Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, (...) and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences. Results Data were collected from 8308 of 11 620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9). Conclusions Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

Because of his profound sense of wonder and celebration, there is much in Chesterton's religious writings that is fresh and pertinent to contemporary discussion.

This paper obtains the weak completeness and decidability results for standard systems of modal logic using models built from formulas themselves. This line of work began with Fine (Notre Dame J. Form. Log. 16:229-237, 1975). There are two ways in which our work advances on that paper: First, the definition of our models is mainly based on the relation Kozen and Parikh used in their proof of the completeness of PDL, see (Theor. Comp. Sci. 113-118, 1981). The point is to (...) develop a general model-construction method based on this definition. We do this and thereby obtain the completeness of most of the standard modal systems, and in addition apply the method to some other systems of interest. None of the results use filtration, but in our final section we explore the connection. (shrink)

This article enlarges classical syllogistic logic with assertions having to do with comparisons between the sizes of sets. So it concerns a logical system whose sentences are of the following forms: Allxareyand Somexarey, There are at least as manyxasy, and There are morexthany. Herexandyrange over subsets (not elements) of a giveninfiniteset. Moreover,xandymay appear complemented (i.e., as$\bar{x}$and$\bar{y}$), with the natural meaning. We formulate a logic for our language that is based on the classical syllogistic. The main result is a soundness/completeness theorem. (...) There are efficient algorithms for proof search and model construction. (shrink)

We construct logical languages which allow one to represent a variety of possible types of changes affecting the information states of agents in a multi-agent setting. We formalize these changes by defining a notion of epistemic program. The languages are two-sorted sets that contain not only sentences but also actions or programs. This is as in dynamic logic, and indeed our languages are not significantly more complicated than dynamic logics. But the semantics is more complicated. In general, the semantics of (...) an epistemic program is what we call aprogram model. This is a Kripke model of ‘actions’,representing the agents' uncertainty about the current action in a similar way that Kripke models of ‘states’ are commonly used in epistemic logic to represent the agents' uncertainty about the current state of the system. Program models induce changes affecting agents' information, which we represent as changes of the state model, called epistemic updates. Formally, an update consists of two operations: the first is called the update map, and it takes every state model to another state model, called the updated model; the second gives, for each input state model, a transition relation between the states of that model and the states of the updated model. Each variety of epistemic actions, such as public announcements or completely private announcements to groups, gives what we call an action signature, and then each family of action signatures gives a logical language. The construction of these languages is the main topic of this paper. We also mention the systems that capture the valid sentences of our logics. But we defer to a separate paper the completeness proof. (shrink)

This paper provides a foundation for the polarity marking technique introduced by David Dowty [3] in connection with monotonicity reasoning in natural language and in linguistic analyses of negative polarity items based on categorial grammar. Dowty's work is an alternative to the better-known algorithmic approach first proposed by Johan van Benthem [11], and elaborated by Víctor Sánchez Valencia [10]. Dowty's system internalized the monotonicity/polarity markings by generating strings using a categorial grammar whose categories already contain the markings that the earlier (...) system would obtain by separate steps working on an already-derived string. Despite the linguistic advantages of the internalized system, no soundness proof has yet been given for it. This paper offers an account. The leading mathematical idea is to interpret categorial types as preorders (in order to talk about monotonicity in the first place), and then to add a primitive operation to the type hierarchy of taking the opposite of a preorder (in order to capture monotone decreasing functions). At the same time, the use of internalized categories also raises issues. Although these will not be addressed in full, the paper points out possible approaches to them. (shrink)

Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled (...) to at least a decent minimum level of care — which might include access to scarce life-saving organs. However, if criminals forfeit their entitlement to the same level of medical care afforded to all members of society, they still would be entitled to a kind of rudimentary decent minimum granted to all persons on simple humanitarian grounds. Almost certainly this entitlement would not include access to organ transplants. (shrink)

The Heythrop Journal, Volume 63, Issue 4, Page 817-827, July 2022.

This paper adds comparative adjectives to two systems of syllogistic logic. The comparatives are interpreted by transitive and irreflexive relations on the underlying domain. The main point is to obtain sound and complete axiomatizations of the valid formulas in the logics.

There has been considerable controversy surrounding the routine circumcision of male infants in the United States. This is of particular concern, since the medical establishments of all the other countries of the developed world have abandoned this procedure as having dubious benefits. This article examines the medical pros and cons of neonatal male circumcision in a historical perspective and suggests that the circumstances that led to its establishment as a routine practice are largely absent today. Reasons for its continued use (...) and ethical and moral issues associated with its practice are then examined closely, especially in light of the current debate surrounding female circumcision. The article concludes that the medical and ethical issues surrounding this practice should be more broadly debated until there is some consensus as to its benefits. Prudence dictates that until such a consensus emerges, the practice should be suspended. (shrink)

The Heythrop Journal, Volume 63, Issue 4, Page 817-827, July 2022.

We present a bimodal logic suitable for formalizing reasoning about points and sets, and also states of the world and views about them. The most natural interpretation of the logic is in subset spaces , and we obtain complete axiomatizations for the sentences which hold in these interpretations. In addition, we axiomatize the validities of the smaller class of topological spaces in a system we call topologic . We also prove decidability for these two systems. Our results on topologic relate (...) early work of McKinsey on topological interpretations of S4 with recent work of Georgatos on topologic. Some of the results of this paper were presented at the 1992 conference on Theoretical Aspects of Reasoning about Knowledge. (shrink)

Examining the psychology of Supreme Court decision-making, this book seeks to understand almost all aspects of the Supreme Court's functioning from a psychological perspective. It addresses many factors of influence, including the background of the justices, how they are nominated and appointed, the role of their law clerks, and more.

Papers delivered at the joint meeting of the Hegel Society of America and the Hegel Society of Great Britain held at Merton College, Oxford, Sept. 1-4, 1981, to mark the 150th anniversary of Hegel's death. Includes bibliographical references and index.

From its first appearance in 1844, Max Stirner’s major work, Der Einzige und sein Eigentum ,[1] has produced little agreement among its many interpreters. The very first of these interpreters was Friedrich Engels, who suggested that Stirner’s doctrines would be quite compatible with Benthamite utilitarianism, which he then admired, and even saw in these doctrines the potential of benefiting communism.[2] Marx, in short order, corrected this optimistic deviation, and then—with a surely repentant Engels—set forth the orthodox gospel for all future (...) generations of communists: Stirner, or “Sankt Max,” was but the speculative spokesman for the petty bourgeois, a decadent Hegelian boasting over the unrestraint of his self inflated ego.[3] Sidney Hook echoed Marx when he condemned Stirner’s work as but the “social defense mechanism of a petty bourgeois soul.”[4] Others, unsatisfied with this “petty” status, elevate him to that of the Grand Bourgeois, or Fascist.[5] Still others, taking an opposite stance, see in Stirner the most articulate defender of individual liberty.[6] In between, he has been called a nihilist, an anarchist, an existentialist, a solipsist, an anti Benthamite, an intemperate capitalist, or—as we might now suspect—an anti capitalist.[7] At least two commentators, lost in the confusion, have managed to escape the need to classify Stirner within the ongoing political and ethical categories and simply declare him to be insane.[8] In short, the list of radically diverse interpretations.. (shrink)

This book examines how, in a series of critical confrontations, Stirner rejected the efforts of his “Young Hegelian” contemporaries to recast Hegel as a revolutionary. For him, the various apocalyptic declarations of these “pious atheists” were only the expressions of adolescent dreams set upon the annihilation of real individuality.

Deep brain stimulation is an experimental procedure for treatment-resistant depression. Some results show promise, but blinded trials had limited success. Ethical questions center on vulnerability: especially on whether depressed patients can weigh the risks and benefits effectively, whether depression causes “desperation,” and whether media portrayals create unrealistic hopes. We interviewed 24 psychiatric inpatients with treatment-resistant depression, qualitatively analyzing their comments. Most had minimal interest in deep brain stimulators. Some might consider them if their depression worsened, if alternatives were exhausted, or (...) if the evidence were stronger. Fears focused on the surgery, adverse effects, and the novelty of the device. Patients felt the depression interfered with their ability to weigh the risks and benefits. Patients seemed highly attuned to the risks, and were skeptical that the treatment would be effective. We conclude that ethical concerns about vulnerability remain, yet patients with treatment-resistant depression were thoughtful and cautious about trying a novel therapy. (shrink)

We present a rendering of some common grammatical formalisms in terms of evolving algebras. Though our main concern in this paper is on constraint-based formalisms, we also discuss the more basic case of context-free grammars. Our aim throughout is to highlight the use of evolving algebras as a specification tool to obtain grammar formalisms.

Two recent policy statements by providers of critical care representing the United States and Europe have rejected the concept and language of “medical futility,” on the ground that there is no universal consensus on a definition. They recommend using “potentially inappropriate” or “inappropriate” instead. As Bosslet and colleagues state: The term “potentially inappropriate” should be used, rather than futile, to describe treatments that have at least some chance of accomplishing the effect sought by the patient, but clinicians believe that competing (...) ethical considerations justify not providing them. Clinicians should explain and advocate for the treatment plan... (shrink)

The global array might prove to be an important and even necessary concept for explaining some multi-modal phenomena from the specificational perspective. However, we suspect that specification exists in energy arrays detectable by single or multiple sensory systems. We argue for a more general modality-neutral perspective and review results from recent research on audiovisual speech perception.