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)

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)

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)

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)

Postmodern understandings of the god concept, based upon sociological and anthropological insights, support the ontological reality of the god concept. AII such god constructs can be understood as real but human products which come out of a situated Drama of the Holy. The reality quotient of any god concept can be seen as a function of solidarity activities within a society. Social justice concerns are, thus, the best indicators of that reality quotient while divisive, exploitative and oppressive practices in the (...) world tend to desanctify both society and nature thus justify Death of God analyses. Two interrelated solidarity activities are discussed for their efficacy in sanctification of nature and society: 1) situated Dramas of the Holy and, 2) social policies in the political economy. A variety of grand narratives are mentioned, each with differing foundational concepts, with which to institute social justice as we move into the 21st century. (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)

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.

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.

When Cicero uncovered and suppressed the Catilinarian Conspiracy as consul in 63 B.c., supporters hailed him ‘father of his country’ and proposed that he be awarded the oak crown normally given to a soldier who had saved the life of a comrade in battle . Our sources connect these honours with earlier heroes such as Romulus, Camillus and Marius, but the Elder Pliny writes as if Cicero was the first before Caesar and the Emperors to be given the title pater (...) patriae. Pliny's point may revolve around Senatorial initiative, and assuming this to be the case he really should have stressed that Cicero received the informal support of a limited number of Senators only, whereas Caesar and the Emperors were honoured by formal vote of the entire Senate. Perhaps Pliny was fooled by the prominence of those who spoke on Cicero's behalf, such as Cato, Catulus and Gellius Publicola. Opponents, on the other hand, angrily rejected calls that Cicero be recognised as the saviour of the state. In their eyes his execution of the Catilinarians marked him as a cruel tyrant. Metellus Nepos proposed Pompey's recall from the East in order to free Rome from Cicero's tyranny. Aside from echoes of patria potestas, it seems obvious that the Romans were thinking in terms of the conventional Greek antithesis between the good king who is like a father to his people and the selfish tyrant who treats his subjects as slaves. The Younger Pliny employs the same basic ideas in his Panegyricus: the cruel tyrant Domitian suppressed freedom and desired honour as a god ; the gentle Trajan is a citizen and father not a tyrant and master . Tacitus has this basic distinction in mind too. Nevertheless, as is well known, Pliny regularly addresses Trajan not as ‘father’ but as ‘master’ in Book 10 of his Letters. This was plainly an acceptable practice on the social plane, if not quite yet on the political. Augustus, Tiberius and Claudius indicated their opposition to dominus as a title for themselves, evidently for its connotations of autocracy and servitude. Domitian, damned as a tyrant, was accused of demanding to be addressed as dominus et deus. The title dominus existed from at least the first century A.d. as a common form of polite address between inferiors and superiors of free birth, not only between masters and slaves. It gradually gained acceptance as an official title of the Emperor through the second century and was advertised widely by the Severi. And yet its tone throughout this period could also be critical when understood in terms of the good king/tyrant antithesis. (shrink)

This paper is divided into two sections. The first aims at showing in a general way that the programme and methods of Berkeley and Professor Ryle are to a large extent similar. The second deals with one problem only. It is an attempt to provide interpretation and commentary on Berkeley's attack on “absolute existence” and on Ryle's attack on the view that there can be different “kinds of existence,” “kinds of status,” or a number of different “worlds.”.

The Sovereignty of Law presents Trevor Allan's most recent and fully elaborated defence of common law constitutionalism - an account of the unwritten or non-codified constitution as a complex articulation of legal and moral principles, defining what in the British context are the requirements of the rule of law. The British constitution is conceived as a coherent set of fundamental principles of the rule of law, legislative supremacy, and separation of powers. These principles.

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)

SummaryThe traditional account of micro‐reductive explanations, in terms of bridge‐law derivations and attribute‐identities, is subjected to critical analysis. Formal expositions of this approach especially those of R. L. Causey, are shown to have oversimplified certain relations between micro‐parts and wholes, and between identities and explanations, and to have neglected a key difference between homogeneous and heterogeneous micro‐explanatory contexts. An alternative treatment of part‐explanation adequacy is outlined and illustrated.

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)

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)

This paper is a critical examination the claim that Galileo was a Platonist. It contends that neither his use of mathematics (as Koyre asserts), nor his hypothetic-deductive method of testing (as Cassirer maintains), nor a realistic interpretation of this abstract theories (as Crombie argues) offers reasonable and consistent evidence that Galileo shared or advocated the metaphysics or methods of Plato.

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)

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)

This article discusses the ‘nature’ of our contemporary fascination with wildness, in light of the popular documentary “Grizzly Man.”Taking as its central point of departure the film’s central protagonist Timothy Treadwell’s fascination with wild grizzlies and director Werner Herzog’s condemnation of it as gross anthropomorphism, this paper will explore the context and basis of our contemporary fascination with wildness in terms of the current debate raging within environmental philosophy between the social constructivist or postmodern position as exemplified by Martin Drenthen (...) and the feral humanist position as articulated by Paul Shepard.The former argues that this fascination with wildness is reflective of certain historical and cultural trends within contemporary western society, while the latter argues that it is reflective of our primordial human heritage. (shrink)