Futile medical interventions have virtually no chance of success. Doctors might perform such procedures because of pressure from families or patients. The doctor might also have an ulterior motive of gain or prefer to do it rather than take time to communicate with the patient about a poor prognosis. Established ways to communicate bad news to patients are not always used by managing physicians with time constraints. The SPIKES protocol method is outlined to assist in sensitive communication where further intervention (...) is futile. This review primarily explores various aspects of medical futility. It also explores strategies for effectively communicating with patients and their families regarding futility interventions. A side-effect of futile interventions is burnout in doctors and other health practitioners (HPs). The complex relationship between futility and burnout is described. (shrink)

A set-theoretical proof of Gowers’ Dichotomy Theorem is presented together with its application to another dichotomy concerning asymptotic l 2 basic sequences.

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of (...) knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

The best-interests standard is a widely used ethical, legal, and social basis for policy and decision-making involving children and other incompetent persons. It is under attack, however, as self-defeating, individualistic, unknowable, vague, dangerous, and open to abuse. The author defends this standard by identifying its employment, first, as a threshold for intervention and judgment (as in child abuse and neglect rulings), second, as an ideal to establish policies or prima facie duties, and, third, as a standard of reasonableness. Criticisms of (...) the best-interests standard are reconsidered after clarifying these different meanings. (shrink)

This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the (...) social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure. (shrink)

Hans Kelsen est, sans conteste, le juriste le plus important de ce siècle. Il n'y a pas une seule question de théorie juridique qu'on puisse traiter aujourd'hui sans examiner d'abord l'analyse qu'il en fait, mais son œuvre ne concerne pas seulement le droit et la philosophie du droit ; elle touche aussi la philosophie politique, l'épistémologie, l'éthique ou la logique. Sa théorie du droit représente, à côté du réalisme, l'une des deux branches du juspositivisme moderne, connue sous le nom de (...) normativisme et que lui-même appelait " Théorie pure du droit ". Elle se donne comme une théorie scientifique qui se borne à décrire son objet, le droit positif, et qui donc est " pure " de tout jugement de valeur. La pureté ne concerne toutefois que la méthodologie. Le droit, lui, n'est nullement pur, car il exprime des choix moraux et politiques. La doctrine kelsenienne pure apparaît ainsi doublement politique : d'une part, elle se donne pour tâche de mettre en évidence la fonction idéologique du droit ; d'autre part, dans la mesure où elle analyse les dispositifs juridiques comme des moyens au service de certaines fins, elle peut servir de fondement à une véritable technologie juridique. C'est cette technologie que Kelsen prétendait appliquer à la politique et qui fonde aussi bien son travail de constituant - il est le père de la Constitution autrichienne et de la première Cour constitutionnelle - que ses écrits sur la démocratie. La Théorie générale du droit et de l'Etat présente à cet égard un intérêt exceptionnel. Elle a été écrite aux Etats-Unis, où Kelsen s'était réfugié au début de la Seconde Guerre mondiale. Comme le souligne Stanley L. Paulson dans son introduction, elle constitue une étape marquante dans l'évolution de sa pensée entre le néokantisme des origines et l'empirisme des derniers écrits. C'est aussi une présentation claire, systématique et concentrée de l'ensemble de sa doctrine et c'est le seul ouvrage de Kelsen qui porte à la fois sur les conditions de possibilité d'une science empirique du droit, sur la théorie générale du droit au sens strict - l'analyse structurale de tous les ordres juridiques possibles - et sur la théorie générale de l'Etat - l'analyse des concepts constitutifs de tout Etat possible. (shrink)

Several prominent voices have called for a democratization of science through deliberative processes that include a diverse range of perspectives and values. We bring these scholars into conversation with extant research on democratic deliberation in political theory and the social sciences. In doing so, we identify systematic barriers to the effectiveness of inclusive deliberation in both scientific and political settings. We are particularly interested in what we call misidentified dissent, where deliberations are starkly framed at the outset in terms of (...) dissenting positions without properly distinguishing the kinds of difference and disagreement motivating dissent. (shrink)

Bioethics is best viewed as both a second-order discipline and also part of public discourse. Since their goals differ, some bioethical activities are more usefully viewed as advancing public discourse than academic disciplines. For example, the “Universal Declaration on Bioethics and Human Rights” sponsored by the United Nations Educational, Scientific, and Cultural Organization seeks to promote ethical guidance on bioethical issues. From the vantage of philosophical ethics, it fails to rank or specify its stated principles, justify controversial principles, clarify key (...) terms, or say what is meant by calling potentially conflicting norms “foundational.” From the vantage of improving the public discourse about bioethical problems and seeking ethical solutions in the public arena, however, this document may have an important role. The goals and relations between bioethics as a second-order discipline and public discourse are explored. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

Numerous U.S. cities suffered immense fiscal strain following the subprime mortgage crisis and financial crash of 2007–8. Diminished revenues, tightened credit, and speculative financing that went bad in the aftermath fueled widespread fiscal distress on the local scale. Although the current moment resembles fiscal crises that crested in cities in the 1970s–90s, two factors distinguish the current period. First, municipal affairs have become thoroughly financialized—dominated by speculative securities and volatile debt arrangements—such that local crisis can no longer be understood apart (...) from financial market instability. Second, local fiscal politics have become increasingly removed from democratic oversight and control. This de-democratization hinders the capacity of political communities to reregulate markets and rebuild urban communities. An analytic model derived from the work of Hyman Minsky and Karl Polanyi emphasizes how cities become ensnared in a “financial instability” cycle and how communities seek to protect themselves by way of the “double movement.”. (shrink)

Two Community Development Corporations in Oakland, California, anchor the following analysis. These legally homogenous organizations have implemented similar “low-income” redevelopment projects widely hailed as representing a single successful blueprint for urban revitalization. Despite their similarities, however, these entities have produced starkly different socio-economic outcomes—a phenomenon traced to the CDCs' divergent internal structures and the contrasting external contexts of their development activities. These variations generated competing “logics” of redevelopment. On one hand, we find a CDC dominated by market-oriented interests and the (...) economic logic of exchange-values, while on the other, we find a CDC dominated by community-oriented interests and the social logic of neighborhood use-values. (shrink)

Self-monitoring theory explains the individual differences in using interpersonal adjustment techniques like self-control, self-regulation, and self-presentation. Self-monitoring plays a key role for understanding the social life. Therefore, it has been one of most popular research topics in social psychology. The aim of this study is to find out if there is a meaningful relationship between religious orientation and self-monitoring, and to determine the direction of the relationship if it exists. Besides, examining the effect of religious group membership on self-monitoring is (...) another aim of this study. In accordance with this purpose, Religious Orientation Scale and Revised Self-Monitoring Scale are applied to sample group which consists of 437 female and 369 male participants aged16 to 65+ living in Bursa. The results has revealed that there is a meaningful positive correlation between intrinsic religious orientation and self-monitoring. In addition, no meaningful relationship between religious group membership and self-monitoring has been confirmed.Summary: The adaptation process of the human being as a social creature starts in a mother's womb and becomes more complicated in consequence of coming into the world which is full of stimulus. In the beginning, this process has only a physical aspect, but with the inclusion of emotional, cognitive, and social factors over time turns into developmental tasks that people will struggle throughout their lives. The social development involves the process of becoming of the individual as an organic part of the society. As the individual realizes the existence of the other, he/she develops similar patterns of behavior that can be approved by the other. Because the meaningful relationships that form the backbone of social development constitute an important part of the self. Belonging is one of the main needs, that the individual shapes his emotions, actions, and decisions more or less in line with this need in order not to encounter the possibility of social exclusion. While belonging is a universal need for every healthy individual, there are differences between individuals in terms of directing the course of the relationship, role sharing, and using situational clues. Individual differences in how people construct interpersonal processes led Mark Snyder to systematize and theorize the concept of self-monitoring. Self-monitoring is a concept that expresses individuals' control of self-presentation, expressive behavior, and non-verbal emotional expression and their regulation. Accordingly, individuals with a high tendency to shape their behavior according to the context are classified as high self-monitors and those with low tendency are classified as low self-monitors. It can be said that adherence to religion, which is one of the determinants of social behavior, is related to self-monitoring. In this context, the main subject of this study is the relationship between self-monitoring and religiosity. The study aims to examine the effect of intrinsic-extrinsic religiosity on individuals' self-monitoring levels. Besides, as a form of religiosity, to reveal whether religious group religiosity affects self-monitoring, the study examines also self-monitoring levels of individuals belonging to the religious group and those who are not.The sample of the study was selected by a simple random sampling method and it consists of 806 participants aged 16 to 65+ living in Bursa in 2017. 437 (54.2%) of the participants in the research are women and 369 (45.8%) are men. In this study, a relational screening model was used for determining the presence, direction, and degree of the relationship between the variables. The questionnaire technique was preferred as the method of gathering information. The questionnaire was arranged in a way that does not require asking the participant any other questions apart from the questions on the form. The questionnaire form used in this research consists of 43 items. At the beginning of the questionnaire, there is a 9-item personal information form that includes demographic items consisting of age, gender, educational status, marital status, occupation, place of residence, socio-economic status, levels of subjective religious involvement, and religious group membership. For the measurement of self-monitoring, a 12-item "Self-Monitoring Scale", which was developed by Mark Snyder, revised by Richard Lennox and Raymond Wolfe and adapted by İlknur Özalp Türetgen and Sevim Cesur to Turkish (α =.80) was used. For the measurement of religious orientation, a 22-item “Religious Orientation Scale” developed by Gordon Allport and Michael Ross and adapted to Turkish by Fatma Gül Cirhinlioğlu was used (α =.90). Data collected through scales were processed by One Way Variance Analysis (ANOVA), t-Test, Pearson Correlation Analysis, and Simple Linear Regression Analysis and turned into research findings.According to the results of the simple linear correlation analysis conducted to reveal whether there is a relationship between the self-monitoring scores of the participants and the intrinsic religious orientation scores, there is a positive and significant relationship between the variables (r = 0.102, p = 0.004 0.05). The result of the correlation analysis between self-monitoring and the level of subjective religious involvement shows that no significant relationship is found (r = 0.051, p = 0.146> 0.05).This research expected that there was a negative relationship between self-monitoring and intrinsic religious orientation. However, the analyses has not reported anticipated results as addressed in the previous research. Therefore, this study opens the door for asking new questions about the subject. Religious groups, by their very nature, can refer the individual to self-presentation control, obedience, to act as deemed appropriate by the group, to adapt to the group, to change behavior without attitude change, and therefore, to attitude-behavior inconsistency. It can be argued that not only religious groups but, by their nature, all social groups create harmony-oriented pressure on the individual. Therefore, it can be predicted that belonging to a group, in general, may have a significant effect on the level of self-monitoring. The high self-monitoring scores of the participants, whether religious or non-religious group members of this study may have reduced the observability of the difference between the two groups. Therefore, repeating the study on a different sample may produce different results. (shrink)

In _Civilization and Its Discontents_, Freud made abundantly clear what he thought about the biblical injunction, first articulated in Leviticus 19:18 and then elaborated in Christian teachings, to love one's neighbor as oneself. "Let us adopt a naive attitude towards it," he proposed, "as though we were hearing it for the first time; we shall be unable then to suppress a feeling of surprise and bewilderment." After the horrors of World War II, the Holocaust, Stalinism, and Yugoslavia, Leviticus 19:18 seems (...) even less conceivable—but all the more urgent now—than Freud imagined. In _The Neighbor_, three of the most significant intellectuals working in psychoanalysis and critical theory collaborate to show how this problem of neighbor-love opens questions that are fundamental to ethical inquiry and that suggest a new theological configuration of political theory. Their three extended essays explore today's central historical problem: the persistence of the theological in the political. In "Towards a Political Theology of the Neighbor," Kenneth Reinhard supplements Carl Schmitt's political theology of the enemy and friend with a political theology of the neighbor based in psychoanalysis. In "Miracles Happen," Eric L. Santner extends the book's exploration of neighbor-love through a bracing reassessment of Benjamin and Rosenzweig. And in an impassioned plea for ethical violence, Slavoj Žižek's "Neighbors and Other Monsters" reconsiders the idea of excess to rehabilitate a positive sense of the inhuman and challenge the influence of Levinas on contemporary ethical thought. A rich and suggestive account of the interplay between love and hate, self and other, personal and political, _The Neighbor_ will prove to be a touchstone across the humanities and a crucial text for understanding the persistence of political theology in secular modernity. (shrink)

Much of the mathematics with which Felix Klein and Sophus Lie are now associated (Klein’s Erlangen Program and Lie’s theory of transformation groups) is rooted in ideas they developed in their early work: the consideration of geometric objects or properties preserved by systems of transformations. As early as 1870, Lie studied particular examples of what he later called contact transformations, which preserve tangency and which came to play a crucial role in his systematic study of transformation groups and differential equations. (...) This note examines Klein’s efforts in the 1870s to interpret contact transformations in terms of connexes and traces that interpretation (which included a false assumption) over the decades that follow. The analysis passes from Klein’s letters to Lie through Lindemann’s edition of Clebsch’s lectures on geometry in 1876, Lie’s criticism of it in his treatise on transformation groups in 1893, and the careful development of that interpretation by Dohmen, a student of Engel, in his 1905 dissertation. The now-obscure notion of connexes and its relation to Lie’s line elements and surface elements are discussed here in some detail. (shrink)

Context: Second-order cybernetics and its implications have been understood within the cybernetics community for some time. These implications are important for understanding the structure of scientific endeavor, and for researchers in other fields to see the reflexive nature of scientific research. This article is about the role of context in the creation and exploration of our experience. Problem: The purpose of this article is to point out the fundamental nature of the circularity in cybernetics and in scientific work in general. (...) I give a point of view on the nature of objective knowledge by placing it in the context of reflexivity and eigenform. Method: The approach to the topic is based on logical analysis of the nature of circularity. Mathematics and cybernetics are both fundamentally concerned with the structure of distinctions, but there can be no definition of a distinction without circularity, since such a definition would itself be a distinction. The article proceeds by explicating the structure of reflexive domains D where the transformations of the domain are in one-to-one correspondence with the domain itself. Results: I show that every element of a reflexive domain has a fixed point. This means that eigenforms arise naturally in reflexive domains. Furthermore, a reflexive domain is itself an eigenform (at a higher level. This supports the context of a second-order science that would study domains of science as part of a larger cybernetic landscape. Implications: The value of the article is in its concise reformulation of the scientific endeavor as a search for eigenforms in reflexive domains. This new view of science is promising in that it includes the former worlds of apparent objectivity and it embraces those newer worlds of science where the theories and theorists become active participants in the ongoing process of creating knowledge. Constructivist content: I argue that the perspective of reflexive domains constitutes a new way to think about the practice of science, with observers deeply imbedded, and objectivity understood as the mutual search for eigenforms. (shrink)

Lars Løvlie, Paul Standish; Introduction: Bildung and the idea of a liberal education, Journal of Philosophy of Education, Volume 36, Issue 3, 16 December 2002.

In lieu of an abstract, here is a brief excerpt of the content:Beyond Ratzinger's Republic:Communio's Postliberal TurnSam Zeno Conedera S.J. and Vincent L. Strand S.J.Is the political future of the West a postliberal one? For the past decade, numerous prominent thinkers in America and Europe have been debating this question. Matters that not long ago were merely of historical interest, such as Pope Gelasius I's understanding of the relation between sacral authority and royal power, Thomas Aquinas's thought on monarchy and (...) Robert Bellarmine's theory of the pope's indirect authority in temporal matters are now increasingly studied for their potential answers to contemporary political questions. This development, which would have been nearly unimaginable just a decade earlier, unsurprisingly has been led by Catholics. We say "unsurprisingly" in view of the long pre-modern tradition of Catholic political thought, as well as the Church's long struggle against liberalism during the nineteenth and early twentieth centuries. Some of the current postliberal writers explicitly connect themselves to both of these aspects by using the term "integralist" to describe their position.1 [End Page 889]This "new integralism" represents a radical departure from the mainstream of Catholic political discourse of the last half century, which has largely sought rapprochement with Western liberalism. A group of writers, led by John Courtney Murray, George Weigel, Michael Novak, and Robert George, have held that the American constitutional order is rooted in the natural law tradition, and therefore is basically friendly to Catholic political thought. The Church's role in American life, they say, is upholding the natural law as a public moral philosophy, while embracing the non-establishment clause of the First Amendment as a matter of principle, in accordance with the teachings of the Second Vatican Council. This "Whig Thomism," which for decades represented the predominant outlook of conservative American Catholics, must now face the challenge of a different sort of Thomism represented by the integralists.2While the engagement between Whig Thomists and integralists has received most of the attention from scholars and journalists alike, another postliberal option has emerged in recent years. Its source is a group of Catholic thinkers associated with the Communio theological movement. Their political vision, which has no single name or label, has a complex and subtle relationship with the thought of earlier Communio writers, most of whom shared the Whig Thomist desire for reconciliation with Western liberalism. [End Page 890] The appearance of a Communio postliberalism therefore represents a significant development within this intellectual tradition. The most important representative of the earlier Communio perspective on political questions is Joseph Ratzinger / Pope Benedict XVI, who has recently been lauded as the "most important Catholic thinker of the twentieth century" on matters at the intersection of theology and politics.3In an article titled "Ratzinger's Republic" that appeared in these pages in 2020, we identified a significant tension in his thought about the Church's contribution to political life.4 Exploring Ratzinger's writings on natural law, we demonstrated that two currents are present. In accord with his fundamental theological commitments about nature and grace and about faith and reason, Ratzinger often questioned the effectiveness of arguments from natural law. He claimed that, since reason is historically conditioned, and therefore in the current order marked by sin, reason needs grace and faith to function properly. Yet, on other occasions, Ratzinger strongly endorsed arguments from natural law, highlighting its role as the foundation of a just democratic political order. We traced this ambivalence about natural law back to a dilemma at the heart of Ratzinger's political thought. On the one hand, in accord with his thinking about the relations of nature and grace and faith and reason, Ratzinger argued that the state needs the Church to supply moral values that the state cannot furnish on its own. On the other hand, he believed it belongs to the very nature of the Church to be separate from the state, and he endorsed nonconfessional, religiously pluralistic states.5 In light of these two commitments, Ratzinger argued that the contribution Christians are to make to the state is to supply moral values that were discerned under the influence of grace and divine revelation but... (shrink)