Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients’ ability to comprehend (...) complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17%) would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician’s decision as to whether to comply with a patient’s AD. Conclusions Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient’s initial wishes and preferences expressed by the AD. (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)

For most observers of economics from both inside and outside the science, the term ‘economics’ is synonymous with neoclassical economics. It is the methodology of neoclassical economics that defines the discipline of economics. ‘Mainstream economics’ is neoclassical economics and anyone entering the discipline today who wishes to obtain an appointment at one of the leading universities of the world is well advised to master its techniques. The fact that virtually every winner of a Nobel prize from Paul Samuelson up to (...) his student Joseph Stiglitz has been a practitioner of neoclassical economics is ample proof of the methodology’s triumph. Despite the dominance of this methodology, however, neoclassical economics has been subject to a steady stream of criticisms and proposals for alternative methodological approaches throughout its life. This article focuses on two relatively recent challenges to the neoclassical orthodoxy that seem to have taken hold of a non-negligible minority of the profession, some of whom can be found at leading universities. These two challenges come from behavioural economics and evolutionary economics. The article describes the strengths and weaknesses of both of these methodological approaches and contrasts them with that of neoclassical economics. It concludes that all three methodologies have something positive to contribute to the study of human behaviour. Key Words: neoclassical economics • behavioural economics • evolutionary economics. (shrink)

BackgroundAn analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.MethodsIn order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These statements (...) were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.ResultsOf 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).ConclusionsFew US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS. (shrink)

Is it possible that all of the social sciences could employ a common methodology? If so, what would it be? This article adresses these questions. It takes off from James Coleman’s recent book, The Foundations of Social Theory. Coleman’s social theory is built on the postulate that individuals are rational actors, the same postulate that most of modern economics is built upon. This article critiques the use of this postulate in economics, and thus questions whether it is a useful building (...) block for the methodological foundations of social science research. It proposes an adaptive view of human behavior as an alternative in which preferences are conditioned by past experience. The work of Joseph Schumpeter is discussed as an exemplar of the methodology advocated here. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bibliography of Resources by and about André E. Hellegers*Compiled by Doris Mueller Goldstein (bio)This bibliography is derived from the holdings of the National Reference Center for Bioethics Literature and the BIOETHICSLINE© database (both of which are at the Kennedy Institute of Ethics and supported by the National Library of Medicine); the archives of Lauinger Library, Georgetown University; the Medline databases of the National Library of Medicine; the WorldCat database (...) of OCLC, Dublin, Ohio, and selected Internet sites.Primarily comprised of writings by Dr. Hellegers, the list also includes interviews and media programs in which he participated, as well as writings about him that were written following his death. The arrangement within each section is by date. The 231 authored pieces reflect the transition from Dr. Hellegers’s early career as a researcher in fetal physiology at Johns Hopkins Medical School, where he published his first research report at the age of 29, to the early years of the Kennedy Institute, where he produced so many provocative columns on bioethical issues that influenced the growth of the field.Due to the diversity of sources and the 40-year time span covered, there are some variations in bibliographic style. Time and availability constraints precluded verifying all of the citations with the original documents. Any additions or corrections should be submitted to the compiler.Works Authored by André E. HellegersNo Date Ethical Issues in Sterilization of the Retarded. Unpublished paper.1956Vitamin B12 Serum Level and Pregnancy. American Journal of Clinical Nutrition 4: 440+, 1956. [With Bacon F. Chow and Kunio Okuda] [End Page 89]1957Vitamin B12 Absorption in Pregnancy and in the Newborn. American Journal of Clinical Nutrition 5: 327+, 1957. [With Bacon F. Chow, Robert E. L. Nesbitt, Kunio Okuda, and David W. Smith]1958The Effects of Acute Hypoxia on the Osmotic Pressure of the Plasma. Quarterly Journal of Experimental Physiology 43: 197+, 1958. [With Donald H. Barron, Frederick C. Battaglia, and Giacomo Meschia]Studies on the Absorption of Vitamin B12 in Human Pregnancy with Especial Reference to the Effect of D-Sorbitol. American Journal of Obstetrics and Gynecology 76: 91+, 1958. [With Bacon F. Chow, Harry Prystowsky, and Vernon Wong]1959The Alveolar PCO2 and PO2 in Pregnant and Nonpregnant Women at Altitude. Proceedings of the Society for Clinical Investigation 38: 1010+, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky]A Comparison of the Oxygen Dissociation Curves of the Bloods of Maternal and Fetal Goats at Various pHs. Quarterly Journal of Experimental Physiology 44: 215–21, July 1959. [With Donald Barron, Giacomo Meschia, Harry Prystowsky, and A. Stark Wolkoff]Fetal Blood Studies. XII. On the Relationship Between the Position of the Oxygen Dissociation Curve of Human Fetal Blood and Adult Fetal Hemoglobin. American Journal of Obstetrics and Gynecology 77: 585+, 1959. [With Paul D. Bruns, Julian Cotter, and Harry Prystowsky]Fetal Blood Studies. XIV. A Comparative Study of the Oxygen Dissociation Curve of Nonpregnant, Pregnant and Fetal Human Blood. American Journal of Obstetrics and Gynecology 78: 489–93, September 1959. [With Paul D. Bruns and Harry Prystowsky]Fetal Blood Studies. XVI. On the Changes in Total Osmotic Pressure and Sodium and Potassium Concentration of Amniotic Fluid During the Course of Human Gestation. Surgery, Gynecology and Obstetrics 109: 509–12, October 1959. [With Frederick Battaglia, Paul D. Bruns, Harry Prystowsky, and Clayton Smisson]Further Observations on the Metabolism of Vitamin B12 in Human Pregnancy. American Journal of Obstetrics and Gynecology 77: 1+, 1959. [With Bacon F. Chow, Harry Prystowsky, Bruno Ranke, and Elma Ranke]The Oxygen Dissociation Curves of the Bloods of Adult and Fetal Llamas. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky] [End Page 90]Transfer of Oxygen Across the Sheep Placenta at High Altitude. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, and Harry Prystowsky]Uterine Blood Flow and Metabolism in Pregnant Sheep at High Altitude. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky]Uterine Blood Flow and Metabolism in Unanesthetized Pregnant Sheep. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo... (shrink)

Two things about Hilary Putnam have not changed throughout his career: some (including Putnam himself) have regarded him as a “realist” and some have seen him as a philosopherwho changed his positions (certainly with respect to realism) almost continually. Apparently, what realism meant to him in the 1960s, in the late seventies and eighties, and in the nineties, respectively, are quite different things. Putnam indicates this by changing prefixes: scientific, metaphysical, internal, pragmatic, commonsense, but always realism. Encouraged by Putnam’s own (...) attempts to distinguish his views from one time to another, his work is often regarded as split between an early period of “metaphysical realism” (his characterization) and a later and still continuing period of “internal realism”. Late Putnam is understood to be a view that insists on the primacy of our practices, while the early period is taken to be a view from outside these, a “God’s Eye view”. As Putnam himself stresses (1992b), this way of dividing his work obscures continuities, the most important of which is a continuing attempt to understand what is involved in judging practices of inquiry, like science, as being objectively correct. Thus Putnam’s early and his current work appear to have more in common than the division between “early” and “late” suggests. In fact, Putnam’s earlier writings owe much of their critical force to his adopting the pragmatic perspective of an open-minded participant in practices of empirical inquiry, a stance not explicitly articulated in these writings but rather taken simply as a matter of course.1 Thus insofaras Putnam’s early writings defend a form of representational realism, they can be regarded as attempts to articulate a realist position at work inside our ordinary practices of making empirical judgments. For this reason, we begin our review of Putnam’s realisms by extracting from the early writings a core of principles that carries over into his current work but underwent significantly different interpretations over time.. (shrink)

In his critical study of Speusippus Leonardo Tarán (T.) expounds an interpretation of a considerable part of the controversial books M and N of Aristotle's Metaphysics. In this essay I want to consider three aspects of the interpretation, the account of Plato's ‘ideal numbers’ (section I), the account of Speusippus’ mathematical ontology (section II), and the account of the principles of that ontology (section III). T. builds his interpretation squarely on the work of Harold Cherniss (C.), to whom I will (...) also refer. I concentrate on T. because he has brought the ideas in which I am interested together and given them a concise formulation; he is also meticulous in indicating the secondary sources with which he agrees or disagrees, so that anyone interested in pursuing particular points can do so easily by consulting his book. (shrink)

This bibliography signals a monumental event in philosophical research and for the future of comparative philosophy, East and West. It is in effect the first volume of the proposed multi-volumed Encyclopedia of Indian Philosophies which has been inaugurated with this research tool. The outline of the bibliography will constitute the table of contents for the subsequent volumes of the forthcoming encyclopedia, now being written by an international team of scholars. The entire enterprise is sponsored by the American Institute of Indian (...) Studies and is under their general supervision. The bibliography, which has taken five years to complete and consists of 9222 entries, will be revised periodically as more material is compiled from the Indian languages and as contemporary work continues. Since Indian thought systems do not clearly differentiate between religious and philosophical expression, the compiler limited his selections to the Indian darsanas and vyakaranas. Indian literature is included if it is philosophical throughout, theoretical in function, and expository in content. This excludes the more didactic literature such as religious scriptures and classics. Three general sections divide the work: Sanskrit texts with authors known; Sanskrit texts with authors unknown; secondary literature arranged according to the various philosophical schools. General sections on Jainism, the traditions of Buddhism, and Hinduism offer philosophical sources for the major Indian religions. The listings are chronological within a particular subject. This not only facilitates additions to the bibliography but also gives a focus to scholarly discussion on a particular point. The work ends with three indices: Index of Names of Persons; Index of Titles ; Index of Books and Articles. The final index should prove the most useful to the researcher and general scholar. The publishing of the bibliography, done in India and according to Indian standards, is inferior in binding and paper stock. The price, Rs.80., has been listed in American bookstores at various prices from $18.00 to $24.00 for those who do not wish to order directly from the Indian publisher. The American Institute of Indian Studies should be commended for directing this work and every effort should be made for the completion of the entire encyclopedia. In terms of Asian studies it is the most significant publishing venture since the appearance of Max Mueller’s Sacred Books of the East over a century ago. Mueller opened the world of Asian religions to Western investigation while this bibliography should expose the breadth of Indian philosophy both in its intrinsic value and its effect upon world philosophy.—W. C. C. (shrink)

The historical antecedents of Frege's treatment of binocular vision in "The thought" were the physiological writings of Johannes Mueller, Hermann von Helmholtz, and Emil du Bois-Reymond. In their research on human vision, logic was assigned an unexpected role: it was to be the means by which knowledge of a world extended in three dimensions arises from stimuli that are at best two-dimensional. An examination of this literature yields a richer understanding of Frege's insistence that a proper epistemology requires us to (...) recognize the existence and importance of nonsensible sources of knowledge. (shrink)

M. Tulli Ciceronis libri qui ad rem publicam et ad philosophiam spectant; vol. ix. Cato Maior de Senectute, Laelius de Amicitia; 50 Pf. vol. x. De Officiis; 80 Pf. ed. Th. Schiche, Leipzig, Freytag.M. Tulli Ciceronis Orationes Selectae; vol. i. Oratio pro Sex. Roscio Arnerino; 30 Pf. vol. ii. In Q. Caecilium Diuinatio, in C. Verrem Accusationis, Lib. iv. v.; ed. H. Nohl; 80 Pf. Leipzig, Freytag.M. Tulli Ciceronis Scripta quae remanserunt omnia. Recognovit C. F. W. Mueller. Partis ii. vol. (...) iii. Leipzig, Teubner, 1886. 2 Mk. 10. (shrink)

Philosophers readily talk about merely verbal disputes, usually without much or any explicit reflection on what these are, and a good deal of methodological significance is attached to discovering whether a dispute is merely verbal or not. Currently, metaphilosophical advances are being made towards a clearer understanding of what exactly it takes for something to be a merely verbal dispute. This paper engages with this growing literature, pointing out some problems with existing approaches, and develops a new proposal which builds (...) on their strengths. (shrink)

I argue that mind-independence realism should be characterised in terms of what I call 'essential', rather than 'modal', independence from our mental lives. I explore the connections between the two kinds of independence, and argue that characterizations in terms of essence respect more intuitions about what realism is, harmonize better with standard characterizations of anti-realism, and avert the threat of subversion from Blackburn's quasi-realist.

In recent work Timothy Williamson argues that the epistemology of metaphysical modality is a special case of the epistemology of counterfactuals. I argue that Williamson has not provided an adequate argument for this controversial claim, and that it is not obvious how what he says should be supplemented in order to derive such an argument. But I suggest that an important moral of his discussion survives this point. The moral is that experience could play an epistemic role which is more (...) epistemically significant than a mere 'enabling' role but not equivalent to an evidential role. (shrink)

In 1896 William James published an essay entitled The Will to Believe, in which he defended the legitimacy of religious faith against the attacks of such champions of scientific method as W.K. Clifford and Thomas Huxley. James's work quickly became one of the most important writings in the philosophy of religious belief. James Wernham analyses James's arguments, discusses his relation to Pascal and Renouvier, and considers the interpretations, and misinterpretations, of James's major critics. Wernham shows convincingly that James was unaware (...) of many destructive ambiguitities in his own doctrines and arguments, although clear and consistent in his view that our obligation to believe in theism is not a moral but a prudential obligation -- a foolish-not-to-believe doctrine, rather than a not-immoral-to-believe one. Wernham also shows that the doctrine is best read as affirming the wisdom of gambling that God exists, a notion which James failed to distinguish from believing and which, among other things, he explicitly identified with faith. James's pragmatism, a theory concerning the meaning of truth, is shown to be quite distinct from the doctrine of The Will to Believe. In concentrating on a careful analysis of this doctrine of the will-to-believe, Wernham not only makes a major contribution to understanding James's philosophy, but also clarifies issues in the philosophy of religion and in the analysis of belief and faith. (shrink)

This reconsideration of Hume’s classic essay “Of Miracles” via the lens of American pragmatist ways of thinking about history and power shifts our attention from Hume’s epistemic concerns about the legitimacy of witnesses and testimony to his distaste for sacred history, his critical stance regarding the social force of revelation, and his disdain for religious authority. To view Hume’s essay both as an articulation of a critical philosophy of history and as an exercise in moral dynamism (social power or, authority, (...) is a result of epistemic transactions), is to intervene in both Hume studies and Contemporary Pragmatism. (shrink)

In vitro meat, or cultured meat, is one of the ideas that are being proposed to help solve the problems associated with the ever growing global meat consumption. The prospect is a source or great moral hope, but also generates doubts and criticism. In this paper, we focus on worries about the alleged unnaturalness of in vitro meat; and the possible deterioration of our relations with nature and animals. We will argue that arguments about naturalness take us to any conclusion (...) we want. As to our relations with nature and animals, we think it more plausible that cultured meat will lead to improvement than to deterioration. (shrink)

In 1896 William James published an essay entitled The Will to Believe, in which he defended the legitimacy of religious faith against the attacks of such champions of scientific method as W.K. Clifford and Thomas Huxley. James's work quickly became one of the most important writings in the philosophy of religious belief. James Wernham analyses James's arguments, discusses his relation to Pascal and Renouvier, and considers the interpretations, and misinterpretations, of James's major critics. Wernham shows convincingly that James was unaware (...) of many destructive ambiguitities in his own doctrines and arguments, although clear and consistent in his view that our obligation to believe in theism is not a moral but a prudential obligation -- a foolish-not-to-believe doctrine, rather than a not-immoral-to-believe one. Wernham also shows that the doctrine is best read as affirming the wisdom of gambling that God exists, a notion which James failed to distinguish from believing and which, among other things, he explicitly identified with faith. James's pragmatism, a theory concerning the meaning of truth, is shown to be quite distinct from the doctrine of The Will to Believe. In concentrating on a careful analysis of this doctrine of the will-to-believe, Wernham not only makes a major contribution to understanding James's philosophy, but also clarifies issues in the philosophy of religion and in the analysis of belief and faith. (shrink)

Originally published in 1944, this book was originally intended as a continuation of the 1943 publication Nautical Mathematics, which is also reissued in this series. In it, the principles set out in Nautical Mathematics are given practical applications, and the text is supplied with exercises to test and clarify the lessons. This book will be of value to anyone with an interest in the history of education in the forces during WWII.

The authors present a case study involving truth telling responsibilities in the setting of nonepileptic seizures. Specifically, over the course of several suspected nonepileptic seizures, a patient’s seizures stopped after he received a saline flush meant to precede the administration of anti-seizure medication. The patient and his surrogate believed he had received the medication each time, and the team wondered whether they should disclose the truth. Some worried that disclosure would reinforce the suspected psychogenic behavior, exacerbating the patient’s condition. In (...) this way, the case study presents a twist on the traditional truth telling archetype. While most truth telling cases center on navigating cultural differences or worries about emotional harm, this case presented concerns about medical harm in the form of exacerbating the patient’s condition. The authors describe the complex patient-family-team dynamic that preceded this ethical dilemma, describe the case, analyze the ethical issue, and describe the outcome. (shrink)