Section 47 of the National Assistance Act is controversial in that it makes provision for the compulsory removal and care of mentally competent adults in certain limited circumstances. A case is described in which it is argued that compulsory management could be justified. This is because the diversity and potentially conflicting nature of the relevant considerations involved in this and a restricted range of other cases, defies their being captured in any wholly rational moral scheme. It follows that if the (...) law is to be both sensitive and just it cannot always provide definitive guidance as to how the community doctor, as the designated decision-maker, should act. The acceptance of his or her judgement is therefore necessary and depends for its proper working on trust, which can only be gained through compassion and respect for the patients concerned. (shrink)

The failure of Western medicine to deal with many of the problems it is currently facing has led to an awareness of the need for a fundamental reappraisal. The way in which medical concepts derived from the nineteenth century have brought technical medical advances in this century and the alliances that medicine has made with statistics and more recently the social sciences, have prevented a questioning of medicine's underlying assumptions. Thus, despite a number of critical initiatives from both within and (...) outside medicine, there has been no coherent development to seriously confront the question 'what is medicine?'. It is suggested that the basis for such a development depends on the return to a philosophical questioning of our conceptual understanding of disease, a subject which has largely been ignored during the past hundred years. (shrink)

Since the nineteenth century the theory and practice of mainstream Western medicine has been grounded in the biomedical model. In the later years of the twentieth century, however, it has faced a range of serious problems, which when viewed collectively, remain unresolved despite a variety of responses. The question we now face is whether these problems can be dealt with by modifying and extending the principles underlying the biomedical model, or whether a more radical solution is required. Recent critiques of (...) Western medicine have focused mainly on the biopsychosocial model in relation to the former approach, but it will be contended that this cannot deal adequately with the challenges that medicine currently faces, because although it addresses both the scientific and humanistic aspects of medicine it fails to harmonise them. I shall therefore argue for the necessity of a more radical approach, and suggest that what is required to accomplish this is the development of a new medical cosmology, rooted in an older and more global framework. Such a fundamental change would inevitably involve a long term process which it is not yet possible to fully comprehend let alone specify in detail. Some of the necessary features of such a new medical cosmology can, however, already be distinguished and the outline of these is described. (shrink)

I read this book shortly after rereading Confessions of a Medicine Man by Alfred Tauber. (MIT Press 1999). As both these books are concerned with searching for the meaning of medicine in a world where scientific and technical goals predominate, it was inevitable that I should compare them. What intrigued me was how two books with a similar purpose could be so different. Tauber is an American physician and philosopher whose book is a personal quest to seek out a medical (...) ethos on which to base his practice. He therefore approaches his task biographically, relating a series of stories illustrative of medical issues that he has found troublesome during his medical career. He then uses these to explore those philosophical …. (shrink)

During the past thirty years a high proportion of all long stay hospital beds have been closed. The responsibility for those who would have occupied those beds previously has to a large extent been transferred from health to social services departments, or to family, voluntary and private care. The overall effect has been to prioritize acute medical care, and to expose the public provision and funding of long term residential care, whether medical or social, to the direct determination of political (...) and economic forces. These policy changes have been introduced under the banner of community care, but are dependent on complex concepts which are morally contentious and often obscure. The purpose of this paper is to analyse these processes as a prerequisite to devising better policies in future. (shrink)

I read this book shortly after rereading Confessions of a Medicine Man by Alfred Tauber. (MIT Press 1999). As both these books are concerned with searching for the meaning of medicine in a world where scientific and technical goals predominate, it was inevitable that I should compare them. What intrigued me was how two books with a similar purpose could be so different. Tauber is an American physician and philosopher whose book is a personal quest to seek out a medical (...) ethos on which to base his practice. He therefore approaches his task biographically, relating a series of stories illustrative of medical issues that he has found troublesome during his medical career. He then uses these to explore those philosophical …. (shrink)

A postgraduate Diploma in Medical Ethics and Law was started in October 1984 by the Centre of Medical Law and Ethics at King's College. It is a part-time one year course designed so as to enable students to continue with full-time employment if they wish. It is multidiscipinary and is open to all who have a first degree in a relevant discipline, for example law, philosophy, theology, medicine and nursing studies. It is unique in combining medical law and medical ethics (...) and has attracted students of high calibre from a variety of backgrounds during its first three years. Building on the experience of the diploma the course is being upgraded to an MA in 1987-88. It will be available either full-time for one year or part-time for two years. (shrink)

Following the first enactment of living will legislation in California in 1976 the majority of the states of the USA have now passed similar laws. However, flaws have been identified in the way they work in practice and many states are considering reviewing their legislation. In Britain there is no legislation but the subject is currently commanding considerable interest. This paper assesses the future prospects for living wills in both the USA and Britain, analysing the different options available and comparing (...) the two countries. If patients who become permanently incompetent are to have their previous autonomous decision-making respected, there is general agreement that advance directives for health care must be introduced. The difficulty is in deciding how to implement them, and especially whether this should be by statutory or non-statutory means, the traditions in the two countries being very different in this respect. It is concluded that whichever route is taken, promoting respect for patient autonomy is as much a matter for education and persuasion of doctors as of the adoption of particular instruments. Doctors should therefore be trained in what constitutes good medical practice in this area and, to ensure that it can be carried out properly, the general level of medical facilities for these patients must also be protected and promoted. (shrink)

Dispersal of individuals from their natal communities at sexual maturity is an important determinant of kin association. In this paper we compare postmarital residence patterns among Pumé foragers of Venezuela to investigate the prevalence of sex-biased vs. bilateral residence. This study complements cross-cultural overviews by examining postmarital kin association in relation to individual, longitudinal data on residence within a forager society. Based on cultural norms, the Pumé have been characterized as matrilocal. Analysis of Pumé marriages over a 25-year period finds (...) a predominant pattern of natalocal residence. We emphasize that natalocality, bilocality, and multilocality accomplish similar ends in maximizing bilateral kin affiliations in contrast to sex-biased residential patterns. Bilateral kin association may be especially important in foraging economies where subsistence activities change throughout the year and large kin networks permit greater potential flexibility in residential mobility. (shrink)

Attention has been given to cross-cultural differences in adolescent growth, but far less is known about developmental variability during juvenility (ages 3–10). Previous research among the Pumé, a group of South American foragers, found that girls achieve a greater proportion of their adult stature during juvenility compared with normative growth expectations. To explain rapid juvenile growth, in this paper we consider girls’ activity levels and energy expended in subsistence effort. Results show that Pumé girls spend far less time in subsistence (...) tasks in proportion to their body size compared with adults, and they have lower physical activity levels compared with many juveniles cross-culturally. Low activity levels help to explain where the extra energy comes from to support rapid growth in a challenging environment. We suggest that activity levels are important to account for the variation of resource and labor transfers in mediating energy availability. (shrink)

Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

This study aimed to determine if people would use social usefulness as a criterion when allocating a kidney to potential recipients. Participants ranked hypothetical patients in order of priority to receive the kidney, using only information on the patients’ volunteering record, intelligence, emotional intelligence, and attractiveness. The results showed that volunteers were prioritized over nonvolunteers, highly intelligent patients over those with average intelligence, patients with high emotional intelligence over those with average emotional intelligence, and good-looking patients over average-looking patients. There (...) was little evidence of personal favoritism. Implications and limitations are discussed. (shrink)

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

The monograph shows that in the last 50 years theoretical linguistics remains a compendium of mutually contradicting doctrines on multiple levels: the level of general theories of language, the level of its main constituents (the lexicon, syntax, and the lexical-syntactic interface that connects them), and the lower levels of specific linguistic problems (such as lexical polysemy, grammatical meanings, etc.). The contradictions of contemporary linguistic theories are indicative of a deep crisis. Evolutionary-synthetic theory of language is aimed at overcoming this crisis. (...) It implements a multidisciplinary approach that describes the language a) in evolutionary and ontogenetic development and b) in close interaction with other human subsystems: the mental representation of the world, human activity and social interaction. Language is defined as a dual system developing in ontogeny: 'universal sensory sublanguage + ethnically specific functional sublanguage' where the sensory sublanguage is used to describe the 'visible' world (accessible to the senses), and the functional sublanguage is employed to describe the conceivable world ('comprehended by human mind'). Within the framework of the approach presented, many problems are solved: 1) the cognitive (non-verbal) language for representing language meanings; 2) diversity and unity of languages (using the structure alternative to Chomsky's Universal Grammar); 3) the main (original) function of the language; 4) the cognitive language of thought (its basis is the lexical and grammatical meanings of the sensory sublanguage); 5) dual (functionally prototypical) structure of human categories; 6) mechanisms in the early acquisition of lexical and grammatical meanings; 7) the meaning (assignment) of the syntactic structure of a sentence, etc. The book deals with a wide range of issues related to human cognition, glottogenesis and anthropogenesis, universal cognitive structures for the representation of objects, actions and situations, so it will be of interest not only to linguists, but also to psychologists, anthropologists, sociologists, philosophers. (shrink)

Abstract An attempt is made to analyse the key notions in the Buddha's Dhamma? ?truth?, ?knowledge?, ?emancipation??by way of the philosophical techniques of the later Wittgenstein. The analysis hence is both comparative and noncomparative. It is comparative because two thought processes from two different traditions are brought together. And it is noncomparative since it brings into focus a philosophical exegesis as against a comparative exposition. In the process not only are philosophical errors in comparative exposition made explicit in our thesis (...) but it also offers a genuine basis for modern Buddhist philosophy. (shrink)

D. A. T. Gasking; Mr. Williams on the a Priori1, Analysis, Volume 6, Issue 5-6, 1 September 1939, Pages 69–78, https://doi.org/10.1093/analys/6.5-6.69.

An Arabic language summary of the history and principles of four key Hellenic schools of philosophy: Cynicism, Skepticism, Epicureanism, and Stoicism.

The Kenya-born philosopher Henry Odera Oruka (1944 - 1995) persistently, and consistently, made proposals for a different moral approach to addressing, and possibly solving, some of the root causes of human conflicts across the world. I will call it “taking suffering seriously” as the basis of his idea of a global-level collective justice which, for him, raised the idea of the ethics of care to the level of global justice. I propose in this paper to show that this concern can (...) be found to be pervasive in Oruka’s works, connecting many of his well known positions as well as less known ones, and to discuss its philosophical merits. (shrink)

The author has recently shown that a mathematical question regarding the fundamental constituents of hardrons cannot be resolved unless the classical axioms of nonfinite mathematics are revised in such a way as to produce a new theory of particle motion in continuous space-time. Under this new theory, the instantaneous position of a moving object has a magnitude that is increasing as the object's velocity. The purpose of this paper is to show that, quite apart from the question of Cantorian axiomatics, (...) the new theory of motion is more consistent with what physicists really believe than the traditional theory of motion. (shrink)