It has been demonstrated that death certificates do not accurately record the actual cause of death in up to one-fourth of cases, as determined from subsequent autopsy findings. The purpose of this study was to explore the use of natural language autopsy data bases as an automated quality assurance mechanism. We translated the account of the major process leading to death, or the primary diagnosis, from all 45,564 narrative autopsy reports obtained at The Johns Hopkins Hospital between May 28, 1889, (...) and June 30, 1987, into the hierarchical system of Medical Subject Heading (MeSH) titles. We obtained a total of 125,772 MeSH title translations, 1,563 of them distinct (average 2.8 per case), ranging in frequency from 6,029 occurrences of LUNG to 1 occurrence apiece of 357 MeSH titles. The natural-language-to-MeSH translations showed expected trends over the past century: fewer infectious diseases; more cardiovascular and neoplastic disease among adults; and more respiratory diseases and congenital malformations in the pediatric age group. The greater availability of autopsy documents in electronic form should increase the value of this resource for quality assurance. (shrink)

The mechanisms by which most receptor protein‐tyrosine kinases (RTKs) transmit signals are now well established. Binding of ligand results in the dimerization of receptor monomers followed by transphosphorylation of tyrosine residues within the cytoplasmic domains of the receptors. This tidy picture has, however, some strange characters lurking around the edges. Cases have now been identified in which RTKs lack kinase activity, but, despite being “dead” appear to have roles in signal transduction. Even stranger are the cases in which genes encoding (...) RTKs produce protein products consisting of only a portion of the kinase domain. At least one such “fractured” RTK appears to be involved in signal transduction. Here we describe how these strange molecules might function and discuss the questions associated with their evolution. BioEssays 23:69–76, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

In the past, hypothesis testing in medicine has employed the paradigm of the repeatable experiment. In statistical hypothesis testing, an unbiased sample is drawn from a larger source population, and a calculated statistic is compared to a preassigned critical region, on the assumption that the comparison could be repeated an indefinite number of times. However, repeated experiments often cannot be performed on human beings, due to ethical or economic constraints. We describe a new paradigm for hypothesis testing which uses only (...) rearrangements of data present within the observed data set. The token swap test, based on this new paradigm, is applied to three data sets from cardiovascular pathology, and computational experiments suggest that the token swap test satisfies the Neyman Pearson condition. (shrink)

'Justice' and 'democracy' have alternated as dominant themes in political philosophy over the last fifty years. Since its revival in the middle of the twentieth century, political philosophy has focused on first one and then the other of these two themes. Rarely, however, has it succeeded in holding them in joint focus. This volume brings together leading authors who consider the relationship between democracy and justice in a set of specially written chapters. The intrinsic justness of democracy is challenged, the (...) relationship between justice, democracy and impartiality queried and the relationship between justice, democracy and the common good examined. Further chapters explore the problem of social exclusion and issues surrounding sub-national groups in the context of democracy and justice. Authors include Keith Dowding, Richard Arneson, Norman Schofield, Albert Weale, Robert E. Goodin, Jon Elster, David Miller, Phillip Pettit, Julian LeGrand and Russell Hardin. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological (...) changes in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological (...) changes in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

My topic is authenticity in or perhaps as painting, not the authenticity of paintings; I know next to nothing about the problem of verifying claims of authorship. I am interested in another kind of genuineness and fraudulence, the kind at issue when we say of a person that he or she is false, not genuine, inauthentic, lacks integrity, and, especially when we say he or she is playing to the crowd, playing for effect, or is a poseur. These are not (...) quite moral distinctions (no one has a duty to be authentic), but they are robustly normative appraisals, applicable even when such falseness is not a case of straight hypocrisy but of lack of self-knowledge or of self-deceit. (A person can be quite sincere and not realize the extent of her submission to the other’s expectations and demands.) This sort of appraisal also has a long history in post-Rousseauist reflections on the dangers of uniquely modern forms of social dependence, and they are prominent worries in the modern novel. (shrink)

The twentieth century has marked transitions in the developed world from an agricultural to an industrial to an information-based society. As the primary work force has evolved from farmers to laborers to knowledge workers, the bases of wealth, power and social interaction have moved from land to mass production to e-commerce. Critical writings from Drucker''s The Age of Social Transformation to Fukuyama''s The Great Disruption, have discussed these transitions and their impact on values. This paper places the issue of downsizing (...) in the context of those discussions, exploring the ethical impact and role in those transitions of the author''s Four Horsemen of Downsizing: Suspicion, Acquisition, Budget-cuts, and Termination. Finally, it discusses Western society''s predilection to use language to construct an epistemological Tower of Babel and the impact that may have on Fukuyama''s conclusion that a Great Reconstruction based on Western values will replace the Great Disruption. (shrink)

The 'Art of Life' is John Stuart Mill's name for his account of practical reason. In this volume, eleven leading scholars elucidate this fundamental, but widely neglected, element of Mill's thought. Mill divides the Art of Life into three 'departments': 'Morality, Prudence or Policy, and Æsthetics'. In the volume's first section, Rex Martin, David Weinstein, Ben Eggleston, and Dale E. Miller investigate the relation between the departments of morality and prudence. Their papers ask whether Mill is a rule utilitarian (...) and, if so, whether his practical philosophy must be incoherent. The second section contains papers by Jonathan Riley and Wendy Donner, who explore the relation between the departments of morality and aesthetics. They discuss issues ranging from supererogation to aesthetic pleasure and humanity's relationship with nature. -/- The papers in the third section consider the Art of Life's axiological first principle, the principle of utility. Elijah Millgram contends that Mill's own life refutes his claim that the Art of Life has a single axiological first principle. Philip Kitcher maintains that Mill has a dynamic axiology requiring us to continually refine our conception of the good. In the final section, three papers address what it means to put the Art of Life into practice. Robert Haraldsson locates an 'Art of Ethics' in On Liberty that is in tension with the Art of Life. Nadia Urbinati plumbs the classical roots of Mill's view of the good life. Finally, Colin Heydt develops Mill's suggestion that we regard our own lives as works of art. (shrink)

We seek to change the conversation about brain death by highlighting the distinction between brain death as a biological concept versus brain death as a legal status. The fact that brain death does not cohere with any biologically plausible definition of death has been known for decades. Nevertheless, this fact has not threatened the acceptance of brain death as a legal status that permits individuals to be treated as if they are dead. The similarities between “legally dead” and “legally blind” (...) demonstrate how we may legitimately choose bright-line legal definitions that do not cohere with biological reality. Not only does this distinction bring conceptual coherence to the conversation about brain death, but it has practical implications as well. Once brain death is recognized as a social construction not grounded in biological reality, we create the possibility of changing the social construction in ways that may better serve both organ donors and recipients alike. (shrink)

This book examines the Condorcet Jury Theorem and how its assumptions can be applicable to the real world. It will use the theorem to assess various familiar political practices and alternative institutional arrangements, revealing how best to take advantage of the truth-tracking potential of majoritarian democracy.

Friesen et al. (2023) article explores tensions within institutional review boards (IRBs) when they aim both to protect participants from harm and to include under-represented populations in clinic...

“April is the cruelest month, breeding Lilacs out of the dead land, mixing memory and desire… ” So, begins T.S. Eliot’s iconic poem, “The Wasteland,” challenging the memory of Chaucer’s April from Canterbury Tales, as being a delightful month to go on pilgrimage. Platonic teachings emphasize that you don’t create, you just remember. Might the inverse might also be true, “You don’t remember, you just create.” As the oneirocritic, Robert Bosnak, contends, you do not actually remember your dreams. You (...) remember your memory you recreate the dream in this time. Since the challenges of post-modernism, this is no longer a far-fetched idea. The eminent historian of immigration, Deborah Dash Moore, defines history in this regard, as “a search for a plausible narrative.” “History” is not a record of what happened, but rather, is a record of what we believe happened, or what we want to believe happened. This brings to the fore Foucault’s documenting the relationship of knowledge to power, as well as Freud’s assertion that material which is unacceptable to the ego, is disguised, in order to make them palatable. This places the notion of memory in a different light. There are incidents that occurred fifty years ago that seem as if they occurred five minutes ago. The depth psychologist and champion of the imagination, James Hillman, referred to this process as “soul-making.” Back to T.S. Eliot: when he studied Sanskrit at Harvard, he was certainly aware that the Sanskrit word for memory, smara (from which smrti “that which is remembered,” is derived) is also an epithet for Kama Deva, the Indian Cupid. Hence, the mixing of memory and desire. Perhaps, in this light, the study of history, which is a form of collective memory, is also a form of mass therapy, an effort to process the collective past. Hegel and Marx both believed classical India to be an inferior civilization because it had “no history,” but collections of mythologies. Maybe classical India, however, held an awareness that all memory is myth, a word which in its early Greek form literally translates as “plot.” Jesus declares (in the Gospel story) “Let the dead bury the dead.” As the Jesus narrative exemplifies, however, burying the dead is no easy task. Perhaps our ongoing, ever-morphing narratives, allow us an oblique opportunity to connect with and process our pain. And in this theatre of memory, the goal may not be to accumulate or catalogue what has been spoken (itihasa), but look a good miller, to process the grain into its essence: from what has passed, and is passing, and is to come, into what always is. Perhaps, the pilgrimage of the mind, on its endless perigination of story, is meant to ultimately take us to love, but that may be unspeakable. Keywords: memory, desire, narrative, history, myth, power. (shrink)

This review confirms Herman’s work as a praiseworthy contribution to East-West and comparative philosophical literature. Due credit is given to Herman for providing English readers with access to Buber’s commentary on, a personal translation of, the Chuang-Tzu; Herman’s insight into the later influence of I and Thou on Buber’s understanding of Chuang-Tzu and Taoism is also appropriately commended. In latter half of this review, constructive criticisms of Herman’s work are put forward, such as formatting inconsistencies, a tendency toward verbosity and (...) jargon, and a neglect of seemingly important hermeneutical issues. Such issues, seemingly substantive but neglected by Herman, are the influence of Buber’s prior familiarity with Hasidic teachings on his encounter with Chuang-Tzu, as well as the prevalence of Hasidic and Taoist thought in Buber’s conception of good and evil. (shrink)

Mill's discussion of ‘the internal sanction’ in chapter III of Utilitarianism does not do justice to his understanding of internal sanctions; it omits some important points and obscures others. I offer an account of this portion of his moral psychology of motivation which brings out its subtleties and complexities. I show that he recognizes the importance of internal sanctions as sources of motives to develop and perfect our characters, as well as of motives to do our duty, and I examine (...) in some detail the various ways in which these sanctions give rise to motivating desires and aversions. (shrink)

_An accessible discussion of the thought of key figures of the Kyoto School of Japanese philosophy._.

Quantum field theories containing massless particles are divergent not just in the ultraviolet but also in the infrared. Infrared divergences are typically regarded as less conceptually problematic than ultraviolet divergences because there is a cancellation mechanism that renders measurable physical observables such as decay rates and cross-sections infrared finite. In this article, I scrutinize the restriction to measurable physical observables that is required to arrive at infrared finite results. I argue that the restriction does not necessitate a retreat to operationalism (...) about the meaning of the theory, but it does call attention to underappreciated features of the infrared regime. (shrink)

Utilitarianism, the great reforming philosophy of the nineteenth century, has today acquired the reputation for being a crassly calculating, impersonal philosophy unfit to serve as a guide to moral conduct. Yet what may disqualify utilitarianism as a personal philosophy makes it an eminently suitable guide for public officials in the pursuit of their professional responsibilities. Robert E. Goodin, a philosopher with many books on political theory, public policy and applied ethics to his credit, defends utilitarianism against its critics and (...) shows how it can be applied most effectively over a wide range of public policies. In discussions of such issues as paternalism, social welfare policy, international ethics, nuclear armaments, and international responses to the environment crisis, he demonstrates what a flexible tool his brand of utilitarianism can be in confronting the dilemmas of public policy in the real world. (shrink)

Revisioning macro-democratic processes in light of the processes and promise of micro-deliberation, Innovating Democracy provides an integrated perspective on democratic theory and practice after the deliberative turn.

The idea to produce the current volume was conceived by Jiirgen Mittelstrass and Robert E. Butts in 1978. Idealist philosophers are wrong about one thing: the temporal gap separating idea and reality can be very long indeed - even ten or so years! Problems of timing were joined by personal problems and by the pressure of other professional commitments. Fortunately, James Brown agreed to cooperate in the editing of the volume; the infusion of his usual energy, good judgement and (...) good-natured promptness saved the volume and made its produc tion possible. Despite the delays, the messages of the papers included in the book have not gone stale. An extremely worthwhile exercise in international philosophical cooperation has come to fruition; the German constructivist philosophical position is here represented in papers in English that will make its contemporary importance available to a larger audience. The editors owe thanks to many persons. All involved in the project owe much to the interest and support of Nicholas Rescher, a friend of the undertaking from the time of its inception. My review of the translations was helped immensely by Andrea Purvis' careful copy editing of the typescript. Most of all, however, we owe gratitude and admiration for the tireless efforts on behalf of this enterprise to Jiirgen Mittelstrass. (shrink)

Bracket out the wrong of committing a wrong, or conspiring or colluding or conniving with others in their committing one. Suppose you have done none of those things, and you find yourself merely benefiting from a wrong committed wholly by someone else. What, if anything, is wrong with that? What, if any, duties follow from it? If straightforward restitution were possible — if you could just ‘give back’ what you received as a result of the wrongdoing to its rightful owner (...) — then matters are morally more straightforward. But in real-world cases that is often impossible, and questions of ‘how much, from whom and to whom?’ become far more vexing. The beneficiary disgorging all benefits of the wrong is part of the story, but where that is not possible or will not suffice to compensate the victim of wrongdoing we discuss various ways of allocating the cost of making the victim whole, including supplementation from public coffers. (shrink)

Democracy used to be seen as a relatively mechanical matter of merely adding up everyone's votes in free and fair elections. That mechanistic model has many virtues, among them allowing democracy to 'track the truth', where purely factual issues are all that is at stake. Political disputes invariably mix facts with values, however, and then it is essential to listen to what people are saying rather than merely note how they are voting. The great challenge is how to implement that (...) deliberative ideal among millions of people at once. In this strikingly original book, Goodin offers a solution: 'democratic deliberation within'. Building on models of ordinary conversational dynamics, he suggests that people simply imagine themselves in the position of various other people they have heard or read about and ask, 'What would they say about this proposal?' Informing the democratic imaginary then becomes the key to making deliberations more reflective - more empathetic, more considered, more expansive across time and distance. (shrink)

Discusses the justification for a minimal welfare state independent of political rhetoric from the right or the left.

"How do we experience time? What do we use to experience it?In a series of remarkable experiments, Robert Ornstein shows that it is difficult to maintain an “inner clock” explanation of the experience".

In a well-known passage in chapter V of On Liberty, J. S. Mill notes that while economic competition is generally socially beneficial and should be permitted, this “Free Trade” doctrine does not follow from the liberty or harm principle because “trade is a social act.” In a largely overlooked passage in chapter IV of the same essay, however, Mill contends that for society to coercively prohibit the practice of piecework – paying workers by the unit rather than by the hour (...) or day – does violate this principle. In this short note, I demonstrate that Mill's reasoning in these two passages is contradictory. (shrink)