OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; (...) lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees. (shrink)

Chastʹ I. Ėsteticheskie uchenii︠a︡ filosofov antichnogo mira -- Chastʹ II. Iskusstvo v suzhdenni︠a︡kh pisateleĭ antichnogo mira.

1. The characterization of Hegel's teaching as dialectical is usually associated with a critique of the logic that preceded his and that was dominant in his time: that of the Wolffians and, in particular, of Kant and the Kantians. All in all, to characterize Hegel's teaching in this way is entirely in accord with the facts. However, when stated in so general a form, it leaves much unclarified and undoubtedly demands further concreteness. The article we offer here for the reader's (...) consideration is an attempt at a concretization of this order. Central to this matter is the question of formal thinking: did Hegel accept the rights of formal thinking, and, if so, to what degree? (shrink)