The attitudes of women patients with cancer were explored when they were invited to participate in one of three randomised trials that included chemotherapy at two university centres and a satellite centre. Fourteen patients participating in and 15 patients declining trials were interviewed. Analysis was based on the constant comparative method. Most patients voiced positive attitudes towards clinical research, believing that trials are necessary for further medical development, and most spontaneously argued that participation is a moral obligation. Most trial decliners, (...) however, described a radical change in focus as they faced the actual personal choice. Almost no one got an impression of clinical equipoise between treatments in the trials, and most patients expressed discomfort with randomisation. A patient’s choice to participate was mainly determined by whether the primary focus was on treatment effect or on adverse effects. Both knowledge about and feelings towards trials originated mostly from the media, although paradoxically the media were largely seen as untrustworthy. Mistrust was shown towards the pharmaceutical industry, and although most patients originally trusted that doctors primarily pursued the interest of patients, they did not trust the adequacy of doctors or industry in maintaining self-regulation. Thus, public control measures were judged to be essential. (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)

Since 1994, when the first fetal imaging boutique appeared in Texas, many sites have been established around the country for parents to receive nonmedical fetal imaging using three- and four-dimensional ultrasound machines. These businesses boast the benefits they offer to parental-fetal bonding, but the medical community objects to the use of ultrasound machines for nonmedical purposes. In this article, I present the statements released by the medical community, highlighting the alarmist strategies used to paint boutique ultrasounds as bad science and (...) elevate the medical use of ultrasounds. Through a close reading of the statements, it is shown that the medical community's primary concern is not the health of the fetus or the woman but rather their place as the sole users of fetal ultrasounds. This detailed analysis reveals a medical community fearful that its authority is being usurped and is therefore responding with statements meant to denigrate boutique fetal ultrasounds. (shrink)

The demand of many scientific areas for the usage of fractional partial differential equations to explain their real-world systems has been broadly identified. The solutions may portray dynamical behaviors of various particles such as chemicals and cells. The desire of obtaining approximate solutions to treat these equations aims to overcome the mathematical complexity of modeling the relevant phenomena in nature. This research proposes a promising approximate-analytical scheme that is an accurate technique for solving a variety of noninteger partial differential equations. (...) The proposed strategy is based on approximating the derivative of fractional-order and reducing the problem to the corresponding partial differential equation. Afterwards, the approximating PDE is solved by using a separation-variables technique. The method can be simply applied to nonhomogeneous problems and is proficient to diminish the span of computational cost as well as achieving an approximate-analytical solution that is in excellent concurrence with the exact solution of the original problem. In addition and to demonstrate the efficiency of the method, it compares with two finite difference methods including a nonstandard finite difference method and standard finite difference technique, which are popular in the literature for solving engineering problems. (shrink)

There was a deep continuity in Wollheim’s thought from his book on F. H. Bradley onward. His notion of the concept of art as deeply interiorized was inextricable from his sense of the psychological unity of the mind and the historical continuity of artistic tradition, seen on analogy with an inherited language. His study of pictorial representation pivoted on the innate psychological capacity of ‘seeing-in’, perceiving the represented subject in a surface from which it was seen as distinct but to (...) which it could be related. The expressiveness of depiction he explained through a psychoanalytic concept of projection in which we come to see a piece of the external world as corresponding to an inward state of mind. He reserved the use of the term ‘imagination’ for the artist’s elaboration of ‘seeing-in’. This he exemplified in accounts of painting by Manet, Friedrich, Titian, and Ingres among others. His critical stance has a close affinity with certain essays by Pater. (shrink)

The study ascertained (1) whether an observer's scope of justice with reference to either the moral agent or the target person of a moral act, would affect his/her judgements of the ethicality of the act, and (2) whether observer judgements of ethicality parallel the moral agent's decision processes in systematically evaluating the intensity of the moral issue. A scenario approach was used. Results affirmed both research questions. Discussions covered the implications of the findings for the underlying cognitive processes of moral (...) judgements, for the link between judgements of fairness and ethicality, as well as for the debate of ethical absolutism versus relativism. (shrink)

The quantum probability flux of a particle integrated over time and a distant surface gives the probability for the particle crossing that surface at some time. We prove the free fluxacross-surfaces theorem, which was conjectured by Combes, Newton and Shtokhamer [1], and which relates the integrated quantum flux to the usual quantum mechanical formula for the cross section. The integrated quantum flux is equal to the probability of outward crossings of surfaces by Bohmian trajectories in the scattering regime.

Internalism about practical reasons claims that there is a necessary connection between what an agent has reason to do and what he would be motivated to do if he were in privileged or optimal conditions. Internalism is traditionally supported by the claim that it alone can capture two conditions of adequacy for any theory of practical reasons, that reasons must be capable of justifying actions, and that reasons must be capable of explaining intentional acts. Robert Johnson, pp. 53–71) has argued (...) that versions of internalism which avoid obvious problems nevertheless fail to capture both conditions. I argue that Johnson's criticisms rest upon a misinterpretation of the 'explanatory condition', and I proceed to formulate a version of internalism which will allow practical reasons to have both justificatory and explanatory force. (shrink)

All illness represents a state of diminished autonomy and therefore the doctor-patient relationship necessarily and justifiably involves a degree of medical paternalism argues the author, an American medical student. In a broad-ranging paper he discusses the concepts of autonomy and paternalism in the context of the doctor-patient relationship. Given the necessary diminution of autonomy which illness inflicts, a limited form of medical paternalism, aimed at restoring or maximising the patient's autonomy is entirely acceptable, and indeed fundamental to the relationship he (...) argues. However, the exercise of this paternalism should be flexible and related to the current 'level of autonomy' of the patient himself. An editorial in this issue comments briefly on this paper. (shrink)

Despite the importance of commitment in moral and political philosophy, there has hitherto been little extended analysis of it. Marcel Lieberman examines the conditions under which commitment is possible, and offers at the same time an indirect argument for moral realism. He argues that realist evaluative beliefs are functionally required for commitment - especially regarding its role in self-understanding - and since it is only within a realist framework that such beliefs make sense, realism about values is a condition for (...) the possibility of commitment itself. His ambitious study addresses questions that are of great interest to analytic philosophers but also makes many connections with continental philosophy and with folk psychology, sociology and cognitive science, and will be seen as a distinctive intervention in the debate about moral realism. (shrink)

t. 1. A-D -- t. 2. E-M -- t. 3. N-S -- t.4. T-I︠A︡.

Consider orthodox motivational judgment internalism: necessarily, A’s sincere moral judgment that he or she ought to φ motivates A to φ. Such principles fail because they cannot accommodate the amoralist, or one who renders moral judgments without any corresponding motivation. The orthodox alternative, externalism, posits only contingent relations between moral judgment and motivation. In response I first revive conceptual internalism by offering some modifications on the amoralist case to show that certain community-wide motivational failures are not conceptually possible. Second, I (...) introduce a theory of moral motivation that supplements the intuitive responses to different amoralist cases. According to moral judgment purposivism (MJP), in rough approximation, a purpose of moral judgments is to motivate corresponding behaviors such that a mental state without this purpose is not a moral judgment. MJP is consistent with conceptual desiderata, provides an illuminating analysis of amoralist cases, and offers a step forward in the internalist-externalist debates. (shrink)