Those teachers in contact with medical students from pre-clinical days onwards will impart their ethical views by example and by precept, but such learning by 'osmosis' is insufficient. There is a knowledge base to be imparted which will enrich the understanding of ethical judgements on clinical problems seen during the undergraduate years. However, the learning process continues after qualification and in particular the doctor's capacity to make ethical clinical judgements will evolve with maturity and experience. It is essential therefore that (...) students see their teachers willing and able to debate ethical issues at the postgraduate level. (shrink)

Beliefs about hypothetical situations need to be 'quarantined' from factual representations, so that our inference processes do not make false conclusions about the real world. Nichols argued for the existence of a place where these special beliefs are kept: the pretence box. We show that this theory has a number of drawbacks, including its inability to account for simultaneously keeping track of multiple imagined worlds. We offer an explanation that remedies these problems: beliefs of content imagination each belong to some (...) number of microtheories; systems of ideas tagged as being true or false only in certain contexts. (shrink)

I present an annotated development of the basic ideas of the Geneva School approach to the foundations of physics and the structures which emerge as mathematical representations of the physically dual notions of state and property.

Full text of erratum: "In the article by D.J. Buller, on p. 278, the y-axis label to Fig. IIb was incorrect. Instead of 'Percentage choosing "Eats cassava root" and "Tattoo," it should have read: 'Percentage choosing "Eats cassava root" and "No tattoo."' We apologise to readers for this error.".

The ordinary concept of death is analysed and compared with revisionary medical definitions, especially those based on irreversible loss of brain function. Prior critics of revisionary definitions have focused on the locus, the brain; I am concerned with the irreversibility condition. I argue that 1) the irreversibility condition is ambiguous, 2) it has unacceptable epistemic and other consequences on any plausible construal, and 3) irreversibility is not part of the ordinary concept of death. I conclude that recent medical definitions seek (...) illegitimately to obtain the certainty of a weak construal of 'irreversible' along with the freedom from moral obligation of the strong construal. (shrink)

In an appreciative preface to the fiftieth volume of the philosophical publications of the Museum Lessianum Pére Dubarle notes the unmistakable fact that since Kant’s critique of speculative theism ‘on sait aussi combien les formes classiques de l’argumentation cherchant à fournir cette preuve sont devenues aujourd ‘hui intellectuellement inopérantes’. In courageous remedy Père Robert aims at developing an argument by rigorous reflection upon the metaphysical implications of the act of scientific knowledge - a contemporary reappraisal of St Augustine’s argument to (...) God as the eternal ground of necessary truth. The very success of modern science poses for Einstein, as much as for Plato, the metaphysical postulate that the world is objectively intelligible. To avoid an immediate option for epistemological idealism or realism, the author reflects upon a second scientific postulate: truth is universal and, therefore, accessible in principle to all. The crucial problem of the possible ground of these successful postulates then arises. (shrink)

We review the fact that an MV-algebra is the same thing as a lattice-ordered effect algebra in which disjoint elements are orthogonal. An HMV-algebra is an MV-effect algebra that is also a Heyting algebra and in which the Heyting center and the effect-algebra center coincide. We show that every effect algebra with the generalized comparability property is an HMV-algebra. We prove that, for an MV-effect algebra E, the following conditions are mutually equivalent: (i) E is HMV, (ii) E has a (...) center valued pseudocomplementation, (iii) E admits a central cover mapping γ such that, for all p, q∈E, p∧q=0⇒γ(p)∧q=0. (shrink)

Recent studies using functional magnetic resonance imaging of patients in a vegetative state have raised the possibility that such patients retain some degree of consciousness. In this paper, the ethical implications of such findings are outlined, in particular in relation to decisions about withdrawing life-sustaining treatment. It is sometimes assumed that if there is evidence of consciousness, treatment should not be withdrawn. But, paradoxically, the discovery of consciousness in very severely brain-damaged patients may provide more reason to let them die. (...) Although functional neuroimaging is likely to play an increasing role in the assessment of patients in a vegetative state, caution is needed in the interpretation of neuroimaging findings. (shrink)

Introduction: Variation across research ethics boards in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy.Aim: To study variation in REB consent requirements for retrospective chart review and who may have access to the medical record for data abstraction.Methods: Thirty 90-min face-to-face interviews were conducted with REB chairs and administrators affiliated with faculties of medicine in Canadian universities, using structured questions around a case study (...) with open-ended responses. Interviews were recorded, transcribed and coded manually.Results: Fourteen sites required individual patient consent for the study to proceed as proposed. Three indicated that their response would depend on how potentially identifying variables would be managed. Eleven sites did not require consent. Two suggested a notification and opt-out process. Most stated that consent would be required if identifiable information was being abstracted from the record. Among those not requiring consent, there was substantial variation in recognising that the abstracted information could potentially indirectly re-identify individuals. Concern over access to medical records by an outside individual was also associated with requirement for consent. Eighteen sites required full committee review. Sixteen allowed an external research assistant to abstract information from the health record.Conclusions: Large variation was found across sites in the requirement for consent for research involving access to medical records. REBs need training in best practices for protecting privacy and confidentiality in health research. A forum for REB chairs to confidentially share concerns and decisions about specific studies could also reduce variation in decisions. (shrink)

In 1736 Colin MacLaurin, Professor of Mathematics in the University of Edinburgh petitioned the Town Council for permission to erect an astronomical observatory in the College to broaden the research and teaching base of the University. After MacLaurin's death, the Town Council and University Senate, more concerned with the promotion of the Infirmary and associated medical teaching, took no further action. The funds raised by MacLaurin were lent to his successor, and largely dissipated. In 1776 the balance was transferred to (...) the proposed Calton Hill Observatory. This private scheme was to be financially self-sufficient, generating income from the casual visitor and fees charged to students. It too failed. Funds were wasted on unnecessary architectural elaboration, the Town Council failed to meet their financial obligations, the University acquiesced in the total inactivity of the Regius Professor of Astronomy, whilst the commercial management-base of the Observatory vitiated any serious scientific activity. (shrink)

That both parts of the sentence refer to the same person is now generally agreed; it is not so much that a change of subject would be, as the commentators are wont to say, ‘un-Sophoclean’, but simply that it would be awkward and clumsy. But to whom do the lines refer?D. B. Gregor argues for Clytaemnestra, but despite the apparent force of some of his arguments I cannot agree. He adds too that the reference to echoes the motif of Electra's (...) speech, but it is just as much the motif of Clytaemnestra's speech, in fact more so. Finally, the first part of the sentence, it is true, could be asserted by the chorus on the strength of some such gesture as the heaving of the bosom, but I cannot see how they could then deduce that Clytaemnestra ‘no longer cares whether justice is on her side’. (shrink)