Individual and Society in Buddhism. W. G. Weeraratne. Metro Printers Ltd., Colombo. 101pp £2.

The author reviews and continues the debate initiated by her recent paper in this journal. The paper was critical of certain aspects of palliative medicine, and caused Ashby and Stoffell to modify the framework they proposed in 1991. It now takes account of the need for artificial hydration to satisfy thirst, or other symptoms due to lack of fluid intake in the terminally ill. There is also a more positive attitude to the emotional needs and ethical views of the patient's (...) family and care-givers. However, clinical concerns about the general reluctance to use artificial hydration in terminal care remain, and doubts persist about the ethical and legal arguments used by some palliative medicine specialists and others, to justify their approach. Published contributions to the debate to date, in professional journals, are reviewed. Key statements relating to the care of sedated terminally ill patients are discussed, and where necessary criticised. (shrink)

The world is not on track to achieve Agenda 2030—the approach chosen in 2015 by all UN member states to engage multiple stakeholders for the common goal of sustainable development. The creation of the 17 Sustainable Development Goals (SDGs) arguably offered a new take on sustainable development by adopting hybrid and principle-based governance approaches, where public, private, not for profit and knowledge-institutions were invited to engage around achieving common medium-term targets. Cross-sector partnerships and multi-stakeholder engagement for sustainability have consequently taken (...) shape. But the call for collaboration has also come with fundamental challenges to meaningful engagement strategies—when private enterprises try to establish elaborate multi-stakeholder configurations. How can the purpose of businesses be mitigated through multi-stakeholder principle-based partnerships to effectively serve the purpose of a common sustainability agenda? In selecting nine scholarly contributions, this special issue aims at advancing this discourse. To stimulate further progress in business studies, this introductory essay, furthermore, identifies three pathways for research on multi-stakeholder engagement processes in support of the Decade of Action along three coupling lines: multi-sector alignment (relational coupling), operational perception alignment (cognitive coupling) and goal and strategic alignment (material coupling). (shrink)

The meaning of the once widely used term the Gibbs Free Energy in terms of available work energy is perfectly illustrated for chemical reactions by the Van’t Hoff Equilibrium Box. Combining this with DeDonder’s extent of reaction variable and using the reaction of $$\hbox {NH}_3$$ to $$\hbox {H}_2$$ and $$\hbox {N}_2$$ at $$200^{\circ }\hbox {C}$$ as an example shows the difference between total work energy and available work energy, and in addition allows calculation of the equilibrium composition, demonstration of the (...) minimum in the Gibbs energy curve, and the standard relationship between $$\Delta _\textrm{r}G^{\circ }$$ and $$\ln {K}$$. (shrink)

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)

Objectives: To compare non-treatment decision making by general practitioners and geriatricians in response to vignettes. To see whether the doctors’ decisions were informed by ethical or legal reasoning.Design: Qualitative study in which consultant geriatricians and general practitioners randomly selected from a list of local practitioners were interviewed. The doctors were asked whether patients described in five vignettes should be admitted to hospital for further care, and to give supporting reasons. They were asked with whom they would consult, who they believed (...) ought to make such decisions, and whether the relatives’ preferences would influence their decision making.Main measures: To analyse the factors influencing the doctors’ decisions not to admit otherwise terminally ill patients to hospital for life prolonging treatment.Results: Seventeen GPs and 18 geriatricians completed the interview. All vignettes produced strong concordance in decision making between both groups. Ten per cent of the doctors would provide life prolonging treatment to patients with severe brain damage. Most would admit a surgical patient regardless of age or disability. Medical reasons were largely used to explain decision making. The wishes of relatives were influential and resource considerations were not. There was variability regarding decision making responsibility.Conclusions: Little attempt was made to link decision making with ethical or legal concepts and there may have been non-recognition, or denial, of the ethical consequences of failure to admit. The process of decision making may involve deception. This may be conscious, because of the illegality of euthanasia, or unconscious , because of deepseated medical and societal reluctance to accept that intentionally withholding life prolonging treatment may equate with intentionally causing death. (shrink)

The functioning of a subject in a changing environment is most effective from the point of view of survival if the subject can form, maintain and use internal representations of the external world for decision-making. These representations are also called reflection in a broad sense. Using it, one can win in reflexive games since an internal representation of the enemy allows predicting their future moves. The goal is to assess the reflexive potential of heuristic model objects – artificial neural networks (...) – in the reflexive games “Even-Odd” (or “Matching pennies”) and “Rock-Paper-Scissors”. We used homogeneous fully connected neural networks of small sizes (from 8 to 45 neurons). Games were played between neural networks with different configurations and parameters (size, step size for modifying weight coefficients). A set of reflexivity criteria is presented, corresponding to different levels of consideration: neuronal, behavioral, formal. The transitivity of formal success in the game is shown. The most successful configurations, however, may not meet other criteria of reflexivity. We hypothesize that the best compliance with the criteria and, as a consequence, universal success in reflection tasks is achievable for heterogeneous configurations with a structure in which the formation of hierarchical systems of attractors is possible. (shrink)

Negotiation is a complex and dynamic decision process during which parties perceptions, preferences, and roles may change. Modelling such a process requires flexible and powerful tools. The use of rule-based formalism is therefore expanded from its traditional expert system type technique, to structuring and restructuring non-trivial processes like negotiation. Using rules we build a model of a negotiation problem. Some rules are used to infer positions and reactions of the parties, other rules are used to modify problem representation when such (...) a modification is necessary. We illustrate the approach with a contract negotiation case between two large companies. We also show how this approach could help one party to realize that negotiations are being carried on against their assumptions and expectations. (shrink)

Objectives—To study the value of taking an ethics history as a means of assessing patients' preferences for decision making and for their relatives' involvement.Design—Questionnaire administered by six junior doctors to 56 mentally competent patients, admitted into general and geriatric medical beds.Setting—A large district general hospital in the United Kingdom.Main measures—To establish whether patients were adequately informed about their illness and whether they minded the information being communicated to their relatives. To establish their preference regarding truthful disclosure and participation in decision (...) making with risk attached. To establish whether they wished to be involved in CPR decision making, and if not, who should make the decision. To establish whether they knew of living wills and whether they had any advance directives.Results—Twenty-four were inadequately informed of their illness.Forty-six said they would want to know were something serious to be found. Twenty-eight wanted to make their own decision if requiring risky treatment and 11 wanted family members involved. Thirty-one wanted to make a cardiopulmonary resuscitation decision and five of these decisions differed from those made by the doctors. Twenty-five preferred the doctors to decide. Eleven of the patients had heard of living wills but only one had executed such a will. Seven of the patients wished to provide advance directives. Three did not find the history taking helpful but none were discomforted.Conclusion—Taking an ethics history is a simple means of obtaining useful information about patients' preferences. (shrink)

This book comprises material on colour which was written by Wittgenstein in the last eighteen months of his life. It is one of the few documents which shows him concentratedly at work on a single philosophical issue. The principal theme is the features of different colours, of different kinds of colour and of luminosity—a theme which Wittgenstein treats in such a way as to destroy the traditional idea that colour is a simple and logically uniform kind of thing. This edition (...) consists of Wittgenstein's basic German text, together with an English translation. (shrink)

The debate about constructivism in physics has led to different kinds of questions that can be conventionally framed in two classes. One concerns the mathematics that is considered for the theoretical development of physics. The other is concerned with the experimental parts of physical theories. It is unnecessary to observe that the intersection between our two classes of problems is far from being empty. In this paper we will mainly deal with topics belonging to the second class. However, let us (...) briefly mention some important problems that have been debated in the framework of our first class. For instance, the following: to what extent do the undecidability and incompleteness results of classical mathematics affect fragments of physical theories, in such way as to have a “real physical meaning”? are the mathematical arguments that seem to be essential for physics justifiable in the framework of traditional mathematical constructivism?The first question has recently been investigated by Pitowski, Penrose, da Costa, Doria, Mundici, Svozil and others. As expected by most logicians, one can construct undecidable sentences whose physical meaning seems to be hardly questionable. This happens both in classical and in quantum mechanics. (shrink)

How scientific assumptions point to God -- How laws of nature point to God -- How physical constants points to God -- How a grand unified theorypoints to God -- How the big bang points to God -- How genetics points to God -- How evolution points to God -- How neuroscience points to God -- How behavioral science points to God -- How semantics points to God -- How logic and math point to God -- How Gödel's theorem points (...) to God. (shrink)

O texto busca refletir criticamente sobre alguns fenômenos sociais contemporâneos, fortemente imbricados, notadamente as tendências contemporâneas de entrincheiramento e achatamento do eu; o reforço da iconomania e da compulsiva produção de avatares de si, em meio a bolhas narcísicas digitais, franqueadas pelas recentes tecnologias de informação e comunicação; e a virtual destruição da intimidade e da privacidade, diante da emergência de panópticos digitais e da vigilância algorítmica. Para tanto, toma-se como ponto de partida proposições apresentadas por Christopher Lasch em sua (...) obra _The Minimal Self: Psychic Survival in Troubled Times_, publicada originalmente em 1984, em particular a própria noção de mínimo eu, as quais são, então, entretecidas com argumentos de Christophe Dejours, Günther Anders, Theodor Adorno, Hebert Marcuse, Jonathan Crary, entre outros. Em acréscimo, busca-se salientar a ancoragem desses processos à hodierna dinâmica de acumulação de capital, a partir da crítica da economia política, perspectiva que atravessa todo o texto, bem como assinalar a atualidade do pensamento de Lasch. (shrink)

OBJECTIVES: Cognitive and sensory difficulties frequently jeopardize informed consent of frail elderly patients This study is the first to test whether preliminary research experience could enhance geriatric patients' capacity to consent. DESIGN/SETTING: A step-wise consent procedure was introduced in a study on fluid balance in geriatric patients. Eligible patients providing verbal consent participated in a try-out of a week, during which bioelectrical impedance and weight measurements were performed daily. Afterwards, written informed consent was requested. Comprehension, risk and inconvenience scores (ranges: (...) 0-10) were obtained before and after the try-out by asking ten questions about the study's essentials and by asking for a risk and inconvenience assessment on a ten-points rating scale. SUBJECTS AND RESULTS: Seventy of the 78 eligible subjects started the try-out and 53 (68%) provided written consent. The comprehension score increased from 5.0 (+/- 2.3) to 7.0 (+/- 1.9) following the try-out (P < 0.001). The number of subjects capable of weighing risks and inconveniences increased from 32 to 48 (P < 0.001). CONCLUSIONS: Research experience improved the capacity to consent, still enabling an acceptable participation rate. Therefore, experienced consent seems a promising tool to optimize informed consent in frail elderly subjects. (shrink)

Radzikowska and Kerre developed L-fuzzy rough set as a fuzzy generalisation of the notion of rough sets. Specifically, they have taken a residuated lattice L as the underlying set of truth degrees. However, in real life, we may encounter situations where truth degrees are not always linear, or where the existence of the least upper bound of two elements is no longer required. Instead, there may be the possibility of having minimal upper bounds, and dually, maximal lower bounds, multilattices have (...) become a suitable algebraic structure for addressing such cases. Our aim is to extend Radzikowska and Kerre's work by replacing a residuated lattice with a multilattice M, thereby obtaining a more flexible structure. We define M-fuzzy rough sets using operators derived from adjoint pairs within the multilattice M. For a tolerance and an equivalence M-fuzzy relation, we define an appropriate M-fuzzy rough set and investigate its properties. (shrink)