I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious (...) roadblocks to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires. (shrink)

Jaegwon Kim’s causal exclusion argument has rarely been evaluated from an empirical perspective. This is puzzling because its conclusion seems to be making a testable claim about the world: supervenient properties are causally inefficacious. An empirical perspective, however, reveals Kim’s argument to rest on a mistaken conception about how to test whether a property is causally efficacious. Moreover, the empirical perspective makes visible a metaphysical bias that Kim brings to his argument that involves a principle of non‐inclusion.

This paper extends previous arguments against the assumption that the study of variation at the molecular level was instigated with a view to solving an internal conflict between the balance and classical schools of population genetics. It does so by focusing on the intersection of basic research in protein chemistry and the molecular approach to disease with the enactment of global health campaigns during the Cold War period. The paper connects advances in research on protein structure and function as reflected (...) in Christian Anfinsen’s The molecular basis of evolution, with a political reading of Emilé Zuckerkandl and Linus Pauling’s identification of molecular disease and evolution. Beyond atomic fallout, these advances constituted a rationale for the promotion of genetic surveys of human populations in the Third World, in connection with international health programs. Light is shed not only on the experimental roots of the molecular challenge but on the broader geopolitical context where the rising role of biomedicine and public health had an impact on evolutionary biology. (shrink)

Rejecting structural contraction has been proposed as a strategy for escaping semantic paradoxes. The challenge for its advocates has been to make intuitive sense of how contraction might fail. I offer a way of doing so, based on a “naive” interpretation of the relation between structure and logical vocabulary in a sequent proof system. The naive interpretation of structure motivates the most common way of blaming Curry-style paradoxes on illicit contraction. By contrast, the naive interpretation will not as easily motivate (...) one recent noncontractive approach to the Liar paradox. (shrink)

The answers to the questions in the title depend on the kind of pluralism one is talking about. We will focus here on our own views. The purpose of this article is to trace out some possible connections between these kinds of pluralism. We show how each of them might bear on the other, depending on how certain open questions are resolved.

Over the last few decades Michael Dummett developed a rich program for assessing logic and the meaning of the terms of a language. He is also a major exponent of Frege's version of logicism in the philosophy of mathematics. Over the last decade, Neil Tennant developed an extensive version of logicism in Dummettian terms, and Dummett influenced other contemporary logicists such as Crispin Wright and Bob Hale. The purpose of this paper is to explore the prospects for Fregean logicism within (...) a broadly Dummettian framework. The conclusions are mostly negative: Dummett's views on analyticity and the logical/non-logical boundary leave little room for logicism. Dummett's considerations concerning manifestation and separability lead to a conservative extension requirement: if a sentence S is logically true, then there is a proof of S which uses only the introduction and elimination rules of the logical terms that occur in S. If basic arithmetic propositions are logically true-as the logicist contends-then there is tension between this conservation requirement and the ontological commitments of arithmetic. It follows from Dummett's manifestation requirements that if a sentence S is composed entirely of logical terminology, then there is a formal deductive system D such that S is analytic, or logically true, if and only if S is a theorem of D. There is a deep conflict between this result and the essential incompleteness, or as Dummett puts it, the indefinite extensibility, of arithmetic truth. (shrink)

Within the evidence-based medicine construct, clinical expertise is acknowledged to be both derived from primary experience and necessary for optimal medical practice. Primary experience in medical practice, however, remains undervalued. Clinicians’ primary experience tends to be dismissed by EBM as unsystematic or anecdotal, a source of bias rather than knowledge, never serving as the “best” evidence to support a clinical decision. The position that clinical expertise is necessary but that primary experience is untrustworthy in clinical decision-making is epistemically incoherent. Here (...) we argue for the value and utility of knowledge gained from primary experience for the practice of medicine. Primary experience provides knowledge necessary to diagnose, treat, and assess response in individual patients. Hierarchies of evidence, when advanced as guides for clinical decisions, mistake the relationship between propositional and experiential knowledge. We argue that primary experience represents a kind of medical knowledge distinct from the propositional knowledge produced by clinical research, both of which are crucial to determining the best diagnosis and course of action for particular patients. (shrink)

ABSTRACT This paper is concerned with the question of whether an individual has a moral obligation to sign a protest petition which has been initiated on moral grounds. It is argued that there is such an obligation when the petition represents a viewpoint with which one broadly agrees. This is a general dury which may lapse with changed circumstances or which may be redeemed by some alternative action. It is argued that the duty to initiate a protest petition is, on (...) the other hand, supererogatory as far as an individual is concerned, but may be a duty for a community or group. Finally it is argued that protest petitions are essentially protests, not against evil deeds as such, but against evil deeds done in one's own name, and are therefore a vital aspect of democracy. (shrink)

As the hospice movement continues to grow, caregivers are increasingly required to interact with dying patients for longer periods and in more intimate and more meaningful ways. Practical models of competent and compassionate communication and understanding need to be developed to accommodate the changing environment of the patient and caregiver and their relationship. We therefore: examine current death education trends in hospice care and education; and describe the need for a more expansive and transpersonal view, and ways of fulfilling that (...) need. The aware patient and the aware caregiver can learn much during the dying trajectory. We hope that someday the potential for expansiveness during the dying trajectory will be more commonly recognized and accommodated as a doorway to the transpersonal. (shrink)

Este estudo resulta de uma investigação sobre as aproximações teóricas entre o pensamento de Willard Van Omar Quine e o pragmatismo filosófico de John Dewey. O enfoque desta abordagem é a concepção naturalista e realista de conhecimento desenvolvida por estes dois teóricos. Busca-‑se compreender as conexões conceituais presentes na epistemologia de ambos, sobretudo, as referências de Quine a um empirismo radical e sem dogmas. O critério de análise comparatória será as seguintes teses: a ruptura com a filosofia apriorística, o naturalismo (...) realista, a crítica aos dogmas do empirismo, a defesa do holismo como alternativa à visão tradicional do conhecimento. (shrink)

Kierkegaard was driven to write The Book on Adler after news spread that a Danish pastor, Adolph P. Adler, claimed to have experienced a revelation in which Christ dictated a new doctrine. Like many others, Kierkegaard was intrigued by Adler--but for different reasons than most. Over the eight years during which Kierkegaard worked on the manuscript, the phenomenon of Adler became a concern secondary to the larger question of authority. Kierkegaard revised the manuscript many times, and published a segment of (...) it as "The Difference between a Genius and an Apostle" in Two Ethical-Religious Essays, but did not publish the work as a whole before his death. The latest integral version of The Book on Adler is included here, along with excerpts from the earlier drafts and a sampling of writing by Adler himself. (shrink)

This paper explores Elisabeth’s remark that ruling and studying each demands an entire person, with the aim of understanding why she might think ruling and intellectual pursuits like philosophy are incompatible with one another. While Elisabeth identifies several barriers to philosophizing, she does not suggest that time constraints are an impediment to both philosophizing and ruling. Situating Elisabeth with respect to Plato, Machiavelli, and Aristotle suggests that she holds there are many similarities between governing and philosophizing. The methodology and skill (...) set of a ruler and a philosopher are very similar; both need to organize their thoughts, consider an array of possible alternatives, gather background information, and be decisive; both take virtue, truth, and justice as their ends, and they are driven by a central concern for something other than themselves. Though both can be moved to high emotions by external forces, they can cultivate the self-awareness that can serve in modulating those emotions in a variety of ways. However, a difference lies in the ways in which the objects of their decisions are constrained in time. This difference in turn disposes each to different emotions. Insofar as their lives are tightly integrated, a ruler and a philosopher would have different affective profiles and organize their lives around different principles. In virtue of these differences, a ruler and a philosopher would indeed need to be two entire persons. (shrink)

Chronic diseases are major causes of health inequalities. Community nurses can potentially make large contributions to chronic illness prevention and management in Israel but may be obstructed by professional dominance of physicians. However, insufficient research exists about community nursing in Israel, and how it may differ from other countries. This study aims to document chronic disease‐related community nursing roles in Israel, identify changes and trends in community nursing roles that may increase social justice, and understand how the roles and trends (...) in community health nursing in Israel may differ from developments in other countries. In‐depth interviews were performed with 55 Israeli health system professionals, and 692 nurse care‐givers were asked open‐ended questions. Interview answers were analyzed to find themes and trends. The study found that community nurse roles in Israel have expanded, especially for chronic disease control. Commonalities exist with countries such as the United States and the UK, albeit with important differences. However, continued conflicts with physicians exist, which can limit nurses' contributions to reducing health inequalities. Community nurses' importance is growing. Enabling them to overcome professional dominance and improve chronic disease control can help reduce health inequalities in Israel and elsewhere. (shrink)

The article presents the feminist discourse on Lilith and asks why she has returned to the centre of activity and creation? It begins with Lilith’s Integrative Myth – a description of the classic Lilith myths – whilst trying to define her image’s central characteristics. Following, I offer one integrative myth: a complex essence that contains contrasts, and stems from a variety of sources, each contributing to the formation of Lilith’s story’s numerous aspects. Lilith’s Revival is discussed, surveying the different ways (...) in which Lilith appears in today’s feminist spiritual discourse, while presenting some of the ways in which her story is re-interpreted and used towards contemporary feminist needs. A feminist Jungian outlook on Lilith’s Myths is included, deciphering Lilith as a symbol of the life-death-life cycle, which leads to a summary of the Jungian analysis’ implications. (shrink)

This collection is the first proceedings volume of the lectures delivered within the framework of the Israel Colloquium for the History, Philosophy and Sociology of Science, in its year of inauguration 1981-82. It thus marks the beginning of a new venture. Rather than attempting to express an ideology of the l}nity of science, this collection in fact aims at presenting a kaleidoscopic picture of the variety of views about science and within science. Three main disciplines come together in this volume. (...) The first of scientists, the second of historians and sociologists of science, the third of philosophers interested in science. The scientists try to present the scientific body of knowledge in areas where the scientific adventure kindles the imagination of the culture of our time. At the same of course, they register their own reflections on the nature of this body time, of knowledge and on its likely course of future development. For the historians and sociologists, in contrast, science is there to be studied diachronically, as a process, on the one hand, and synchronically, as a social institution, on the other. As for the phil9sophers, finally, their contribution to this series is not meant to remain within the confines of what is usually seen as the philosophy of science proper, or to be limited to the analysis of the scientific mode of reasoning and thinking: it is allowed, indeed encouraged, to encompass alter native, and on occasion even competing, modes of thought. (shrink)

In contrast to attempts that have been made to measure the clarity of reporting of the methods of clinical trials in journal articles, we report here an attempt to measure the accuracy of methods reporting. We focus in this article on eligibility criteria as a test case for the reporting of clinical trial methods. We examined the reporting of eligibility criteria in the protocol, methods paper (if applicable), journal article, and Clinical Alert for articles appearing in print between January 1988 (...) and September 1994 for which a Clinical Alert had been issued. Eligibility criteria were further classified into five categories in order to examine the content of information loss, if any. On average, 82% of protocol eligibility criteria were reported in methods papers. Journal articles and Clinical Alerts fared somewhat worse: 63% of criteria were reported in journal articles, 19% in Clinical Alerts. In all three categories of medical communication, the reporting of criteria that defined the study disease tended to be complete; reporting of criteria relating to trial precision, patient safety, legal and ethical concerns, and administrative considerations, was not complete. We found that criteria for clinical trial eligibility are frequently under-reported in medical communications. Moreover, some of the criteria omitted are of considerable clinical importance. We suggest that in the design phase of clinical trials, proposed eligibility criteria be scrutinized closely. Those criteria that survive this scrutiny and that have clinical import must be reported upon fully and accurately when communicating trial results. (shrink)

This article suggests that motivations to engage in research, as in any other human activity, are both explicit and implicit. Explicit motivations tend to be objective and rationalist, concerned with such goals as the advancement and organization of knowledge. But implicit motivations, the 'hidden agendas' of research, also exist and can influence the objectives, methods, and conclusions of the research process. In addition, a highly affectively charged activity such as research also develops its own set of symbolic meanings, which further (...) complicate its various expressions. In this article, three such symbolic meanings are identified: purpose and seriousness; maturity and adulthood; and legitimacy and belonging. The article highlights qualitative research as a methodology compatible with much of family medicine's philosophy and theoretical foundations; and discusses the role of behavioural scientists in participating in a research agenda for the field. The article concludes with a plea for the discipline of family medicine to opt for authenticity in research, rather than settling for a superficial legitimacy in the eyes of other medical specialties. (shrink)

Contributors discuss the work of thinkers such as Cass Sunstein and Jeremy Waldron in their exploration of the relations between philosophical theories and everyday life. They elucidate major attempts to reconcile theory with practice in the Western tradition, from Herodotus to Heidegger, and discuss topics such as the role of theory in judicial decision-making and the political implication of theory. Of interest to philosophers, lawyers, and social scientists. Annotation copyright by Book News, Inc., Portland, OR.