Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case of (...) a phase II investigational trial of intravenous thiamine for delirium prevention in patients undergoing haematopoietic stem cell transplantation to emphasise several shortcomings in the overarching prioritisation of clinical over research uses of scarce drugs. Specifically, we present the following considerations: clinical use may not have stronger evidence than research use; a strong scientific rationale for research use may outweigh the claim for clinical indications in which there is weak evidence; treatment within the context of a clinical trial may be the standard of care; and research use may not only benefit patients receiving the treatment but also offers the prospect of improving future clinical care. In summary, we argue against allocation schemes that prohibit all research uses of scarce drugs and instead recommend that allocation schemes include a balanced approach that weighs risks and benefits of access to scarce drugs irrespective of the research versus clinical use designation. (shrink)

Studies in Hindu Law and Dharmaśāstra. By Ludo Rocher. Edited with an introduction by Donald R. Davis, Jr. Anthem South Asian Normative Traditions Studies. London: Anthem Press, 2012. Pp. 759. £80, $130.

A total of 366 UK children in four different schools, one in Wales, one in Northern Ireland, and two in England, were asked to respond to 20 potentially stressful life experiences. Each event was rated on a scale ranging from 7 to 1 , and the scale value and interquartile range were calculated. In addition, whether or not a given event was actually experienced was noted. Across the groups, there was a very high degree of agreement on all three measures, (...) the median correlations being 0.95 for scale values, 0.70 for interquartile ranges, and 0.92 for incidence. Furthermore, the pooled UK results were found to correlate equally closely with the figures previously obtained in the USA and five other countries. The possibility of a prevalent ‘culture of childhood’, cutting across geo‐political boundaries and ethnic groupings, appears to receive further support. (shrink)

The validity of an argument depends on the soundness of its premises. In the recent paper by Steele et al., conclusions are based on the initial construction of definitions relating to ‘desire’ and...

This essay explores the significance and implications of the causal theory of reference for the current debate on the necessity and exchangeability of the divine title ‘Father’ in the discourse of the Church. Identifying ‘Father’ as a vocative term historically grounded in the speech of Jesus and his Apostles, the authors assert that it successfully refers to God, functioning very much like a proper name. They also identify linguistic barriers to its replacement by other terms.

. Hindu law represents one of the least known, yet most sophisticated traditions of legal theory and jurisprudence in world history. Hindu jurisprudential texts contain elaborate and careful philosophical reflections on the nature of law and religion. The nature of Hindu law as a tradition has been subject to some debate and some misunderstanding both within and especially outside of specialist circles. The present essay utilizes the familiar framework of legal realism to describe the fundamental concepts of law and legal (...) procedure in Hindu jurisprudence. Questions about the place of natural law theory and legal positivism in relation to Hindu law are also considered. (shrink)

This paper examines preferences among uncertain prospects when the decision maker is uneasy about his assignment of subjective probabilities. It proposes a two-stage lottery framework for the analysis of such prospects, where the first stage represents an assessment of the vagueness (ambiguity) in defining the problem's randomness and the second stage represents an assessment of the problem for each hypothesized randomness condition. Standard axioms of rationality are prescribed for each stage, including weak ordering, continuity, and strong independence. The ‘Reduction of (...) Compound Lotteries' axiom is weakened, however, so that the two lottery stages have consistent, but not collapsible, preference structures. The paper derives a representation theorem from the primitive preference axioms, and the theorem asserts that preference-consistent decisions are made as if the decision maker is maximizing a modified expected utility functional. This representation and its implications are compared to alternative decision models. Criteria for assigning the relative empirical power of the alternative models are suggested. (shrink)

This study makes a sizeable leap forward in our understanding of the philosophical and jurisprudential thought related to ownership and inheritance in medieval and early modern India. A seminal 1962 monograph by J.D.M. Derrett has long provided the best account of the intellectual history of Indic ideas of ownership and property. Both concepts in turn underpinned debates about inheritance that later became central to the British colonial administration of what came to be known as Hindu law in the nineteenth century. (...) Fleming's book clears away extraneous detours in Derrett's work to focus instead on three clear lineages of legal thought that each draw on distinct philosophical foundations. The result is a story with... (shrink)

If patriotism can thus be seen as an incentive or as an instigation even in such a recondite science as epistemology, how much more readily can it be seen to perform such functions in other studies more immediately or inextricably bound up with communal human life? I pass over instances that occur to me—for instance, the Victorian Jesuit, Father Hopkins, declaring that every good poem written by an Englishman was a blow struck for England--and profit instead, if I may, by (...) the presence among us of Edward Said. I do not know, and it is none of my business to know, what passport Said presents at the international frontier. But it is surely common knowledge among us that he has deep and feelingful and intimate allegiances to the state of Lebanon. Who of us has failed to connect this with his books Orientalism and The Question of Palestine? The point is that, having made this connection, none of us thinks the worse of Said. On the contrary, we recognize that he has a special stake in such topics and therefore speaks on them with a special authority. Unless I am mistaken, that stake and that authority are, in a perhaps extended sense, patriotic. And whatever our speculative objections to the idea and the principle of patriotism, in practice we recognize it and we honour it.What I am questioning, it will now be plain, is the principle of "disinterest." "The disinterested pursuit of knowledge"—it is what in our distinct disciplines all of us have paid lip-service to, and perhaps more than lip-service. But when we come right down to it, is it what we believe? The honest patriot declares an interest; and if we are wise, we take note of the declaration, making allowances and reserving doubts accordingly. But what are we to make of the scholar who declares no interest, who claims implicitly to be truly disinterested. Can we believe him? And if we cannot, what guidance do we have as to what reservations to make, what doubts to entertain? I am of one mind with my Marxist colleagues who, from a political position very far from mine, warn us to be especially suspicious of the scholar who claims to have no axe to grind. We, all of us, have axes to grind; the crucial distinction is between those who know this about themselves and those who don't.Let me make myself clear. When I urge that the terms "patriotism" and "patriotic" be reinstated in our discourse, and particularly in those forms of our discourse that may be called "interpretation," I do not imply that patriotism is a nobler, a more elevated instigation than sundry others, mostly ideological, of which we are more aware. The point is precisely that of these others we are aware because we share a vocabulary which acknowledges them, whereas "patriotic" has been banished from our vocabulary, and so the reality which the word represents is left out of our calculations. Let me admit for the sake of argument what I do not in fact believe-- that patriotism is a concept and a sentiment so besmirched by the unholy uses made of it that, if mankind is to survive, patriotism will have to be eradicated. Even if that were the case, it remains true that patriotic interest and incitement are very far from having been eradicated from the world that we in fact inhabit, and try to interpret, here and now; and if we try to work within a vocabulary that pretends otherwise, we condemn ourselves to producing interpretations that are drastically partial and perhaps disastrously misleading. The point is not whether patriotism is a good thing or a bad thing but simply that it is; it exists, as powerful factor which we all in our hearts acknowledge even as our vocabulary refuses to. And when we speak in this context of "the world," we certainly include in that world ourselves, who offer to interpret it. Every one of our interpretations is coloured by the fact that we, the several interpreters, are British or American, French or Italian or Russian or whatever. If we think otherwise, we deceive ourselves; and yet where, in any of our currently acceptable vocabularies, determined as all of them are by the glib rationalism of the Enlightenment, do we find that momentous fact about ourselves acknowledged? Where is it acknowledged, for instance, in the vocabulary of feminism that "woman," as conceived by an American writing about Italians, cannot help but be significantly different from "woman" as conceived by an Italian looking at Americans? Or again, an Italian woman may well, we must suppose, be an Italian patriot; but where, in the current vocabulary of feminists, is that dimension of her "woman-ness" allowed for? Let it be acknowledged only so as to be deplored; but let it in any event be acknowledged. At the moment, it isn't.Donald A. Davie, the distinguished poet, is Andrew W. Mellon Professor of the Humanities at Vanderbilt University and honorary fellow of Saint Catharine's College, Cambridge and of Trinity College, Dublin. He has edited The New Oxford Book of Christian Verse, and his Collected Poems 1950-1970 appeared in 1972. His latest publications are Dissentient Voice and These the Companions; Recollections. (shrink)

In this paper I challenge the reader to witness the environmental and feminist aegis as an epicine confrontation with nature whose main goal is to reconcile a lost partnership with the archetype I have labeled Sophia. Sophia, whose providential origins lie somewhere amid the great pre-Hellenic gnostic cults, can only bring salvation if she is liberated by humanity through the resacralization of nature. It is this change in consciousness that points toward a radical environnlental ethic and a total reconceptualization of (...) the becoming process. (shrink)

What differentiates expressions of pain from other facial expressions? Which facial features convey the most information in an expression of pain? To answer such questions we can explore the expertise of human observers using psychophysical experiments. Techniques such as change detection and visual search can advance our understanding of facial expressions of pain and of evolved mechanisms for detecting these expressions.