The issue of wrongful disability arises when parents face the choice whether to produce a child whose life will be unavoidably flawed by a serious disease or disorder (Down syndrome, for example, or Huntington’s disease) yet clearly worth living. The authors of From Chance to Choice claim, with certain restrictions, that the choice to produce such a child is morally wrong. They then argue that an intuitive moral approach––a “person-affecting” approach that pins wrongdoing to the harming of some existing or (...) future person––cannot account for that wrong since the choice to produce such a child cannot, under the logic of the nonidentity problem, harm that child. The authors propose that we supplement the person-affecting approach with an “impersonal” principle that takes the form of their well-known principle N. In this paper, I argue that the authors are mistaken to suppose that a plausibly articulated person-affecting approach cannot account for the wrong of wrongful disability. We can retain an intuitive, comparative, “worse for” account of harm and still identify serious harms imposed by the choice of wrongful disability. In particular, I argue that harm, both to the impaired child and to others, comes not in the form of that procreative choice’s procreative effect but rather in the form of its many distributive effects. I also argue that the rare, residual case in which a person-affecting approach would approve of the choice of wrongful disability does not function as a counterexample to that approach. As a separate matter, I address legal claims for wrongful disability, which are closely akin to claims for wrongful life. The legal claim is brought by the impaired child, not against the parents, but rather against health care providers whose negligent failure to diagnose or inform parents of an increased risk of a genetic or congenital impairment results in the birth of the impaired child. The authors’ treatment of the moral wrong that is done as impersonal in nature suggests that courts are correct to dismiss any such claim. Once we identify harm, however, the person-affecting approach can identify a clear foundation in the law for the wrongful disability claim. (shrink)

The idea of meaning plays, together with the notion of caring, a pivotal role in recent nursing theory, informing its approach to philosophy, research and practice. Unlike caring, however, it has received relatively little analytical attention – a fact that is surprising in view of the scepticism about meaning that is characteristic of much contemporary philosophy and social theory. This paper reviews the philosophical literature on meaning, highlighting sceptical currents in the Wittgensteinian corpus, neo‐behaviourism and poststructuralism. It also considers a (...) similar line of thought that has emerged in social theory, questioning the explanatory value of concepts such as ‘practice’, ‘culture’, ‘norms’, ‘tacit knowledge’, and ‘tradition’. All these perspectives suggest that there is something wrong with the common‐sense picture of a set of shared, implicit rules that account for our ability to understand and communicate; and they all point to an alternative picture which is naturalistic, materialist and causal, and which depicts ‘shared meaning’ as a rather mysterious quality, unable to explain the familiar regularities of verbal and nonverbal behaviour. In this picture, while the idea of meaning can be retained, it ceases to be something shared, and becomes something individual and idiosyncratic, a unique cluster of associations, concomitants, and other habits of thought. The paper closes with a brief interpretation of what the alternative implies for a research methodology in nursing. In particular, it proposes that certain well established approaches will have to be abandoned, and that qualitative strategies will have to be grounded in a rigorous scientific framework, rather than in techniques (such as phenomenology), which presuppose a misleading and inaccurate conception of what meaning is. (shrink)

Introduction : a divided discipline -- A genealogy of agency -- Reforming a paradigm : constructivism to rational constructivism -- A rational constructivist theory of identity and strategy -- Jerusalem : the unsubstitutable core value -- Jihad for Jerusalem : Israel the tiger 1967-1997 -- Jihad for Jerusalem : Iran the cub 1967-1997 -- Jihad for Jerusalem : Saudi Arabia the paper tiger 1967-1997 -- Jihad for Jerusalem : Jordan the mouse 1967-1997 -- Conclusion : the future of Jerusalem.

The framework of Findlay & Walker's target article provides a first attempt to model the saccadic system at all levels. Their scheme is based on two main principles. These are “parallel processing of saccade timing and metrics” and “competitive inhibition through winner-take-all strategies.” In our opinion, however, both concepts are in their strictest sense at odds with the current knowledge of the saccadic system, and need to be refined to make the scheme more relevant.

Although interesting, the hypotheses proposed by Phillips & Silverstein lack unifying structure both in specific mechanisms and in cited evidence. They provide little to support the notion that low-level sensory processing and high-level cognitive coordination share dynamic grouping by synchrony as a common processing mechanism. We suggest that more realistic large-scale modeling at multiple levels is needed to address these issues.

Tertiary healthcare ethics (HCE) consultation occurs when an HCE consultant at a healthcare facility requests guidance from one or more senior HCE consultants who are not members of that facility’s HCE consultation service. Tertiary HCE consultants provide advanced HCE guidance and/or mentoring to facility (secondary) HCE consultants, mirroring healthcare consultation in clinical practice. In this article, we describe advantages and challenges of providing tertiary HCE consultation through a hub-and-spoke model administered by a national integrated HCE service.

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

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

This article is a reconstruction of the key philosophical ideas of the Russian educationist I. P. Ivanov (1923-1992). We present a logical and methodological analysis of these ideas and demonstrate their connectedness to the practice of education and upbringing. These ideas are reinterpreted through the language of the modern philosophy of education.

The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ‘spirituality’ have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, I (...) adopt a different premise, rejecting unsupported claims, and surveying the ‘spirituality’ terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non‐naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology – resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. (shrink)

Книга предназначена для специалистов в области философии и феноменологии религии, христианской теологии, а также для студентов и аспирантов соответствующих специальностей.

For 150 years after Galileo's condemnation in 1633, there were many references to the trial, but no sustained, heated or polarized discussions. Then came the thesis that Galileo was condemned not for being a good astronomer but for being a bad theologian (using Scripture to support astronomical hypotheses); it began in 1784-1785 with an apology of the Inquisition by Mallet du Pan in the Mercure de France and the printing in Tiraboschi's Storia della letteratura italiana of an apocryphal letter attributed (...) to Galileo but forged by Onorato Gaetani. This thesis is not only untenable and false but inverts and subverts the truth; it proved to be long-lasting and widely accepted; so it may be labeled a myth. It was held by such writers as . Afterwards, it was generally abandoned, its death knell being pope John Paul II's speeches in 1979-1992. The myth seems to have acted as a catalyst insofar as its creation encouraged the proliferation of pro-clerical accounts and the articulation of pro-Galilean ones, thus making the discussion of Galileo's trial the cause celebre it is today. (shrink)

This book provides a clear and nuanced appraisal of Hegel's treatment of Africa, India, and Islam, and of the implications of this treatment for postcolonial and global studies. Analyzing Hegel's master-slave dialectic and his views on Africa, India, and Islam, it situates these views not only within Hegel's historical scheme but also within a broader European philosophical context and the debates they have provoked within Hegel scholarship. Each chapter explores various in depth readings of Hegel by postcolonial critics, investigating both (...) the Eurocentric and potentially global nature of his dialectic. Ultimately, the book shows both where of this profoundly influential thinker archetypally embodies certain Eurocentric traits that have characterized modernity and how, ironically, he himself gives us the tools for working towards a more global vision. Offering a concise introduction not only to an important dimension of Hegel's thought - his orientation towards "empire" - but also to the various issues raised by postcolonial theory and global studies, this book will be of use to philosophers as well as advanced students of literary and cultural theory alike. (shrink)

There is a theistic argument which is discussed at least twice in the Hume corpus, both times rather perfunctorily. This perfunctoriness has carried over to some of his commentators, who are not always clear as to what the argument is or about the force of Hume’s comments on it. On page 23 of A Letter from a Gentleman to his Friend in Edinburgh Hume calls it “the metaphysical Argument a priori” and in Part 9 of Dialogues concerning Natural Religion simply (...) “the argument a priori”.1 It is the argument of Demea. (shrink)

Для широкого круга читателей (слушателей, аспирантов, преподавателей) интересующихся данной проблемой.