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)

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content analysis. (...) The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

This paper examines people's reasoning about identity continuity and its relation to previous research on how people value one-of-a-kind artifacts, such as artwork. We propose that judgments about the continuity of artworks are related to judgments about the continuity of individual persons because art objects are seen as physical extensions of their creators. We report a reanalysis of previous data and the results of two new empirical studies that test this hypothesis. The first study demonstrates that the mere categorization of (...) an object as “art” versus “a tool” changes people's intuitions about the persistence of those objects over time. In a second study, we examine some conditions that may lead artworks to be thought of as different from other artifacts. These observations inform both current understanding of what makes some objects one-of-a-kind as well as broader questions regarding how people intuitively think about the persistence of human agents. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

Epicurus, born at Samos, Greece, in 341 BC, and died at Athens in 270 BC, founded a school of philosophy in the ancient world which has little to do with the meanings that surround the word "Epicureanism" today and more to do with living a mindful, simple life, maximizing simple pleasures and minimizing pain, such as the irrational fear of death--"Death is nothing to us, since when we are, death has not come, and when death has come, we are not." (...) Epicurus did not believe that humans would be punished for their sins after death, and stressed the search for lasting pleasures during the life we have, such as tranquility, friendship, and philosophical inquiry. What is good is what is pleasurable and what is bad is what is painful. Epicurus was a prolific author, but very few of his writings have come down to us. Included in this collection, edited and translated by George K. Strodach, are a collection of observations that were preserved by the biographer of ancient philosophers, Diogenes Laertius, and three important letters. (shrink)

This chapter introduces the edited volume, The Oxford Handbook of Philosophy and Psychiatry. Published in 2013, the centenary of Karl Jaspers' General Psychopathology, the chapter draws lessons from the last hundred years for the coming century. No predictions are made. Instead, five 'conditions for flourishing' are set out: 1) Particular Problems - the importance of focussing on well-defined particular problems rather than general theory building, 2) Product- orientation - remaining always responsibly product oriented in the specific sense that both sides (...) put in the work necessary to 'go deep' with each other's fields, 3) Partnership - working in partnerships of one kind or another, 4) Process - constant reflection on process based on peer review but leaving scope for the occasional rogue voice to cut innovatively against the grain, and 5) Q - a condition of a different kind, Q is an empirically derived measure of the balance between in-group cohesion and out-group openness required to support creativity. Illustrations are given of how these five conditions for flourishing have underpinned the rapid expansion of philosophy and psychiatry in the closing decades of the twentieth century, and, correspondingly, are also reflected in the Handbook as a whole. Overviews and commentaries on individual contributions to the Handbook are given in extended editorial introductions to each of its eight sections. (shrink)

In the wider ecumenical movement, bearing witness to each other in true friendship is a creative gesture inspired by the Holy Spirit. It cuts across religious and denominational divides. The friendship between Gandhi and CF Andrews is invoked as an example of East and West bearing witness to each other. In ancient Asian religious context, mutual witnessing is extended to all sentient beings. From the Orthodox tradition three themes are highlighted as contributing to the Spirit-movement for mutual witness and healing (...) of divisions, namely, Theosis or divinization, the Perfecting work of the Holy Spirit and the Eighth Day. Humanity and the whole creation are involved in the process of divinization. Our mutual relationship is defined by this journey together. The Holy Spirit is continually renewing the creation which is pneumatodynamic, or energized by the Spirit from the beginning to the eschaton. Human beings as leaders and priests of creation are to respond to and cooperate in the perfecting work of the Spirit. The more we rely on the power of the Holy Spirit, the more united and reconciled in Christ we become. (shrink)

We have conducted an experimental study of V-type electromagnetically induced transparency in sodium. Its principles are elucidated by a simple model. Measurements show decreased fluorescence and absorption depending on the detuning of the driving and probe fields, which is in agreement with the results of numerical simulation.

The obstacle to more objective knowledge of early Pythagoreanism is the ideological conflict over the proper mission of historiography. Not only the confusing evidence, but also the different investigative procedures and theories of history employed, make solving the Pythagorean problem difficult. I analyze the historiographic methodologies of some modern historians of Pythagoreanism in respect to the kinds of historical explanation they provide. Immediately ideological controversy arises between idealist and materialist historians. ;My critical evaluation proceeds from two theses. The content of (...) ideas reflects their social referents. Consequently, one must identify the class interests of early Pythagoreans. Writing history is a contemporary undertaking by which historians reflect their own social interests. Therefore, historiographic methodology continually must be objectified to overcome the subjectivism of historical relativism. ;I review the reconstructions of six historians. John Burnet, an empiricist, held that the Greeks entirely broke from their religious past to develop philosophy. F. M. Cornford, a Durkheimian, used anthropology to reveal philosophy's totemic content. J. E. Raven is a philologist; he maintaned that ancient philosophy was the Eleatic-Pythagorean debate. W. K. C. Guthrie, an eclectic, held that science served Pythagorean religious interests. These idealist historians attributed the Greek achievement to absolutized temperaments or racial factors; the development of ideas is not mediated by practical necessity. George Thomson and Alban Winspear are historical materialists. They explained ancient philosophy by showing the class interests of philosophers in a mercantile economy based on slave labor. ;After introducing the Pythagorean problem, I present, by chapter, first an exposition of each historian's account of the causes of Greek philosophy and then his exposition of early Pythagoreanism. My analyses follow each section. In the first part of the final chapter I discuss each historian in the context of the ideological controversy. In the second part I present a general outline of procedure for scientific historiography. (shrink)

Useful as a starting point and as a resource to revisit as our perspectives shift, this empowering book encourages individuals to "seek answers that will mark ...

NGO-based and rigorously monitored development programmes are bringing about important and positive socio-economic changes in the developing world. However, there are numerous instances of the employment of aggressive and grueling monitoring techniques which objectify the subject of development, the primary stakeholder, claiming development results as the successful achievement of goals of the donor or implementing organization. It is in this context that one can speak of an ethic of monitoring development programmes. The paper argues that such an ethic can be (...) positively based on principles like empowering people through development work without hurting their sense of self-worth, the principle of trust and partnership and, negatively, never striving to objectify any person or people for the achievement of some objective, even if this objective is in itself honourable and desirable. The paper contends that if development is freeing the subject, the central player, to exercise their capability to live their life to the fullest, then development monitoring and development work in general has to enhance freedom, autonomy and openness. (shrink)

The concept of authenticity plays an important role in how people reason about objects, other people, and themselves. However, despite a great deal of academic interest in this concept, to date, the precise meaning of the term, authenticity, has remained somewhat elusive. This paper reviews the various definitions of authenticity that have been proposed in the literature and identifies areas of convergence. We then outline a novel framework that organizes the existing definitions of authenticity along two key dimensions: describing the (...) type of entity that is evaluated and describing the source of information that is consulted. We argue that this convergence across a number of papers, and more importantly, across a number of domains, reflects significant progress in articulating the meaning of authenticity. We conclude by suggesting new avenues for research in this area, with particular attention toward psychological process. (shrink)

The third edition covers topics of recent interest in the twenty-first century, such as Heroic Medicine, Gender Identity, Wealth Inequality, LGBTQ Issues, and more. This encyclopedic work includes more than 1,000 essays organized by broad categories related to ethical issues.

Taking the Heideggerian critical ontology of technology as its base, this volume looks at postcolonial modernization and development in the global south as the worldwide expansion of the western metaphysical understanding of reality. We live today in an increasingly globalizing technological society that Martin Heidegger described in the middle of the last century as 'the planetary imperialism of technologically organized man.' Consequent upon this cultural-intellectual globalization, the ahistorical, violent, individualistic, calculative and capitalistic logic of the metaphysics of technology is permeating (...) the life-world, even of the world's poorest peoples, in ways they could neither choose nor control. This volume questions the political ethics and justice of post-war development discourse in the light of the egalitarian aims of modern societies, cultural freedom of communities and nations, and the ecological limits of the planet. The final chapters discuss the alternative proposal of development as various conceptions of good life and equitable human flourishing amidst equally flourishing non-human life and non-living beings. This unique volume is the first book-length treatment of the ontology of modernization and development in the global south from a Heideggerian stance. (shrink)