Background While it is generally acknowledged that self-prescribing among physicians poses some risk, research finds such behaviour to be common and in certain cases accepted by the medical community. Largely absent from the literature is knowledge about other activities doctors perform for their own medical care or for the informal treatment of family and friends. This study examined the variety, frequency and association of behaviours doctors report providing informally. Informal care included prescriptions, as well as any other type of personal (...) medical treatment (eg, monitoring chronic or serious conditions). Method A survey was sent to 2500 randomly-selected physicians in Colorado, 600 individuals returned questionnaires with usable data. The authors hypothesised: (1) physicians would prescribe the same types of treatment at home as they prescribed professionally; and (2) physicians who informally prescribed addictive medications would be more likely to engage in other types of informal medical care. Results Physicians who wrote prescriptions for antibiotics, psychotropics and opioids at work were more likely to prescribe these medications at home. Those prescribing addictive drugs outside of the office treated more serious illnesses in emergency situations, more chronic conditions and more major medical/surgical conditions informally than did those not routinely prescribing addictive medications. Physicians reported a variety of informal care behaviour and high frequency of informal care to family and friends. Discussion The frequency and variety of informal care reported in this study strongly argues for profession-wide discussion about ethical and guideline considerations for such behaviour. These areas are discussed in the paper. (shrink)

"Paradox drives a good deal of philosophy in every tradition. In the Indian and Western traditions, there is a tendency among many philosophers to run from contradiction and paradox. If and when a contradiction appears in a theory, it is regarded as a sure sign that something has gone amiss. This aversion to paradox commits them, knowingly or not, to the view that reality must be consistent. In East Asia, however, philosophers have reacted to paradox differently. Many East Asian philosophers-both (...) in the Daoist and the Buddhist traditions-have openly embraced paradox. They have taken compelling arguments for contradictory positions to suggest that the world is-at least in some respects, and often in very deep respects-inconsistent, and that our best theories of the world will therefore be inconsistent. This book is an initial survey of the writings of some influential East Asian thinkers who were committed to paradox, and for good reason. Their acceptance of contradiction allowed them to develop important insights that evaded those who consider paradox out of bounds"--. (shrink)

Theoretical models of schizophrenia have traditionally emphasized the biological social, and environmental forces that lead to the dysfunction that characterizes this disorder. However important these aspects may be, an understanding of schizophrenia is incomplete without attention to the first-person perspective of those who continue to struggle to find meaning and security in the midst of this disorder. Encouragingly, an interest has grown steadily in recent years in understanding subjective experience in schizophrenia, and can be found within a range of bodies (...) of research, including.. (shrink)

How might we usefully apply concepts and procedures derived from the study of other complex dynamical systems to analyzing systemic change in education? In this article we begin to define possible agendas for research toward developing systematic frameworks and shared terminology for such a project. We illustrate the plausibility of defining such frameworks and raise the question of the relation between such frameworks and the crucial task of aggregating data across ‘systemic experiments’, such as those conducted under the Urban Systemic (...) Initiative sponsored by the US National Science Foundation. Our discussion includes a review of key issues identified by groups of researchers regarding Defining the System, Structural Analysis, Relationships Among Subsystems and Levels, Drivers for Change, and Modeling Methods. (shrink)

This chapter contains sections titled: Studying the Complexity of Educational Change Developing a Conceptual Framework Lessons for Modeling from Real Cases A Philosophical Note Conclusions References.

According to our data, 38.5 % of S&P 1500 firms have at least one professor on their boards. Given the lack of research examining the roles and effects of academic faculty as members of boards of directors on corporate outcomes, this study investigates whether firms with professor–directors are more likely to exhibit higher corporate social responsibility performance ratings. Results indicate that firms with professor–directors do exhibit higher CSR performance ratings than those without. However, the influence of professor–directors on firm CSR (...) performance ratings depends on their academic background—the positive association between the presence of professor–directors and firm CSR performance ratings is significant only when their academic background is specialized. Finally, this positive association weakens when professor–directors hold an administrative position at their universities. (shrink)

In our original piece, we suggested that contemporary phenomenological models of schizophrenia such as the ipseity-disturbance model emphasize perceptual and cognitive elements of self-disturbances, potentially neglecting the presence and central importance of painful affect in the experience of schizophrenia. We concluded that integrating affect within developing phenomenological models would offer not only a theoretical advance but also a possible path to more effective recovery-oriented treatment. In response, Phillips agrees there is incontrovertible evidence of painful affect central to the experience of (...) schizophrenia. He expresses concerns though about a danger in falsely reducing.. (shrink)

The modal interpretation of quantum mechanics allows one to keep the standard classical definition of realism intact. That is, variables have a definite status for all time and a measurement only tells us which value it had. However, at present modal dynamics are only applicable to situations that are described in the orthodox theory by projective measures. In this paper we extend modal dynamics to include positive operator measures. That is, for example, rather than using a complete set of orthogonal (...) projectors, we can use an overcomplete set of nonorthogonal projectors. We derive the conditions under which Bell's stochastic modal dynamics for projective measures reduce to deterministic dynamics, showing that Brown and Hiley's generalization of Bohmian mechanics [quant-ph/0005026, ] cannot be thus derived. We then show how deterministic dynamics for positive operators can also be derived. As a simple case, we consider a Harmonic oscillator, and the overcomplete set of coherent state projectors. We show that the modal dynamics for this POM in the classical limit correspond to the classical dynamics, even for the nonclassical number state |n>. This is in contrast to the Bohmian dynamics, which for energy eigenstates, the dynamics are always non-classical. (shrink)

H. Jay Dinshah, the father of the modern vegan movement in America and founder of American Vegan Society, eloquently explains ethical reasons for veganism. His daughter Anne updates and edits his pioneering writings. Over forty vegan luminaries tell how they were influenced and inspired by Jay. Together they encourage readers to explore ways to promote positive action in the world towards veganism through “dynamic harmlessness.”.

Uses an ongoing legal controversy to explore the controversial subject of religious liberty and education.

How might we usefully apply concepts and procedures derived from the study of other complex dynamical systems to analyzing systemic change in education? In this article we begin to define possible agendas for research toward developing systematic frameworks and shared terminology for such a project. We illustrate the plausibility of defining such frameworks and raise the question of the relation between such frameworks and the crucial task of aggregating data across ‘systemic experiments’, such as those conducted under the Urban Systemic (...) Initiative sponsored by the US National Science Foundation. Our discussion includes a review of key issues identified by groups of researchers regarding (1) Defining the System, (2) Structural Analysis, (3) Relationships Among Subsystems and Levels, (4) Drivers for Change, and (5) Modeling Methods. (shrink)

The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted (...) baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

Objectives To characterize the prevalence and content of pediatric triage policies.Methods We surveyed and solicited policies from U.S. hospitals with pediatric intensive care units. Policies were analyzed using qualitative methods and coded by 2 investigators.Results Thirty-four of 120 institutions (28%) responded. Twenty-five (74%) were freestanding children’s hospitals and 9 (26%) were hospitals within a hospital. Nine (26%) had approved policies, 9 (26%) had draft policies, 5 (14%) were developing policies, and 7 (20%) did not have policies. Nineteen (68%) institutions shared (...) their approved or draft policy. Eight (42%) of those policies included neonates. The polices identified 0 to 5 (median 2) factors to prioritize patients. The most common factors were short- (17, 90%) and long- (14, 74%) term predicted mortality. Pediatric scoring systems included Pediatric Logistic Organ Dysfunction-2 (12, 63%) and Score for Neonatal Acute Physiology and Perinatal Extensions-II (4, 21%). Thirteen (68%) policies described a formal algorithm. The most common tiebreakers were random/lottery (10, 71%) and life cycles (9, 64%). The majority (15, 79%) of policies specified the roles of triage team members and 13 (68%) precluded those participating in patient care from making triage decisions.Conclusions While many institutions still do not have pediatric triage policies, there appears to be a trend among those with policies to utilize a formal algorithm that focuses on short- and long-term predicted mortality and that incorporates age-appropriate scoring systems. Additional work is needed to expand access to pediatric-specific policies, to validate scoring systems, and to address health disparities. (shrink)

The present study focuses on furthering the theoretical foundations of the field of spirituality and religiosity in the workplace by providing a parsimonious definition, and multi-dimensional model for the construct of spirituality grounded in a pluralistic and historically authentic framework using the Sophia Perennis or Perennial Philosophy. In this process, the study addresses the dilemma of religiosity versus spirituality faced by researchers in this area, 175). It also addresses concerns regarding the potential conflicts related to spirituality and religiosity that could (...) arise in a secular workplace, which emphasizes inclusiveness and equality. A three factor model of spirituality is developed using the grounded theory approach, 3–21) and is corroborated by factor analysis of multiple samples, and participants representing three major world faith traditions. (shrink)

As is the case with most pre‐modern philosophers of India, very little historical information is available about Bhartṛ‐hari. There are many interesting legends, some turned into extensive plays and poems, current about him. However, it is impossible to determine on their basis even whether there was only one philosopher called Bhartṛ‐hari. The appellation “philosopher” could unquestionably be applied to the author or authors of at least two Sanskrit works that are commonly ascribed to Bhartṛ‐hari.

In this paper I argue for the Atlas-Kempson Thesis that sentences of the form The A is not B are not ambiguous but rather semantically general (Quine), non-specific (Zwicky and Sadock), or vague (G. Lakoff). This observation refutes the 1970 Davidson-Harman hypothesis that underlying structures, as full semantic representations, are logical forms. It undermines the conception of semantical presupposition, removes a support for the existence of truth-value gaps for presuppositional sentences (the remaining arguments for which are viciously circular), and lifts (...) the Russell-Strawson dispute of 1950–1964 from stalemate to a formulation in which a resolution is possible for the first time. Suggestions of Davidson, Montague, Stalnaker, Kaplan and H. P. Grice are shown to be inadequate semantic descriptions of negative, presuppositional sentences. I briefly discuss the radical Pragmatics view of my 1975 publications and suggest that it too fails to do justice to the linguistic data. I speculate that Semantic Representations should be given the form (more or less) of computer programs, describable in Dana Scott's mathematical semantics for programming languages. (shrink)

Providing an accessible examination of ethics, Doing Ethics in Media, introduces students to ethical theory and provides a grounded discussion of ethics in the context of today's media outlets. Emphasizing the understanding of ethics, the text will help readers 'do ethics' expeditiously, honestly, and efficiently when they enter the workplace and need to make critical ethical decisions on deadline. The text is organized around six decision-making questions, and cases demonstrate the application of these questions to real-world scenarios. Each chapter focuses (...) on a specific ethical theory or issue, with a thorough discussion of the key points accompanied by practical applications, demonstrated through references to classic and contemporary issues in media. Student voices are heard throughout the book, illustrating how they have grappled with and applied the concepts in their own worlds and in the media. Distinctive features include: a new approach to ethical decision making through the "5W's and H" questions that serve as the book's framework; discussions and case studies aimed at five media disciplines: journalism, new media, advertising, public relations, and entertainment. Cases engage students at early stages of their careers, and consider that most students will change careers several times comprehensive materials on classic moral theory and current issues such as truth telling and deception, values, persuasion and propaganda, privacy, diversity, loyalty, moral development, and codes of ethics user-friendly approach throughout the book challenges students to think for themselves rather than imposing answers on them connects the model or theory to every decision-making challenge (44 cases and dozens of practical applications) a Companion Website with ancillary materials for students and for instructors (including a test bank and instructor's manual). This text has been written for undergraduates and graduate students studying media ethics in mass media, journalism, and media studies. It also will serve students in rhetoric, popular culture, communication studies, and interdisciplinary social sciences"--Provided by publisher. (shrink)

Do the rich descriptions and narrative shapings of literature provide a valuable resource for readers, writers, philosophers, and everyday people to imagine and confront the ultimate questions of life? Do the human activities of storytelling and complex moral decision-making have a deep connection? What are the moral responsibilities of the artist, critic, and reader? What can religious perspectives—from Catholic to Protestant to Mormon—contribute to literary criticism? Thirty well known contributors reflect on these questions, including iterary theorists Marshall Gregory, James Phelan, (...) and Wayne Booth; philosophers Martha Nussbaum, Richard Hart, and Nina Rosenstand; and authors John Updike, Charles Johnson, Flannery O'Connor, and Bernard Malamud. Divided into four sections, with introductory matter and questions for discussion, this accessible anthology represents the most crucial work today exploring the interdisciplinary connections between literature, religion and philosophy. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Intracellular pH (pHi) regulation is a homeostatic function of all cells. Additionally, the plasma membrane‐based transporters controlling pHi are involved in growth factor activation, cell proliferation and salt transport – all processes active in early embryos. pHi regulation in the early embryos of many species exhibits unique features: in mouse preimplantation embryos, mechanisms for correcting excess acid apparently are inactive, while excess base is removed by the mechanism common in differentiated cells. Additionally, unlike differentiated cells, mouse preimplantation embryos are highly (...) permeable to H+ until the blastocyst stage, where the epithelial cells surrounding the embryo are impermeable. In several non‐mammalian species, of which the best‐studied is sea urchin, cytoplasmic alkalinization at fertilization is necessary for development of the embryo, and elevated pHi must be maintained during early development. Thus, pHi regulatory mechanisms appear to be important for early embryo development in many species. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Changed Life: Becoming True to Who I amJay Kyle PetersenI was born intersex in 1952 in the county hospital of a very small, ultraconservative town in rural Southwestern Minnesota. My biological parents and paternal grandparents raised me on a small family farm nearby. I knew by age four I was a boy. No one told me. There was nothing to decide. I have always known I am male. (...) My parents never discussed my unusual condition with me and died having never accepted me. They denied my true identity and instead chose to give me a girl’s name and raise me as a girl.My paternal grandmother knew I was different. She lived on the farm with us and, as she explained to me later on in life, changed my diapers and helped take care of me as an infant and toddler. She also was a Certified Nurse’s Aide in the pediatric ward of the county hospital where I was born and could see that anatomically I was different from other infants. She remained my lifelong ally and friend until her death in 1993. She and Grandpa provided an oasis in their farmhouse where I felt accepted. I felt relaxed and comfortable in their company, and could just be myself. Grandpa took me fishing. Grandma drove me to 4–H State Fair demonstrations and supported me in the audience for which she had helped prepare me. My grandmother taught me good humor, excellence and how it was okay to make mistakes. Much later, in 1977, she drove four hours alone to Minneapolis in blizzard conditions to be my “concerned family person” during chemical dependency treatment, when my mother and dad refused and she also celebrated with me after my successful completion of the program. I loved her and she loved me and she showed it. With her I found refuge away from the pressure and abuse in our farmhouse.But my grandparents and parents did not show me affection physically. The only touch I felt from my family, except my paternal grandparents, was abusive including certain religious figures outside our family. Farm animals and pets provided warmth, love, acceptance, and companionship. I loved riding around the farm on the back of my pet pig, Lucy. Nature, especially trees, wild weather, and local lakes provided rest for my stretched, weary nerves and stimulation for my imagination. There was something about the vivid and contrasting colors, even the sounds and livingness about it all—rich deep moist greens, clean pure vast open blues, dark warm earth which I laid upon and felt in my hands. These and the soothing sounds of the wind gently moving through tree leaves and corn leaves and the lake water lapping calmly upon sandy shores, as Grandpa cast out his line: all this I found both relaxing and energizing and allowed for me the safety and environment to rest, let go and expand so my natural inclinations to express myself creatively could open up. Otherwise, I had a very lonely, frustrated, painful, humiliating childhood and adolescence filled with mounting anger and a sense of futility because I could not be or express my real male self—including my attraction to girls.The cultural and religious pressure I felt, the increased abuse and social lies I was forced to live with—including being forced to wear girls’ clothing against my will—became unbearable. I sought [End Page 106] refuge in addiction early on—food for comfort, nicotine for mood alteration, alcohol given to me by my dad, and more. I became suicidal, and remained for a long time terribly depressed.The geneticist I have consulted for the last four years says that physicians who examined me prior to my genital surgeries described my genitals as “male structures formed without enough testosterone,” rather than female structures formed in the presence of excess androgen. She told me that the features recorded in my medical records, and that she had observed, indicate androgen exposure in utero along with an inherited genetic condition such that she says my condition began at conception. I was born with XX karyotype and testing for usual causes for androgen excess with someone... (shrink)

By the start of the Victorian period the school of British economists acknowledging Adam Smith as its master was in the ascendancy. 'Political Economy', a catch-all title which ignored the diversity of viewpoints to be found amongst the discipline's leading proponents, became associated in the popular mind with moral and political forces held to be uniquely conducive to the progress of an increasingly industrialised and competitive society. 'Political Economy' served in turn as the focus for critics of equally diverse moral (...) and political persuasions, who sought to challenge the materialism of contemporary society and offer their own assessments of the profound social changes of the time. In the introductory essay to the collection of readings from such 'critics of capitalism', the editors review the principles of the early economists, the way in which these principles were appropriated and applied by their Victorian successors and the contrasting modes which critics of popular economic ideas assumed. Subsequent extracts from the writings of the Owenite Socialist John Bray, Carlyle, Marx and Engels, J. S. Mill, Ruskin, Arnold, T. H. Green, William Morris and G. B. Shaw, demonstrate both the breadth of the possible grounds for ideological opposition to the prevailing philosophy and the shifting nature of the debate as 'Political Economy' itself was revealed as incapable of explaining or responding to the changing conditions of the 1870s. Headnotes to the extracts describe the genesis of individual debate and discuss distinctive stylistic features. Annotation in the form of footnotes and endnotes has been designed to gloss obscure allusions and arguments. In making more accessible the socio-economic writings of those authors now better known for their imaginative work, this volume will enable readers to reach a more profound appreciation of the central role such work played in developing the moral vision embodied in their more lastingly popular books and essays. (shrink)

These essays take up contemporary debates concerning the rationality of legal and political institutions. Roberto Unger proposes a "politics of modernism"--a politics appropriate to the historical experience that Nietzsche calls "nihilism" and identifies as the re-grounding of all values in human will. Unger's aim is to heighten the artificiality, plasticity or revisability of all social arrangements, so that the self may perpetually overcome its context. But such an attempt to give the idea of self-overcoming a political translation threatens to be (...) devoid of any content beyond the reiterated assertion of the will. Wittgenstein's remarks on rule-following give voice to an anxiety that recurs in contemporary legal culture: Can a rule--in words that H. L. A. Hart once used--"step forward to claim its own instances"? Wittgenstein does not deny that it can, but he wishes to call attention to our captivation by a picture of a "rule by itself," according to which this "stepping forward" seems queer in light of an otherwise unbridgeable gap between a rule and its application. In the grip of such a picture, it becomes tempting to think that the normative demand of a rule must be activated by an interpretation. Such a thought leads not only to philosophical perplexity, but to failures of justification in the court-room. To make sense of Aristotle's notion of corrective justice, we need the idea that a judgment can be genuinely in accord with a universal even though the content of the universal cannot be completely spelled out in detachment from the concrete situations to which it is applied. It is plausible to see much of contemporary tort law as a specification of corrective justice. But attempts to supply corrective justice with a consequentialist foundation are unable to account for the significance of wrongful agency in tort law, while attempts to supply it with a deontological foundation are unable to account for the significance of the tort victim's loss. (shrink)

h e "Urban Legend" of Punctuated Equilibrium's Threefold History: The opponents of punctuated equilibrium have constructed a fictional history of the theory, primarily (I suppose) as a largely unconscious expression of their hope for its minor importance […] This supposed threefold history of punctuated equilibrium also ranks about as close to pure fiction as any recent commentary by scientists has ever generated. In stage one, the story goes, we were properly modest, obedient to the theoretical hegemony of the Modern Synthesis, (...) and merely trying to bring paleontology into the fold. But the prospect of worldly fame beguiled us, so we broke our ties of fealty and tried, in stage two, to usurp power by painting punctuated equilibrium as a revolutionary doctrine that would dethrone the Synthesis, resurrect the memory of the exiled martyr (Richard Goldschmidt), and reign over a reconstructed realm of theory. But we were too big for our breeches, and the old guard still retained some life. They fought back mightily and effectively, exposing our bombast and emptiness. We began to hedge, retreat, and apologize, and have been doing so ever since in an effort to regain grace and, chastened in stage three, to sit again, in heaven or Valhalla, with the evolutionary elite. (shrink)

This article uses the writings of Alfred Schutz as catalysts to analyze three distinctive modes of transcendences operative in human experience. Particular attention is given to the role symbolic awareness plays in the formation and embodiment of moral value. I argue that Schutz''s theory of symbols is helpful in illuminating the way shared horizons of value meaning and collective moral purpose can occur in relation to cultural and geographical anonymity. I then draw upon the moral theory of H. Richard Niebuhr (...) to highlight the positive role that symbolic value horizons play in preventing ethnocentric world-views and in promoting common centers of discourse and visions of wholeness. (shrink)