Background and objective: Code status discussions may fail to address patients’ treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPR). This study aimed to investigate patients’ resuscitation preferences, knowledge of CPR and goals of care. Design, setting, patients and measurements: 135 adults were interviewed within 48 h of admission to a general medical service in an academic medical centre, querying code status preferences, knowledge about CPR and its outcome probabilities and goals of care. Medical records were reviewed for clinical information (...) and code status documentation. Results: 41 (30.4%) patients had discussed CPR with their doctor, 116 (85.9%) patients preferred full code status and 11 (8.1%) patients expressed code status preferences different from the code status documented in their medical record. When queried about seven possible goals of care, patients affirmed an average of 4.9 goals; their single most important goals were broadly distributed, ranging from being cured (n = 36; 26.7%) to being comfortable (n = 8; 5.9%). Patients’ mean estimate of survival to discharge after CPR was 60.4%. Most patients believed it was helpful to discuss goals of care (n = 95; 70.4%) and the chances of surviving inhospital CPR (n = 112; 83.0%). Some patients expressed a desire to change their code status after receiving information about survival following inhospital CPR (n = 11; 8.1%) or after discussing goals of care (n = 2; 1.5%). Conclusions: Doctors need to address patients’ knowledge about CPR and take steps to avoid discrepancies between treatment orders and patients’ preferences. Addressing CPR outcome probabilities and goals of care during code status discussions may improve patients’ knowledge and influence their preferences. (shrink)

In this study, we examine the belief bias effect in syllogistic reasoning under both standard presentation and in a condition where participants are required to respond within 10 seconds. As predicted, the requirement for rapid responding increased the amount of belief bias observed on the task and reduced the number of logically correct decisions, both effects being substantial and statistically significant. These findings were predicted by the dual-process account of reasoning, which posits that fast heuristic processes, responsible for belief bias, (...) compete with slower analytic processes that can lead to correct logical decisions. Requiring rapid responding thus differentially inhibits the operation of analytic reasoning processes, leading to the results observed. (shrink)

The opioid epidemic has claimed the lives of more than 183,000 individuals since 1999 and is now the leading cause of accidental death in the United States. Meanwhile, rates of incarceration have quadrupled in recent decades, and drug use is the leading cause of incarceration. Medication-assisted treatment or MAT is the gold standard for treatment of opioid use disorder. Incarcerated individuals with opioid use disorder treated with methadone or buprenorphine have a lower risk of overdose, lower rates of hepatitis C (...) transmission, and lower rates of re-incarceration. Despite evidence of improved outcomes, many jails and prisons do not offer MAT to individuals with opioid use disorder. This seems partly due to a scientifically unjustified preference for an abstinence-only treatment approach. The absence of MAT in prisons and jails results in poor outcomes for individuals and poses a public health threat to communities. Furthermore, it disproportionately harms poor communities and communities of color. Health care providers in prisons and jails have an ethical obligation to offer MAT to individuals with opioid use disorder to mitigate risk of infectious diseases, opioid overdose and health disparities associated with incarceration. (shrink)

The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice‐based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt (...) “on the job.” We suggest that learning “on‐the‐job” is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the “invisible learning” which occurs as newly qualified nurses learn to delegate and supervise. (shrink)

This paper is about the moral status of those human beings with profound intellectual disabilities (PIDs). We hold the common sense view that they have equal status to ‘normal’ human beings, and a higher status than any non-human animal. We start with an admission, however: we don’t know how to give a fully satisfying theoretical account of the grounds of moral status that explains this view. And in fact, not only do we not know how to give such an account, (...) but the most satisfying account of moral status that we know (which we call ‘the standard account’) entails that our view is false. It entails that those with PIDs have a lower status than ordinary human beings and an equal status to non-human animals. Now, in this paper, we do absolutely nothing to try to show where the standard account goes wrong, and we do absolutely nothing to resolve the difficulties we see in developing an alternative account that supports our view. Indeed, we do not give any argument against the standard account or in favour of our own view. Instead, we raise the following question: in order to be justified in continuing to hold our view, are we obliged to give such an account? Our answer will be that we are not. (shrink)

In the noble tradition of Jaron Lanier's You Are Not a Gadget (Penguin, 2011), Curtis White's We, Robots takes the radical position that maybe we shouldn't cede every bit of control, humanity, and decision making to technology, and that the techno-futurists in our mix have things dangerously backwards. What a notion! In this sharply argued and rousing book, White not only attacks the technology-loving establishment, but offers a beautiful and essential alternative.

Almost any modern reader's first encounter with Darwin's writing is likely to be the "Historical Sketch," inserted by Darwin as a preface to an early edition of the Origin of Species, and having since then appeared as the preface to every edition after the second English edition. The Sketch was intended by him to serve as a short "history of opinion" on the species question before he presented his own theory in the Origin proper. But the provenance of the "Historical (...) Sketch" is somewhat obscure. Some things are known about its production, such as when it first appeared and what changes were made to it between its first appearance in 1860 and its final form, for the fourth English edition, in 1866. But how it evolved in Darwin's mind, why he wrote it at all, and what he thought he was accomplishing by prefacing it to the Origin remain questions that have not been carefully addressed in the scholarly literature on Darwin I attempt to show that Darwin's various statements about the "Historical Sketch," made primarily to several of his correspondents between 1856 and 1860, are somewhat in conflict with one another, thus making problematic a satisfactory interpretation of how, when, and why the Sketch came to be. I also suggest some probable resolutions to the several difficulties. (shrink)

This posthumous book represents the first publication of one of the seminars of Cornelius Castoriadis, a renowned and influential figure in twentieth-century thought. A close reading of Plato's _Statesman_, it is an exemplary instance of Castoriadis's pragmatic, pertinent, and discriminating approach to thinking and reading a great work: "I mean really reading it, by respecting it without respecting it, by going into the recesses and details without having decided in advance that everything it contains is coherent, homogeneous, makes sense, and (...) is true." Castoriadis brings out what he calls _The Statesman_'s "quirky structure," with its three digressions, its eight incidental points, and its two definitions, neither of which is deemed good. He does not hesitate to differ with the text, to show that what is, in appearance, secondary is really essential, and that the denunciation of the Sophists accommodates itself quite well to the use of sophistical procedures. Castoriadis shows how _The Statesman_ takes us into the heart of what is distinctive in the late Plato: blending, acceptance of the mixed, of the intermediate. These transcriptions of Cornelius's afford the reader an opportunity to discover his trenchant, convincing, energetic, provocative, and often droll voice. Here is a hitherto unknown Castoriadis, who reflects as he speaks, collects himself, corrects himself, and doesn't hesitate to revisit key points. In short, this is Castoriadis's thinking in action. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:120 HISTORY OF PHILOSOPHY Opera theologica quae latine edidit, 3 vols. (Roterodami, 1651-1660). His religious polemics with Amyrault and Grofius were famous. Paul Dibon, professor at the Ecole Pratique des Hautes Etudes, is the most prominent contemporary historian of seventeenth-century Dutch philosophy and intellectual life; he is perfectly aware of the fact that genuine history can only be founded on solid erudition, and this inventory is a first-class contribution (...) to it. Only those who ignore the difficulties of this kind of research will underestimate the enormous effort it involves--an effort which is, much more than a pedantic and mechanical listing of data, a kind of venatio, requiring a continuous alertness, a surprising amount of imagination and intelligence, a painstaking precision, and an enormous background of knowledge. The letters are arranged in chronological order (with the exception of a few which are undated). Each entry lists the date, the names and locations of the sender and addressee, and the opening words of the letter. The status of the letter (original/ minute/copy/printed) is indicated, as is the library in which the letter is located (and the call number), and/or, if the letter was published, the printed source. Thirty-two libraries were explored. GIORGIO TONELLI State University o/ New York at Binghamton Introduction to Newton's Principia. By I. Bernard Cohen. (Cambridge, Mass.: Harvard University Press, 1971. Pp. xxx+380. $30.00) Over the past dozen years or so Newtonian scholarship has burgeoned as never before, and a first and fundamental result has been the publication of more and more of the wealth of manuscript material and letters that Newton left as a legacy of potential insight and confusion to future scholars. To date, the most imposing of the undertakings in publication have been The Correspondence (1959- ), begun under the editorship of H. W. Turnbull and continued more recently under that of J. F. Scott, and the Mathematical Papers (1967- ), started and continuing under the editorship of D. T. Whiteside. Selected documents of importance have been published by I. Bernard Cohen, assisted by Robert E. Schofield, in Isaac Newton's Papers and Letters on Natural Philosophy... (1958), by A. R. Hall and Marie Boas Hall in Unpublished Scientific Papers o/ Isaac Newton (1962), and by J. W. Herivel in The Background of Newton's Principia (1965); additional documentary material has appeared in studies by Alexandre Koyr6, I. Bernard Cohen, Johannes A. Lohne, D. T. Whiteside, Richard S. Wesffall, J. E. McGuire and P. M. Rattansi, and still others--a full bibliography would run to considerable length. Nor, although the uncertainties in the interpretation of the documents are sometimes overwhelming, has this spate of publication merely served to replace one set of scholarly puzzles by another. The traditional, monolithic and impenetrable image of Newton "with his prism and silent face, / The marble index of a mind for ever / Voyaging through strange seas of Thought, alone..." has lost something of its hypnotic hold, and we begin to discern some of the steps, not to say jogs and leaps, in Newton's actual journey of thought and discovery. The volume here under review introduces another major enterprise in Newtonian scholarship, a "variorum" edition of the Principia. The edition itself, which has yet to appear, will consist primarily of a facsimile reproduction of the third edition (1726)-the last edition that Newton himself supervised----collated line by line with the variant readings in the two prior editions and in a manuscript of the first edition, and with the BOOK REVIEWS 121 corrections, improvements, and additions that Newton entered into copies of the first and second editions. This textual part of the edition was delivered to the press in 1966; additional parts are in various stages of preparation. There is to be a Commentary dealing with the prefaces, definitions, laws of motion, and the first three sections of Book I and most of Book III, along with English versions and modern analytical paraphrases of the sections dealt with, a glossary, and a number of short essays on such topics as the astronomical and physical data used by Newton, the mathematical background to the understanding of the Principia, and the analysis of... (shrink)

BackgroundThe merits and drawbacks of moral relevance models of addiction have predominantly been discussed theoretically, without empirical evidence of these potential effects. This study develops and evaluates a novel survey measure for assessing moral evaluations of patient substance misuse (ME-PSM).MethodsThis measure was tested on 524 health professionals (i.e., physicians, nurses, and other health professionals) in California (n = 173), urban France (n = 102), and urban China (n = 249). Demographic factors associated with ME-PSM were investigated using analyses of variance (...) (ANOVAs) and t-tests, with results suggesting that ME-PSM is higher among younger health professionals, nurses (when compared with physicians and other health professionals), and Chinese health professionals (when compared with French and American health professionals).ResultsResults provide preliminary support for the psychometric quality of the survey measure introduced in this study, including the existence of a single latent structure and partial invariance of collected data across countries.ConclusionThe survey measure for ME-PSM which was developed and tested in the current study appears to hold potential utility for use as a measure of moral views of patient substance misuse. With development, this measure may be used to examine moral evaluations, both as factors of stigma and of other clinical factors associated with the treatment of patients with substance use disorders. (shrink)

Dans ce livre novateur, Caroline Muller nous propose une lecture minutieuse de la correspondance entre des femmes (et quelques hommes) de la haute société et leurs directeurs de conscience, ces prêtres chargés de guider la vie spirituelle et de sonder la vie intérieure des catholiques, principalement des femmes, au xixe siècle. En cela, son livre est à la fois une histoire de la spiritualité, de l’aristocratie, du mariage et de la vie familiale, ainsi que de l’intimité et du genre. Échappant...

Pragmatism has affected American historical writing since the early twentieth century. Such contemporaries and students of Peirce, James, and Dewey as Frederick Jackson Turner, W. E. B. Du Bois, James Harvey Robinson, Charles Beard, Mary Beard, and Carl Becker drew on pragmatism when they fashioned what was called the “new history.” They wanted to topple inherited assumptions about the past and replace positivist historical methods with the pragmatists' model of a community of inquiry. Such widely read mid-twentieth-century historians as Merle (...) Curti, Henry Steele Commager, and Richard Hofstadter embraced the perspectivalism, fallibilism, and instrumentalism of the pragmatists, thereby helping to sustain the tradition during its nadir in American philosophy departments. Many historians have been drawn to the study of pragmatism during its recent renaissance; others have advanced pragmatist-inspired philosophies of history. Through such prominent contemporary historians as Thomas Haskell, David Hollinger, and Joyce Appleby, the ideas of Pierce, James, and Dewey continue to influence the historical profession. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and argues (...) that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

Exgesis on Mīmāṃsābhāṣya, Śabarasvāmi's commentary on Jaiminī's Mīmāṃsāsūtra, basic aphoristic work of the Mīmāṃsā school in Hindu philosophy; includes supercommentaries.

Articles on sentence in Sanskrit grammar according to Mimamsa philosophy.

T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, applied (...) ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

Critical study of Nyāyamañjarī of Jayanta Bhaṭṭa, active 850-910, work on Nyaya philosophy.

Ghazzālī, 1058-1111; views on behaviorism ; religious aspects; Islam.

Study of the philosophical basis and elements of ayurvedic medicine in Garuḍapurāṇa.

Study of Advaita philosophy with reference to Buddhist doctrines of Śunyavāda and Vijñānavāda.

On the classic Hindu philosophies of Nyaya and Vaiśeṣika ; autocommentary on Bhāṣāpariccheda with Sanskrit and Hindi commentaries.

Sanskrit text with Hindi verse translation of Aṣṭāvakragītā, work on Vedanta philosophy.

Exegesis, with text, on the Nyāyasūtra of Gautama, basic aphoristic text of Nyāya.

Commentary on Brahmasūtra of Bādarāyana, basic work on the fundamentals of Vedanta philosophy.

Prācīnanyāẏa, nabyanyāẏa, o baiśeshika-darśana.