Background and objective: Code status discussions may fail to address patients’ treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPR). This study aimed to investigate patients’ resuscitation preferences, knowledge of CPR and goals of care. Design, setting, patients and measurements: 135 adults were interviewed within 48 h of admission to a general medical service in an academic medical centre, querying code status preferences, knowledge about CPR and its outcome probabilities and goals of care. Medical records were reviewed for clinical (...) information and code status documentation. Results: 41 (30.4%) patients had discussed CPR with their doctor, 116 (85.9%) patients preferred full code status and 11 (8.1%) patients expressed code status preferences different from the code status documented in their medical record. When queried about seven possible goals of care, patients affirmed an average of 4.9 goals; their single most important goals were broadly distributed, ranging from being cured (n = 36; 26.7%) to being comfortable (n = 8; 5.9%). Patients’ mean estimate of survival to discharge after CPR was 60.4%. Most patients believed it was helpful to discuss goals of care (n = 95; 70.4%) and the chances of surviving inhospital CPR (n = 112; 83.0%). Some patients expressed a desire to change their code status after receiving information about survival following inhospital CPR (n = 11; 8.1%) or after discussing goals of care (n = 2; 1.5%). Conclusions: Doctors need to address patients’ knowledge about CPR and take steps to avoid discrepancies between treatment orders and patients’ preferences. Addressing CPR outcome probabilities and goals of care during code status discussions may improve patients’ knowledge and influence their preferences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Veterans Affairs National Center for Clinical EthicsJames L. Bernat (bio)The veterans health administration is the largest health care system in the United States and, indeed, is larger that the health care system of many foreign countries. In February 1991 the Department of Veterans Affairs (V.A.) in Washington, D.C. awarded a contract to the clinical ethics group at the Veterans Affairs Medical Center in White River Junction, Vermont to (...) establish the V.A. National Center for Clinical Ethics. In this article I describe the organizational context, mission, operation, and future direction of the Center, which William A. Nelson, Ph.D., and I co-direct.The Veterans Health AdministrationThe Department of Veterans Affairs operates 171 hospitals providing services ranging from primary, secondary, and tertiary medical care to psychiatric hospitals, rehabilitation centers, and nursing homes. The V.A. also provides outpatient services at all hospitals and at dozens of free-standing outpatent clinics. V.A. medical centers employ over 14,000 physicians and serve approximately 4.5 million veteran patients (Hollingsworth and Bondy 1990; Mirvis 1990).The V.A. serves an important educational function, providing training sites for medical students, postgraduate physicians, and trainees in other health-related fields. Approximately 78 percent of V.A. medical centers are affiliated with medical schools. Over one-third of all American medical students and over 40 percent of interns and residents spend a portion of their training in V.A. medical centers. More than 100,000 students in all health-related fields train in V.A. facilities annually (Hollingsworth and Bondy 1990).Research is another mission of the V.A. Many academic physicians and scientists derive their research and salary funding from V.A contracts and awards. The V.A. Research Career Development Program provides the means for many medical school faculty members to achieve successful careers as scientists and clinical investigators. Although research accounts for only slightly more than 1 percent of the V.A. medical budget, two V.A. researchers have been awarded the Nobel Prize (Hollingsworth and Bondy 1990). [End Page 385]In comparison to other medical care settings, the average V.A. patient is likely to be older, poorer, male, less well-educated, more chronically ill, and more expensive to care for. Many patients first patronize the V.A. system after they have been bankrupted by the costs of a major illness. Unlike young, healthy patients ideally favored by health maintenance organizations, these patients immediately require large expenditures for hospitalizations, medications, and other treatments. Additional burdens have been placed on V.A. facilities by a record of chronic federal underfunding over the past decade, despite expanded patient censuses at every facility.Bioethical issues arise in V.A. facilities with great frequency for several reasons. Older and poorer patients are often sicker, have fewer home-support resources, and have completed fewer advance directives for health care. Chronic operational underfunding requires explicit health care rationing systemwide. Academic physicians within the V.A. system have multiple professional duties that have the potential for conflict. Although their primary duty is to their patients, they also must serve the federal government and their medical school academic supervisors. The practice of medical care rationing pits the physician's professional duty to his patient against his duty to the system (Mirvis 1990).The V.A. has responded to these bioethical demands with several initiatives. Hospital ethics advisory committees have been developed in nearly every V.A. medical center. The V.A. National Bioethics Committee has been empaneled to encourage uniform policies across the V.A. system concerning bioethical issues. Most recently, funds were provided for the V.A. National Center for Clinical Ethics.Functions of the National Center for Clinical Ethics (NCCE)The NCCE has a fourfold mission: 1) to enhance the quality of clinical ethics programs at all 171 V.A. medical centers nationwide; 2) to staff the V.A. National Bioethics Committee; 3) to assist administrators and planners in the V.A. Central Office on policy development concerning bioethical issues; and 4) to study, organize, and coordinate clinical, educational, and research bioethics programs throughout the system.Enhancing the quality of clinical ethics programs at V.A. medical centers is largely an... (shrink)

Perhaps the time has come in Ukraine, when “pedagogy, which puts a person at the center of everything, is now hopelessly outdated”. Perhaps it’s time to help schools enter the three-dimensional world where God rules all things and where He defines “me”, “you”, “us”, “them.” The President sent to us by God set the goal to make a change in the philosophy of the school in Ukraine. It turns out, V.A Yushchenko. has in his heart to set another goal for (...) Ukrainian education: to give our students the knowledge necessary for eternity. Will the realization of this goal become a big change, deep and thorough? It depends on us - practical teachers, methodologists, theorists, experimenters, academics and officials, all whom God has called to serve in the field of education, "to sow the rational, the good, the eternal.". (shrink)

The charge of treason and the judgment of insanity have left questions that invariably intrude on an assessment of Pound’s life and work. Critics frequently adopt a strategy of separating the life and the work, but tactical review is often necessary. There is a lightness in Pound’s writing that speaks of a being detached from the concerns of the world. Yet with his economic theory of social credit, his political and racial views, as well as his concern for other writers, (...) he is of the world—in the world and part of it. He was decidedly not tied to geography. He had no region or period, and he was as comfortable in Confucian China as in Dante’s Florence or twentieth-century Rome. He could work anywhere. He wrote The Pisan Cantos while jailed in Italy. The Cantos were published while he was in a mental wart at St. Elizabeths, yet a court found that he could not understand the charges against him. Can such an impairment and such achievement occur at the same time? If you say no, then what of the treason? Did he feign madness to escape punishment? Could Pound have been convicted of treason?In this paper, I intend to examine what has been loosely referred to as “the trial of Ezra Pound” and to show that Pound’s case should have been brought to trial within one or two years after his commitment to St. Elizabeths because he had a reasonable chance of being found not guilty of treason; even if found guilty, the circumstances in mitigation of a long prison term would have been so evident that he would have likely spent considerably less time in prison than he spent locked up at the mental institution. I will do this, in part, by reviewing the similarities and differences between Pound’s case and three other treason cases that came to trial within the first years after World War II. The English case, Rex v. Joyce, was tried shortly after the close of the war and well before Pound’s competency hearing on 13 February 1945.3 The law applied in Joyce would have led Pound’s lawyer to seek some postponement of trial until the American courts decided whether to follow the English lead. The other two cases involve the Americans, Douglas Chandler and Robert Best, employees of German radio, who were indicted with Pound in 1943. 3. William Joyce was an American who came to be known as “Lord Haw Haw.” He was hanged at Wandsworth, England, 3 Jan. 1946. He was the best known of the “radio traitors.” He began his programs, “This is Jairmany calling,” and would then prophesy the destruction of English towns and cities. The name “Lord Haw Haw” was created by the English journalist, Jonah Barrington, to ridicule Joyce and to make him appear idiotic. Conrad L. Rushing is a Superior Court Judge in California and an occasional lecturer in law at the University of California, Berkeley. He teaches a course in law and literature at the California Judges College and is a founder of the Sane Jose Poetry Center. (shrink)

This article addresses a pertinent challenge to Scandinavian realism which follows from the widespread perception that the fundamental philosophical premises on which the movement relies, are no longer tenable. Focusing on Alf Ross’s version of Scandinavian realism which has often been at the centre of critical attention, the author argues that Ross’s theory can survive the fall of logical positivism through an exercise of philosophical reconstruction. More specifically, he claims that it is possible to dismount Ross’s realist legal theory (...) almost intact from its commitments to logical positivism and embed it into an alternative naturalist philosophical program that is currently very strong in contemporary philosophy. In so doing, the author applies a narrow Quinean conception of naturalism, also known as replacement naturalism, which differs from a broader inclusive conception which has been applied by other scholars in the field but which leaves the philosophical crisis of Scandinavian realism unsolved. (shrink)

Cet article traite de christianisme ancien, de littérature apocalyptique et de gnose, trois champs de recherche liés à ma recherche doctorale, dans le but de discuter de leur réception dans l’espace public contemporain. Les différents exemples donnés dans ce texte montrent bien que cet espace public contemporain est toujours friand de sujets religieux, en particulier dans les domaines cités. Il est vrai que cet intérêt a été moussé par des ouvrages de fiction et des livres qui utilisent le christianisme comme (...) arrière-plan, mais sans être au courant des recherches actuelles. Le rôle du chercheur en sciences des religions apparaît donc crucial et reste au centre de l’ensemble des considérations réunies ici. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedThe Ambitions of Curiosity: Understanding the World in Ancient Greece and China. By G.E.R. Lloyd. Cambridge: Cambridge University Press, 2002. Pp. xvi + 175. Price not given.The Art of the Han Essay: Wang Fu's Ch'ien-Fu Lun. By Anne Behnke Kinney. Tempe: Center for Asian Studies, Arizona State University, 1990. Pp. xi + 154. Paper $10.00.The Autobiography of Jamgön Kongtrul: A Gem of Many Colors. By Jamgön Kongtrul Lodrön (...) Thayé and translated by Richard Barron (Chökyi Nyima). Ithaca, New York: Snow Lion Publications, 2003. Pp. xxii + 549. Price not given.Awesome Nightfall: The Life, Times, and Poetry of Saigyō. By William R. LaFleur. Boston: Wisdom Publications, 2003. Pp. xiii + 173. Paper $14.95.Becoming the Compassion Buddha: Tantric Mahamudra for Everyday Life. By Lama Thubten Yeshe, edited by Robina Courtin, and foreword by Geshe Lhundub Sopa. Boston: Wisdom Publications, 2003. Pp. xi + 194. Paper $14.95.Between Two Worlds East and West: An Autobiography. By J. N. Mohanty. New Delhi: Oxford University Press, 2002. Pp. ix + 134. Hardcover RS 525.00.The Chinese Face of Jesus Christ. Edited by Roman Malek, S.V.D. Sankt Augustin, Germany: Institut Monumenta Serica and China-Zentrum; and Nettetal, Germany: Steyler Verlag, 2002. Pp. 391. EUR 40.00.Chinese Medicine in Contemporary China: Plurality and Synthesis. By Volker Scheid. Durham and London: Duke University Press, 2002. Pp. xiv + 407. Hardcover $69.95. Paper $23.95.Confucian Feminist: Memoirs of Zeng Baosun (1893-1978). Translated and adapted by Thomas L. Kennedy. Philadelphia: American Philosophical Society, 2002. Pp. xxi + 170. Price not given.Consciousness Studies: Cross-Cultural Perspectives. By K. Ramakrishna Rao. Jefferson (North Carolina) and London: McFarland and Company, 2002. Pp. 367. Hardcover $65.00.Constituting Communities: Theravāda Buddhism and the Religious Cultures of South and Southeast Asia. Edited by John Clifford Holt, Jacob N. Kinnard, and Jonathan S. Walters. Albany: State University of New York Press, 2003. Pp. viii + 224. Hardcover $65.50. Paper $21.95.Developments in Indian Philosophy from Eighteenth Century Onwards: Classical and Western. By Daya Krishna. Volume X Part 1 of History of Science, Philosophy and Culture in Indian Civilization, edited by D. P. Chattopadhyaya. New [End Page 110] Delhi: Centre for Studies in Civilizations, 2001. Pp. xxiii + 417. Hardcover RS 1200.East and West: Identità e dialogo interculturale. By Giangiorgio Pasqualotto. Venezia: Marsilo Editori, 2003. Pp. 210. EUR 16.00.Effortless Action: Wu-wei as Conceptual Metaphor and Spiritual Ideal in Early China. By Edward Slingerland. New York: Oxford University Press, 2003. Pp. xii + 352. Price not given.Encountering Kā lī: In the Margins, at the Center, in the West. Edited by Rachel Fell McDermott and Jeffrey J. Kripal. Berkeley and Los Angeles: University of California Press, 2003. Pp. xviii + 321. Hardcover $55.00, £37.95. Paper $21.95, £15.95.Encyclopedia of Chinese Philosophy. Edited by Antonio S. Cua. New York and London: Routledge, 2003. Pp. xx + 1020. Hardcover $150.00.Essays on Indian Philosophy. By J. N. Mohanty and edited by Purushottama Bilimoria. New Delhi: Oxford University Press, 2002. Pp. xxxvii + 347. Paper RS 525.00.Faith, Humor, and Paradox. By Ignacio L. Götz. Westport, Connecticut: Praeger Publishers, 2002. Pp. 136. Hardcover $61.95.Four Illusions: Candrakīrti's Advice for Travelers on the Bodhisattva Path. Translated by Karen C. Lang. New York: Oxford University Press, 2003. Pp. xv + 240. Price not given.The Great Awakening: A Buddhist Social Theory. By David R. Loy. Boston: Wisdom Publications, 2003. Pp. 223. Paper $16.95.The Hidden History of The Tibetan Book of the Dead. By Bryan J. Cuevas. New York: Oxford University Press, 2003. Pp. xi + 328. Price not given.Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. By Paul U. Unschuld. Berkeley and Los Angeles: University of California Press, 2003. Pp. xii + 520. Hardcover $75.00, £52.00.In Dewey's Wake: Unfinished Work of Pragmatic Reconstruction. Edited by William J. Gavin. Albany: State University of New York Press, 2003. Pp. vi + 249. Hardcover $71.50. Paper $23.95.Knowledge and Freedom in Indian Philosophy. By Tara Chatterjea. Lanham, Maryland: Lexington Books, 2002. Pp. xvi + 159. Hardcover... (shrink)

La traduction de l'epistrophe grecque en conversio latine a pu laisser entendre une continuite entre le retour des philosophies grecques neoplatoniciennes et l'evenement religieux proprement chretien de la conversion. Le paradigme en serait le passage de Plotin a Augustin. Mais peut-on oublier que les grecques classiques n'ont pas d'ethique du repentir et que, sans ce rapport au temps de la faute, la constitution de soi n'a ni le meme sens ni le meme lieu? C'est le travail du Centre A.J. (...) Festugiere de Paris X-Nanterre sur les entrecroisements et reprises entre philosophie et religion qui est a l'origine des etudes rassemblees en cet ouvrage. Que nous voyions apparaitre aujourd'hui une nouvelle forme de repentir publique convie a mieux distinguer deux modeles de constitution de soi qui se reconnaissent en ce que l'accent porte tantot sur l'etre et tantot sur le temps. (shrink)

Islamic scholars, who encountered works on the classification of sciences together with their translation activities, formed their own classification traditions by classifying the sciences from different perspective. These classifications, which position the sciences by considering the connection between reason and revelation, and pointing to the hierarchy and relationship between the sciences, also reflect the understanding of science on which they are based. In this context, we can talk about two different classification traditions put forward by Islamic philosophers on the one (...) hand and Islamic scholars on the other. At this point, Tashkoprīzāda (d. 958/1561), one of the 16th century Ottoman scholars, created an original classification of sciences that influenced the future by benefiting from both traditions. Tashkoprīzāda, who sees the classification of sciences as a branch of science at the same time, has written four valuable books in this field, especially his book called Miftāhu’s-sa‘āda. These works contain rich information about the history of sciences as well as the classification of sciences. He determined the sciences of fiqh and usūl al-fiqh as a sub-branch of shar‘ī sciences and gave both historical and current information about these sciences by focusing on the works of influential scholars. Tashkoprīzāda, who is followed Hanafi sect and saw the Hanafi school as the most virtuous one, handled the fiqh section by putting the Hanafi school in the center. One of the remarkable points is that Tashkoprīzāda completed the part in which he dealt with the historical process of Hanafi fiqh with two great scholars, such as Mewlānā Calāleddīn al-Konewī (v. 672/1273) and Sheikh Badraddin as-Simāwī (v. 823/1420), who stood out with their Sufism. It is also important in terms of showing the mystic environment in which Tashkoprīzāda was influenced and his approach to the relationship between tasawwuf and fiqh. Another point that makes Tashkoprīzāda’s works stand out in terms of the history of sciences is that he mentions famous and acceptable works by referring to the curriculum of his period and surroundings. Thus, Tashkoprīzāda reveals the classification of sciences as a whole with its history, hierarchy and curriculum. (shrink)

We consider fine hierarchies in recursion theory, descriptive set theory, logic and complexity theory. The main results state that the sets of values of different Boolean terms coincide with the levels of suitable fine hierarchies. This gives new short descriptions of these hierarchies and shows that collections of sets of values of Boolean terms are almost well ordered by inclusion. For the sake of completeness we mention also some earlier results demonstrating the usefulness of fine hierarchies.

It is a strange fact that people's opinions of psychoanalysis are only rarely tentative or unemphatic. It seems that one must either love it or hate it. Professor Cioffi, in a recent paper, has shown that he is no lover of psychoanalysis, and he makes what appears to be a devastating attack on Freud's theories and methods and on the credibility of the whole psychoanalytic discipline. Without wanting to ally myself wholeheartedly with the opposite camp, I want to show that (...) many of the main contentions of his paper are wrong. I shall argue that the objections he makes which, if valid, would be the most serious for Freudian theory, are unfounded. (shrink)

The ternary, not binary, Kripke-type relation on a set of possible worlds is an essential part of the semantics of entailment by Routley-Meyer [2]. The unpopularity of such approach among many logicians is due to its intuitive vague content and complexity. An attempt is made to use not one ternary relation but two binary relations and necessity of bibinarness is demonstrated. It is shown that both semantics are equal hence the soundness and completeness of the system R of entailment can (...) be established with the respect to the bibinary semantics. Furthermore, the ternary semantic with discrete matrix for Lukasiewicz system Lℵ0 , which was proposed in [3], could be transformed into the bibinary one and it leads to the conclusion of the completeness and soundness of Lℵ0 with the respect to the bibinary semantic. The brief consideration of the bibinary semantic intuitive content is added, which further logical study could be based on. (shrink)

Work on the methodology of natural science involves serious difficulties over and above those encountered in any other aspect of natural science or of philosophy. Reference is to the obvious fact that in discussing methodological questions of, for example, physics, so as to be precise, it is not enough to know physics: it is also necessary to familiarize oneself with certain branches of philosophy, the history of science, and so forth. Furthermore, a professional cannot limit himself to "general familiarity" with (...) the material. He has to know the details and, if possible, the entire literature on the question under discussion. However, the volume of literature on physics has, within the memory of the author alone — that is, over approximately forty years — multiplied dozens of times. I cannot say how great has been the increase in the quantity of information on the methodology of natural science and related disciplines. But what is important is that the amount of material that has accumulated to date is enormous. Some notion of the scale of the work may be gained from the abstract journal Obshchestvennye nauki za rubezhom. Seriia 8. Naukovedenie. For example, no. 1 for 1980 contained abstracts of 72 articles and books; this amounts to over 400 titles a year . When we add to this the Soviet literature and the need to include material from many years, we arrive at a figure of four digits. Naturally, only a very small portion of the literature is made use of in any particular piece of work, but it is impossible to know beforehand which items will be specifically needed. (shrink)

The scientific career of the outstanding Russian physiologist A. A. Ukhtomskii was complex and full of contradictions. A descendant of Prince Vsevolod Big Nest [Bol'shoe Gnezdo] of Suzdal', he was strongly influenced by the traditions and legends of his caste. As a juvenile he was sent to the Nizhnii Novgorod Corps of Cadets where he developed a profound interest in philosophy, psychology, history, and literature. His fellow cadets of the same age were amazed at, and sometimes ridiculed the young Ukhtomskii's (...) attempts to find answers to the burning questions of the day in the books of Shakespeare and Dostoevsky and in scientific works. Ukhtomskii's notebooks and synopses of those years show how this youth, from age 15 to 17, pondered over cardinal problems of world view, the contradictions of Russian society, and the future of science. The barracks life of the cadets, the rigorous schedule and supervision did not suppress Ukhtomskii's persistent desire to get a closer knowledge of the life of Nizhnii Novgorod, a major mill town and river port. He managed to make the acquaintance of members of a group of Marxist workers and maintained contact with one of them, M. Ia. Iakovlev , for over 40 years. (shrink)