_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:EDWARD W. STRONG, 1901--1990 Edward W. Strong, one.of the founders and leaders of the Journal of the HistoryofPhilosophy,passed away on January 13, 199o, after a long struggle with cancer. Born in Dallas, Oregon in 19~ 1, he was eighty-eight years old when he died. He did his undergraduate studies at Stanford, receiving his B.A. in 1925. Then he went on to graduate studies at Columbia, where he received a (...) master's degree in 1927 and a Ph.D. in 1937. He taught at City College in New York from 1927 to 1932, and then began his long career at the University of California, Berkeley, where he remained for the rest of his academic life. During World War II, he became laboratory manager of the university's Radiation Laboratory (now called the Lawrence Berkeley Laboratory), which was part of the Manhattan Project to develop the atomic bomb. After the war, Strong became a full professor in 1947, chairman of the Sociology Department from 1946 to 1952, Associate Dean of the College of Letters and Sciences from 1947 to 1955, a leader of the Academic Senate and its Educational Policy Committee, and Chancellor of the Berkeley campus from 1961 to 1965.This was a period of very rapid growth for the campus as well as its most troubled time. When the student rebellion--the Free Speech Movement--broke out, Strong tried valiantly but unsuccessfully to preserve those academic values he felt most challenged. As the conflict wore on, he ceased to have the full support of his superiors, the President of the Universityand the Board of Regents, who negotiated a resolution with the students, the effects of which are still being felt at Berkeley and elsewhere in the United States. Some feel that Strong's position in the struggle that transformed American universities has not been properly understood, and that his role has been portrayed unfairly to enhance that of his superiors. In any event, he resigned as Chancellor and became Professor Emeritus in 1967. Strong developed his interest in the history of philosophy, history of science, and history of ideas at Columbia during its heyday as a center for such concerns, under the leadership of John Dewey and Frederick Woodbridge. He told me that he was also very much influenced by the historical interests of Morris Raphael Cohen, his senior colleague at City College. His dissertation, Proceduresand Methods,was, and still is, a basic study of the origin and development of modern science. (It was mentioned approvingly in an article by Ernst [9] 10 JOURNAL OF THE HISTORY OF PHILOSOPHY 29:1 JANUARY 1991 Cassirer, in 194o). In contrast to E. A. Burtt, whose MetaphysicalFoundationsof ModernPhysicalSciencestressed the philosophical and theological concerns of the early scientists, Strong emphasized the practical engineering concerns that were involved at the time. This led him to studies of Kepler, Galileo, and Newton, as well as to the scientific views of medieval thinkers, and modern views in the philosophy of science. Philosophically he was a naturalist, continuing the Columbia tradition. He was also very interested in Bergson's views, especially as they related to modern scientific ideas. He was the inspirer and founder of the History of Science discussion group at Berkeley, which became an important forum for creative research in this area. Strong was President of the American Philosophical Association in 1959. Because of the limited attention and concern given to the history of philosophy in most of the then-existing philosophicaljournals in America, the American Philosophical Association in 1957 approved in principle the establishment of a journal devoted to the history of philosophy, and appointed a committee of six members--Paul Kristeller, Gregory Vlastos, Richard McKeon, Julius Weinberg, John Goheen, and Edward Strong--to explore "ways and means to this end." Since all American philosophical journals at that time were published in the East and Midwest, Strong and Goheen were encouraged to try to establish the journal in the West. Strong has detailed the efforts to do this in his article, "The Founding of theJournal oftheHistoryofPhilosophy,"Journalof theHistoryofPhilosophy~5 (1987): 179-83. I first met Ed Strong at Trinity College, Dublin, in the summer of 1953, when I was a... (shrink)

To each computable enumerable (c.e.) set A with a particular enumeration {As}s∈ω, there is associated a settling function mA(x), where mA(x) is the last stage when a number less than or equal to x was enumerated into A. One c.e. set A is settling time dominated by another set B (B >st A) if for every computable function f, for all but finitely many x, mB(x) > f(m₄(x)). This settling-time ordering, which is a natural extension to an ordering of the (...) idea of domination, was first introduced by Nabutovsky and Weinberger in [3] and Soare [6]. They desired a sequence of sets descending in this relationship to give results in differential geometry. In this paper we examine properties of the <st ordering. We show that it is not invariant under computable isomorphism, that any countable partial ordering embeds into it, that there are maximal and minimal sets, and that two c.e. sets need not have an inf or sup in the ordering. We also examine a related ordering, the strong settling-time ordering where we require for all computable f and g, for almost all x, mB(x) > f(mA(g(x))). (shrink)

What system of morals should rational people select as the best for society? Using a contemporary psychological theory of action and of motivation, Richard Brandt's Oxford lectures argue that the purpose of living should be to strive for the greatest good for the largest number of people. Brandt's discussions range from the concept of welfare to conflict between utilitarian moral codes and the dictates of self-interest.

Scholars of ethics, and of human behavior more generally, will find this book consistently stimulating and rewarding.

Richard Brandt is one of the most eminent and influential of contemporary moral philosophers. His work has been concerned with how to justify what is good or right not by reliance on intuitions or theories about what moral words mean but by the explanation of moral psychology and the description of what it is to value something, or to think it immoral. His approach thus stands in marked contrast to the influential theories of John Rawls. The essays reprinted in (...) this collection span a period of almost 30 years and include many classic pieces in metaethical and normative ethical theory. The collection is aimed at both those moral philosophers familiar with Brandt's work and at those philosophers who may be largely unfamiliar with his work. The latter group will be struck by the lucid unpretentious style and the cumulative weight of Brandt's contributions to topics that remain at the forefront of moral philosophy. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Richard Brandt is one of the most influential moral philosophers of the second half of the twentieth century. He is especially important in the field of ethics for his lucid and systematic exposition of utilitarianism. This new book represents in some ways a summation of his views and includes many useful applications of his theory. The focus of the book is how value judgments and moral belief can be justified. More generally, the book assesses different moral systems and theories (...) of justice, and considers specific problems such as the optimal level of charity and the moral tenability of the criminal law. This book will be essential reading for all professional philosophers concerned with ethics, and will prove helpful to students as well. (shrink)

Clouser and Gert’s 'A Critique of Principlism’ (1990) has ignited debate over the adequacy of substituting principlism for moral theory as a means for dealing with biomedical dilemmas. Clouser and Gert argue that this sort of substitution is not adequate to the task. I examine their argument in light of recent defences of principlism on this score, those of B. Andrew Lustig (1992), David Degrazia (1992), and Beauchamp and Childress (1994). I argue that both sides in the debate have assumed (...) differing conceptions of a moral theory that virtually guarantee their respective conclusions. These differing conceptions are motivated by antecedent epistemological commitments. The present debate over principlism is therefore inconclusive. Future discussion should focus on the underlying epistemological issues. (shrink)

Religious violence may trigger feelings of repulsion and indignation, especially in a society that encourages toleration and respect, but rejection contradicts the principles of inclusion that define a democracy and its core moral values. How can we think ethically about religious violence and terrorism, especially in the wake of such atrocities as 9/11? Known for his skillful interrogation of ethical issues as they pertain to religion, politics, and culture, Richard B. Miller returns to the basic tenets of liberalism to (...) divine an ethical response to religious extremism. He questions how we should think about the claims and aspirations of political religions, especially when they conflict so deeply with liberal norms and practices, and he suggests how liberal critics can speak confidently in ways that respect cultural and religious difference. Miller explores other concerns within these investigations as well, such as the protection of human rights and a liberal democratic commitment to multicultural politics. In relating religion and ethics, he develops a new lens for viewing political religions and their moral responsibilities. This probing inquiry also forces us to rethink our response to 9/11. (shrink)

In their paper, Hildt (2023) surveys several socio-ethical and regulatory issues arising from research into, and the potential emergence of, artificial consciousness—synthetic beings with a claim t...

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Opponents of the provision of therapeutic, healthy limb amputation in Body Integrity Identity Disorder cases argue that such surgeries stand in contrast to the goal of medical practice – that of health restoration and maintenance. This paper refutes such a conclusion via an appeal to the nuanced and reflective model of health proposed by Georges Canguilhem. The paper examines the conceptual entanglement of the statistically common with the normatively desirable, arguing that a healthy body can take multiple forms, including that (...) of an amputee, provided that such a form enables the continuing ability to initiate new norms of existence. It concludes that the practice of healthy limb amputation in cases of Body Integrity Identity Disorder is not only compatible with the goal of medicine but is potentially the only method of achieving this goal in the face of a complex and often mischaracterized disorder. (shrink)

Interventions are medically necessary when they are vital in achieving the goal of medicine. However, with varying perspectives comes varying views on what interventions are (un)necessary and, thus, what potential treatment options are available for those suffering from the myriad of conditions, pathologies and disorders afflicting humanity. Medical necessity's teleological nature is perhaps best illustrated in cases where there is debate over using contentious medical interventions as a last resort. For example, whether it is appropriate for those suffering from body (...) integrity dysphoria to receive healthy limb amputations. This paper explores how one's perception of medicine's goal underpins whether interventions are necessary or unnecessary, using the controversial topic of therapeutic amputation as an example. By contrasting ‘classical’ amputations with their more contentious counterparts, it highlights how the idea of medical necessity influences and restrains clinical decision-making. The paper starts by giving an account of body integrity dysphoria, focusing on the debate concerning elective amputation's justifiability. It then introduces Georges Canguilhem's vitalist theory of health, paying particular attention to his emphasis on adaptability. Then, this paper uses his theory as a lens through which to evaluate the appropriateness of therapeutic amputation as a medically necessary procedure. Ultimately, the paper highlights how the label of medical necessity is withheld from potential therapeutic interventions because they fail to conform to pre-established ideas of medicine's purpose and that by doing so, potential harm befalls those who are left with no effective treatments and must look for solutions in the non-clinical world. (shrink)

This paper explores the impact that developments in the field of neuroprosthetics will have on the ethical viability of healthy limb amputation, specifically in cases of Body Integrity Identity Dis...

In her paper, Robinson asserts that if one is convinced by the arguments assigning personhood according to a threshold criterion, one should also be open to the potential for a secondary personhood threshold, satisfied when one is pregnant, which confers temporary enhanced moral status. Rather than grounding such a claim on a fetus’s possession, or lack thereof, of personhood, Robinson argues that the pregnant person’s status as a ‘unique being’ is enough to satisfy the requirements of such an additional personhood (...) classification. 1 She justifies her claim via three arguments: (1) that the pregnant person is, in fact, more than a singular individual; (2) that pregnant people play a critical role in the human race’s continuation and (3) that the significant harms and burdens to which pregnant people have been exposed to historically and contemporary requires counterbalancing with enhanced protections. Unfortunately, despite Robinson’s best efforts, she does not... (shrink)

Systems-oriented social epistemology, studies epistemic systems in which individuals work together to determine the epistemic status (true, justified, true beyond a reasonable doubt, e...

We shall proceed as follows: In section ii, we shall give a brief over-view of the literature on Gilbert, more to indicate general directions of interest than to present any in-depth analysis. Then, in the main body of this presentation, section iii, we will present three ways in which we think it is accurate to claim that Gilbert influenced Descartes. These are: (1) Gilbert gave Descartes a new definition of an organ; (2) Gilbert gave Descartes a new definition of what (...) constitutes life and animation; (3) Gilbert gave Descartes a new view of natural motion. (shrink)

Cryopreservation presents the possibility of circumventing irreversible death through the body’s extreme cooling. Once cooled, this ‘cryon’ is then stored at sub-zero temperatures until medical kno...

Global human population expansion is rooted in a remarkably successful evolutionary innovation. The neolithic transformation of the natural world gave rise to a symbiosis between humans and their domesticated plant and animal partners that will expand from a current 20 per cent to 60 percent of terrestrial biomass by the middle of the coming century. Such an increase must necessarily be accompanied by a concomitant decrease in wildlife biomass. We suggest that current trends in population growth are unlikely to abate (...) for three reasons: first, there are intrinsic biological pressures to reproduce regardless of social engineering; second, the character of the domestic alliance makes it a formidable competitor to wildlife; and third, the timeframe before population doubling is, from a biological perspective, virtually instantaneous. This paper draws from a wide body of research in the biological and social sciences. We neither condone nor endorse this picture of inexorable population increase. Rather, we appeal for a change in the nature of the discussion of population among environmentalists, to focus on the question of how best to manage what wildlife will be left on the margins of a domesticated world. (shrink)

Business Ethics, the Environment & Responsibility, EarlyView.