A relative value of life dependent on age has been produced from a survey of 721 randomly selected individuals together with other observations of professional practice. The results are presented in diagrammatic form. If two identical people, except for age, present for medical treatment for a life-threatening condition and only one can be treated then the diagram indicates what the choice should be.

_The purpose _of the article is to introduce into scientific circulation works by Ukrainian scholar Taras Zakydalsky on the philosophy of Hryhorii Skovoroda. Taras Zakydalsky is a representative of the Ukrainian diaspora, philosopher, and member of Canadian NTSh (Shevchenko Scientific Society of Canada). _Theoretical basis._ We consider the uniqueness of H. Skovoroda’s philosophy, which stimulates not only intellectually but also spiritually enlightens the reader. The reasons for the complex perception and interpretation of Hryhorii Skovoroda’s philosophy are highlighted. We have verified (...) the main methods of its interpretation given in the works by Dmytro Chyzhevskyi. The influence of philosophical thought of thinkers of Antiquity and the Middle Ages: Aristotle, Epicurus, the Church Fathers, and Tertullian has been studied. We have comprehended H. Skovoroda’s interpretation of the Bible as a two-layer existence, the symbolic world that makes the foundation of his philosophy. The peculiarity of the thinker’s division of the heart into "internal" and "external" is analyzed. Hryhorii Skovoroda’s position on the Good and the evil is stated. The Good is identified with God, and the evil – with the real world, the man can choose between the two. Much attention is paid to the understanding of man as a microcosm – rational thinking, and thought is the fundamental cause of human activity, which generates all existence. Hryhorii Skovoroda’s philosophy of metaphysics as the existence of three worlds is highlighted: the first is the macrocosm (the whole surrounding world), the second is the microcosm (the man), and the third is the symbolic world (the Bible). "Monodualism" as a characteristic feature of H. Skovoroda’s work is analyzed. We have highlighted H. Skovoroda’s attitude to the transcendence of God, which is not separated from the world but is present in it directly. The understanding of faith as a forced act of self-love is analyzed because by loving ourselves we love God. The criteria for true and false faith have been clarified. The significance of H. Skovoroda’s aphorism that _what is necessary is useful, and not useful is unnecessary_ is considered. Examples of ethical principles in H. Skovoroda’s philosophy are considered. Peculiarities of the concept HAPPINESS are revealed. This concept is a universal means of existence of the Good, its source is gratitude to God. _Originality_ of the article is in the systematic presentation of the philosophy of the heart by Hryhorii Skovoroda and the analysis of the integrity of the "inner man", the true meaning of life as interpreted by Taras Zakydalsky. _Conclusions_ summarize the "anthropological pragmatism" of the philosopher, whose main idea is to apply practical skills for the benefit of society. (shrink)

We characterize strict Mittag-Leffler modules in terms of free realizations of positive primitive formulas, and rings over which projectives are trivial in terms of various notions of separability of strict Mittag-Leffler modules. © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Coastal ecosystems are increasingly dominated by humans. Consequently, the human dimensions of sustainability science have become an integral part of emerging coastal governance and management practices. But if we are to avoid the harsh lessons of land management, coastal decision makers must recognize that humans are one of the more coastally dependent species in the biosphere. Management responses must therefore confront both the temporal urgency and the very real compromises and sacrifices that will be necessary to achieve a sustainable coastal (...) ecosystem, one that is economically feasible, socially just, and ecologically sound. (shrink)

The cosmetics, detergents and food industries trial development products using healthy human volunteer studies. They also use human tissue for in vitro investigations. Hitherto, the ethics of such work has not been regulated. The UK Human Tissue Act will have legal implications on current arrangements for such studies within the industry, especially with regards to informed consent and seeking ethical review of research proposals. At present, however, it is unclear who will fund ethical review for use of ‘relevant material’ in (...) non-medical research, and on the required status of ethics committees to review such work. The principles behind the sampling, storage and processing of ‘relevant material’ are largely identical whether it be for medical or non-medical investigations. It is argued, therefore, that this is further justification for industry and professional bodies to adopt best practice of ethical review for all studies in ‘grey areas’ outside the scope of regulations. This would follow closely those standards applied to biomedical research. (shrink)

_ Source: _Volume 40, Issue 1, pp 104 - 115 It is intended in this study to present initial reliability and validity data for the Russian adaptation of the Multidimensional Inventory of Religious/Spiritual Well-being, as being related to personality factors and psychopathology. Therefore, the first version of the MI-RSWB-R was applied to a sample of 192 non-clinical subjects, together with the NEO Five Factor Inventory and the Symptom-Check-List. The original six-factor structure of the scale could be replicated for the MI-RSWB-R, (...) which also provides satisfying psychometric properties. In accordance with previous research the RSWB total score was linked to more favorable personality traits such as Extraversion, Openness to Experience, and Agreeableness, which was paralleled by substantial negative correlations with increased psychopathology. Our findings support the reliability and structural validity of the MI-RSWB-R as a standardized instrument for addressing the spiritual dimension in Russian populations. Further research in clinical surroundings is now recommended. (shrink)

The aim of this research was to gain insight into the experiences and perspectives of individual members of a Medical Research Ethics Committee regarding their individual roles and possible tensions within and between these roles. We conducted a qualitative interview study among members of a large MREC, supplemented by a focus group meeting. Respondents distinguish five roles: protector, facilitator, educator, advisor and assessor. Central to the role of protector is securing valid informed consent and a proper risk-benefit analysis. The role (...) of facilitator implies that respondents want to think along with and assist researchers in order to help medical science progress. As educators, the respondents want to raise ethical and methodological awareness of researchers. The role of advisor implies that respondents bring in their own expertise. The role of assessor points to contributing to the overall evaluation of the research proposal. Various tensions were identified within and between roles. Within the role of protector, a tension is experienced between paternalism and autonomy. Between the role of protector and facilitator tensions occur when the value of a study is questioned while risks and burdens for the subjects are negligible. Within the role of assessor, a tension is felt between the implicit nature of judgments and the need for more explicit formulations. Awareness of various roles and responsibilities may prevent one-sided views on MREC work, not only by members themselves, but also by researchers. Tensions within and between the roles require reflection by MREC members. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)

Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

Integrated information theory (IIT) is a candidate theory of consciousness that highlights the role of complex interactions between parts of a system as the basis of consciousness – and, due to its general information-theoretic formulation, is capable of making statements about consciousness in neural and non-neural systems alike. Here, we argue that a system radically different to a human brain, host to complex physiological and functional structures capable of integrating information, can be found in the meristems and vascular system of (...) higher plants. Following a pragmatic and ontologically innocent approach, neither taking for granted that plants are conscious nor dismissing the possibility that they are, we argue that the time is ripe to apply analysis tools inspired by IIT to plants, taking advantage of recent developments in both plant imaging and information theory. We introduce and discuss the relevant literature, and pro information and integration in plant behaviour, assessing the plausibility of plant sentience. If successful, these experiments could position plants as the next frontier in consciousness science, and urge us to rethink our perspectives on consciousness, how to measure it, and its prevalence amongst living beings. (shrink)

The normative significance of proximity in ethics is considered, giving an overview of the contemporary debates about proximity in ethics and focusing on three main perspectives that take proximity to have normative significance. The first perspective is represented by meta-ethical positions, where a basic moral claim is said to originate from an irreducible, particular and unique otherness that shows up in human vulnerability. The second perspective presents a psychologically and philosophically based analysis of human emotions, which is taken to form (...) a basis for rudimentary moral sensitivity and care. The third version of an ethics of proximity claims that personal relationships and partiality overrride impartialist and universalist ethical considerations. On the basis of this analysis, the sources of normativity and the essence of proximity as a normative consideration are elaborated. Finally, the relevance of an ethics of proximity to professional ethics in healthcare is discussed. From an ethics of proximity, it might be argued that institutions must attempt to organise medical care and nursing care so that a certain partiality and patient-centred care might be favoured and trump distributivist considerations of justice in healthcare. (shrink)

Objectives To investigate empirically the motivations for not consenting to DNA biobanking in a Swedish population-based study and to discuss the implications. Design Structured questionnaires and semistructured interviews. Setting A longitudinal epidemiological project (PART) ongoing since 1998 in Stockholm, Sweden. The DNA-collection wave took place during 2006–7. Participants 903 individuals completed the questionnaire (participation rate 36%) and 23 were interviewed. All individuals had participated in both non-genetic waves of the project, but refused to contribute saliva samples during the DNA-collection wave. (...) Main outcome measures Motivations behind refusing to consent to DNA biobanking, with subsequent focus on participants' explanations regarding this unwillingness. Results Public refusal to consent to DNA biobanking, as revealed by the questionnaire, was mainly explained by a lack of personal relevance of DNA contribution and feelings of discomfort related to the DNA being used for purposes other than the respective study. Interviews of individuals representing the second motivation, revealed a significant mistrust of DNA biobank studies. The underlying beliefs and attitudes were associated with concerns about integrity, privacy, suspiciousness and insecurity. However, most interviewees were supportive of genetic research per se and interpreted their mistrust in the light of distressing environmental influences. Conclusion The results suggest a need for guidelines on benefit sharing, as well as trustworthy and stable measures to maintain privacy, as a means for increasing personal relevance and trust among potential participants in genetic research. Measures taken from biobanks seem insufficient in maintaining and increasing trust, suggesting that broader societal measures should be taken. (shrink)

Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly life quality, (...) social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives. (shrink)

Ion channels are transport proteins present in the lipid bilayers of biological membranes. They are involved in many physiological processes, such as the generation of nerve impulses, hormonal secretion, and heartbeat. Conformational changes in the ion channel-forming protein allow the opening or closing of pores to control the ionic flux through the cell membranes. The opening and closing of the ion channel have been classically treated as a random kinetic process, known as a Markov process. Here the time the channel (...) remains in a given state is assumed to be independent of the condition it had in the previous state. More recently, however, several studies have shown that this process is not random but a deterministic one, where both the open and closed dwell-times and the ionic current flowing through the channel are history-dependent. This property is called long memory or long-range correlation. However, there is still much controversy regarding how this memory originates, which region of the channel is responsible for this property, and which models could best reproduce the memory effect. In this article, we provide a review of what is, where it is, its possible origin, and the mathematical methods used to analyze the long-term memory present in the kinetic process of ion channels. (shrink)

Ideal rods and clocks are defined as an infinitesimal symmetry of the spacetime, at least in the non-quantum case. Since no a priori geometric structure is considered, all the possible models of spacetime are obtained.