Infant A was born at term with an antenatal diagnosis of gastroschisis. His parents were well informed about the condition and understood that he would require surgery. However, at delivery, his bowel was found to be severely compromised. Infant A returned from theatre with only four centimeters of small bowel. This is physiologically devastating and easily qualifies as ultrashort bowel syndrome (USBS). Whilst the prognosis from ultrashort bowel syndrome is greatly improving, the condition continues to carry a significant risk of (...) mortality and morbidity, in part attributable to treatment itself. The cornerstone of management of USBS is provision of intravenous parenteral nutrition (PN). This is not a physiologically normal route of nutrition; it is a medical treatment. Infant A’s parents questioned whether continuation of active treatment was appropriate. If a treatment is not in the patient’s best interests, then it can be argued it is not justified to administer it. Decisions about quality of life are intensely personal. Where there is a significant burden of treatment, even when there is a potential for increased survival, whether the course of treatment is in the child’s best interests must be taken with huge emphasis on the parental perspective and their family values. For well-informed, realistic parents who are welcoming of the full picture of information and implications of their decision, I argue that parents are best placed to make the decision for their child. Long-term PN for USBS may well be a medically encouraged treatment. However, it should not be medically mandated. (shrink)

Coastal ecosystems are increasingly dominated by humans. Consequently, the human dimensions of sustainability science have become an integral part of emerging coastal governance and management practices. But if we are to avoid the harsh lessons of land management, coastal decision makers must recognize that humans are one of the more coastally dependent species in the biosphere. Management responses must therefore confront both the temporal urgency and the very real compromises and sacrifices that will be necessary to achieve a sustainable coastal (...) ecosystem, one that is economically feasible, socially just, and ecologically sound. (shrink)

Où se trouve le sérieux? L'auteur se pose cette question peu commune, et se met en quête d'une réponse. Il propose une articulation du sérieux selon les modes épistémologique, esthétique et éthique, pour l'approcher indirectement par le feint, le comique et le léger. Il s'attaque d'abord au problème que pose une quête du sérieux par le " feint ", ce qui le conduit à des interprétations originales du doute cartésien, du langage philosophique et de la connaissance scientifique : il distingue (...) le feint du fictif et du faux, mais constate aussi que le feint a tendance à se transformer en l'un ou en l'autre. L'auteur s'aventure ensuite dans le domaine esthétique où, à partir d'une critique de la théorie bergsonienne du rire, il développe sa propre interprétation du comique ; il soutient que la musique est l'art relativement le plus sérieux, mais que le sérieux comme tel est absent de l'art. Passant à la morale, il se voit obligé d'abord de s'expliquer avec les existentialistes français, ennemis déclarés du sérieux, puis, après une franche appréciation du sérieux de notre époque, d'admettre finalement que le léger y joue un rôle essentiel aussi. Distinguant en plus le sérieux du fanatique, l'auteur tente de préciser les rapports entre le sérieux et la foi, la Bible, et la pensée kierkegaardienne. Il conclut que la philosophie, et plus particulièrement la métaphysique, est le ressort du sérieux, mais que le philosophe est tenu par son sérieux même de chercher toujours plus loin. Le livre est écrit sous la forme de carnets, dans un style clair et engageant ; non dépourvu d'humour, il s'adresse à tout lecteur philosophiquement averti. (shrink)

Amongst Kant's lesser known early writings is a short treatise with the curious title Dreams of a Spirit-Seer Explained by Dreams of Metaphysics, in which, with considerable acumen and brilliance, and not a little irony, Kant exposes the empty pretensions of his contemporary, the Swedish visionary and Biblical exegete, Emanuel Swedenborg, to have access to a spirit world, denied other mortals. Despite his efforts, it must be feared, however, that Kant did not, alas, succeed in laying the spirit of Swedenborg (...) himself to rest once and for all, for there has arisen in our own day, and within philosophy itself, a movement of thought, if such it can be called, which, like that of Swedenborg, is founded upon an unbridled and unhealthy exercise of the imagination, and apparently believes that philosophical problems can be discussed and resolved by the elaboration of fantastical, and at times repulsive, examples; if we require a name for this contemporary pretence at philosophy, we could take as our model the Italian word for science fiction, fantascienza, and call it ‘fantaphilosophy’: it is my aim to show that this fantaphilosophy is a phantom philosophy. (shrink)

This article won the Mind prize essay competition announced last year, for an essay defending the academic pursuit of philosophy. The author is at present a free-lance philosopher; at the time of writing the paper he was a part time lecturer at the University of Newcastle upon Tyne, in the department that has since closed. His collection of aphorisms, Sentences and Slogans has recently been published privately (for details, see 'Books Received').

There are doubtless many with personal experience of suffering, or of comforting others in distress, who would agree with Milton thus far that philosophic argument is powerless to satisfy those who in their anguish ask the question ‘Why did it happen to me?’ Yet to think so is to underestimate both the necessity and the power of reason: clarity of mind and the disposition to argue are commonly enhanced rather than diminished by suffering; and if reason is an essential part (...) of man's nature, it should serve him, if anywhere, in the trials of life. We have every justification, therefore, despite common opinion, for seeking a rational answer to the question proposed. It must, however, be admitted at the outset that there is no direct answer to the question which can both withstand critical scrutiny and bring genuine comfort to the afflicted, an answer, that is, which accepts the question as it stands with its attendant presuppositions; but there is an indirect answer, which, precisely by rejecting one or more of these presuppositions and restating the question, can indeed satisfy these two requirements. Before such an answer can be outlined, however, the question in its traditional form must be examined and the traditional answers to it critically reviewed. (shrink)

English summary: It seems that reason is less a universal principle than something inherently bound to the contexts in which it appears. These contributions to a conference held on the occasion of Christoph Schwobel's 60th birthday explore the character of reason's manifold contexts: the grounding of reason in the inner word of God 's Trinitarian life as well as the disclosure of reason and and its limits in human conversation. German description: Vernunft scheint in der Gegenwart weniger ein allgemeines Prinzip (...) als eine in Kontexte eingebundene Grosse zu sein. Die Beitrage einer Tagung anlasslich von Christoph Schwobels 60. Geburtstag, gehen der Frage nach dem Charakter dieser Kontextbindung nach: der Begrundung der Vernunft im trinitarischen Gesprach wie der Erschliessung und Problematisierung der Vernunft im menschlichen Gesprach. Mit Beitragen von V. Brummer, G. van den Brink, C. Drobe, H. J. Eckstein, D.-M. Grube, J. Halfwassen, S. Heine, F. Hermanni, E. Herms, W. Harle, W. Homolka, W. Jeanrond, R. W. Jenson, D. Kelsey, A. F. Koch, A. Kupsch, V. Leppin, P.-C. Lai, P. Lo, A. Min, J. Moltmann, M. Muhling, P. Peterson, M. Sarot, F. Schweitzer, A. Torrance, J. Webster, M. Welker, M. Wendte, M. Wisse, H. Wisskirchen und L. Zak. (shrink)

This work extend to residuated lattices the results of [ 7 ]. It also provides a possible generalization to this context of frontal operators in the sense of [ 9 ]. Let L be a residuated lattice, and f : L k → L a function. We give a necessary and sufficient condition for f to be compatible with respect to every congruence on L . We use this characterization of compatible functions in order to prove that the variety of (...) residuated lattices is locally affine complete. We study some compatible functions on residuated lattices which are a generalization of frontal operators. We also give conditions for two operations P ( x , y ) and Q ( x , y ) on a residuated lattice L which imply that the function $${x \mapsto min\{y \in L : P(x, y) \leq Q(x, y)\}}$$ when defined, is equational and compatible. Finally we discuss the affine completeness of residuated lattices equipped with some additional operators. (shrink)

In this paper we study the variety of order Hilbert algebras, which is the equivalent algebraic semantics of the order implicational calculus of Bull.

First published in 2003. Routledge is an imprint of Taylor & Francis, an informa company.

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

In this paper, the authors attempt to prove there is a relationship between Borges’ “Argumentum ornithologicum” and Anselm’s argument “Argumentum ontologicum”. We suggest Borges, using the image of a flock of birds, with oriental reminiscences, half joking, half serious attempts to prove the existence of God. We demonstrate the fallacies incurred by Borges and why his “Argumentum” has no place within the traditional set of ontological arguments. However, it would easy to forget that Borges’ claim is not philosophical, nor theological, (...) nor apologetic, but rather ironic or paradoxical. (shrink)

In Ontology, quality determines beings. The quality-quantity bipolarity reveals that a conceptual logical comprehension that can include negation must be a dialectical logic. Quality is a precise characteristic of something capable of augmentation or diminution while remaining identical through differences or quantitative changes. Thus, quality and in opposition quantity are inextricably linked, giving definition to each other, so constituting a logical bipolarity. The theory is that a magnitude G is never separated from secondary qualities α and β, and therefore, a (...) measure depends on a concrete quality Gα or Gβ, that is to say on one pole of a logical bi-pole. However, the particular number, the unit, that expresses the result of a measure is the quality G alone. Examples drawn from physical and chemical experiments illustrate these ideas and elaborate the structure of the concept of opposition between the secondary qualities α and β of a magnitude G. (shrink)

We review the history of the road to a manifestly covariant perturbative calculus within quantum electrodynamics from the early semi-classical results of the mid-twenties to the complete formalism of Stueckelberg in 1934. We choose as our case study the calculation of the cross-section of the Compton effect. We analyse Stueckelberg's paper extensively. This is our first contribution to a study of his fundamental contributions to the theoretical physics of the twentieth century.

Les principaux problèmes que Bultmann a posés au plan de l’exégèse historique des textes évangéliques étaient commandés par des positions théologiques et continuent pour ce motif à interroger les théologiens catholiques, qui parfois le rejettent dans le camp tantôt du scientisme tantôt du dogmatisme.Contre la théologie libérale des « vies de Jésus », il élève une double protestation, d’ordre christologique : il revendique le caractère historique de la foi chrétienne, et historique : il prend au sérieux la visée eschatologique de (...) la prédication de Jésus. Marquée en ses origines par un rationalisme dogmatique, l’exégèse historico-critique travaille à son tour la théologie, l’oblige à assumer sa propre historicité et à sortir ainsi de son propre positivisme dogmatique.Réservant – à juste titre – à la foi de dire le sens de la Croix, Bultmann semble séparer le fait et le sens et mettre l’historiographie et la théologie en rapport contradictoire de double vérité. Nous savons mieux aujourd’hui qu’il n’y a de faits qu’interprétés ; la foi atteint la vérité historique des faits, mais doit renoncer à demander de les établir « scientifiquement » à une historiographie censée « objectivement neutre ». En soutenant que le sens de la Croix relève d’une décision de foi, Bultmann nous rappelle utilement, ainsi que l’a reconnu R. Marlé, qu’on ne peut jamais évacuer le skandalon de la foi.The principal problems that Bultmann presented as regards the historical exegesis of evangelical texts were guided by theological positions and continued, for this reason, to question Catholic theologians, who sometimes put him in the camp of scientism and sometimes in that of dogmatism.Against the liberal theology of the “lives of Jesus”, he raised a double protest : of a christological nature and of a historical nature . Marked in its origins by dogmatic rationalism, historical-critical exegesis works in its turn on theology, obliges it to assume its own historicity and this to escape from its own dogmatic positivism.Allowing faith – and for good reason – to decide the meaning of the Cross, Bultmann seems to separate the fact and the meaning and to put historiography and theology in contradictory rapport of a double truth. We know better today that there are only interpreted facts ; faith attains the historical truth of facts, but must renounce the demand to establish them “scientifically” to a historiography believed to the “objectively neutral”. In holding that the meaning of the Cross depends on a decision of faith, Bultmann helpfully reminds us, as R. Marlé recognized, that one can never escape the skandalon of faith. (shrink)

This paper reports a study of planning processes in the five-disc Tower of London (TOL) task in 20 younger and 20 older adult participants. A concurrent direct ''think-aloud'' method was used to obtain data on planning processes prior to moving discs in the TOL. A check was made of the effects of verbalising by comparing performance data from the experimental groups with data from control groups who did not verbalise during planning or moving. Verbalising slowed down planning and moving but (...) did not appear to distort the participants' approaches to the task. Older and younger participants did not differ in average moves taken to solve the tasks. However, older participants' planning was less complete and more error-prone than that of younger participants. The planning processes were characterised as showing a means-ends ''goal selection'' strategy. In this strategy participants (1) identify a single active goal disc at the start, (2) select moves and move sequences to enable the placing of the current goal disc in its target position, and (3) continue in this way until all discs are in their target positions. Age differences were found in the planning stage, during which there was no stimulus support and hence a substantial working memory load. During the move phase there was stimulus support and hence little loading of working memory. Age differences in moves required were not found in the move phase. As older participants tend to have depleted working memory capacity the present results suggest that working memory is heavily loaded in TOL planning but less so in the move phase of TOL. (shrink)