The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals (4–12) to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework’s five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. (...) The design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students. (shrink)

Written by two of the leading figures in the field, this is a lucid and systematic introduction to semantics as applied to transformational grammars of the ...

Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on t...

The target articles in this “Roe v. Wade” special issue of AJOB rightly point to multiple ethical harms of an imminent end to full federal protection for legal abortion in the United States, p...

Consciousness has been widely regarded as the central arena for the mental solution of problems. A variant view locates the business end of problem solving elsewhere, with conscious intervention only for intermittent monitoring and goal-setting. In this scenario conscious awareness, with `intelligent' processes generally, is largely specialized to the construction and communication of appropriate after-the-event histories and explanations.The first part of the paper traces a long march undertaken by main-stream artificial intelligence basing itself on the first assumption. Disappointment with the (...) result has prompted interest in the second view, which forms the main topic of Part 2, 1995, pp. 52-66). (shrink)

In _Ecce Homo_ Friedrich Nietzsche calls himself "the first immoralist" and adds "that makes me the annihilator _par excellence_". Lester Hunt examines this and other radical claims in order to show that Nietzsche does have a coherent ethical and political philosophy. He uses Nietzsche's writings as a starting point for a critique of a wider, contemporary ethical project - one that should inform our lives as well as our thoughts.

Uses of stored skill-models to accelerate simulator-based real-time training in a control skill are discussed. A real-time coach must deliver advice at three levels: (1) what to do next, (2) what to watch for, and (3) what went wrong. Human learning and machine learning results are presented using different screen representations of a pole-and-cart balancing task.

Using 20 video recordings of Emergency Room treatment and over 5 years of Emergency Room fieldwork data, this study elucidates how interactional processes serve as resources for generating a cultural script of death in Japan called ‘Mitori’. A sudden death at a hospital, in which a patient is removed from their social network, is often considered as the opposite of a ‘good home death’. This study shows how hospital deaths in Japan are strongly interrelated with family participation. After showing the (...) point where medical professionals decide to terminate resuscitation attempts, the analysis depicts interactional steps that shift the definition of environment from a place for treatment toward a place where ‘Mitori’ occurs; that is, a family encounter occurs with a dying patient. Conversation between a doctor and a family member consists of a step-by-step evidence- building story. The final section displays both conversational and physical resources used to establish ‘Mitori’. (shrink)

In Anerkennung der für Gegenwartsgesellschaften konstitutiven Diversität ihrer Bevölkerungen diskutieren Bioethik und Medizin verstärkt die kulturelle Relativität ihrer eigenen Voraussetzungen, die Kulturspezifik „anderer“ Positionen und die Möglichkeiten kulturübergreifender Orientierungen. Dabei kommt häufig ein Kulturbegriff zum Einsatz, der aus der Perspektive der aktuellen Sozial- und Kulturanthropologie zu statisch, zu homogenisierend und zu sehr auf Differenz und Abgrenzung hin orientiert ist. Der Beitrag diskutiert zunächst Konzepte von Kultur, die solche Verkürzungen zu vermeiden suchen. Sie betonen hingegen Verflechtungszusammenhänge unter dem Vorzeichen intensivierter Globalisierung (...) und deuten Kultur aktiv und reflexiv, als Ressource menschlichen Tuns, und nicht deterministisch als Kausalfaktor. Anschließend wird der ethnographische Forschungsstand zu Patientenverfügungen in westlichen Gesundheitssystemen zusammengefasst. Zeitintensive, qualitative Forschung verdeutlicht die Gefahr einer Kulturalisierung sozialer Ungleichheiten, die spezifische Positionalität bioethischer Prämissen und die Vielfalt und Komplexität im Umgang mit Patientenverfügungen. Der Beitrag schließt mit Hinweisen darauf, wie Diversität in Entscheidungsprozessen am Ende des Lebens jenseits von Kultur analysiert werden kann. (shrink)

The definition of an expert system as a knowledge‐based source of advice and explanation pinpoints the critical problem which confronts the would‐be builders of such systems. How is the required body of knowledge to be elicited from its human possessors in a form sufficiently complete for effective organization in computer memory? This article reviews recent advances in the art of automated knowledge‐extraction from expert‐supplied example decisions. Computer induction, as the new approach is called, promises both important parallels to the human (...) capacity for concept formation and also commercial exploitability. (shrink)

ABSTRACT Co-parents who differ in their ideal child rearing policies should compromise, argues Marcus William Hunt. Josh Milburn and Carlo Alvaro dispute this when it comes to veganism. Milburn argues that veganism is a matter of justice and that to compromise over justice is (typically) impermissible. I suggest that compromise over justice is often permissible, and that compromise over justice may be required by justice itself. Alvaro offers aesthetic, gustatory, and virtue-based arguments for ethical veganism, showing that veganism involves (...) sensibilities and virtues, and argues that veganism involves a belief. Alvaro takes this to show that parental compromise is impermissible. I suggest that Alvaro’s arguments are implausible and that the shaping of a child’s sensibilities and virtues is an apt matter for parental compromise. (shrink)

The commentaries on the Ethica nova and the Ethica vetus written by some masters of the arts – presumably operating in the Paris faculty – in the first half of the thirteenth century expound in an original way the doctrine of the virtutes consuetudinales which Aristotle, at the end of the first book of his Ethica (I 13), distinguishes into the two main classes of the “moral virtues” and the “intellectual virtues”. The present paper aims at highlighting the particularly important (...) task which is assigned to the intellectual virtues in these early commentaries: joining man to God directly, through a contemplation which becomes love. The masters of the arts maintain that the moral virtues, in spite of the definition given by Aristotle (habitus a quo quis bonus est et opus eius bene reddit), are not sufficient alone to bring man to perfection, but that other more perfect virtues, namely the intellectual ones, are needed in order to make him know and love the supreme good. Having no knowledge of the sixth book of the Ethica, in which Aristotle deals in particular with the intellectual virtues, our masters know only their general description and are concerned with clarifying their relationships with the moral virtues, compared to which they appear to be sometimes really distinct and sometimes united to them in sharing the recta ratio, so much that they may constitute a double virtue. Although the masters of the arts seem to be well-informed about the teaching of the theologians – which they often cite without opposing to it, albeit stressing their own philosophical point of view –, it is significant that no reference whatsoever is made by them to the theological virtues and that they have recourse to the themes of Avicennian mysticism such as the doctrine of the two faces of the soul. Besides presenting the commentaries on the Ethica vetus from a general point of view, I will focus on the Paris commentary in Ethicam veterem (Paris BN lat. 3804A, ff. 152ra-159vb, 241ra-247vb; Paris BN lat. 3572, ff. 226ra-235ra), of which I am preparing a critical edition. The Paris commentary contains in fact a special and original discussion of the doctrine of the virtutes intellectuales. (shrink)

Frankfurt cases are purported counterexamples to the Principle of Alternative Possibilities, which implies that we are not morally responsible for unavoidable actions. A major permutation of the counterexample strategy features buffered alternatives; this permutation is designed to overcome an influential defense of the Principle of Alternative Possibilities. Here we defend the buffering strategy against two recent objections, both of which stress the timing of an agent’s decision. We argue that attributions of moral responsibility aren’t time-sensitive in the way the objectors (...) suppose. We then turn to the crucial question of when an action is relevantly avoidable—when, in the parlance of the literature, an alternative possibility is robust. We call attention to two plausible tests for robustness that merit further consideration, showing that the agents in buffered Frankfurt cases don’t pass these tests, despite being morally responsible for their actions. (shrink)

Accounts of scientific explanation disagree about what’s required for a cause, law, or other fact to be a reason why an event occurs. In short, they disagree about the conditions for explanatory relevance. Nonetheless, most accounts presuppose that claims about explanatory relevance play a descriptive role in tracking reality. By rejecting the need for this descriptivist assumption, I develop an expressivist account of explanatory relevance and explanation: to judge that an answer is explanatory is to express an attitude of _being (...) for being satisfied by that answer_. I show how expressivism vindicates ordinary scientific discourse about explanation, including claims about the objectivity and mind-independence of explanations. By avoiding commitment to ontic relevance relations, I rehabilitate an irrealist conception of explanation. (shrink)

When physical structures resonate in proximity to each other they will under certain circumstances 'sync up' in a shared resonance frequency. This is the phenomenon of spontaneous selforganization. General resonance theory (GRT), a theory of consciousness developed by Hunt and Schooler, suggests that consciousness is a product of various shared resonance frequencies at different physical scales. I suggest a heuristic for calculating the boundaries and resulting capacity for phenomenal consciousness in such resonating structures. Shared resonance results in phase transitions (...) in the speed and bandwidth of information exchange and thus richer and more complex consciousness. This approach is a solution to the 'combination problem' and 'boundary problem' of consciousness. The proposed mathematical heuristic is a practical approach for identifying potential conscious structures and the spatial and temporal boundaries of such structures over time, and also for calculating the capacity for phenomenal consciousness of any putative conscious entity. The slowest-frequency shared resonance -- the 'slowest common denominator'-- is the limiting factor for the spatial extent of any macro-consciousness. Various synchrony indexes are discussed. I describe some limitations of the proposed framework, and how it compares to Tononi's integrated information theory. IIT's constellation- qualia characterization framework is compatible with GRT and may be a useful tool in conjunction with GRT's quantification framework. (shrink)

Consciousness has been widely regarded as the central arena for the mental solution of problems. A variant view locates the business end of problem solving elsewhere, with conscious intervention only for intermittent monitoring and goal-setting. In this scenario conscious awareness, with `intelligent' processes generally, is largely specialized to the construction and communication of appropriate after-the-event histories and explanations.The first part of the paper traces a long march undertaken by main-stream artificial intelligence basing itself on the first assumption. Disappointment with the (...) result has prompted interest in the second view, which forms the main topic of Part 2 , 1995, pp. 52-66). (shrink)

Recently there has been an unexpected rebirth of Turing's imitation game in the context of commercial demand. To meet the new requirements the following is a minimal list of what must be simulated. Real chat utterances are concerned with associative exchange of mental images. They are constrained by contextual relevance rather than by logical or linguistic laws. Time-bounds do not allow real-time construction of reasoned arguments, but only the retrieval of stock lines and rebuttals, assembled Lego-like on the fly. A (...) human agent has a place of birth, age, sex, nationality, job, family, friends, partners, hobbies etc., in short a profile. Included in the profile is a consistent personality, which emerges from expression of likes, dislikes, pet theories, humour, stock arguments, superstions, hopes, fears, aspirations etc. On meeting again with the same conversational partner, a human agent is expected to recall not only the profile, but also the gist of previous chats, as well as what has passed in the present conversation so far. A human agent typically has at each stage a main goal, of fact-provision, fact elicitation, wooing, selling, "conning" etc. A human agent also remains ever-ready to maintain or re-establish rapport by switching from goal mode to chat mode. Implementation of this last feature in a scriptable conversational agent will be illustrated. (shrink)

The first work to introduce Foucault's ideas on law to both graduates and undergraduates.

This paper's first part, reviewed attempts to model real-world problem solving as machine-executable logic. Part 2 considers an alternative model in which the solution of problems is primarily the work of visualization supported by automatized skills. Consciousness operates at the level of goal-setting and monitoring, and of the construction and communication of after-the-event commentaries, not as a problem solver. Engineering designs based on this model have proved convenient and effective. `Structured induction' is now routinely used to recover and articulate expertise (...) that in the human solver remains tacit. A seminal case of computer-mediated superarticulacy is described in which a human problem solver was enabled to transform an elaborate, but largely blind and unconscious, mental skill into a fully aware, communicable and machine-executable theory. (shrink)

Comparisons have frequently been made between the works of Dante and Milton, more often than not by critics with a definite predilection one or the other poet. The author of this systematic comparison has approached the task without partisanship, but with a warm admiration for both poets. It is her contention that, although Dante was generally out of favor during the seventeenth century, even in Italy, Milton had read the Divina Commedia sympathetically and with care by the time he came (...) to write Paradise Lost. In substantiation Professor Samuel cites many parallel uses of language, imagery, theme, and method, while also taking note of divergences. Source materials are given in the appendixes, including Milton's references to Dante and a list of previously published comparisons. (shrink)

Nel contributo si analizzano le valutazioni che Ernst Cassirer e Jonas Cohn, in alcuni loro scritti pubblicati tra il 1903 e il 1918, espressero in modo esplicito o implicito l’uno del pensiero dell’altro nelle sfere della teoria della conoscenza e dell’estetica e a proposito della questione del rapporto fra la cultura tedesca e l’ebraismo. Si delineano, allo scopo di comprendere il loro dialogo, i diversi orientamenti della scuola neokantiana marburghese e della scuola neokantiana sud-occidentale, delle quali furono fondatori i loro (...) rispettivi maestri, Hermann Cohen e Wilhelm Windelband. Si ricorda infine l’interesse che ambedue gli autori mostrarono, nelle opere composte durante l’esilio dalla Germania, da cui Cassirer emigrò nel 1933, Cohn nel 1938, per la letteratura religiosa ebraica e cristiana come fonte di concetti filosofici quali l’individuo, l’amore verso l’altro, Dio come persona. (shrink)

二〇〇六年三月、富山県の射水市民病院で入院中の末期患者七人の人工呼吸器が取り外され、死亡していたことが明らかになった。実際にはいかなる事態が起きたのか?その後つづいた「尊厳死法制化」をめぐる政府・医療 界・メディア等の動きも踏まえ、今、日本の終末期医療に真に求められていることは何かを渾身で問いかける。.