Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

August Wilhelm von Schlegel, who did so much to rend the already torn artistic reputation of Euripides in the early nineteenth century, is singularly lenient in his criticism of the Hecuba. His adverse comment is limited to three points only: The first, that ‘the two actions of this piece—the sacrifice of Polyxena and the revenge on Polymestor on account of the murder of Polydorus—have nothing in common with each other but their connexion with Hecuba’; the second, that ‘the second half (...) destroys the soft impressions of the first in a highly repulsive manner’; and the third, that it is ‘not very suitable that Hecuba should display such presence of mind in her revenge.’ In this leniency he differs from one of the latest modern English critics, Professor G. Norwood,2 who does not hesitate to condemn the play as ‘on the whole poor and uninteresting,’ ‘far below the best of Euripides' work’; and from his great predecessor, J. J. Reiske, who condemned the play on ten distinct counts, all different from those that form the basis of SchlegeFs own argument. (shrink)

Spranger's Preliminary Skeleton List of the Manuscripts of Euripides mentions four gnomological manuscripts:The first and the third of these manuscripts contain miscellaneous excerpts of many classical and scriptural authors, arranged under various subject headings; though some of the excerpts are Euripidean, these manuscripts have no more right to be classified as Euripidean than have the manuscripts of Orion or Stobaeus. They are, therefore, wrongly included in Spranger's list.

Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen was used to assess fear and (...) violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500 g was defined as low birthweight and preterm birth as birth before completion of 37 weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 ]. Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not. (shrink)

The need to make young scientists aware of their social responsibilities is widely acknowledged, although the question of how to actually do it has so far gained limited attention. A 2-day workshop entitled “Prepared for social responsibility?” attended by doctoral students from multiple disciplines in climate science, was targeted at the perceived needs of the participants and employed a format that took them through three stages of ethics education: sensitization, information and empowerment. The workshop aimed at preparing doctoral students to (...) manage ethical dilemmas that emerge when climate science meets the public sphere (e.g., to identify and balance legitimate perspectives on particular types of geo-engineering), and is an example of how to include social responsibility in doctoral education. The paper describes the workshop from the three different perspectives of the authors: the course teacher, the head of the graduate school, and a graduate student. The elements that contributed to the success of the workshop, and thus make it an example to follow, are (1) the involvement of participating students, (2) the introduction of external expertise and role models in climate science, and (3) a workshop design that focused on ethical analyses of examples from the climate sciences. (shrink)

Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

It was with this bitter intervention from Thrasymachus, occurring halfway through the first of its ten Books, that that work begins to come urgently alive. For the remainder of Book I the Socrates of the Dialogue asks questions and raises objections, while Thrasymachus keeps urging that in fact the just become through their very justice the victims of exploitation–the suckers!

This paper describes the topological aspect of a logic-based, artificial intelligence approach to formalising the qualitative description of spatial properties and relations, and reasoning about those properties and relations. This approach, known as RCC theory, has been under development for several years at the University of Leeds. The main rationale for this project is that qualitative descriptions of spatial properties and relationships, and qualitative spatial reasoning, are of fundamental importance in human thinking about the world: even where quantitative spatial data (...) are most important, they must be attached to the components of a perceived spatial structure if we are to make use of them. RCC theory covers other qualitative aspects of spatial description and reasoning, but the topological properties and relations of spatially extended entities are fundamental to our work. The topological formalisms used by mathematicians are, in general, not well suited to the task of formalising the kinds of ‘common-sense’ or ‘everyday’ qualitative spatial description and reasoning which are our primary interest. Nevertheless, we must come to grips with the concepts of topology as practised by mathematicians if we are not to risk constantly ‘reinventing wheels’. (shrink)

Mitchell et al.'s claim, that their propositional theory is a single-process theory, is illusory because they relegate some learning to a secondary memory process. This renders the single-process theory untestable. The propositional account is not a process theory of learning, but rather, a heuristic that has led to interesting research.

No philosopher is needed to say where reality may be found. The fool no less than the wise man is in direct touch with real existence at every moment of his waking or dreaming life. To find reality might be a problem for timeless gods beyond the flux of nature—if timeless gods can be said to have problems—but natural creatures encounter reality at every turn. Nor need we look to the philosopher for knowledge. A division of labor having been made (...) between philosopher and scientist, it is to the scientist that we turn for most of our knowledge. Nevertheless, tasks for the philosopher remain and one of these is to make clear what knowledge is, for, to have knowledge is one thing; to know what knowledge is, is another. Science, we may safely assume, constitutes our best claim to knowledge but not all who know their science can say why it is knowledge. (shrink)

The literature of science speaks of many things in the heavens and on earth that neither the man in the street nor the scientist in his laboratory, can directly see with his eyes or touch with his fingers. Scientific hypotheses refer to atoms and genes, cosmic rays and electrostatic charges. No one can deny the importance of these hypothetical constructions; without them we could neither understand nor manage the world which we directly experience. They simplify the system of laws that (...) relate observable variables to one another. They suggest further research and enable us to predict what will be found if certain operations are carried out. The sporadic and disjointed collection of observed objects and events, and the occurrence of the unusual ones which we call illusions, are explained by correlating them with a hypothetical physical or physiological state of affairs that has order and spatio-temporal continuity. (shrink)

Bernard Williams argues that human mortality is a good thing because living forever would necessarily be intolerably boring. His argument is often attacked for unfoundedly proposing asymmetrical requirements on the desirability of living for mortal and immortal lives. My first aim in this paper is to advance a new interpretation of Williams' argument that avoids these objections, drawing in part on some of his other writings to contextualize it. My second aim is to show how even the best version of (...) his argument only supports a somewhat weaker thesis: it may be possible for some people with certain special psychological features to enjoy an immortal life, but no one has good reason to bet on being such a person. (shrink)