clinical testing may be tested anonymously for HIV. A large majority (89%) said they would agree to their blood being tested, although 74% wanted the opportunity to consent. These findings indicate broad support for UAT of blood in a group of patients whose samples are included in the HIV surveillance programme. The findings suggest the need for greater attention to be given to the provision of information and, if replicated in a larger survey, may justify a reappraisal of UK policy on UAT. (shrink)

The definition of what constitutes minimal monitoring rests not so much on a scientific analysis of physiologic variables and their specificity, sensitivity, and predictiveness, but more on a usage pattern in a given community or country. In the United States, the minimal monitoring standards accepted in the majority of institutions and used for routine anesthesia care of patients not classified as high risk include (1) the alert anesthesiologist or nurse anesthetist observer, (2) an electrocardiogram, (3) a blood pressure measuring (...) device, and (4) an oxygen analyzer in the breathing circuit. To this basic cluster of monitors can be added a finger plethysmograph, a neuromuscular junction monitor, a temperature probe, and an esophageal/precordial stethoscope which are used in many communities. In the near future we expect to see a capnograph and a pulse oximeter added to this list, and later on the automated anesthesia record. (shrink)

Book review of 'The ethics of memory' by A. Margalit.

In the Laura Ashworth case in 2008, the Human Tissue Authority considered itself bound to overturn a deceased daughter's alleged wish that one of her kidneys should go to her mother, who at the time had end stage kidney failure and was on dialysis. 12 This was so even though Laura's earlier wish to be a living donor would most likely have been authorised, had the formal assessment process begun. The decision provoked much criticism. The recent Department of Health document (...) Requested Allocation of a Deceased Donor Organ, published 29 March 2010, developed by the UK health administrations together with the HTA and NHS Blood and Transplant , which is the main organ allocation body in the UK, seeks to resolve this ethical dilemma by setting out the circumstances in which requests for such deceased donations may be acceptable. 3 The most important conditions appear to be:a. the donation must be unconditional in nature;b. there must be …. (shrink)

Capote, apparently having mistaken craft for art, has reported on an event. Dreiser, in transcending time, has reported on the truth of human nature.