Some theorists, worried about liberalism’s potential as a foundation for public health ethics, suggest that republicanism provides a better background of justification for public health policies, interventions, etc. In this article, this suggestion is put to the test, and it is argued that (i) contemporary (civic) republicanism and liberalism are not nearly as opposed as it is sometimes suggested, and that (ii) the kind of republicanism which one leading scholar in the field, Bruce Jennings, as an alternative to liberalism, does (...) not reflect the contemporary understanding of republicanism as held by, e.g. Phillip Pettit et al. (shrink)

If it is true, as suggested by Sir Michael Marmot and other researchers, that status impacts health and therefore accounts for some of the social gradient in health, then it seems to be the case that it would be possible to bring about more equality in health by equalizing status. The purpose of this article is to analyze this suggestion. First, we suggest a working definition of what status precisely is. Second, following a luck egalitarian approach to distributive justice, we (...) consider whether and to which extent individuals are responsible themselves for their position in a status hierarchy. Third, we consider the contours of a difficult question, namely which political measures are feasible in order to reduce health-affective inequalities in status and fourth, whether or to what extent such measures are legitimate. We argue that on the basis of these considerations, we have at least some prima facie reasons to counter (at least some) status inequalities in order to equalize health. (shrink)

We argue that on logical grounds the constructivist algorithms mentioned by Quartz & Sejnowski (Q&S) do not resolve the learning paradox. In contrast, a neural network might acquire a more powerful structure by means of phase transitions. The latter kind of developmental mechanism can be in agreement with the constructivist manifesto.

Paperback. The book treats two general questions: 1. Whether Erasmanism and Erasmian Humanism existed as a recognizable attitude during the sixteenth and early seventeenth centuries; 2. Whether Erasminism represented a definable middle way between the confessional conflicts of these times. How important was Erasmanism in these respects? The treatment of these two questions is geographically limited to those countries where Erasmus himself was active: Italy, The Netherlands, Holy Roman Empire, Switzerland and England.Erasmanism as a concept has hardly been studied before, (...) although the term is used freely by scholars of the early modern period. This book is a first attempt at a begriffsgeschichte of Erasminism. (shrink)

PURPOSE: To evaluate the effects of social support on comprehension and recall of consent form information in a study of Parkinson disease patients and their caregivers.DESIGN and METHODS: Comparison of comprehension and recall outcomes among participants who read and signed the consent form accompanied by a family member/friend versus those of participants who read and signed the consent form unaccompanied. Comprehension and recall of consent form information were measured at one week and one month respectively, using Part A of the (...) Quality of Informed Consent Questionnaire .RESULTS: The mean age of the sample of 143 participants was 71 years . Analysis of covariance was used to compare QuIC scores between the intervention group and control group . In the 1-week model, no statistically significant intervention effect was found . However, the intervention status by patient status interaction was statistically significant . In the 1-month model, no statistically significant intervention effect was found . Again, however, the intervention status by patient status interaction was statistically significant . At both time periods, intervention group patients scored higher on the QuIC than did intervention group caregivers, and control group patients scored lower on the QuIC than did control group caregivers.IMPLICATIONS: Social support played a significant role in enhancing comprehension and recall of consent form information among patients. (shrink)

The practice of coercive measures in psychiatry is controversial. Although some have suggested that it may be acceptable if patients are a danger to others or to themselves, others committed themselves to eliminate it. Ethical, legal and clinical considerations become more complex when the mental incapacity is temporary and when the coercive measures serve to restore autonomy. We discuss these issues, addressing the conflict between autonomy and beneficence/non-maleficence, human dignity, the experiences of patients and the effects of coercive measures. We (...) argue that an appeal to respect autonomy and/or human dignity cannot be a sufficient reason to reject coercive measures. All together, these ethical aspects can be used both to support and to reject a non-seclusion approach. The total lack of controlled trials about the beneficial effects of coercive measures in different populations however, argues against the use of coercive measures. (shrink)

The same research proposal was submitted to 24 district health authority (DHA) research ethics committees in different parts of the country. The objective was to obtain permission for a multi-centre research project. The study of neonatal care in different types of unit (regional, subregional and district), required that four health authorities were approached in each of six widely separated health regions in England. Data were collected and compared concerning aspects of processing, including application forms, information required, timing and decision-making. The (...) key finding was that ethics committees received and processed the applications variably, reflecting individual factors and local problems. To improve consensus and facilitate multicentre studies, standard forms and instructions are suggested and the establishment of a national committee or advisory group advocated. (shrink)

(...) . (shrink)

SummaryWe present a systematic discussion of the structural and conceptual simplifications of proofs of standard theorems afforded by nonstandard methods and examine to what extent the resulting nonstandard proofs satisfy the informal criterion of “plausibility”. We introduce the concept of a “standard detour” and show that all nonstandard proofs considered avoid such detours. Among the proofs examined are proofs of the Intermediate Value Theorem, the Riemann Integration Theorem, the Spectral Theorem for compact Hermitian operators, and the Arzela‐Ascoli Theorem.RésuméNous discutons systématiquement (...) les simplifications structurelles et conceptuelles apportées par des méthodes non standard aux démonstrations de théorèmes standard et examinons jusQuà quel point de telles démonstrations non standard satisfont à un critère informel de plausibilityé. Nous introduisons la notion de détour standard et montrons que toutes les démonstrations non standard considérées évitent de tels détours. Parmi les démonstrations examinées: celles du théoréme de la valeur intermédiate, du théorème ?on;intégration de Riemann, du théorème spectral pour les opérateurs hermitiques compacts et du théorème ?on;Arzelà‐Arcoli.ZusammenfassungWir stellen eine systematische Betrachtung der durch die Nichtstandard‐Methoden gegebe‐nen strukturellen und begrifflichen Vereinfachungen von Beweisen von Standardsätzen an, und untersuchen, wie weit die entstandenen Nichtstandard‐Beweise das informelle Kriterium der Plausibilität erfüllen. Wir führen den Begriff eines Standard‐Umweges ein, und zeigen, dass alle betrachteten Nichtstandard‐Beweise solche Umwege vermeiden. Unter den betrachteten Beweisen befinden sich Beweise des Zwischenwertsatzes, des Riemannschen lntegralsatzes, des Spektralsatzes für kompakte, hermitische Operatoren, und des Theorems von Arzelà‐Ascoli. (shrink)

Background and objectives: Physicians are exposed to matters of existential character at work, but little is known about the personal impact of such issues. Methods: To explore how physicians experience and cope with existential aspects of their clinical work and how such experiences affect their professional identities, a qualitative study using individual semistructured interviews has analysed accounts of their experiences related to coping with such challenges. Analysis was by systematic text condensation. The purposeful sample comprised 10 physicians (including three women), (...) aged 33–66 years, residents or specialists in cardiology or cardiothoracic surgery, working in a university hospital with 24-hour emergency service and one general practitioner. Results: Participants described a process by which they were able to develop a capacity for coping with the existential challenges at work. After episodes perceived as shocking or horrible earlier in their career, they at present said that they could deal with death and mostly keep it at a distance. Vulnerability was closely linked to professional responsibility and identity, perceived as a burden to be handled. These demands were balanced by an experience of meaning related to their job, connected to making a difference in their patients’ lives. Belonging to a community of their fellows was a presupposition for coping with the loneliness and powerlessness related to their vulnerable professional position. Conclusions: Physicians’ vulnerability facing life and death has been underestimated. Belonging to caring communities may assist growth and coping on exposure to existential aspects of clinical work and developing a professional identity. (shrink)

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was (...) used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

Aristotle and the sea battle, by G. E. M. Anscombe.--Aristotle's different possibilities, by K. J. J. Hintikka.--On Aristotle's square of opposition, by M. Thompson.--Categories in Aristotle and in Kant, by J. C. Wilson.--Aristotle's Categories, chapters I-V: translation and notes, by J. L. Ackrill--Aristotle's theory of categories, by J. M. E. Moravcsik.--Essence and accident, by I. M. Copi.--Tithenai ta phainomena, by G. E. L. Owen.--Matter and predication in Aristotle, by J. Owens.--Problems in Metaphysics Z, chapter 13, by M. J. Woods.--The meaning (...) of agathon in the Ethics of Aristotle, by H. A. Prichard.--Agathon and eudaimonia in the Ethics of Aristotle, by J. L. Austin.--The final good in Aristotle's Ethics, by W. F. R. Hardie.--Aristotle on pleasure, by J. O. Urmson.--Bibliography (p. 335-41). (shrink)

Categorical proof theory is an approach to understanding the structure of proofs. We illustrate the idea first by analyzing G0̈del's Dialectica interpretation and the Diller-Nahm variant in categorical terms. Then we consider the problematic question of the structure of classical proofs. We show how double negation translations apply in the case of the Dialectica interpretations. Finally we formulate a proposal as to how to give a more faithful analysis of proofs in the sequent calculus.

Changes being introduced to deregulate the Dutch health care system after decades of extensive state control are to be welcomed, and will in future require consumers to be ‘well‐informed, cost‐conscious and assertive patients, who are aware of their responsibility for their own health.’ R.B. Kool MD, PhD and E.J.J.M. Kimman PhD are attached to the Department of Business Ethics in the Faculty of Economics and Econometrics at The Free University, P.O. Box 7161, 10107 MC Amsterdam.