Our hospital routine requires that all new admissions must be asked about their code status. It is not uncommon for an otherwise healthy patient to request that a do-not-resuscitate order be placed in their chart. Presumably, these patients who wish to have a DNR order are acting on the belief that should an unforeseen, irreversible condition occur that leads to a cardiac arrest, they would not want to undergo resuscitation. Tragically, we have witnessed several instances in which potentially life-saving interventions (...) were withheld in viable patients in non-arrest settings for reversible conditions because the patients had a DNR order in the chart. Unfortunately, this happens when the treating physicians are not aware of the limited scope of a DNR order and instead use the order as a blanket prohibition against all components of resuscitation. This communication failure is due to misconceptions that patients and their physicians have with regard to such orders. The medical community is well overdue to improve the end-of-life decisions offered to patients beyond relying on the outdated term DNR.LIMITATIONS OF DNR ORDERSDespite the major advances in critical care medicine in the past few decades, doctors have not substantially improved their ability to address end-of-life decisions any better than by using the all-encompassing term DNR. Currently, the term is generally accepted as an order to prohibit the use of interventions to reverse a cardiac or pulmonary arrest.1 2 What is frequently forgotten with the DNR order is that …. (shrink)

Summary A study of the metallurgy and manufacturing techniques of a group of eight astrolabes using non-destructive methods has produced the earliest evidence for systematic use of high-zinc brass. To produce this alloy, the brass industry supplying the Lahore instrument makers must have co-melted metallic copper and zinc. This brass-making technology was previously believed to have been developed on an industrial scale in the nineteenth century in Europe. This work hypothesizes that this technology was used in Lahore on an industrial (...) scale as early as ad 1601. In addition, this work hypothesizes that the α + β brass alloy was used specifically for its ease in manufacturing the thin sheet brass required for astrolabe-component manufacture. (shrink)

Newton's conception of time has had a profound influence upon science, particularly psychology. Five characteristics of explanation have devolved from Newton's temporal framework: objectivity, continuity, linearity, universality, and reductivity. These characteristics are outlined in the present essay and shown to be central to psychological theories and methods. Indeed, Newton's temporal framework is so central that it often goes unexamined in psychology. Examination is important, however, because recent critics of Newton's framework - including both scientists and philosophers - have questioned its (...) validity and usefulness. (shrink)

The two epigraphical monuments which have preserved parts of the treaties of alliance between Athens, on the one hand, and Rhegion and Leontinoi, respectively, on the other, must be studied together, for both treaties had their old preambles erased in 433/2 and their validity reaffirmed as of that year. The new preambles, both dating from the same day, were inscribed in the erasures and juxtaposed, somewhat awkwardly, before the body of the old texts thatstill remained.

This first article is intended as a brief introduction to the general philosophical assumptions of Newton: namely, his mathematicism, empiricism, positivism, reductionism, and dualism. These five "isms" provide an important background to the main articles that are also briefly described.

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes.The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles.This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

Edith Stein was Husserl's student and private secretary. This study of empathy was originally her doctoral dissertation. After a reduction to pure consciousness, she describes the essence of empathy as a kind of perception sui generis, both like and unlike other acts of consciousness. Different theories of experiencing the other are briefly evaluated. The second part of the book is devoted to the role of empathy in the constitution of the psycho-physical individual and, ultimately, of the person. Written in short, (...) numbered paragraphs, the analysis tends to be jerky and without direction. But there is a sustained description of the living body, antedating Merleau-Ponty's corps vécu by thirty years. The translation seems too literal, and typographical errors abound.—A. B. D. (shrink)

This is a systematic and admirably clear exposition of a philosophical anthropology by the dean of Latin-American philosophers—it is nothing less than philosophy in the grand manner. Romero begins with a novel theory of intentionality. Intentional consciousness differentiates man from the lower animals. For this consciousness is originally an objectifying and cognitive awareness. From man's intentional consciousness Romero then traces the constitution of the self, a community, and spiritual consciousness. Basically, man is a duality of his intentional, aggressive consciousness and (...) his spiritual, disinterested consciousness; this duality is manifested in the phenomena of self-consciousness, sociability, historicity, and meaning. A greater part of the book is devoted to spirit, the essentially human element of man's being, and the cource[[sic]] of universality, unity, freedom, and value. There are many echoes of Heidegger, Scheler, Dilthey, Hartmann, and Husserl in Romero's work, but his system is an original synthesis of their different views.—A. B. D. (shrink)

This book is primarily for the patient and empathetic poetaster; it is a treasure-chest of themes on the imagination, metaphor, day-dream, and memory. Bachelard presents a phenomenology of the poetic image of inner or inhabited space, or what he terms "felicitous space." Inner space refers not only to the house of man but to the houses of things, drawers, chests, and wardrobes, and to the houses of animals, nests and shells. Bachelard's method is to articulate the many reverberations which any (...) poetic image calls forth in the reader's mind. He masterfully interprets the images which he draws from a vast amount of literary material and he is also adept at describing his own daydreams. The last two chapters deal with a dialectic of inside and outside and a phenomenology of "roundness" which he had hoped to include in a later, more metaphysical work.—A. B. D. (shrink)

Rome and Carthage had established peaceful diplomatic relations before 300 b.c. — as early as the close of the sixth century according to Polybius, whose dating there no longer seems good cause to doubt. A second treaty was struck probably in 348. Both dealt essentially with traders' and travellers' obligations and entitlements, so any military or political terms sprang from that context. In both, the Carthaginians agreed to hand over any independent town they captured in Latium. In the first treaty (...) they were not to establish a fort in Latium either; in the second, the Romans were not to found a city in Carthaginian Africa, Spain or Sardinia. But independent military considerations are the stuff of a third treaty concluded during Rome's war with Pyrrhus. Rome and Carthage now pledged each other military aid in certain circumstances, as we shall see. And ‘geopolitical’ concerns of a very broad kind imbued a treaty which was reported by the third-century historian Philinus of Agrigentum. By this, he stated, ‘the Romans must keep out of the whole of Sicily, the Carthaginians out of Italy’ . This is Polybius' citation of Philinus' allegation; Polybius himself then roundly rejects the very existence of such a pact and declares himself at a loss to understand how his predecessor could record it, but modern scholarship is no longer all that ready to accept his view. A strong majority of historians prefer to follow the Agrigentine, and many see 306 b.c. as the likely year for the agreement because Livy records a ‘renewal’ then of a foedus with Carthage. (shrink)

This brief work valuably shows how a distinguished historian ascertains the causes of his historical facts. Koht, a Norwegian European historian, eschews any philosophy of history, claiming only that the nature of man is permanent through historical change. Drawing from his own historical research he discusses the significance of the different forces of history. These are religion, economics, class consciousness, the power of the state, war, revolt, science, and internationalism. No one force or cause is primary.—A. B. D.

Early versions of satellite and radiosonde datasets suggested that the tropical surface had warmed more than the troposphere, while climate models consistently showed tropospheric amplification of surface warming in response to human-caused increases in greenhouse gases. We revisit such comparisons here using new observational estimates of surface and tropospheric temperature changes. We find that there is no longer a serious discrepancy between modeled and observed trends in the tropics. Our results contradict a recent claim that all simulated temperature trends in (...) the tropical troposphere are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”.This emerging reconciliation of models and observations has two primary explanations. First, because of changes in the treatment of buoy and satellite information, new surface temperature datasets yield slightly reduced tropical warming relative to earlier versions. Second, recently developed satellite and radiosonde datasets now show larger warming of the tropical lower troposphere. In the case of a new satellite dataset from remote sensing systems, enhancedRSS warming is due to an improved procedure of adjusting for inter-satellite biases. When the RSS-derived tropospheric temperature trend is compared with four different observed estimates of surface temperature change, the surface warming is invariably amplified in the tropical troposphere, consistent with model results. Even if we use data from a second satellite dataset with smaller tropospheric warming than in remote sensing systems RSS, observed tropical lapse rates are not significantly different from those in all model simulations.Our results contradict a recent claim that all simulated temperature trends in the tropical troposphere and in tropical lapse rates are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”. (shrink)

Based on the Mahlon Powell lectures given at Indiana University, this slim, well translated book is surprisingly rich and visionary in its pursuit of a metaphysics of language. Dufrenne, a phenomenologist, argues that positivistic and syntactical linguistics wrongly ignore the phenomenon of living speech, while formal logic, seeking to rid itself of its natural and intuitive origins, is necessarily rooted in them. What is needed is a phenomenology of human speech which would lead to a metaphysics of man's spoken intercourse (...) with the world. In the end, poetry has the last word.--A. B. D. (shrink)

Sutton ( 2010 ) claims that on our analysis (2007), the problem in the two-envelope paradox is an error in counterfactual reasoning. In fact, we distinguish two formulations of the paradox, only one of which, on our account, involves an error in conditional reasoning. According to Sutton, it is conditional probabilities rather than subjunctive conditionals that are essential to the problem. We argue, however, that his strategy for assigning utilities on the basis of conditional probabilities leads to absurdity. In addition, (...) we show that a crucial presupposition of Sutton’s argument — namely, that one can know that envelope A contains n simply on the basis of a stipulation — is mistaken. (shrink)