In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

Extant semantic theories for languages containing vague expressions violate intuition by delivering the same verdict on two principles of classical propositional logic: the law of noncontradiction and the law of excluded middle. Supervaluational treatments render both valid; many-Valued treatments, Neither. The core of this paper presents a natural deduction system, Sound and complete with respect to a 'mixed' semantics which validates the law of noncontradiction but not the law of excluded middle.

This series will include monographs and collections of studies devoted to the investigation and exploration of knowledge, information and data-processing systems of all kinds, no matter whether human, (other) animal or machine. Its scope is intended to span the full range of interests from classical problems in the philosophy of mind and phi losophical psychology through issues in cognitive psychology and socio biology (concerning the mental capabilities of other species) to ideas related to artificial intelligence and computer science. While primary (...) emphasis will be placed upon theoretical, conceptual and epistemologi cal aspects of these problems and domains, empirical, experimental and methodological studies will also appear from time to time. Among the most challenging and difficult projects within the scope of artificial intelligence is the development and implementation of com puter programs suitable for processing natural language. Our purpose in compiling the present volume has been to contribute to the foundations of this enterprise by bringing together classic papers devoted to crucial problems involved in understanding natural language, which range from issues of formal syntax and logical form to those of possible-worlds and situation semantics. The book begins with a comprehensive introduc tion composed by Jack Kulas, the senior editor of this work, which pro vides a systematic orientation to this complex field, and ends with a selected bibliography intended to promote further research. If our efforts assist others in dealing with these problems, they will have been worthwhile. J. H. F. (shrink)

In Wrong Medicine, Lawrence J. Schneiderman, M.D., and Nancy S. Jecker, Ph.D., address issues that have occupied the media and the courts since the time of Karen Ann Quinlan. The authors examine the ethics of cases in which medical treatment is offered--or mandated--even if a patient lacks the capacity to appreciate its benefit or if the treatment will still leave a patient totally dependent on intensive medical care. In exploring these timely issues Schneiderman and Jecker reexamine the doctor-patient relationship and (...) call for a restoration of common sense and reality to what we expect from medicine. They discuss economic, historical, and demographic factors that affect medical care and offer clear definitions of what constitutes futile medical treatment. And they address such topics as the limits on unwanted treatment, the shift from the "Age of Physician Paternalism" to the "Age of Patient Autonomy," health care rationing, and the adoption of new ethical standards. (shrink)

(1985). Development of a Questionnaire to Measure Secondary School Pupils’ Attitudes to Computers and Robots. Educational Studies: Vol. 11, No. 1, pp. 33-40.

Amyotrophic lateral sclerosis (ALS; also called motor neuron disease) is a devastating medical condition that progressively robs patients of their ability to move, speak and eventually breathe. At present, many physicians are hesitant to propose tracheostomy and respiratory support in the terminal phase of ALS. In accordance with the principle of patient autonomy, physicians should respect the right of the ALS patient to accept or refuse any treatment, including mechanical ventilation. Also, in environments where euthanasia or physician-assisted death is legal, (...) such requests can be acceptable. At least two conditions are necessary for full autonomy. To have a claim on full autonomy, people need to have intact cognitive abilities, and to exercise this right they must be able to communicate. In the past, the first condition was in doubt (indeed, overlap with other neurodegenerative diseases is sometimes suspected and some patients with ALS are thought to have associated frontotemporal dementia) and the second was severely compromised in patients with devastating motor impairment (communication being limited to the twitch of a finger or the blink of an eye). In this issue of J Neurol Neurosurg Psychiatry, Lakerveld and colleagues1 investigated cognition in 11 patients with late stage ALS (see page 25). They showed preserved cognitive functioning (ie, language, executive function, intelligence, learning and long term memory) compared with healthy controls. Assessments were exclusively based on a ‘‘yes–no’’ response mode. Because of the absence of verbal and motor communication, the neuropsychological assessment of these patients is complicated, and adapted testing is needed. By using a ‘‘yes–no’’ response mode based on the remaining motor abilities of the patient, this study proves the possibility of assessing patients with minimal motor capacities. (shrink)

‘Agathon and Eudaimonia in the Ethics of Aristotle’ is a response to an article on the meaning of Agathon in the Ethics of Aristotle, published by H. A. Pritchard in 1935. In this paper, Pritchard argued that Aristotle regarded Agathon to mean ‘conducive to our happiness’ and, consequently, that he maintained that every deliberate action stems, ultimately, from the desire to become happy. Austin finds fault with this view: first, Agathon in Aristotle does not have a single meaning, and a (...) fortiori not the one Pritchard suggested; secondly, if one had to summarise the meaning of ‘being agathon’ in one phrase, then ‘being desired’ cannot fulfil this function, for there are other objects of desire besides τό άγαθόν. (shrink)