Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

A phenomenalist philosophy which employs the Principle of Acquaintance (PA) plus the Principle that what exists are the referents of certain meaningful terms, defined by PA, cannot include either universals or particulars in its ontology, but is limited to instances of universals as constituting the range of ontological existents. Universals must be omitted since they are repeatable and, hence, never wholly presented or contained, whereas the objects of direct acquaintance are wholly and exhaustively presented. Furthermore, no entities beyond characters (qualities (...) and relations) are given in direct acquaintance; hence, particulars, too, must be omitted for the phenomenalist who relies on PA. (shrink)

We examine the evolution of the concept of stability in community ecology, arguing that biologists have moved from an emphasis on biotic communities characterized by static balance, to one of dynamic balance (returning to equilibrium after perturbation), to the current concept of stability as persistence. Using Wimsatt's (1987) analysis of how false models can often lead to better ones, we argue that failed attempts to link complexity with stability have significant heuristic value for community ecologists. Nevertheless, we argue that, (A) (...) because there is no common characteristic that stability terms presuppose, community ecology might be better served by abandoning the concept of stability and by employing instead specific terms such as 'persistence', 'resistance', and 'variability'. (B) The current emphasis (of stability terms) on persistence of species provides little basis for explaining possible mechanisms that might account for persistence. (shrink)

In this note I shall: discuss Vivas' definition of "naturalism" and his criticism of naturalistic theories; characterize a naturalistic theory which Vivas overlooks, and which, hence, invalidates his attempted refutation; suggest criticisms of Vivas' "axiological realism", with special attention to the central doctrine of the objectivity of values.

Four models of forgiveness are identified; the health model, the philosophical model, the Christian model and the prosocial model. All define the term ‘forgiveness’ in a way which is consistent with their particular perspective. The authors offer a definition of forgiveness and propose an integrated model of forgiveness which seeks to incorporate contributions from all four areas, but is not biased towards any one model. Four levels of transgression are identified and categorized according to the degree of perceived damage. Apology-automatic (...) and apology-dependent responses are distinguished from a forgiveness response which is restricted to Levels 3 and 4. The advantages of adopting a forgiveness strategy for both the forgiver and forgiven as opposed to other responses, i.e., revenge, denial, and condoning are discussed. The authors provide a definition and model which integrates the important contributions from each of the areas discussed. (shrink)

Originally published in 1935, this book contains the text of lectures delivered earlier in that year at the Young Public School Masters' Conference on a variety of topics concerning the challenges facing modern educators. The issues covered include the teaching of Classics, modern languages and internationalism. This book will be of value to anyone with an interest in the history of education.

A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics (...) of health care. The moral status of any system of managed care ought to be judged with respect to its congruence with Gospel teachings about the care of the sick, Papal Encyclicals, and the documents of the Second Vatican Council. In this essay, I look at the important conceptual or definitional issues of managed care, assess these concerns over against the source and content of a Catholic ethic of health care, and outline the necessary moral requirements of any licit system of health care. (shrink)

A comprehensive anthology of selections for the Introductory Philosophy of Religion course, this text surveys more than 50 responses to the question, "Is religious belief a viable option in today's world?" Organizes selections around central theistic positions and attacks on those positions. Pro-con format encourages lively discussions.