Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements (...) usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (shrink)

Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

The Mesillas Yesharim / Path of the Just was the masterpiece of Rabbi Moshe Chaim Luzzatto, the great mystic, philosopher, sage, and saint. For centuries, this classic text for better living has been every man's primer for ideal life. Wherever there were Jews there was a well-thumbed Mesillas Yesharim. In this book, Rabbi Twerski applies the text and themes of Mesillas Yesharim to the everyday challenges of the 90s. He shows us how we can succeed in the quest for (...) a better life and in bettering ourselves. (shrink)

Answers to the questions of what justifies conscientious objection in medicine in general and which specific objections should be respected have proven to be elusive. In this paper, I develop a new framework for conscientious objection in medicine that is based on the idea that conscience can express true moral claims. I draw on one of the historical roots, found in Adam Smith’s impartial spectator account, of the idea that an agent’s conscience can determine the correct moral norms, even if (...) the agent’s society has endorsed different norms. In particular, I argue that when a medical professional is reasoning from the standpoint of an impartial spectator, his or her claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us, and should thus be respected. In addition to providing a justification for conscientious objection in medicine by appealing to the potential truth of the objection, the account advances the debate regarding the integrity and toleration justifications for conscientious objection, since the standard of the impartial spectator specifies the boundaries of legitimate appeals to moral integrity and toleration. The impartial spectator also provides a standpoint of shared deliberation and public reasons, from which a conscientious objector can make their case in terms that other people who adopt this standpoint can and should accept, thus offering a standard fitting to liberal democracies. (shrink)

This book describes Carmeli's cosmological general and special relativity theory, along with Einstein's general and special relativity. These theories are discussed in the context of Moshe Carmeli's original research, in which velocity is introduced as an additional independent dimension. Four- and five-dimensional spaces are considered, and the five-dimensional braneworld theory is presented. The Tully-Fisher law is obtained directly from the theory, and thus it is found that there is no necessity to assume the existence of dark matter in the (...) halo of galaxies, nor in galaxy clusters.The book gives the derivation of the Lorentz transformation, which is used in both Einstein's special relativity and Carmeli's cosmological special relativity theory. The text also provides the mathematical theory of curved space?time geometry, which is necessary to describe both Einstein's general relativity and Carmeli's cosmological general relativity. A comparison between the dynamical and kinematic aspects of the expansion of the universe is made. Comparison is also made between the Friedmann-Robertson-Walker theory and the Carmeli theory. And neither is it necessary to assume the existence of dark matter to correctly describe the expansion of the cosmos. (shrink)

Physicians frequently ask whether they should give patients what they want, usually when there are considerations pointing against doing so, such as medicine’s values and physicians’ obligations. It has been argued that the source of medicine’s values and physicians’ obligations lies in what has been dubbed “the internal morality of medicine”: medicine is a practice with an end and norms that are definitive of this practice and that determine what physicians ought to do qua physicians. In this paper, I defend (...) the claim that medicine requires a morality that is internal to its practice, while rejecting the prevalent characterization of this morality and offering an alternative one. My approach to the internal morality of medicine is constructivist in nature: the norms of medicine are constructed by medical professionals, other professionals, and patients, given medicine’s end of “benefitting patients in need of prima facie medical treatment and care.” I make the case that patients should be involved in the construction of medicine’s morality not only because they have knowledge that is relevant to the internal morality of medicine—namely, their own values and preferences—but also because medicine is an inherently relational enterprise: in medicine the relationship between physician and patient is a constitutive component of the craft itself. The framework I propose provides an authoritative morality for medicine, while allowing for the incorporation, into that very morality, of qualified deference to patient values. (shrink)

I introduce a new distinction between two types of paternalism, which I call ‘internal’ and ‘external’ paternalism. The distinction pertains to the question of whether the paternalized subject’s current evaluative judgments are mistaken relative to a standard of correctness that is internal to her evaluative point of view—which includes her ‘true’ or ‘ideal’ self—as opposed to one that is wholly external. I argue that this distinction has important implications for (a) the distinction between weak and strong paternalism; (b) the distinction (...) between soft and hard paternalism; and (c) medical practice, where internal paternalism can, and probably often does, occur. (shrink)

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Résumé L'article propose une nouvelle approche dans l'analyse de la sémantique polydimensionnelle du texte littéraire. Notre modèle dynamique synthétise les traits communs propres à la psychomécanique du langage et à la sémantique interprétative. Cette orientation des recherches permet de renforcer l'analyse des isotopes narratifs par la description de leur genèse pré-discursive. Appliqué à l'étude du texte littéraire, ce modèle manifeste des possibilités supplémentaires dans l'examen des mécanismes intrinsèques de la cohésion textuelle.

In the latter part of the fifteenth century, a Jewish translator, working together with a Slavic amanuensis, translated into the East Slavic language of the Grand Duchy of Lithuania three medieval Hebrew translations of Arabic philosophical texts: the Logical Terminology, a short work on logic attributed to Maimonides (but probably by a different medieval Jewish author); and two sections of the Muslim theologian Al-Ghazali's famous Intentions of the Philosophers. Highlighting the unexpected role played by Jewish translators as agents of cultural (...) transmission in the heady messianic atmosphere leading up to the year 1492, these texts drew the attention of the Orthodox Church authorities as being in the possession of the enlightened heretical sect known as the Judaizers, which had emerged in Novgorod and spread to Moscow. Reflecting three and even four layers of translation, Prof. Moshe Taube's new triple-language critical edition of the Logika of the Judaizers displays the Slavic texts alongside the Hebrew translations on which they are based and accompanies them with a modern English translation. In his comprehensive introduction and commentary, Taube surveys earlier scholarly efforts to identify the provenance and purport of the translations, discusses the linguistic and textological issues raised by these early Ruthenian texts, puts forward the likely dissimilar motivations of the Jewish translator and the Christians who commissioned the work, and reveals the translator's probable identity. The present publication, a long-awaited desideratum, will be of interest not only to historians of the Great Duchy of Lithuania and of the principality of Muscovy, but also to scholars of Jewish history and of the history of philosophy and science, as well as to linguists studying the history of the Belorussian, Ukrainian and Russian languages. (shrink)

In The Sources of Normativity, Korsgaard argues for what can be called “The Universality of Humanity Claim” (UHC), according to which valuing humanity in one’s own person entails valuing it in that of others. However, Korsgaard’s reliance on the claim that reasons are essentially public in her attempt to demonstrate the truth of UHC has been repeatedly criticized. I offer a sentimentalist defense, based on Adam Smith’s moral philosophy, of a qualified, albeit adequate, version of UHC. In particular, valuing my (...) humanity, understood as (my awareness of) my perspective and the reasons determined from within it, entails valuing your humanity, understood as (your awareness of) your perspective and the reasons determined from within it. Given Korsgaard’s emphasis on the publicity of reasons in her argument for UHC, I also discuss the role of reasons in my account. I argue that the relative weights of (at least some of) an agent’s reasons are determined from within a shared evaluative point of view, namely, the standpoint of what Smith calls “the impartial spectator.” These reasons have normative authority over and constrain the agent’s private reasons, that is, those that are determined from within her own particular evaluative point of view. (shrink)

My question in the chapter is this: could (and should) the role of the physician be construed as that of a friend to the patient? I begin by briefly discussing the “friendship model” of the physician-patient relationship—according to which physicians and patients could, and perhaps should, be friends—as well as its history and limitations. Given these limitations, I focus on the more one-sided idea that the physician could, and perhaps should, be a friend to the patient (a “physician-qua-friend model” of (...) the physician-patient relationship). I show that given recent developments in our understanding of the physician-patient relationship, this idea is far from asinine. I then make the case that the most plausible conception of the physician-qua-friend model incorporates the following components: (a) a common goal, that is, one that physician and patient share; (b) certain forms of equality between physician and patient; (c) an ideal of a caring physician. Finally, I show how the model can be instantiated in a certain type of physician-patient interaction, namely, in physician-assisted dying. (shrink)

Almaatouq et al.'s prescription for more integrative experimental designs is welcome but does not address an equally important problem: Lack of adequate theories. We highlight two features theories ought to satisfy: “Well-specified” and “grounded.” We discuss the importance of these features, some positive exemplars, and the complementarity between the target article's prescriptions and improved theorizing.

Obsessive-Compulsive Disorder and Uncertainty examines the intrapsychic features of the self as it presents within OCD compulsive doubting. Moshe Marcus and Steven Tuber suggest a phenomenological framework through which to consider the interplay between the cognitive as well as affective components required to make judgments.

In his early teaching, from the 1920s through the 1950s, Yeshayahu Leibowitz (1903-1994) stands out as one of the most fascinating religious Zionist thinkers. He strives to establish a Jewish democratic state whose democratic aspects will be channeled toward the establishment of an exemplary society, one that can express its religious roots within a modern democratic context. Leibowitz thus attaches enormous importance to democracy in terms of both its political components and its modern Orthodox aspirations. In this respect, he is (...) the most radical spokesman of the Neo-Orthodox notion of Torah with Derekh Eretz , as translated into religious-Zionist terms. (shrink)

Sijilmassi et al. argue that myths around shared ancestry and history exploit an evolved psychology of interdependence. In contrast, we argue that psychological exploitation is not required. Rather, such myths may be one method, among many, to create a shared understanding of group boundaries, which can be “self-enforcing.” We summarize the game-theoretic basis for this account and some supportive evidence.

This is an introduction to set theory and logic that starts completely from scratch. The text is accompanied by many methodological remarks and explanations.

In Judaism Straight Up, Moshe Koppel explores the central differences between traditional societies--including traditional Judaism--and contemporary cosmopolitan ones. He explains everything you always wanted to know about the subtleties of Jewish morality, tradition, and belief, and how these have unfolded to beat cosmopolitanism at its own game: advancing cooperation, fairness, and freedom. Written with incisiveness and droll wit--and a scientific sensibility that draws on economics, game theory, and other disciplines--Judaism Straight Up reveals the secret of Jewish traditionalism's endurance."--Page [4] (...) of cover. (shrink)

Though the notion of the free, or self-governed community, originated in ancient Greece, the Greek polis seems to pose a problem for the modern post-Hobbesian concept of sovereignty. For the latter presupposes that of the State, that is an agency which monopolizes the use of violence, as an instrument by which sovereignty is constituted. Yet, the polis was not a State but rather what the anthropologists call a stateless community. The latter is characterized by the absence of ‘government’, that is (...) of an agency which has separated itself from the rest of social life and which monopolizes the use of violence. In stateless societies the ability to use force is more or less evenly distributed among armed or potentially armed members of the community. Being stateless, then, in what sense can we say that the polis was sovereign? On the practical level the Greek polis had a very limited ability to control and direct legislation. The decentralised nature of Greek society and the absence of coercive apparatuses meant that the laws had to be identical with the customs of the community or else that decisions had to be shared by a wide consensus, which imposed a severe limitation on the ability of the poleis to change their laws or initiate changes in the community. On the theoretical level, the absence of a State was complementary to the absence of the notion of sovereign, whether it is a person or an institution or a body which was above the law and a source of the law. Thus Greek ‘republicanism’ was different from the modern one in as much as it did not have the notion of ‘the people’ as a constituting element and Greek ‘rule of law’ lacked the modern notion of a positive open legislation. (shrink)

This is the first of a series of papers devoted to the thorough investigation of refinement based on an underlying partial relational model. In this paper we restrict attention to operation refinement. We explore four theories of refinement based on an underlying partial relation model for specifications, and we show that they are all equivalent. This, in particular, sheds some light on the relational completion operator due to Woodcock which underlies data refinement in, for example, the specification language Z. It (...) further leads to two simple alternative models which are also equivalent to the others. (shrink)