Next SectionWhilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems. The bioethics literature has (...) defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow. (shrink)

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant (...) both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice. (shrink)

Copyright © 2008 by International Union for Health Promotion and Education.

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine initiatives, it is (...) important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)

(No abstract is available for this citation).

Community-based healthcare organisations manage competing, and often conflicting, priorities. These conflicts can arise from the multiple roles these organisations take up, and from the diverse range of stakeholders to whom they must be responsive. Often such conflicts may be titled conflicts of interest; however, what precisely constitutes such conflicts and what should be done about them is not always clear. Clarity about the duties owed by organisations and the roles they assume can help identify and manage some of these conflicts. (...) Taking divisions of general practice in Australia as an example, this paper sets out to distinguish two main types of conflicts of interest, so that they may be more clearly identified and more effectively managed. (shrink)

Neglected and tropical diseases, pervasive in developing countries, are important contributors to global health inequalities. They remain largely untreated due to lack of effective and affordable treatments. Resource-poor countries cannot afford to develop the public health interventions needed to control neglected diseases. In addition, neglected diseases do not represent an attractive market for pharmaceutical industry. Although a number of international commitments, stated in the Millennium Development Goals, have been made to avert the risk of communicable diseases, tropical diseases still remain (...) neglected due to delays in international assistance. This delay can be explained by the form international cooperation has generally taken, which is limited to promoting countries’ national interests, rather than social justice at a global level. This restricts the international responsibility for global inequalities in health to a humanitarian assistance. We propose an alternative view, arguing that expanding the scope of international cooperation by promoting shared health and economic value at a global level will create new opportunities for innovative, effective and affordable interventions worldwide. It will also promote neglected diseases as a global research priority. We build our argument on a proposal to replace the patenting system that currently regulates pharmaceutical research with a global fund to reward this research based on actual decreases in morbidity and mortality at a global level. We argue that this approach is beneficent because it will decrease global health inequalities and promote social justice worldwide. (shrink)

This book addresses the problem of how to make democratically-legitimate public policy on issues of contentious bioethical debate. It focuses on ethical contests about research and their legitimate resolution, while addressing questions of political legitimacy. How should states make public policy on issues where there is ethical disagreement, not only about appropriate outcomes, but even what values are at stake? What constitutes justified, democratic policy in such conflicted domains? Case studies from Canada and Australia demonstrate that two countries sharing historical (...) and institutional characteristics can reach different policy responses. This book is of interest to policymakers, bioethicists, and philosophers, and will deepen our understanding of the interactions between large-scale socio-political forces and detailed policy problems in bioethics. (shrink)

ABSTRACTCertain restrictions on public funding for assisted reproductive technology are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein a source of moral (...) guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. (shrink)

Certain restrictions on public funding for assisted reproductive technology (ART) are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein (sometimes) a source (...) of moral guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. (shrink)

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions and consider the implications if the autonomy of drinking behavior is substantially compromised. Our discussion (...) demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

BackgroundThere is a growing concern about artificial intelligence (AI) applications in healthcare that can disadvantage already under-represented and marginalised groups (eg, based on gender or race).ObjectivesOur objectives are to canvas the range of strategies stakeholders endorse in attempting to mitigate algorithmic bias, and to consider the ethical question of responsibility for algorithmic bias.MethodologyThe study involves in-depth, semistructured interviews with healthcare workers, screening programme managers, consumer health representatives, regulators, data scientists and developers.ResultsFindings reveal considerable divergent views on three key issues. First, (...) views on whether bias is a problem in healthcare AI varied, with most participants agreeing bias is a problem (which we call the bias-critical view), a small number believing the opposite (the bias-denial view), and some arguing that the benefits of AI outweigh any harms or wrongs arising from the bias problem (the bias-apologist view). Second, there was a disagreement on the strategies to mitigate bias, and who is responsible for such strategies. Finally, there were divergent views on whether to include or exclude sociocultural identifiers (eg, race, ethnicity or gender-diverse identities) in the development of AI as a way to mitigate bias.Conclusion/significanceBased on the views of participants, we set out responses that stakeholders might pursue, including greater interdisciplinary collaboration, tailored stakeholder engagement activities, empirical studies to understand algorithmic bias and strategies to modify dominant approaches in AI development such as the use of participatory methods, and increased diversity and inclusion in research teams and research participant recruitment and selection. (shrink)

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

Department of Medical Education, Flinders University of South Australia, GPO Box 2100, Adelaide SA 5001. Tel. : +61-8-7225-1111; Fax: +61-8-8204-5675; Email: lee0359{at}flinders.edu.au ' + u + '@ ' + d + ' '/ /- ->.This paper analyses the role of communication strategies in pandemic influenza planning. Our central concern is with the extent to which nations are using communication to address issues of social justice. Issues associated with disadvantage and vulnerability to infection in the event of an influenza pandemic raise (...) distinct questions about how well less well off groups will be protected. The potential for a public health emergency of this type to exacerbate existing inequalities, making those in less well off positions worse off, makes social justice an important consideration for pandemic planners. National PI plans offer insights into the ways that nations may use communication to address issues of disadvantage, thereby providing a way of examining how communication strategies are presented and their potential to mitigate inequities. Our research reviewed 12 national PI plans and assessed the extent to which nations are using communication to assist and limit possible harms to less well off groups. We outline in this paper some important issues and considerations associated with social justice and flu planning, in particular if and how plans are addressing inequalities. CiteULike Connotea Del.icio.us What's this? (shrink)

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women (...) who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

Across the world, pain is under-treated in emergency departments. We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to an epistemic preference for signs over symptoms on the part of some practitioners, and some ED practices that themselves worsen pain (...) by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under-treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under-treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem-solve along lines pre-established by modern medical science. We conclude by touching on some potential solutions for ED practice. (shrink)

How does the advancement of the sciences relate to the ways in which their founding figures are remembered? According to the stark picture painted by Alfred N. Whitehead in 1917, “the establishment of a reverential attitude towards any statement made by a classical author” had barred the progress of logic for several centuries: “Scholars became commentators on truths too fragile to bear translation. A science which hesitates to forget its founders is lost”. In the eyes of many critics, Sigmund Freud's (...) psychoanalysis may well be an example of such a lost cause. From the founding book The Interpretation of Dreams to his very last statements, Freud never ceased to affirm that psychoanalysis was a science: “What else can it be?”. Yet not only the fact that he has become one of the classic authors of the twentieth century, but also a number of very specific traits of psychoanalytic institutions have nourished the suspicion that Freud was less the founder of a science than of a sort of quasi-religious movement, a secular sect thriving on a personality cult. (shrink)

ArgumentAnimals played an important role in the formation of psychoanalysis as a theoretical and therapeutic enterprise. They are at the core of texts such as Freud's famous case histories of Little Hans, the Rat Man, or the Wolf Man. The infantile anxiety triggered by animals provided the essential link between the psychology of individual neuroses and the ambivalent status of the “totem” animal in so-called primitive societies in Freud's attempt to construct an anthropological basis for the Oedipus complex in Totem (...) and Taboo. In the following, we attempt to track the status of animals as objects of indirect observation as they appear in Freud's classical texts, and in later revisionist accounts such as Otto Rank's Trauma of Birth and Imre Hermann's work on the clinging instinct. In the 1920s and 1930s, the Freudian conception of patients' animal phobias is substantially revised within Hermann's original psychoanalytic theory of instincts which draws heavily upon ethological observations of primates. Although such a reformulation remains grounded in the idea of “archaic” animal models for human development, it allows to a certain extent to empiricize the speculative elements of Freud's later instinct theory and to come to a more embodied account of psychoanalytic practice. (shrink)

Physicians, philosophers, and theologians consider how to address death and dying for a diverse population in a secularized century.Most of us are generally ill-equipped for dying. Today, we neither see death nor prepare for it. But this has not always been the case. In the early fifteenth century, the Roman Catholic Church published the Ars moriendi texts, which established prayers and practices for an art of dying. In the twenty-first century, physicians rely on procedures and protocols for the efficient management (...) of hospitalized patients. How can we recapture an art of dying that can facilitate our dying well? In this book, physicians, philosophers, and theologians attempt to articulate a bioethical framework for dying well in a secularized, diverse society.Contributors discuss such topics as the acceptance of human finitude; the role of hospice and palliative medicine; spiritual preparation for death; and the relationship between community, and individual autonomy. They also consider special cases, including children, elderly patients with dementia, and death in the early years of the AIDS epidemic, when doctors could do little more than accompany their patients in humble solidarity.These chapters make the case for a robust bioethics—one that could foster both the contemplation of finitude and the cultivation of community that would be necessary for a contemporary art of dying well.ContributorsJeffrey P. Bishop, Lisa Sowle Cahill, Daniel Callahan, Farr A. Curlin, Lydia S. Dugdale, Michelle Harrington, John Lantos, Stephen R. Latham, M. Therese Lysaught, Autumn Alcott Ridenour, Peter A. Selwyn, Daniel Sulmasy. (shrink)

_An exploration of philosophical and religious ideas about humor in modern philosophy and their secular implications._.

This book contributes to the contemporary revival of pragmatism as a practical and ultimately, as Mayer argues, necessary philosophical stance within democratic schools. Given that pragmatism addresses the question of how people can move forward in the absence of transcendent Truth, the author shows how pragmatism also-and not incidentally-provides grounds for pluralistic democratic societies to move forward in the absence of shared belief systems. Weaving together philosophical analysis and classroom discourse research, Mayer explores the relationships among pragmatism, progressive (...) educational theory, and democratic knowledge construction processes and their implications for enacting progressive educational practices in schools. Several original, research-based heuristics that can serve in reliably identifying, studying, and orchestrating distinctively democratic knowledge construction processes are presented. The importance of granting all students a share of interpretive authority is also emphasized. For in learning to observe and reflect on one's own terms, attend closely to the observations and interpretations of one's peers, and reason collaboratively in a transparent and principled manner, young people are enculturated into essential democratic values, commitments, and practices. This book is written for a general audience and is intended for all those concerned with strengthening the democratic character of schools and societies. It is likely to appeal to scholars, researchers, and practitioners with interests in philosophy and classroom discourse and curriculum studies, as well as philosophers of education and the social sciences more broadly. (shrink)

A Yale physician's fascinating and wise exploration of why so many people die poorly and how a medieval bestseller on the art of dying well holds important lessons for today.

Hermann von Helmholtz allows for not only physiological facts and psychological inferences, but also perspectival reasoning, to influence perceptual experience and knowledge gained from perception. But Helmholtz also defends a version of the view according to which there can be a kind of “perspectival truth” revealed in scientific research and investigation. Helmholtz argues that the relationships between subjective and objective, real and actual, actual and illusory, must be analyzed scientifically, within experience. There is no standpoint outside experience from which we (...) can reason, no extra-sensory knowledge of the constitution of the “ideal subject” or of the properties of “real objects.” In the tradition of psychophysics inherited by Helmholtz, we can arrive at a kind of perspectival analysis of perceptual experience, which embeds an account of that experience within the context of the history and situation of the perceiving subject. That analysis is relative to the perceiving subject, but the perspectival explanations Helmholtz constructs are not thereby relativist: in fact, for Helmholtz, the more squarely the perceiving subject is placed in a scientific, perspectival context, the more facts we are able to learn about her experience and the objects with which she interacts. (shrink)

The early history of German patriotism is complex and illuminates many of patriotism’s potential virtues as well as its dangers. Throughout the late eighteenth and early nineteenth centuries, patriotism’s overarching connotation was devotion to the greater good, but whether that greater was local, national, or global varied dramatically. Early uses of patriotism were devoid of national or military connotations and instead denoted local engagement in public projects and willingness to aid to those in need. The patriot moreover worked for enlightened (...) political reform, convinced that good government could convert subjects into citizens. Patriotism also had distinct cosmopolitan connotations, indicating someone who had humanity’s good generally as a goal. In the early aftermath of the French Revolution, acting in the interest of humanity’s development meant supporting the revolutionaries as the best hope for furthering political progress. As the Revolution dissolved into the Terror, German intellectuals hoped that Germany could assume the mantle of progress: being a patriot meant supporting German culture as a means of furthering humanity’s enlightenment. The Napoleonic Wars, however, shifted Germans’ attitude significantly: years of French occupation culminated in patriotism being defined as favoring German culture and unity in the interest of defeating the French. Patriotism’s nationalist connotations from that point intensify significantly. But its early history argues for remembering and revitalizing its potential to unite the local with the global and to promote enlightened civic engagement in the pursuit of political progress. (shrink)

In a famous debate between Thomas Kuhn and Karl Popper, Popper accused Kuhn and Quine of propagating the “Myth of the Framework”: that some broad set of specific background commitments are required for interlocutors to be able to have a fruitful conversation. The Myth of the Framework could be used to argue for a beneficial version of the canon: that training in these shared background commitments allows for the growth of a robust community of inquiry. Popper argues, however, that the (...) position that truth or inquiry can be framework-dependent is a pernicious form of relativism, and undermines the possibility of rational inquiry. I subject Popper’s view to criticism, showing that it can be used to undermine “orthodoxy” and the canon in some ways, but that it props up the canon in others. In closing, the paper examines the connections between Popper’s position on the community of inquiry and standpoint epistemology, and argues for the claim that Popper’s view, to be persuasive, requires a more robust account of how critical inquiry relies on the evaluative capacities of rational agents within a community. (shrink)

Taking Philosophy Seriously initiates a meta-philosophical dialogue that challenges the division between academic and practical philosophy. In contradistinction to the perfectionist tradition of philosophy, it offers a melioristic view of philosophy that rethinks the approach to philosophy, reinvigorates its academic teaching and secures the respectability of its practitioners outside the academe. It addresses the neglected topic of philosophers education through a subtle analysis of the mentor-apprentice relationship and the remedies philosophers have found to its tensions. It reveals the problems inherent (...) in emulating past practical philosophies from Alexandrian times, the Enlightenment or the 19th century, and the necessity of reevaluating the tools, reconsidering the means, and rethinking the methods of the contemporary practice of philosophy. To that purpose, it problematizes the notions of dialogue, self-knowledge, and self-transformation, and questions the feasibility of autonomy and self-integration as well as the differentiation between philosophy and psychology. It offers original solutions to the problems it highlights and points to unique benefits in the practice of philosophy that contribute to resolving the contemporary crisis of philosophy.This book combines high academic standards and an accessible style, and will engage academic and practical philosophers alike, professionals in education and the helping professions, and the general public. -- Provided by publisher. (shrink)

Calling on philosophers as the custodians of rationality to reconsider their responsibility toward their communities and the state of civilization at large, this book considers philosophy to be a practical discipline. Largely foreign to philosophers and non-philosophers alike, this conception of philosophy discloses the relevance of its unique contributions to contemporary society. The book offers a compelling and accessible analysis of philosophy also in relation to religion, psychology, the New Age Movement, and globalization, and exemplifies through a wide range of (...) current problems how philosophers can fulfil their responsibility. Its argument that responsibility lies where one is capable of doing what is needed, and even more so, when no one else can do it, targets philosophers. However, its innovative study of contemporary philosophy coupled with its original contributions to the problems at hand will engage academics and students from other disciplines, as well as a general readership. (shrink)

The growing contradictions inherent in capitalism are concentrated, as though at a focal point, in the monetary field—the most, vulnerable point in the whole capitalist economy. The extended period of the general crisis of capitalism is punctuated by periodic bursts of monetary crisis.

T. 1. Beim jungen Augustinus.--T. 2. Die antimanichäische Epoche.