Objective: To determine if the medical record might overestimate the quality of care through false, and potentially unethical, documentation by physicians.Design: Prospective trial comparing two methods for measuring the quality of care for four common outpatient conditions: structured reports by standardised patients who presented unannounced to the physicians’ clinics, and abstraction of the medical records generated during these visits.Setting: The general medicine clinics of two veterans affairs medical centres.Participants: Twenty randomly selected physicians from among eligible second and third year internal (...) medicine residents and attending physicians.Main measurements: Explicit criteria were used to score the medical records of physicians and the reports of SPs generated during 160 visits . Individual scoring items were categorised into four domains of clinical performance: history, physical examination, treatment, and diagnosis. To determine the false positive rate, physician entries were classified as false positive , false negative, true positive, and true negative.Results: False positives were identified in the medical record for 6.4% of measured items. The false positive rate was higher for physical examination and diagnosis than for history and treatment . For individual physician subjects, the false positive rate ranged from 0.098 to 0.397.Conclusions: These data indicate that the medical record falsely overestimates the quality of important dimensions of care such as the physical examination. Though it is doubtful that most subjects in our study participated in regular, intentional falsification, we cannot exclude the possibility that false positives were in some instances intentional, and therefore fraudulent, misrepresentations. Further research is needed to explore the questions raised but incompletely answered by this research. (shrink)

What is sexual orientation? The contemporary consensus among philosophers is that it is a disposition. Unsurprisingly, recent debates about the metaphysics of sexual orientation are almost entirely intramural. Behavioral dispositionalists argue that sexual orientation is a disposition to behave sexually. Desire dispositionalists argue that it is a disposition to desire sexually. We argue that sexual orientation is not best understood in terms of dispositions to behave or dispositions to desire before arguing that dispositions tout court fail to illuminate sexual orientation. (...) We then introduce and defend the idea that sexual orientation is best understood in terms of categorical phenomenal properties of sexual arousal. (shrink)

We argue that abduction does not work in isolation from other inference mechanisms and illustrate this through an inference scheme designed to evaluate multiple hypotheses. We use game theory to relate the abductive system to actions that produce new information. To enable evaluation of the implications of this approach we have implemented the procedures used to calculate the impact of new information in a computer model. Experiments with this model display a number of features of collective belief-revision leading to consensus-formation, (...) such as the influence of bias and prejudice. The scheme of inferential calculations invokes a Peircian concept of ‘belief’ as the propensity to choose a particular course of action. (shrink)

The lively debate over the constitutional foundations of judicial review has been marred by a formalism which obscures its point and value.ed from genuine issues of substance, the rival positions offer inadequate accounts of the legitimacy of judicial review; constitutional theory must regain its connection with questions of political principle and moral value. Although the critics of ultra vires have rightly emphasized the foundational role of the common law, they have misconceived its nature and implications. On the one hand, they (...) have invited the charge of judicial supremacism by marginalizing the role of legislative intent; on the other, their affirmation of absolute parliamentary sovereignty (within the context of this debate) undermines the critique of ultra vires. In substance, therefore, the rival camps occupy essentially the same ground, equally trapped by a formalism that entrenches a stark confrontation between parliamentary sovereignty and the rule of law. A conception of shared sovereignty, or interdependent sovereignties, provides a better foundation for judicial review. (shrink)

Various attempts have been made in recent years to present Christianity in such a way that no use is made of the traditional dichotomy between the ‘natural’ and the ‘supernatural’. Braithwaite, Hare, and van Buren, for instance, appear to have no use for the dichotomy; and I think that, without too much distortion, one can say the same of Bultmann, Tillich, and Robinson. I am not, however, concerned in this paper with the work of any one thinker as such, but (...) rather with a general climate of opinion. What I want to do is to examine the grounds on which it might be argued that belief in the supernatural is discredited. The issue seems to me of special importance at the present time, since, if these grounds are inadequate, programmes of reform under the general heading ‘Christianity without the supernatural’lose much of their point; if, on the other hand, the grounds are compelling, then reform of some kind is forced upon us whatever the accompanying difficulties. (shrink)

Martin Heidegger's explication of Pindar's assertion that ‘to glorify was the essence of poetry’ puts it quite well. He tells us that for Pindar the word does not derive its force from what is already complete in itself. For then man would be glorifying what is already glorious, that which already has the power to impress men. At best the word then would denote an acknowledgment or a confession of being impressed. Instead, he insists, the word denotes the power of (...) making to appear, or to extol a place. 1. (shrink)

Animal and plant species exhibit an astonishing diversity of sexual systems, including environmental and genetic determinants of sex, with the latter including genetic material in the mitochondrial genome. In several hermaphroditic plants for example, sex is determined by an interaction between mitochondrial cytoplasmic male sterility (CMS) genes and nuclear restorer genes. Specifically, CMS involves aberrant mitochondrial genes that prevent pollen development and specific nuclear genes that restore it, leading to a mixture of female (male‐sterile) and hermaphroditic individuals in the population (...) (gynodioecy). Such a mitochondrial‐nuclear sex determination system is thought to be rare outside plants. Here, we present one possible case of CMS in animals. We hypothesize that the only exception to the strict maternal mtDNA inheritance in animals, the doubly uniparental inheritance (DUI) system in bivalves, might have originated as a mitochondrial‐nuclear sex‐determination system. We document and explore similarities that exist between DUI and CMS, and we propose various ways to test our hypothesis. (shrink)

Ronald Dworkin's theory of law forges a close connection between questions about the truth of propositions of law and the question of political obligation: law as integrity is a theory of legal practice that purports to explain, not only how the content of law is determined, but also why the law—in ordinary cases—imposes an obligation of obedience. The theory (as presented) is ultimately incoherent. If we accept Dworkin's theory of the grounds of law we are obliged to reject his claims (...) about its force; alternatively, if we accept his view of the force of law, we must reject his theory about its grounds: he cannot be correct about both force and grounds. Dworkin supposes that, in extraordinary cases, the force of law is cancelled or overridden; but the relevant considerations of justice are wholly internal to our identification of the content of law. Consistently elaborated, integrity denies the offending requirements legal status: lex injusta non est lex. (shrink)

My analysis of the constitutional foundations of judicial review has been criticized by Paul Craig; but his objections confuse the ‘constructive’ account of legislative intent I defend with the ‘literal’ conception (reflecting the views of individual legislators) I expressly repudiate. He thinks we must choose between legislative intent, literally conceived, and common law principle. This mistake exemplifies the peculiar character of Craig's ‘common law model’ of judicial review, in which the requirements of the rule of law, on one hand, and (...) the relevant statute, on the other, exist in separate mental worlds. That model is conceptually confused, rejecting the doctrine of ultra vires that (unqualified) legislative supremacy entails, and ultimately grounded in a wholly implausible view of the relationship between common law and statute. It subordinates both statutory text and purpose to common law doctrine, treated as largely self-contained and impervious to context. It ignores the interdependence of legislative and judicial power, impeding a genuine integration of statutory command and common law principle. (shrink)

Originally published in 1955. The Madhyamika philosophy is, in the author's view, the philosophy which created a revolution in Buddhism and through that in the whole range of Indian philosophy. This volume is a study of the Madhyamika philosophy in all its important aspects and is divided into three parts: Historical: this traces the origin and development of the Madhyamika philosophy. The second part concentrates on a full and critical exposition of the Madhyamika philosophy, the structure of its dialectic, its (...) conception of the Absolute and its ethics and religion. The last part of the book compares the Madhyamika with some of the well-known dialectical systems of the West (Kant, Hegel and Bradley) and undertakes a short study of the different absolutisms (Madhyamika, Vijnanavada and the Vedanta). (shrink)

The key points in Meynell's argument seem to me to be as follows: It is logically absurd to say of an action or of a state of affairs that it is good unless at least some or other of the qualities w, x, y, z, etc. are present. Similarly it is logically absurd to talk of human flourishing unless some or other specifiable features are present in a person's life. The Heimler questionnaire shows us the sorts of ways in which (...) the notion of human flourishing might be ‘unpacked’, viz, in terms of satisfaction through friendship, etc. I am in full agreement with him over and I shall simply add some further comments on the notion of ‘evaluating’; but as far as is concerned I shall voice some doubts and reservations. (shrink)

In this paper I shall examine a variety of situations in which human agents make use of force. Section I will be concerned with the use of force in medical contexts, Section Ii with the use of force in defence of property, and Section in with the use of force in resolving international disputes. I shall argue that the boundary between what is and is not morally permissible needs to be, drawn more stringently than is commonly supposed. While agreeing that (...) in some medical contexts and in some situations where defence of property is involved the use of force may be necessary and even morally required, I shall suggest that in the absence of any suitably constituted world court the use of force in attempting to resolve international disputes creates a morally different situation. (shrink)

This chapter contains sections titled: Hunting as the Pursuit of Wild “Life” Carnal Bonds and the Way of All Flesh Saintly Chewing and the Corruption of the Flesh The Vital Paradox: The Acceptance of Death as Affirmation of Life Notes.

T. R. Miles; IV—The “Mental” - “Physical” Dichotomy, Proceedings of the Aristotelian Society, Volume 64, Issue 1, 1 June 1964, Pages 71–84, https://doi.org/10.1.

This paper presents preliminary solutions to three conceptual problems posed by the use of triage to sort candidates for scarce medical resources: (1) By what criteria are the candidates grouped? (2) To what extent can triage be justified? (3) Under what conditions are different versions of triage equivalent? Four explicit methods of applying triage are described and compared, with the aid of examples. The extent to which they either maximize expected utility or show cost-benefit dominance is discussed. And cases in (...) which one triage method reduces to another are contrasted with others where no such reduction occurs. (shrink)

This volume is concerned with the concept of rationality and the interrelations between rationality, belief and desire in the explanation and evaluation of human action. The book is conceived and structured to represent some of the most important general differences of approach to these problems, and also to connect them with problems about the relation of individual to social behaviour which are of central interest to historians, social theorists and economists as well as to philosophers. The essays have all been (...) commissioned for this volume and have not appeared elsewhere. The idea for the book arose from the meetings of philosophers and social scientists sponsored by the Thyssen Foundation, and is therefore a continuation of the informal series begun by C. Hookway and P. Pettit Action and Interpretation. (shrink)

Leontius of Jerusalem is considered the most accomplished of the neo-Chalcedonian theologians of the sixth century. He shows himself, in his Testimonies of the Saints, to be an ecumenical theologian attempting to convince Syrian anti-Chalcedonians that their objections to Chalcedon are baseless, since all agree, beneath their antithetical formulae, on a christology of hypostatic union. They are urged to abandon their self-important yet discredited mentor, Severus, and to see that Chalcedon had no secret agenda. Gray's edition of this important early (...) Christian treatise provides an introduction, the Greek text, and notes, together with a new translation into readable, modern English. (shrink)

T. R. Miles; IV—The “Mental” - “Physical” Dichotomy, Proceedings of the Aristotelian Society, Volume 64, Issue 1, 1 June 1964, Pages 71–84, https://doi.org/10.1.

Basṭāmī, ʻAlī ibn Ṭayfūr, active 16th century-17th century. Akhlāq-i ḥusnaʹ ; Islamic ethics- Early works to 1800.

Collection of Buddhist philosophical texts written by Mongolian monks and scholars.