Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

An outline of the life of Heraclides and his fragmentary writings (on the theory of matter, astronomy, ethical and religious topics) is followed by an attempt to reconstruct his thought. He emerges as not so much a profound thinker as a many-sided writer of considerable literary gifts and occasional flashes of brilliance.

There are a number of fragments attributed to Theophrastus, as well as titles in Diogenes Laertius' catalogue of his writings , of which it is uncertain whether they should be placed among his logical or rhetorical works. In this note I want to give my reasons for excluding one of them from my forthcoming edition of his logical fragments. It is not my intention here to discuss all the questions it raises; I hope to come back to them in a (...) later volume of my commentary. (shrink)

By a “world-outlook” I mean a systematic account of the nature of the world which claims, by showing the place of man in the scheme of things, to indicate the point and purpose of his life. The theory of the world is often called a metaphysical theory and the theory of conduct an ethical or moral theory. In my opinion the clarification and criticism of world-outlooks is a fundamental part of philosophy. Indeed, I hardly think that philosophy would have existed (...) as something distinct from science or poetry but for the tendency to attempt some explanation of the world as the scene of human endeavour. When Kant referred to “the inevitable problems of pure reason” about “God, freedom, and immortality,” he was referring in a summary way to the fundamental philosophical task of analysing and criticizing world-outlooks, a task that may be undertaken even by those philosophers who do not believe that any world-outlook is or could be adequate. It is clear, of course, that the civilized religions, since they seek to show how human conduct fits in with some Divine Plan or Cosmic Conflict, have world-outlooks. It is, however, misleading to look upon religions and world-outlooks as the same thing, as some people do. For in ordinary usage religion involves belief in supernatural beings and conduct regulated in the light of this belief, but according to some world-outlooks there are no supernatural beings, while according to others beings may exist deserving that description but human conduct need take no account of them. (shrink)

(1997). The fly in the ointment: A study of relativism in MacIntyre and Goodman as applied to innocence and guilt in Kafka's the trial. The European Legacy: Vol. 2, Fourth International Conference of the International Society for the Study of European Ideas, pp. 609-614.

Gary Kemp defends Realist approaches to the paradox of analysis. Other, prima facie equally viable approaches to this problem are the Nominalist one of Langford and Camap and the Conceptualist one of Prior and Stalnaker. In the context of a fuller survey focus is set on the realist attempt. This puts one in a better position to arbitrate between these approaches and give a more final assessment of the realist one, including an assessment of Kemp's defence of it. The Conceptualist (...) one, as it turns out, triumphs over the others, and is the basis for a Wittgensteinian vie w of the a priori which is analyzed in the second part of the paper. (shrink)