We construct a nonlow2 r.e. degree d such that every positive extension of embeddings property that holds below every low2 degree holds below d. Indeed, we can also guarantee the converse so that there is a low r.e. degree c such that that the extension of embeddings properties true below c are exactly the ones true belowd.Moreover, we can also guarantee that no b ≤ d is the base of a nonsplitting pair.

Being a patient and living a life -- Clinical space and traits of healing -- False starts and frequent failures -- Three journeys : A.'Ibuprofen and love', B. 'Staying tuned up', C. 'We all want the same things' -- Being a patient : the moral field -- Rethinking healthcare ethics : the patient's moral authority.

Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of 1502 (...) French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)

Shoemaker (1996) presenteda prioriarguments against the possibility of ‘self‐blindness’, or the inability of someone, otherwise intelligent and possessed of mental concepts, to introspect any of her concurrent attitude states. Ironically enough, this seems to be a position that Gopnik (1993) and Carruthers (2006, 2008, 2009a,b) have proposed as not only possible, but as the actual human condition generally! According to this ‘Objectivist’ view, supposed introspection of one's attitudes is not ‘direct’, but an ‘inference’ of precisely the sort we make about (...) the attitudes of others, an inference that has the advantage in our own case ofonlyour own sensory data and memories, our behavior, and of the context we are in; i.e. we are all substantially self‐ blind. After sorting out a number of methodological and verbal issues, I argue, first, that thea prioriarguments against Objectivism don't succeed, and that Gopnik and Carruthers are right to regard the issue as an empirical one. On the other hand, I think they seriously underestimate the difficulty of establishing Objectivism. It is unlikely there is an inferential procedure from the data of pure sensation, behavior and context to the relevant self‐attributions that would be as spectacularly reliable as people manifestly seem to be. Moreover, there is a simpler model: the mind very likely consists of a panoply of sub‐routines some of whose outputs are ‘tagged’ for their having been so processed, rather in the way that software ‘documents’ are on standard computers. Introspection plausibly consists in a person's simply attending to distinctive constellations of these tags, even though they may lack phenomenal feels. This draws attention to an important independent fact: that much of phenomenology (or ‘what it's like’ to be in a certain state) may be constituted by facts that are not phenomenal. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

Pain is not a primitive sensory event but rather a complexperception and a process by which a person interacts with theinternal and external environments, constructs meaning, andengages in action. Because folk beliefs are central to meaning,folk concepts of pain play multiple causal roles in a painpatient's interaction with health care providers and others.In every case, the notion of pain is linked to a goal-directedbehavior that is useful to the person. The wide variation inconcepts of pain across individuals suffering with painunderscores (...) the richness and complexity of the pain experience.In some cases involving chronic pain, the patient may form amaladaptive cluster of behaviors around the concept of pain.Patient beliefs and expectations are an important part of manychronic pain syndromes, and patients can benefit fromintervention directed at revising the individual's folk model of pain. Memetics offers a framework for identifying the memesthat patients hold and determining whether patient memes fitor clash with provider memes. (shrink)

Scholarly work in the area of the wisdom movement and its literature has opened up, in the last half-century, new vistas in Old Testament religion and theology. The research has progressed on such different fronts and intensified so rapidly that a survey charting its movement and achievement is necessary to appreciate the achievement and sense its implications.

In the last number of C.Q. Mr. A. D. Knox has drawn up a list of Theocriteans who, he suggests, ‘have all of them made the most elementary mistake’ of failing to consider the possibility at least that it is the Boy, and not the Fox, who is the subject of καθξ in Id. I. 51. From that list he will have to with-draw two names, Gow and Campbell. This construction, which Mr. Knox propounds as a novelty, had been suggested (...) by Mr. Gow in C.R. XLIV., pp. 9–10. For my part, I am not ingenious, and that syntactical possibility would no more have occurred to me independently than would Mr. Gow's three renderings of it, two of which are ‘until he sets her vinous breakfast upon a more solid basis’ and ‘until he sets her grapes on toast’; as little could I ever have thought, with Mr. Knox, of ‘the obvious necessity’ for this fox ‘of rest after a heavy meal’; still less of those further inevitable eventualities1 at which he hints with such delicacy in his quotation of Aelian V. 39. In regard to these and all such matters, to my mind ‘it were to consider too curiously to consider so.’ For even in Greek which represented for my ears some such English as ‘until she set him a-breakfastant upon the dries,’ if there was one thing with which I was completely satisfied it was with the Fox as subject; that seemed so perfectly in keeping both with the happy playfulness of the passage and with the richly idiomatic φατ as applied to a graven image of an animal. But from the fact that I criticized Mr. Gow's note it is obvious that I was familiar with his idea. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI).Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs.Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies.Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

Muhammed Kâsım Nânotevî başkanlığında kurulan Diyobendîlerin ta-savvuf ile irtibatını konu edinen bu çalışmanın temel amacı, Hint alt kıtasının dinî yaşantısında etkin olan Diyobendîlerin tasavvufa olan yaklaşımlarını analiz etmektir. Çalışmada öncelikle Diyobend’in kuruluşu, İngilizlere karşı mücadeleleri, Osmanlı Devleti ile temasları ve daha sonra Diyobendîlerin tasavvuf anlayışına dâir bilgilere yer verilmiştir. Onların tasavvuf ile ilişkileri araştırılırken literatür açısından Diyobendîler ile ilgili temel kaynaklara bakılmıştır. Bu kaynaklar geniş bir incelemeye tabi tutularak onların tasavvufa bakış açıları tespit edilmeye çalışılmıştır. Elde edilen sonuçlar kısaca şöyle (...) özetlenebilir: Sünnî olan Diyobendîler tasavvufu şerîatın bir parçası olarak görmektedirler. Onlar, mânevî hastalıklardan korunmak için tasavvufa sarılmaya, mürşidlerin sünnete ittibasına ve bid’atlardan uzak durmaya önem vermiş, ayrıca nübüvvetin velâyetten üstün olduğunu, kerâmetin hak olduğunu ve vahdet-i vücûdun tasavvufun esaslarından biri olmayıp bunun bir hâl olduğunu ifade etmişlerdir. Eğitim müfredatlarında tasavvuf klasiklerinin yanı sıra kendi mürşidlerinin yazdığı eserleri de okutan Diyobendîlerin tasavvufun birçok konusunda söz sahibi oldukları tespit edilmiştir. (shrink)

If a hereditary predisposition to colorectal cancer or breast cancer is diagnosed, most guidelines state that clinical geneticists should request index patients to inform their at-risk relatives about the existence of this condition in their family, thus enabling them to consider presymptomatic genetic testing. Those identified as mutation carriers can undertake strategies to reduce their risk of developing the disease or to facilitate early diagnosis. This procedure of informing relatives through the index patient has been criticised, as it results in (...) relatively few requests for genetic testing, conceivably because a certain number of relatives remain uninformed. This pilot study explored attitudes toward informing family members and relevant practices among clinical geneticists. In general, clinical geneticists consider it to be in the interests of family members to be informed and acknowledge that this goal is not accomplished by current procedures. The reasons given for maintaining present practices despite this include clinical ‘mores’, uncertainty about the legal right of doctors to inform family members themselves, and, importantly, a lack of resources. We discuss these reasons from an ethical point of view and conclude that they are partly uninformed and inconsistent. If informing relatives is considered to be in their best interests, clinical geneticists should consider informing relatives themselves. In the common situation in which index patients do not object to informing relatives, no legal obstacles prevent geneticists from doing so. An evaluation of these findings among professionals may lead to a more active approach in clinical practice. (shrink)

Bu çalışmada din görevlilerinin mesleki doyumu ile örgütsel adalet algısı arasındaki ilişki incelenmiştir. Çeşitli kurum çalışanları örnekleminde, yapılan çalışmalar örgütsel adalet ile mesleki doyum arasında bir ilişkinin olduğunu göstermektedir. Fakat din görevlileri ile ilgili olarak örgütsel adalet ile mesleki doyum arasındaki bir ilişkiyi konu edinen bir çalışmaya rastlanmamıştır. Yapılan işten memnuniyet duymak anlamına gelen mesleki doyum çalışanın iş verimini artırmaktadır. Bununla ilişkili olarak da çalışanın, kurumu tarafından çalışanlara adil davranıldığına ilişkin algısı mesleki doyumunu etkilemektedir. Bu çalışmada din görevlilerinin örgütsel adalet (...) algısı ve mesleki doyumu arasındaki ilişkiyi belirlemek için, ilişkisel tarama modeli kullanılmıştır. Veriler ise örgütsel adalet ölçeği, mesleki doyum ölçeği ve demografik değişkenlerin de bulunduğu bir form ile Antalya’da görev yapan 380 din görevlisinden elde edilmiştir. Söz konusu iki değişken arasındaki ilişkinin analizinde korelasyon ve yapısal eşitlik modeli kullanılmıştır. Çalışma sonucunda din görevlilerinin örgütsel adalet algısının, mesleki doyum ile orta düzeyde, pozitif yönde ve anlamlı ilişkisinin olduğu tespit edilmiştir. Açıklanan varyans açısından ise örgütsel adalet algısının, mesleki doyuma ilişkin toplam varyansın %17’sini açıkladığı belirlenmiştir. (shrink)

This book consists of a collection of essays written between 1965 and 1981. Some have been published elsewhere; others appear here for the first time. Although dealing with different figures and different periods, they have a common theme: all are concerned with examining how the method of hy pothesis came to be the ruling orthodoxy in the philosophy of science and the quasi-official methodology of the scientific community. It might have been otherwise. Barely three centuries ago, hypothetico deduction was in (...) both disfavor and disarray. Numerous rival methods for scientific inquiry - including eliminative and enumerative induction, analogy and derivation from first principles - were widely touted. The method of hypothesis, known since antiquity, found few proponents between 1700 and 1850. During the last century, of course, that ordering has been inverted and - despite an almost universal acknowledgement of its weaknesses - the method of hypothesis (usually under such descriptions as 'hypothetico deduction' or 'conjectures and refutations') has become the orthodoxy of the 20th century. Behind the waxing and waning of the method of hypothesis, embedded within the vicissitudes of its fortunes, there is a fascinating story to be told. It is a story that forms an integral part of modern science and its philosophy. (shrink)

"This book maps the moral terrain in the grounded reality of human experience without relying on theories or systems of ethics as the primary orienting strategy. Moral awareness needs first to be appreciated for what it is before it is made to conform to theories or systems. And moral consciousness is not a steady or stable set of perceptions; as we change so do the moral challenges that most concern us"--.

El artículo revisa las aportaciones más trascendentes que Jordi Ferrer ha hecho a la tradición racionalista de la prueba jurídica y evalúa críticamente el limitado papel que, desde su óptica, le corresponde desempeñar a la epistemología en la discusión general sobre los estándares de prueba apropiados para las distintas ramas del derecho. Más específicamente, se analiza la irrelevancia que Ferrer parece atribuir a dicha disciplina –o el silencio que debe guardar–, respecto del establecimiento del estándar de prueba deseable en materia (...) penal. Se concede que, en efecto, le corresponde al pueblo tomar la decisión de qué estándar implementar. No obstante, se sostiene, ello no impide que la epistemología incida en el proceso de formación de dicha decisión mediante la realización de observaciones, el ofrecimiento de argumentos y la propuesta de metodologías adecuadas, con miras a que aquella se tome en un contexto mejor informado y sea lo más racional posible. Se ilustra esta posición haciendo referencia al proyecto de epistemología jurídica de Larry Laudan. (shrink)

Three standard psychometric tests were administered to parents who volunteered their children for a randomised, double-blind placebo-controlled trial of a new asthma drug and to a control group of parents whose children were eligible for the trial but had declined the invitation. The trial took place at a children's hospital in Australia. The subjects comprised 68 parents who had volunteered their children and 42 who had not, a participation rate of 94 per cent and 70 per cent, respectively. The responses (...) of these parents to the Gordon Survey of Interpersonal Values Questionnaire, the Coopersmith Self-Esteem Inventory and the Cattell Sixteen Personality Factor Questionnaire were analysed by computer. There was a marked difference between the psychological profiles of the two groups of parents. Volunteering parents put more value on benevolence while non-volunteering parents were more concerned with power and prestige. The self-esteem of volunteering parents was much lower than that of non-volunteering parents. Finally, volunteering parents were more introverted, exhibited greater anxiety and low supergo, while non-volunteering parents appeared to have greater social confidence and emotional stability. Since an individual's values, self-esteem and personality may be important antecedents of behaviour, these findings suggest that parents who volunteer their children for clinical research are not only socially disadvantaged and emotionally vulnerable, but may also be psychologically predisposed to volunteering. Furthermore, these findings provide evidence for the existence of a psychosocial 'filter' effect of the informed consent procedure, which may be discouraging the better educated, more privileged and psychologically resilient members of society from participation as research subjects. (shrink)

Three standard psychometric tests were administered to parents who volunteered their children for a randomised, double-blind placebo-controlled trial of a new asthma drug and to a control group of parents whose children were eligible for the trial but had declined the invitation. The trial took place at a children's hospital in Australia. The subjects comprised 68 parents who had volunteered their children and 42 who had not, a participation rate of 94 per cent and 70 per cent, respectively. The responses (...) of these parents to the Gordon Survey of Interpersonal Values Questionnaire, the Coopersmith Self-Esteem Inventory and the Cattell Sixteen Personality Factor Questionnaire were analysed by computer. There was a marked difference between the psychological profiles of the two groups of parents. Volunteering parents put more value on benevolence while non-volunteering parents were more concerned with power and prestige. The self-esteem of volunteering parents was much lower than that of non-volunteering parents. Finally, volunteering parents were more introverted, exhibited greater anxiety and low supergo, while non-volunteering parents appeared to have greater social confidence and emotional stability. Since an individual's values, self-esteem and personality may be important antecedents of behaviour, these findings suggest that parents who volunteer their children for clinical research are not only socially disadvantaged and emotionally vulnerable, but may also be psychologically predisposed to volunteering. Furthermore, these findings provide evidence for the existence of a psychosocial 'filter' effect of the informed consent procedure, which may be discouraging the better educated, more privileged and psychologically resilient members of society from participation as research subjects. (shrink)