Managed care has brought wide-ranging changes to the health care system. Some of these changes have been well publicized. Among them are the financial pressures that have resulted in numerous mergers of health care institutions, the restriction on the ability of patients to select their physician of choice, and the ever diminishing number of days that patients are permitted to stay in the hospital. Individual physicians, too, have been affected. For example, they are under pressure to see more patients per (...) unit time and to use fewer resources. Utilization review and payment methods may make them reluctant to undertake the full set of diagnostic tests and therapeutic interventions when they might otherwise have done so. (shrink)

A survey of democratic institutions and republics reveals the aristocratic origins of democracy.

In the last decade, careful studies of the living brain have opened the way for human consciousness to return to the heights it held before the behavioristic coup of 1913. This is illustrated by seven cases: the discovery of widespread brain activation during conscious perception; high levels of regional brain metabolism in the resting state of consciousness, dropping drastically in unconscious states; the brain correlates of inner speech; visual imagery; fringe consciousness; executive functions of the self; and volition. Other papers (...) in this issue expand on many of these points. . In the past, evidence based on subjective reports was often neglected . It is still true that brain evidence has greater credibility than subjective reports, no matter how reliable. What is new is increasing convergence between subjective experiences and brain observations. For that reason it is no longer rare to see the word 'consciousness' and 'subjectivity' in major science journals. No one so far has discovered a gulf dividing mind and brain. On the contrary, the new evidence supports the central role of consciousness as it was regarded over more than two millenia of written thought. In a sense this was predictable. Nature is full of unexpected convergences -- between fruit fly genes and the human body, between the arc of a tennis ball and the orbit of Mars, and between consciousness and the brain. These convergences show once again the remarkable unity of the observable universe. (shrink)

The French sociological tradition has long regarded the ‘individual’ as a reality situated outside its area of intellection and investigation. According to Durkheim, the individual is a psychological object par excellence. Sociology has thus long favored the study of collectives (groups, classes, categories, institutions, microcosms), suggesting that the individual was a reality which, in itself, fell short of the social. The article discusses a method from the mid-1990s of researching sociology at an individual scale. This approach is essentially embedded in (...) the French sociological tradition, from Durkheim to Bourdieu via Halbwachs, despite the inflections and criticisms it might have of this tradition, while also drawing on the main theoretical knowledge of Norbert Elias’ relational and process-focused sociology. From empirical realization in methodological and theoretical reflexivity, this research program has progressed in dialog with various types of scientific knowledge more classically oriented toward the individual and their mental realities, such as cultural psychology, psychoanalysis, cognitive psychology or the neurosciences. (shrink)

The scholastic philosopher is interested in definition for a different reason than the lexicographer and linguist. The philosopher is trying to learn things. Fe defines, after investigating reality, in an attempt to describe reality clearly and to sum up some aspect of his understanding of reality. Hence, we find our scholastic philosophers adopting as a main feature of their method this insistence on defining, on precise and detailed explanation of their definitions, and on proving that their definitions da correctly express (...) what a nature or activity is. A dictionary of the language of scholastic philosophy fitted to the needs of beginners and of undergraduate students of the subject is not available in English. (shrink)

I discuss donald davidson's argument for the psycho-Physical identity theory and contend that it fails: it relies on an implausible account of mental and physical events. Davidson proposes a linguistic test for determining whether a given event is mental or physical. I argue that the assumptions that are necessary for employing such a criterion of the mental are either false or presuppose the truth of the identity theory.

Numerous ethical issues have emerged from the industrialization of animal agriculture. Those issues ultimately rest in large measure upon overuse of antibiotics. How this has occurred is discussed in detail in this paper.

Singapore's Human Organ Transplant Act presumes that competent adults consent to donate their kidneys in the event of a fatal accident, unless they have refused in writing. No family consent is required. What can other countries wishing to implement a presumed‐consent model of organ donation learn from Singapore's experience?

In 1854 the biologist Thomas Henry Huxley pointed to a significant change in the way that reviewers were treating books that endorsed deeply flawed scientific theories. In the past, “when a book had been shown to be a mass of pretentious nonsense,” it “quietly sunk into its proper limbo. But these days appear, unhappily, to have gone by.” Due to the “utter ignorance of the public mind as to the methods of science and the criterion of truth,” scientists were now (...) forced to review such books in order to expose their deficiencies (Huxley 1903, 1). Huxley’s observation indicates how the development of a mass reading audience in mid-nineteenth century Britain transformed the very nature of scientific controversy. Scientists were compelled to debate the validity of theories in new public sites, not just in exclusive scientific societies or in specialized scientific journals with limited circulation. It was during the nineteenth century that public controversy—not limited to science alone—became possible for the first time. In this short piece I will discuss how the “communications revolution” produced a public space for the debate over evolutionary theory in mid-nineteenth century Britain. I will focus on periodicals as one of those public spaces in which the debate took place.1 As Huxley found, attempting to resolve a scientific controversy in the general periodical press could be a risky venture. Although a non-specialized journal could provide the public space necessary for reaching the reading audience, maintaining scientific authority in such a site was somewhat problematic. (shrink)

This essay begins with the contention that phenomenology has taken a “hermeneutic turn,” “the things themselves” are always already interpreted. Philosophers often elaborate their own positions through a “reading” of the works of other philosophers. This is the case for Claude Lefort. Through his interpretive reading of the works of Machiavelli one sees the origin of Lefort’s idea of the autonomy and the anonymity of the political and thus his notion of political modernity. In tracing the evolution of Lefort’s relationship (...) to Marx, we witness the process by which he disengages himself from his early “enchantment” with the works of Marx and the idea of the proletariat as a class bearing universal interest. Ultimately he criticizes Marx for his attempt to derive the political from the dimension of the social. This issues in his theory of totalitarianism as the attempt of a regime to close in on itself, thus denying any gesture to the dimension of the other. (shrink)

While colonialism, in general, is a contested concept, as are the conditions that constitute its negation, political decolonisation seems to be a relatively settled argument. Where such decolonisation occurred, political independence, and its attendant democratic system and the undergirding of the rule of law, signify the self-evidentiality of such political decolonisation. This article rethinks this self-evidentiality of political independence as necessarily a decolonial political accomplishment in Ghana. This critical enterprise opens the documents that founded the newly independent state to alternative (...) reading to demonstrate how the colonial folded itself into the dictate of freedom. (shrink)

This biography, the first of Richard Spencer Childs, begins in the Progressive Era when Childs initiated and pursued two fertile ideas: the short ballot doctrine and the council-manager plan. Childs understood that the simplification of the task of the voter was a question pressing for solution and that the council-manager plan would transform municipal government. This comprehensive work discusses other aspects of Childs' broad reform agenda. His proposals included: county government reform; reform in state government administration; unicameral state legislatures; reapportionment (...) of state legislatures; selection of judges by appointment; replacement of elective county coroners with appointed professional medical examiners; democratization of state political parties; and reform of the Presidential nominating system. Based on Childs' papers and personal interviews with Childs, this biography advances scholarship on the Progressive Era and contributes to the historiographical debate on the nature of reform. (shrink)

The authors constructed an algorithm that relates leaf contour to the ratio between the two parts of the leaf using the function θ’=nθm, wherem is the allometric exponent. Using this model, it is possible to simulate the contour of symmetrical or asymmetrical leaves. The authors hypothesize that the portion of the leaf contour that agrees with the simulation is linked to a constraint imposed by the initial asymmetry of the leaf primordium. The final shape of the leaf results more from (...) a summation of cumulative processes through time than from a single process. In the analysis of foliar allometry, it is important to take into consideration the different phases of leaf development, since the nature of the allometric constants may change from one phase to the next, even though their numerical value may remain the same. (shrink)