This article analyses the constitutional crisis that was triggered in Chile by the events of 18 October 2019. The purpose is to explain the link between the constitution and social unrest and to explore whether a constituent process, such as the one designed in Chile, has the potential to address the unrest that produced it. The failed experience of Bachelet’s constituent process and the Latin American reform processes of the last thirty years show the threats and challenges of the (...) future Chilean constitution. (shrink)

_ Source: _Page Count 26 The dilemma of presentism is sometimes represented as a choice between the increased relevance and utility of a historiographic practice that can articulate its relation to the present and the increased objectivity or openness to the otherness of the past of a historiographic practice that articulates the past “on its own terms.” The present article argues that, at least with reference to intellectual history, we should understand that ideas appear most fully when they are run (...) through a multitude of contexts and not rooted exclusively in circumstances contemporaneous to _either_ the original emergence of an idea _or_ the writer and first reader of the historical account. The following thesis is advanced: ideas appear only over time, and the contextualization, decontextualization, and recontextualization of ideas in different places and times are all essential to such intellectual historical “appearance.” The article then articulates its position more precisely by means of Robert Brandom’s inferentialism. And, finally, this line of inquiry is exemplified and interrogated by means of a concrete historiographic case—namely, a political theoretical investigation of the intellectual legacy of the Weimar Republic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS God and Creation in Christian Theology: Tyranny or Empowerment? By KATHRYN TANNER. Oxford and New York: Basil Blackwell, 1988. Pp. viii + 196. $39.95 (hardbound). In describing the role of the human will in salvation, Thomas Aquinas remarks that justification indeed requires an act of human free choice, namely one which takes place when God "infuses the gift of justifying grace in such a way that he (...) simultaneously moves the free will (liberum arbitrium) to accept the gift of grace" (Summa theologiae I-II, 113, 3, c). When they encounter this sort of remark in Aquinas-and parallel remarks can he found across the whole ecumenical tradition of Christian theology-contemporary theologians may well be puzzled by two thirig~..One is Aquinas's evident conviction that an utterly robust view of God's power and sovereignty (such that whatever God wills to happen, happens) is fully compatible with the ascription of genuine and ineradicable freedom to human beings. But perhaps even more striking is the fact that Aquinas apparently takes this compatibility, so problematic for much of modern theology, to be obvious: it occasions no visible perplexity, appeal to mystery, or lengthy explanation, but is simply invoked in passing to help deal with the theological issue under discussion. In this powerfully argued and provocative book, Kathryn Tanner undertakes to clear up both of these perplexities. She develops an original and richly textured account of how Christian thinkers could and can maintain uncompromising accounts of both divine sovereignty and creaturely independence and freedom without falling into incoherence, and she also explains how what was once obvious now so easily seems bafHing. Tanner begins by arguing that the coherence of Christian claims about God and creatures can best be displayed by an explicitly secondorder analysis which aims to lay bare the rules governing well-formed Christian discourse, rather than by constructing a first-order ontological and metaphysical account of the relationship between God and the world. The book explicitly concentrates, " not on what theologians are talking about, but on.the way they are saying it " (p. 11). Tanner undertakes this " semantic ascent," which. she articulates with considerable nuance, partly in order to proceed in a way congruent with powerful recent developments in philosophy (European as well as Anglo8 ~1 BOOK REVIEWS American) and theology, but more basically because she thinks the issue itself demands this kind of treatment. However available in their own right, accounts of the relations between God and creatures cast in first-order metaphysical language are, theologians of quite different conviction have often maintained, veiled in a certain inevitable obscurity which limits their explanatory value; one cannot " reconcile God's agency with the creature's active powers through any material explanation of the actual mechanism found in some ' causal joint ' between the two" (p. 26; Thomas's way of putting this point, as Tanner is aware, is to say that we have no modus significandi for descriptions in divinis [see p. 12]). By contrast, the rules for coherent Christian discourse about God and creatures, if we can find any, can be stated with comparative clarity and precision: they will be straightforward directives to speak in certain ways and not in others. Moreover, the problems in speaking coherently about divine power and the contingent independence of creatures are not confined to a particular scheme of firstorder theological concepts and judgments but recur across a wide range of differing schemes; correlatively, if we can isolate second-order rules for Christian discourse about God and creatures those rules " may structure very different theological schemes, schemes distinguished by their first-order claims by vocabulary, philosophical frames of reference etc." (p. 29). Tanner's project, then, is a certain kind of transcendental argument: she wants to show "how it is possible for Christians to affirm certain statements while holding on to others that seem to conflict with them" (p. 20). If rules which govern apparently conflicting statements about God and creatures in Christian discourse can in fact be isolated, and it can be shown how they are followed by Christian theologians, then, Tanner argues, the project will have succeeded; the coherence of Christian discourse about God and creatures will have been displayed... (shrink)

The article is focused on reviewing and analyzing the results of the All-Russian scientific and practical conference “Managing sustainable development of Russian regions in the new reality» held in Chelyabinsk on October 26, 2021, and it is a digest of the main conference events.

3AM magazine follows up their 2014 publication Philosophy at 3AM: Questions and Answers with a new collection interviews, this time focused on ethics. Interviewer Richard Marhsall presents 26 interviews, balanced both in terms of specialty, gender, and seniority, so that the result is a balanced and engaging portrait of the state of the art in ethics today.

The conflict between pregnant women freely using cocaine and the well-being of fetuses presents a difficult social problem. Since 1985, at least 200 women, in thirty states, have been criminally prosecuted for using illicit drugs or alcohol during pregnancy. Such policies enjoy considerable public and political support. Nonetheless, treatment programs that include referral to law enforcement officials raise serious ethical and legal issues for hospitals and health care providers. In this paper, we assess the development of one medical university's controversial (...) treatment program for pregnant women addicted to cocaine.In October 1989, the Medical University of South Carolina instituted a new program, called the Interagency Policy on Management of Substance Abuse During Pregnancy, designed “to ensure appropriate management of patients abusing illegal drugs during pregnancy.” This program required some pregnant women to seek drug counseling and prenatal care under the threat of criminal sanctions. (shrink)

The article is devoted to reviewing and analyzing the results of the All-Russian scientific and practical conference “Municipal management in new realities: modern challenges and opportunities”, held in Chelyabinsk on October 26—27, 2023, and is a digest of the main events of the conference.

The article is devoted to reviewing and analyzing the results of the All-Russian scientific and practical conference “Public administration in new realities: modern challenges and opportunities”, held in Chelyabinsk on October 26—27, 2022, and is a digest of the main events of the conference.

This LNCS book is part of the FOLLI book series and constitutes the proceedings of the 9th International Workshop on Logic, Rationality, and Interaction, LORI 2023, held in Jinan, China, in October 2023. The 15 full papers presented together with 7 short papers in this book were carefully reviewed and selected from 40 submissions. The workshop covers a wide range on the following topics such as agency; argumentation and agreement; belief representation; probability and uncertainty; belief revision and belief merging; (...) knowledge and action; dynamics of informational attitudes; intentions, plans, and goals; decision making and planning; preference and utility; cooperation; strategic reasoning and game theory; epistemology; social choice; social interaction; speech acts; knowledge representation; norms and normative systems; natural language; rationality; philosophical logic. (shrink)

This paper presents two hitherto unknown dream reports by Ludwig Wittgenstein, written down by him in October 1942. The two reports are introduced by the title “Ein Traum” and found in his Nachlass item Ms-126, pages 21–26. They are edited here in parallel diplomatic and linear, gently normalized transcription. Facsimiles of the pages containing the reports can be viewed on Wittgenstein Source where they were published in the spring of 2016.

On October 26, 1984, Dr. Leonard Bailey and the transplant team of Loma Linda University Medical Center in California operated on a five-pound baby girl born a few weeks earlier with hypoplastic left heart syndrome. In babies born with this defect the left side of the heart is much smaller than the right and is unable to pump sufficient blood to sustain life for more than a few weeks. This rare defect occurs about once in every 12,000 live births; (...) it accounts for about a quarter of all cardiac deaths of newborns. In an operation known as a xenograft, involving cross-species transplantation of an organ, Dr. Bailey removed the defective heart from the baby and replaced it with the heart of a baboon. (shrink)

On October 26–27, 1962, the first meeting of the Society for Phenomenology and Existential Philosophy took place in Evanston, Illinois. Seven months earlier, on March 19, 1962, Columbia Records released the debut album of a young folk singer from Hibbing, Minnesota. Topics discussed at the SPEP meeting included the "phenomenology of perception, existential aesthetics, value theory, the life-world, the emotions, and expressive meaning."1 Songs on the album included two originals—"Talking New York" and "Song to Woody"—and covers of several gospel (...) and blues songs, including "In My Time of Dyin'," "Fixin' to Die," and "See That My Grave Is Kept Clean." The SPEP archives don't indicate whether anyone at the meeting in... (shrink)

Born on October 26, 1946, Carlos Ulises Moulines studied Physics, Philosophy and Psychology at the University of Barcelona, obtaining a Degree in Philosophy from that same University and a PhD in Philosophy from the University of Munich, supervised by Wolfgang Stegmüller. He is one of the most outstanding contemporary philosophers of science and one of the most prominent exponents of metascientific structuralism. In this interview he talks about biographical aspects, philosophy of science in general and specific topics, as well (...) as presenting his impressions on some topics related to academic life. (shrink)

One way to enter this morass is offered by the June 11 issue of the New York Review of Books. The frontcover headline reads "How to Deal With the Crisis"; the issue features a symposium of specialists on how to do so. It is very much worth reading, but with attention to the definite article. For the West the phrase "the crisis" has a clear enough meaning: the financial crisis that hit the rich countries with great impact, and is therefore (...) of supreme importance. But even for the rich and privileged that is by no means the only crisis, nor even the most severe. And others see the world quite differently. For example, in the October 26, 2008 edition of the Bangladeshi newspaper The New Nation, we read. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist and Catholic Monks Talk about CelibacyThomas Ryan, CSPThe electronic sign at the Minneapolis–St. Paul airport was flashing "Orange Alert" as a dozen Buddhist monks arrived in their burnt orange robes from around the country for three days of dialogue on celibacy with a similar number of Catholic monastics come together from various monasteries at St. John's Abbey in Collegeville, Minnesota. As he opened the October 26–29, 2006, (...) meeting, Rev. William Skudlarek, executive director of Monastic Interreligious Dialogue (MID), said, "You (Buddhists) have been at this for some five-to-seven hundred years longer than we have. We have something to learn."This was the second Monks in the West interreligious dialogue. The first took place in 2004 at the City of Ten Thousand Buddhas in northern California. On the Catholic side, the participants came from the Benedictine, Cistercian, and Camaldolese monasteries. On the Buddhist side, they came from the Theravada, Mahayana, and Tibetan traditions. Through the event, participants began the day with an hour of quiet sitting in meditation and joined the monastic community at St. John's for their rhythm of daily prayer.The first session dealt with theory, the "why" of celibacy. Buddhist participants explained that their teachings focus on seeing how suffering is created and cured. Attachments give rise to suffering, so advancement in the spiritual life requires letting go of one's attachments. Attachment to desires, among which are sexual desires, is a hindrance to spiritual progress. "Raging desire takes away choice, freedom," said Rev. Kusala Bhikshu, a Buddhist chaplain at UCLA, in his opening presentation. "The senses must be controlled in order to be free."Brother Gregory Perron from St. Procopius monastery in Indiana spoke of how monastic life demands a profound understanding and acceptance of solitude. "Celibacy is a tool," offered Perron, "a skillful means like intentional simplicity of life, by which our heart is burrowed out and the core of our being laid bare. By embracing it, the monk accepts the aloneness that characterizes every human being."In response to Buddhist reflections on the illusory nature of the body, Catholic participants pointed out Christianity's remarkably positive evaluation of the [End Page 143] body in the doctrines of the Incarnation, the bodily Resurrection and Ascension of Jesus, and the indwelling of the Holy Spirit. Both sides acknowledged balancing points of reference as well, such as, in Christianity, Paul's "Who will rescue me from this body of death?" (Rom 7:24). Though humankind ranks eighth from the bottom in Buddhism's thirty-two-realm cosmology, that level is the only one where spiritual growth can happen. Thus human form is in the end praised by the Buddha.In the second session, the participants moved from theory to practice. Rev. Jisho Perry from the Shasta Buddhist Abbey in California said that "the whole thrust of training is not to give in to desire that arises." He described the Buddhist method of accepting sexual feelings without either acting on them or repressing them, but just letting them pass through. "The right use of will is willingness, not willpower—the willingness to sit there and let that feeling pass through," he said.Fr. Skudlarek expressed appreciation for this Buddhist approach to transforming the sexual energy. "I never got a sense in our training of accepting the feeling with awareness and letting it pass without acting on it. You had to fight it! And the more you resisted, the stronger it got!"Rev. Heng Sure, who teaches at the Graduate Theological Union in Berkeley, presented celibacy as the first step in a three-step process that goes from celibacy to stillness to insight. "It should not be seen just as a difficult adjunct to the spiritual path, but as essential to it," he said. The practice of meditation represents daily periods when the senses are stilled and not allowed to pursue sense objects. "Something happens to the energy in the stillness; the pressure goes away." In married life, he explained, spiritual practice is "partial and piecemeal," making celibacy a more effective means to move toward insight and the peace and happiness that flow from it. In the discussion, Benedictine Fr. Mark... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist and Catholic Monks Talk about CelibacyThomas Ryan, CSPThe electronic sign at the Minneapolis–St. Paul airport was flashing "Orange Alert" as a dozen Buddhist monks arrived in their burnt orange robes from around the country for three days of dialogue on celibacy with a similar number of Catholic monastics come together from various monasteries at St. John's Abbey in Collegeville, Minnesota. As he opened the October 26–29, 2006, (...) meeting, Rev. William Skudlarek, executive director of Monastic Interreligious Dialogue (MID), said, "You (Buddhists) have been at this for some five-to-seven hundred years longer than we have. We have something to learn."This was the second Monks in the West interreligious dialogue. The first took place in 2004 at the City of Ten Thousand Buddhas in northern California. On the Catholic side, the participants came from the Benedictine, Cistercian, and Camaldolese monasteries. On the Buddhist side, they came from the Theravada, Mahayana, and Tibetan traditions. Through the event, participants began the day with an hour of quiet sitting in meditation and joined the monastic community at St. John's for their rhythm of daily prayer.The first session dealt with theory, the "why" of celibacy. Buddhist participants explained that their teachings focus on seeing how suffering is created and cured. Attachments give rise to suffering, so advancement in the spiritual life requires letting go of one's attachments. Attachment to desires, among which are sexual desires, is a hindrance to spiritual progress. "Raging desire takes away choice, freedom," said Rev. Kusala Bhikshu, a Buddhist chaplain at UCLA, in his opening presentation. "The senses must be controlled in order to be free."Brother Gregory Perron from St. Procopius monastery in Indiana spoke of how monastic life demands a profound understanding and acceptance of solitude. "Celibacy is a tool," offered Perron, "a skillful means like intentional simplicity of life, by which our heart is burrowed out and the core of our being laid bare. By embracing it, the monk accepts the aloneness that characterizes every human being."In response to Buddhist reflections on the illusory nature of the body, Catholic participants pointed out Christianity's remarkably positive evaluation of the [End Page 143] body in the doctrines of the Incarnation, the bodily Resurrection and Ascension of Jesus, and the indwelling of the Holy Spirit. Both sides acknowledged balancing points of reference as well, such as, in Christianity, Paul's "Who will rescue me from this body of death?" (Rom 7:24). Though humankind ranks eighth from the bottom in Buddhism's thirty-two-realm cosmology, that level is the only one where spiritual growth can happen. Thus human form is in the end praised by the Buddha.In the second session, the participants moved from theory to practice. Rev. Jisho Perry from the Shasta Buddhist Abbey in California said that "the whole thrust of training is not to give in to desire that arises." He described the Buddhist method of accepting sexual feelings without either acting on them or repressing them, but just letting them pass through. "The right use of will is willingness, not willpower—the willingness to sit there and let that feeling pass through," he said.Fr. Skudlarek expressed appreciation for this Buddhist approach to transforming the sexual energy. "I never got a sense in our training of accepting the feeling with awareness and letting it pass without acting on it. You had to fight it! And the more you resisted, the stronger it got!"Rev. Heng Sure, who teaches at the Graduate Theological Union in Berkeley, presented celibacy as the first step in a three-step process that goes from celibacy to stillness to insight. "It should not be seen just as a difficult adjunct to the spiritual path, but as essential to it," he said. The practice of meditation represents daily periods when the senses are stilled and not allowed to pursue sense objects. "Something happens to the energy in the stillness; the pressure goes away." In married life, he explained, spiritual practice is "partial and piecemeal," making celibacy a more effective means to move toward insight and the peace and happiness that flow from it. In the discussion, Benedictine Fr. Mark... (shrink)

1. IntroductionIn his dissertation written under Wilhelm Hennis in 1991, Franz-Josef Ehrle was the first to write about the lecture “Probleme der Staatssoziolo-gie” (“Problems of State Sociology”) that Max Weber gave to the Vienna Sociological Society on October 25, 1917.1 Ehrle used as his source the report on the lecture published in the Neue Freie Presse on October 26, 1917.2 Ehrle also mentions a diary entry made by Josef Redlich, who was among the audience: “Thursday evening, a brilliant (...) lecture by Max Weber(Heidelberg) at the Sociological Society.”3 There exists a short biography of Redlich, taken from an excursus on “The Representatives of the (Bourgeois) Austrian Peace Movement” (“Die Vertreter der (bürgerlichen) österreichischen Friedensbewegung”): “Josef Redlich (1869–1936), jurist and politician, 1907–1918 MöAH (Deutsche Fortschrittspartei/German Progressive Party), Oct.–Nov. 1918, last Imperial and Royal Finance Minister.”4 Ehrle also indicates that Redlich met Max Weber in Vienna in 1909 at the General Congress of the Society for Social Politics (Verein für Sozialpolitik), but that Redlich’s acquaintance with Alfred Weber went back further (as shown in Redlich’s diary entry of September 2, 1909: “Saw Alfred Weber again”).5 Furthermore, a longer meeting with Max Weber is mentioned in Redlich’s diary in 1916 (on June 6).6 When Weber was staying in Vienna in 1917 and 1918, he also met privately with Redlich, and Arthur von Rosthorn attended one of these meetings with his wife (entry of May 9, 1918). Finally, Redlich wrote about his acquaintance with Max Weber in a letter to Hugo von Hofmannsthal on December 3, 1926. Ehrle summarizes Weber’s meetings in Vienna as being “limited primarily to his contacts from academia, economics (Hammerschlag), and politics (and, here, above all the economic field (Mataja, Riedl, Schüler)),” often encouraged by the fact that “academics held ministerial posts and ministers held academic posts.”7. (shrink)

On September 27, 1595, two Ukrainian bishops, having received from the Ukrainian-Belorussian Episcopate all powers and having letters from the Nuncio and the King to the Pope and Cardinal Secretary, went on a long journey to Rome. On October 26 they were already on the Italian territory. Bypassing Venice, they stay in Padua, where the local bishop congratulates them holy and heartfelt, endowing their lunch for several days.

Lecture on Nietzsche's relativism and perspectivism given at a conference on the 'crisis of reason' in Amersfoort, the Netherlands, October 26, 1991. Nietzsche claims that truth does not exist and knowledge is not possible, because knowledge serves life and is bound to an organic position. In fact, this is a paradox that refutes itself. Knowledge has evolved precisely because organisms must have limited, perspectivistic knowledge of their environment from a subjective point of view. In science, subjectivity can even be (...) transcended to some extent by making models that take into account the effects of our subjective experience of the world. The fact that theories are ‘just models’, ‘just interpretations’ does not mean that knowledge is impossible, because models and interpretations can be improved, corrected and be more or less adequate. In fact, Nietzsche relativism is incompatible with his metaphysical, psychological and ethical claims which implicitly claim a kind of philosophical or scientific progress. (shrink)

[Esotericism. One-day Workshop about the Annale n. 25 of the Storia d'Italia Einaudi]. This section contains the proceedings of the one-day workshop on the book Esoterismo, published as the Annale n. 25 in the collection "History of Italy" by Einaudi. The workshop was organized by ISPF on the October 26, 2011 to promote the discussion on the significance of Western esotericist traditions in Italian history. S. Caianiello’s introduction highlights some major concepts and goals of the recent field of studies (...) about Western Esotericism, and some open problems about its definition. M. Cambi comments on the substantial transformation of esotericist themes in Giordano Bruno’s natural philosophy, whereby the sources of the magician’s power are completely enclosed in the realm of nature, thus rejecting any transcendent foundation. M. Conforti focuses on "the function and opportunities" offered by the Western Esotericism approach "to the genesis and development of early modern science" and comments from this perspective on different contributions in the volume, emphasizing however the importance of largely pre-existing traditions in the history of science and medicine which have long challenged the wiggish separation between science and magic, rational and irrational thought. L. Simonutti provides new material to the general theme, with a historical-philosophical analysis of the esotericist elements in Picart’s iconography of the 18th Century edition of "Cymbalum mundi". F. Sofia discusses the effective role of esotericist traditions in the attempts to establish a "civil religion" in Italy from Risorgimento to Fascism, a history in which, she argues, it is difficult to establish "how much esotericism was an intentional choice or the product of an unavoidable nicodemism". C. Castellano reviews the contributions dedicated to the "political teology" of Italian Risorgimento, dealing in depth with the complex relationship between Freemasonry and Carbonari in Italy – in her view, more of a cultural than of a strictly political connection – and highlights the relevance of the anticurial component in their esotericist inspiration. G.M. Cazzaniga, author and editor of the Annale, beyond reacting to the different stimuli offered by the discussion, provides a brief history of Western Esotericism studies in Europe and of the reasons of their difficult reception in Italy. (shrink)

Article Kollektive Standardisierungen der materiellen Kultur im ausgehenden Neolithikum und am Beginn der Bronzezeit in Mitteleuropa. Ein Fallbeispiel zu „Riesenbechern“ und glockenbecherzeitlicher Siedlungskeramik was published on October 26, 2017 in the journal Zeitschrift für Kultur- und Kollektivwissenschaft (volume 3, issue 2).

On October 29, 2013, Texas House Bill 2 went into effect, greatly changing women’s access to an abortion in the state. This bill requires that physicians performing clinic-based abortions obtain admitting privileges at a hospital within 30 miles of the clinic. A few months later, on January 1, 2014, the Texas Health and Safety Code was amended to include the requirement that all abortion clinics must meet the standards of an ambulatory surgical centre. These requirements will result in heavy (...) burdens for women seeking an abortion. Many clinics cannot afford the upgrade and are being forced to close down. On August 29, 2014, a Federal District Court for the Western District of Texas ruling to overturned the two proposed requirements. The court deemed them unconstitutional violations of a woman’s right to obtain an abortion recognizing that their purpose was to create obstacles for women. The ruling was appealed and the Federal Appeals Court allowed for the new regulations, forcing all but eight clinics in Texas to close their doors. Before the enactment of HB2, there were approximately 40 abortion clinics serving Texas’ population of about 26 million. The new regulations would force all except eight clinics to close down. The remaining clinics are located in four cities forcing many women to travel hundreds of miles to access them. For some, it is more feasible to leave Texas to go to an abortion clinic outside the state. Even if every woman seeking an abortion was able to travel to one of the remaining clinics, the clinics could not meet the demand. Both of these requirements, the ambulatory surgical requirement and the admitting privileges requirement, constitute an undue burden for women. But what about the physicians? These requirements also place an undue burden on physicians who want to perform abortions. For affected physicians, it is difficult or impossible to obtain admitting privileges at a nearby hospital. Many hospitals are denying these privileges to physicians because the hospitals have no interest in participating in performing abortions and gain nothing by allowing it. If the majority of abortion clinics are forced to close down, physicians who want to perform abortions would have to relocate to one of the four cities mentioned previously, or even leave the state. Women seeking an abortion have to travel to the clinic once or twice. Physicians would have to relocate permanently. Much of the focus of these rulings has been on women’s rights and what constitutes an undue burden for women. In addition to this, physician’s rights should also be considered. There have been several cases of doctors facing harassment and even death threats for performing abortions. Fear of such treatment has led to many doctors to decline to perform abortions. Doctors do not have an obligation to perform abortions but it is within their rights as physicians to do so. However, given this harsh treatment by anti-abortion groups, not a lot of doctors are willing. The new regulations will leave open clinics in four cities in Texas making it more difficult for those few doctors who want to perform abortions to do so. The new regulations impose undue burdens on women and doctors alike. On Tuesday, October 14, the Supreme Court struck down the new requirements allowing thirteen clinics in Texas to reopen. (shrink)

Volume 20, Issue 10, October 2020, Page 26-29.

Philosophical Studies, Vol. 26 (October, 1974), pp. 77-94.

Lecture given Wednesday 27 October 1993 at a Physics - Computer Science Colloquium at the University of New Mexico. The lecture was videotaped; this is an edited transcript. It also incorporates remarks made at the Limits to Scientific Knowledge meeting held at the Santa Fe Institute 24-26 May 1994.

Volume 20, Issue 10, October 2020, Page 24-26.

Volume 24, Issue 10, October 2024, Page 26-29.

Background Providing understandable information to patients is necessary to achieve the aims of the Informed Consent process: respecting and promoting patients’ autonomy and protecting patients from harm. In recent decades, new, primarily digital technologies have been used to apply and test innovative formats of Informed Consent. We conducted a systematic review to explore the impact of using digital tools for Informed Consent in both clinical research and in clinical practice. Understanding, satisfaction and participation were compared for digital tools versus the (...) non-digital Informed Consent process. Methods We searched for studies on available electronic databases, including Pubmed, EMBASE, and Cochrane. Studies were identified using specific Mesh-terms/keywords. We included studies, published from January 2012 to October 2020, that focused on the use of digital Informed Consent tools for clinical research, or clinical procedures. Digital interventions were defined as interventions that used multimedia or audio–video to provide information to patients. We classified the interventions into 3 different categories: video only, non-interactive multimedia, and interactive multimedia. Results Our search yielded 19,579 publications. After title and abstract screening 100 studies were retained for full-text analysis, of which 73 publications were included. Studies examined interactive multimedia, non-interactive multimedia, and videos, and most studies were conducted on adults. Innovations in consent were tested for clinical/surgical procedures and clinical research. For research IC, 21 outcomes were explored, with a positive effect on at least one of the studied outcomes being observed in 8/12 studies. For clinical/surgical procedures 49 outcomes were explored, and 21/26 studies reported a positive effect on at least one of the studied outcomes. Conclusions Digital technologies for informed consent were not found to negatively affect any of the outcomes, and overall, multimedia tools seem desirable. Multimedia tools indicated a higher impact than videos only. Presence of a researcher may potentially enhance efficacy of different outcomes in research IC processes. Studies were heterogeneous in design, making evaluation of impact challenging. Robust study design including standardization is needed to conclusively assess impact. (shrink)

Background: Eye movement desensitization and reprocessing [EMDR] is an innovative, evidence-based and effective psychotherapy for post-traumatic stress disorder [PTSD]. As with other psychotherapies, the effectiveness of EMDR contrasts with a limited knowledge of its underlying mechanism of action. In its relatively short life as a therapeutic option, EMDR has not been without controversy, in particular regarding the role of the bilateral stimulation as an active component of the therapy. The high prevalence of EMDR in clinical practice and the dramatic increase (...) in EMDR research in recent years, with more than 26 randomized controlled trials published to date, highlight the need for a better understanding of its mechanism of action. Methods: We conducted a thorough systematic search of studies published until October 2017, using PubMed, ScienceDirect, Web of Knowledge and Scopus databases that examined the mechanism of action of EMDR or provided conclusions within the framework of current theoretical models of EMDR functioning. Results: Seventy-five studies were selected for review and classified into three overarching models; (i) psychological models (ii) psychophysiological models and (iii) neurobiological models. The evidence available from each study was analysed and discussed. Results demonstrated a reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy. Recently, more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy. Discussion: Despite the increasing number of studies that published in recent years, the research into the mechanisms underlying EDMR therapy are still in its infancy. Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Patient Self-Determination ActElizabeth Leibold McCloskey (bio)What are the ethics of extending the length of life? We know that we cannot artificially end life (Thou Shalt not Kill), but how about artificially extending life? Is that always good, sometimes good?... In ethics, is keeping people alive the highest good? Should our priority be to keep people breathing?... What does basic religious ethics say about this?(John C. Danforth, letter to (...) the author, 19 August 1989)The Patient Self-Determination Act, signed into law as part of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) last November, marks the first time that Congress has passed legislation concerning the ethics of life-sustaining medical treatment. The bill was spearheaded by Senator John C. Danforth (RMO), who has a special interest in this area. An Episcopal priest, Danforth was formerly an assistant chaplain at New York's Memorial Sloan-Kettering Cancer Center and now sits as a senior member of the Senate Finance Committee, which oversees Medicare and Medicaid. Although Senator Danforth's legislative initiative was not a result of the Cruzan case, it was in his state of Missouri that the U.S. Supreme Court case involving removal of Nancy Cruzan's feeding tube arose (Cruzan v. Director of Missouri Department of Health, U.S. Supreme Court, 58 LW 4916, 26 June 1990). From his unique vantage point, he felt it was time to craft a legislative response to some of the difficult issues surrounding prolongation of life.The short answer to Senator Danforth's questions about when to artificially extend life is simple enough: people must be free to determine that for themselves. Common law and common sense dictate such a conclusion; living will and health care proxy statutes, enacted in almost every state, codify that right. The Catholic moral tradition teaches that one is not morally obligated to use extraordinary means to prolong life, a tradition shared both by the mainline Protestant and the reform and conservative Jewish community. Yet most people are unaware of their fundamental legal right to make such decisions, and as court cases from Quinlan (In re Quinlin, 137 N.J. Super. 227, 1975) to Cruzan demonstrate, few know [End Page 163] how to make arrangements for this right to be exercised if they become incapacitated.Meanwhile, health care practices are often driven by a denial of death. When Senator Danforth and Senator Daniel Patrick Moynihan (D-NY) introduced the bill on October 17, 1989, Senator Danforth said:More and more it is arguable that we play God by subjecting people to unwanted and sometimes unnecessary treatment, treatment that unnaturally prolongs the dying process. Our health care system has become obsessed with extending life, at times neglecting the caring component of medicine and trampling on the rights of patients.(Congressional Record 1989, 135:5.13566)The American Hospital Association estimates that 70 percent of deaths now occur after a determination to withhold or withdraw medical treatment. Many of those decisions are made without the benefit of an incapacitated patient's views, yet a Harvard study revealed that 95 percent of the population would like to prepare in advance for such decisions. Only 4 percent of hospitals have a systematic method of asking patients if they have an advance directive. Family members confront painful choices in the face of uncertainty about their loved one's wishes and it can be even more painful when a family knows the patient's desires but providers and the courts act otherwise because clear evidence is lacking.The Patient Self-Determination Act is rooted in the belief that people should be given information that enables them to specify the extent of medical treatment they wish to receive should they become incapacitated. The public should be educated about applicable state laws that protect the individual's right to make such choices through the use of an advance directive.The Act moves toward that goal by promoting knowledge of state laws. It requires every hospital, nursing home, home health agency, hospice, and health maintenance organization that participates in Medicaid or Medicare to routinely give all adult patients information about advance directives. Patients will also be given information on the... (shrink)