S. I. Benn; VI*—Freedom, Autonomy and the Concept of a Person, Proceedings of the Aristotelian Society, Volume 76, Issue 1, 1 June 1976, Pages 109–130, https://.

“Evidence based medicine” is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content of EBM, (...) EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism. (shrink)

Background: Ethical dilemmas are an integral part of medicine. Whether physicians actually feel that they have made ethically problematic treatment decisions or choices in their work is largely unknown. Identifying physicians with ethical problems, and the types of problems and underlying factors, might benefit organisational and educational efforts to help physicians solve ethical dilemmas in a constructive way. We investigated how the frequency and types of ethically difficult treatment decisions vary by specialty.Method: A mail survey of all non-retired Finnish physicians (...) was conducted in 2004. Of those who had made any ethically problematic treatment decisions, the types of decisions and reasons given for these decisions were asked for. Factor analysis was used to investigate clustering of ethically problematic treatment decisions, and logistic regression to investigate the effect of specialty, adjusted for age and gender.Results: Psychiatrists experienced ethically problematic treatment decisions most frequently, followed by pulmonologists, internists and neurologists. Problems were reported least often by pathologists, laboratory physicians and ophthalmologists. Overtreatment was more common than undertreatment in most specialties, with the exception of psychiatrists who emphasised undertreatment and patient rights issues.Conclusion: Physicians of different specialties differ significantly regarding frequency and types of ethically problematic treatment decisions they have made. Psychiatrists differ from all other specialists in reporting more undertreatment and patient rights issues. Experiencing ethically problematic decisions might affect the quality of care and physician well-being in many ways. The findings could be useful for both under- and postgraduate ethics education. (shrink)

In Australia and Oregon, USA, legislation to permit statutory sanctioned physician-assisted dying was enacted. However, opponents, many of whom held strong religious views, were successful with repeal in Australia. Similar opposition in Oregon was formidable, but ultimately lost in a 60-40% vote reaffirming physician-assisted dying. This paper examines the human dilemma which arises when technological advances in end-of-life medicine conflict with traditional and religious sanctity-of-life values. Society places high value on personal autonomy, particularly in the United States. We compare the (...) potential for inherent contradictions and arbitrary decisions where patient autonomy is either permitted or forbidden. The broader implications for human experience resulting from new legislation in both Australia and Oregon are discussed. We conclude that allowing autonomy for the terminally ill, within circumscribed options, results in fewer ethical contradictions and greater preservation of dignity. (shrink)

ABSTRACT This paper is about the problem of the moral responsibility resting on any person to form rational beliefs about, and moral attitudes towards, the deterrent threat of mutual assured destruction (MAD), which still lies behind the graduated nuclear response strategies now more fashionably discussed by military experts. The problem is to decide what kinds of reasons there are, and how to arrive in the light of them at determinate conclusions about deterrence and unilateral disarmament. Consequential arguments would be powerful, (...) if only they were determinate; but not only do they not point conclusively to one strategy rather than another, there is not even sufficient reason for accepting one rather than another of the competing optimising criteria by which the strategies might be assessed. So the reasons of other kinds against forming a conditional intention to retaliate with a massive second strike could be conclusive, if retaliation itself could do no (consequential) good, and if, as is claimed, the conditional intention could not be simulated. To form such an intention is held to be contrary to core values of a humane, rationalist culture. To assent to a nuclear retaliatory strike would do violence to the moral nature of anyone participating in such a culture, and to form an intention to make (or condone) such a strike would be a corruption of such a nature. So too would condoning the fostering of such an intention in others, as a way of making the retaliatory intention credible. The author accordingly considers this argument against MAD, and for unilateral nuclear disarmament, sufficient, given the inadequacy of the consequential arguments, while acknowledging that this might involve great sacrifice. The paper concludes, however, by considering whether anyone can reject nuclear deterrence who also believes that resistance to Nazism in 1939 was justified, given the then prevailing belief that the war might be massively destructive. The author holds that there is no inconsistency in both supporting resistance to evil, even at risk of total destruction, and in refusing to form or condone a conditional intention to do equivalent but pointless evil in order to make a threat credible. (shrink)

I SHALL develop, in this article, certain distinctions suggested by recent contributions to the philosophical discussion of punishment, which help to clarify the issues involved. Having separated out what I consider the four central philosophical questions, I shall suggest an approach to them, which, while mainly utilitarian, takes due account, I believe, of the retributivist case where it is strongest, and meets the main retributivist objections.

Vizantiĭsʹkyĭ neoplatonizm i︠a︡k predmet relihii︠e︡znavchoho ta istoryko-filosofsʹkoho doslidz︠h︡enni︠a︡ -- Formuvanni︠a︡ vizantiĭsʹkoho neoplatonizmu u tvorakh Ĭoana Filopona (Dionisii︠a︡ Areopahita) -- Filosofii︠a︡ butti︠a︡ Maksyma Spovidnyka--kulʹminat︠s︡ii︠a︡ rozvytku vizantiĭsʹkoho neoplatonizmu -- Vizantiĭsʹkyĭ neoplatonichnyĭ esent︠s︡ializm kint︠s︡i︠a︡ VII-pochatku XIV stolitʹ -- Palamizm i︠a︡k osoblyva forma vizantiĭsʹkoho neoplatonizmu.

The interpretation of the crisis state of our society has occasioned numerous attempts to analyze its economic foundation—the nature, functions, and effectiveness of state ownership. The idea that various forms of ownership, private ownership included , can compete within the single economic system of Soviet society is now no longer a novelty. A number of economists insist that share-holding ownership is a possible and effective form of public ownership. The purpose of the present article is to attempt to demonstrate the (...) possibility and necessity of also permitting private capital within the structure of the emerging property relations in the Soviet economy. (shrink)

يقدم المؤلف لنا قانونا اجتماعيًا لعلماء النفس والاجتماع السياسي صاغه كالآتي: (إذا زاد عدد الأفراد الذين يمارسون تصرّفًا يعدّ خزيًا، وتساهل القانون في محاسبة مرتكبيه، وعجز الناس عن إيقافه أو وجدوا له تبريرًا، تحوّل إلى ظاهرة ولم يعد خزيًا كما كان). و من هذه العبارة التقديمية يمكن أن نؤكد أن هذا الكتاب لا يمكن إيفاءه حقه بنبذة موجزة، فهو سفر فكري ممتع، حيث يتناول المؤلف فيه بشكل تحليلي وعلمي مقنع أهم الموضوعات التي تشغل العقل العربي، ما بين شخصيات سياسية كصدام (...) وسليماني، وما بين فكرة الموت والانتحار، والبغاء والجريمة، والالحاد والإيمان، واللاوعي الجمعي العربي وما يحمله من أمراض وانحرافات، والتحرش والكبت، والفساد والسلطة، واللغة العربية والحضارة. (shrink)

Издание содержит: История исследования творчества в психологии; Феноменология творческой личности.

The prophylactic use of antibiotics has become a routine procedure in many areas of medicine. In neurosurgery, however, there is considerable debate over their use in the prevention of postoperative infection. We pose several ethical questions about antibiotic prophylaxis in a neurosurgical setting. These questions are discussed under the following categories: responsible usage of antibiotics; the ethical dilemmas of controlled, antibiotic clinical trials, and some problems inherent in not using prophylactic antibiotics.