This essay comments on the articles by Loretta M. Kopelman and Anita Silvers. It extends their analyses and concludes that consistency and the total absence of conflict may be unavailable when one interprets and applies the Americans with Disabilities Act.

This essay comments on the articles by Loretta M. Kopelman and Anita Silvers. It extends their analyses and concludes that consistency and the total absence of conflict may be unavailable when one interprets and applies the Americans with Disabilities Act.

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established , how medical protocols are administered , how medical certainty is evaluated and medical responsibility is framed , and how medical knowledge is transmitted and how medical (...) care is allocated . The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

Our understanding of gender carries significant bioethical implications. An errant account of gender-specific disease can lead to overgeneralizations, undergeneralizations, and misdiagnoses. It can also lead to problems in the structure of health-care delivery, the creation of policy, and the development of clinical curricula. In this volume, Cutter argues that gender-specific disease and related bioethical discourses are philosophically integrative. Gender-specific disease is integrative because the descriptive roles of gender, disease, and their relation are inextricably tied to their prescriptive roles within (...) frames of reference. An integrative account of gender-specific disease carries ethical implications because our understanding of gender-specific disease is evaluative, and our evaluations of gender-specific disease entail judgments concerning the praiseworthiness and blameworthiness of a clinical event. Cutter supports a "both/and" emphasis on context and integration in relation to gender-specific disease and bioethical analyses. While the text mainly focuses on gender-specific diseases that affect women, Cutter also includes examples involving men, children, and members of the LGBT community. (shrink)

Thinking Through Breast Cancer is a philosophical analysis of breast cancer inspired by the author's journey as a breast cancer patient. It sets out to show the relevancy of philosophical thinking in medicine today and shares advice about how to navigate the uncertainty of breast cancer diagnosis, treatment, and survival.

The classification of clinical problems, such as AIDS, requires choices. Choices are made on epistemic (i.e., knowledge-based) and non-epistemic (i.e., action-based) grounds. That is, the ways in which we classify clinical problems, such as AIDS, involve a balancing of different understandings of clinical reality and of clinical values among participants of the clinical community. On this view, the interplay between epistemic and non-epistemic interests occurs within the embrace of particular clinical contexts.The ways in which we classify AIDS is the topic (...) of this paper. We consider the extent to which we construct clinical reality; we examine a suggested classification of AIDS; and we conclude suggesting that the choice regarding how to classify AIDS is the result of negotiation among participants in the clinical community. (shrink)

For decades, presidents of the Association of American Geographers have written insightful columns in the AAG Newsletter. One of the most popular sections of the newsletter, these columns illustrate the changes and consistencies of geography over the past thirty-four years. They offer an insight into the past of the geography discipline and a broader perspective on the future. Previously inaccessible even to most professional geographers, the Presidential Columns will now be available in Presidential Musings from the Meridian: Reflections of the (...) Nature of Geography. (shrink)

We obtain in this paper a representation of the formulae of extensions ofL by generalized quantifiers through functors between categories of first-order structures and partial isomorphisms. The main tool in the proofs is the back-and-forth technique. As a corollary we obtain the Caicedo's version of Fraïssés theorem characterizing elementary equivalence for such languages. We also discuss informally some geometrical interpretations of our results.

The objectives of this study were to develop a high-density chromosome bin map of homoeologous group 7 in hexaploid wheat, to identify gene distribution in these chromosomes, and to perform comparative studies of wheat with rice and barley. We mapped 2148 loci from 919 EST clones onto group 7 chromosomes of wheat. In the majority of cases the numbers of loci were significantly lower in the centromeric regions and tended to increase in the distal regions. The level of duplicated loci (...) in this group was 24% with most of these loci being localized toward the distal regions. One hundred nineteen EST probes that hybridized to three fragments and mapped to the three group 7 chromosomes were designated landmark probes and were used to construct a consensus homoeologous group 7 map. An additional 49 probes that mapped to 7AS, 7DS, and the ancestral translocated segment involving 7BS also were designated landmarks. Landmark probe orders and comparative maps of wheat, rice, and barley were produced on the basis of corresponding rice BAC/PAC and genetic markers that mapped on chromosomes 6 and 8 of rice. Identification of landmark ESTs and development of consensus maps may provide a framework of conserved coding regions predating the evolution of wheat genomes. (shrink)

Developing an intellectualist account of skill, Stanley and Williamson define skill as a kind of disposition to action-guiding knowledge. The present paper challenges their definition of skill. While we don’t dispute that skill may consist of a cognitive, a dispositional, and an action-guiding component, we argue that Stanley and Williamson’s account of each component is problematic. In the first section, we argue, against Stanley and Williamson, that the cognitive component of skill is not a case of propositional knowledge-wh, which is (...) typically indexical. In the second section, we seek to show that Stanley and Williamson face difficulties in arguing for a generic claim about skill as a kind of disposition, and they fail to defend intellectualism about skill based on the dispositional account. In the third section we argue that Stanley and Williamson need a more detailed account of the action-guiding aspect of skill to avoid several difficulties, including a threat of a regress. We close with some lessons for the debate over intellectualism and anti-intellectualism about skill. (shrink)

Psychological research has shown that cognitive illusions, of which visual illusions are just a special case, are systematic and pervasive, raising epistemological questions about how error in all forms of research can be identified and eliminated. The quantitative sciences make use of statistical techniques for this purpose, but it is not clear what the qualitative equivalent is, particularly in view of widespread scepticism about validity and objectivity. I argue that, in the light of cognitive psychology, the ‘error question’ cannot be (...) dismissed as a positivist obsession, and that the concepts of truth and objectivity are unavoidable. However, they constitute only a ‘minimal realism’, which does not necessarily bring a commitment to ‘absolute’ truth, certainty, correspondence, causation, reductionism, or universal laws in its wake. The assumption that it does reflects a misreading of positivism and, ironically, precipitates a ‘crisis of legitimation and representation’, as described by constructivist authors. (shrink)

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

This article presents an overlooked case of research misconduct and violations of basic principles of medical and business ethics. When Bayer’s Cutter Laboratories realized that their blood products, Factor VIII and IX or antihemophiliac factor (AHF), were contaminated with human immunodeficiency virus (HIV), the financial investment in the product was considered too high to destroy the inventory. Cutter misrepresented the results of its own research and sold the contaminated AHF to overseas markets in Asia and Latin America without (...) the precaution of heat treating the product recommended for eliminating the risk. As a consequence, hemophiliacs who infused the HIV-contaminated Factor VIII and IX tested positive for HIV and developed AIDS. (shrink)

R. K. Elliott once commended R. S. Peters' work in philosophy of education for being an authentic expression of the self. Many philosophers, probably including Peters, might see this more as a weakness. In an attempt to resolve this difference various kinds of continuity between philosopher and philosophy are explored. These point to an ideal of a two-way, and ultimately ‘organic’, relationship whereby the philosophy expresses the self and the self is formed by the philosophy. Ways of teaching to favour (...) the development of such authenticity in novice philosophers are discussed. (shrink)

In this article the Reformer Martin Luther is to be situated against the backdrop of his medieval theological context – considering especially Bernard of Clairvaux. It is well-known that he held in great esteem Bernard and the theology he represented. First of all, Luther's relationship to Bernard is to be investigated by way of a historiographic review of the research that was done in the past 150 years. How did one consider Luther’s attitude toward Bernard, and how did Luther research (...) specifically value this attitude? In this research, denominational positions appear to have played a important role. Secondly, the attempt is made here to sketch Bernard’s place in Luther’s own tradition. Next to the medieval scholastic theology, there were diverse other influences that became important for the young Luther. Bernard’s specific place within the complexity of medieval traditions is to be determined. This is being explained by presenting seven significant texts mainly from Luther’s works, which are added to this article. Finally, the attempt is made to determine more closely Bernard’s place in Luther’s theology between Scholasticism and Mysticism. If one wants to do justice to Bernard in Luther's works, one must take into consideration the way in which Luther has perceived him, namely as a theologian of the Scriptures, a theologian of experience and a preacher of Christ par excellence along the lines of monastic theology. (shrink)

The objective of this work is to categorize the available fly ashes in different parts of the world into distinct groups based on its compositional attributes. Kohonen's self-organizing feature map and radial basis function networks are applied in a cascading fashion for the classification of fly ashes in terms of its chemical parameters. The basic procedure of the methodology consists of three stages: apply self-organizing neural net to ascertain possible number of groups, delineate them and identify the group sensitive attributes; (...) find mean values of sensitive attributes of the elicited groups and augment them as start-up prototypes in k-means algorithm and find the refined centroids of these groups; incorporate the centroids in a two layer radial basis function network and fine-tune the delineated groups and develop an indexing equation using the weights of the stabilized network. Further, to demonstrate the utility of this classification scheme, the so formed groups were correlated with their performance in High Volume Fly Ash Concrete System [HVFAC]. The categorization was found to be excellent and compares well with Canadian Standard Association's [CSA A 3000] classification scheme. (shrink)

In this paper we define Martin-L¨of complexes to be algebras for monads on the category of (reflexive) globular sets which freely add cells in accordance with the rules of intensional Martin-L¨of type theory. We then study the resulting categories of algebras for several theories. Our principal result is that there exists a cofibrantly generated Quillen model structure on the category of 1-truncated Martin-L¨of complexes and that this category is Quillen equivalent to the category of groupoids. In particular, 1-truncated Martin-L¨of complexes (...) are a model of homotopy 1-types. In order to establish these facts we give a proof-theoretic analysis, using a modified version of Tait’s logical predicates argument, of the propositional equality classes of terms of identity type in the 1-truncated theory. (shrink)

It is the intention in this article to explain the electoral stagnation of the Republican People’s Party (Cumhuriyet Halk Partisi, CHP) in the light of the 2015 parliamentary elections in Turkey. Drawing on theories of voting behavior, the article uncovers the organizational shortcomings within the party and the problem of credibility that have emerged as significant impediments to the party in addressing long-term historical-structural issues, mainly the division of Turkish society between the religious periphery and the secular center. Furthermore, the (...) strong identification between the ruling Justice and Development Party (Adalet ve Kalkınma Partisi, AKP) and its partisans have made party-switching difficult, having been achieved, above all, through the provision of economic benefits and public services and the consolidation of party identification through growing polarization and division in Turkish politics. Last but not least, the changes to the political environment between the June 7 and November 1, 2015 elections, pushed stability and security to the top of the agenda, as well as AKP’s electoral adjustments in the run-up to the November 1 elections inhibited any possible flow of votes to the CHP. (shrink)