Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

New dimensions in different ethical scenarios following genetic information require new medical-ethical Action Guides for physician-patient interaction. This paper discusses the ambiguity in moral choice between a “right not to know” and “a duty to know”, regarding parental decisionmaking pro or contra selective abortion following prenatal screening for autosomal dominant polycystic kidney disease (Potter III) and related public policy issues.

The existence of consciousness in animals may have been overlooked. Continuity in consciousness between humans and animals is predicted by evolutionary theory. However, there are specific methodological difficulties associated with investigating such a phenomenon: it cannot be directly measured; animals, unlike humans, cannot directly tell us about their conscious experience; experiments which have made comparisons to human consciousness cannot detect consciousness of a different form; application of the law of parsimony in science has traditionally led to the conclusion that it (...) does not exist. (shrink)

Legal education in continental Europe -- The law of nature in European courts -- Legal education in England -- The law or nature in English courts -- Legal education in the United States -- The law of nature in American courts.

The German philosopher Rickert substituted for Hegel's formulation of the dialectic a "Heterological Principle of Thought" where identity and otherness become moments within the pure logical object of thought. The logical object of thought takes precedence over dialectical movement, and otherness takes precedence over negation. Flach expounds and defends Rickert's position against its critics. The discussion is specialized but contains some valuable insights into Hegel. --R. H. K.

Mole's (2008 [this issue]) argument that consciousness is a necessary concomitant of attention rests on the question of what is being attended in spatial attention. His answer is space. Some authors, including ourselves, claim that the fact that the processing of unseen objects can be modulated by spatial attention (e.g. Kentridge et al., 1999; 2004; 2008; Marzouki et al., 2007; Sumner et al., 2006) demonstrates that visual attention is not a sufficient precondition for visual awareness. Mole, however, contends that as (...) space, rather than any object that might occupy that space, is what is being attended, these experiments do not constitute evidence for a dissociation between attention and consciousness. We disagree. To understand the source of this disagreement we need to understand the various processes encompassed by the term 'attention' and to consider experimental evidence illustrating how these processes operate. We review evidence that spatial attention can be deployed with the specific goal of determining the properties of objects occupying the attended region of space. One might, for example, attend to a location with the goal of determining the colour of objects occupying that space as efficiently as possible. Mole's assumption that all that is attended in spatial attention is space is not consistent with this evidence. We conclude that attention can be directed at objects by mechanisms of so- called 'spatial attention' without those objects necessarily eliciting conscious visual experience and hence that attention is not a sufficient precondition for visual awareness. (shrink)

It may seem faintly absurd to claim or imply that a Vergilian cento has suffered unjustified neglect from scholars. These works—of which there are sixteen, covering a period of over three centuries within Late Antiquity—are usually treated at best with amused tolerance, and at worst with angry disdain. Though always ingenious, sometimes funny, and occasionally informative about the reception of Vergil, they are seldom admired. Even among Italian scholars, some of whom have paid much attention to centos, a recession has (...) set in since the annus mirabilis of 1981, which saw two editions of the Medea of Hosidius Geta. Proba has, deservedly, attracted more attention than most; her aims and methods as a Christian poetess were carefully and illuminatingly studied twenty years ago by Reinhard Herzog, and her interest as a female Roman aristocrat has brought her further attention, especially in recent years. The main aim of the present article is to suggest a particular context and a serious purpose for her cento. A postscript will show that it went on to enjoy considerable popularity until the end of the century, and an introductory section will discuss its date, but very briefly, since Matthews has convincingly said most of what needs to be said about a recent attempt to redate it. Proba's preface, much of it not in cento form, calls for detailed treatment from various angles—textual, literary, historical—and will be explored in a separate article. (shrink)

The cento of Proba has recently enjoyed a remarkable upsurge of scholarly interest. A welcome translation was provided in 1981, and an article of five years later, scrutinizing the evidence for its date and authorship, has aroused much controversy. In two recent contributions vindicating the traditional date new or more precise suggestions have been made about the poem's historical context. In between these, yet another article has argued, without confirming or refuting the revised dating and attribution, that in various ways (...) the work reflects the interest of the aristocratic ladies of the Anician family. And now there is a second article by Danuta Shanzer, repeating many of her early points and adding some interesting new ones. All this sudden attention is not unmerited, for as Herzog observed long ago the work is not of the comic or trivializing kind that Ausonius envisaged in his comments on the genre and does not degrade Vergil but rather, at least in the often quoted words of its prefatory poem, ‘improves’ him. (shrink)

I argue that the current view (as held by, eg., Warnock, Anscombe and Stenius) of Wittgenstein's theory of language in the Tractates is mistaken. This view maintains that Wittgenstein's theory is one of 'isomorphism'; that, roughly, a sentence has meaning in virtue of its being a facsimile of a fact or possible fact. But a detailed study of significant passages in the Tractattis shows that Wittgenstein held no such view. His use of important terms, such as Salz, Bild, Sachverhalt, Tatsache (...) , etc., has been crucially misunderstood. There is no isomorphism. The theory is not about sentences at all, but about talking sense. (shrink)