OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; (...) lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees. (shrink)

Chastʹ I. Ėsteticheskie uchenii︠a︡ filosofov antichnogo mira -- Chastʹ II. Iskusstvo v suzhdenni︠a︡kh pisateleĭ antichnogo mira.

Russia is a country of extremes, as everyone knows. No matter what we do we are driven, as a rule, now to the extreme left and then to the extreme right. In the contemporary historiography of Soviet philosophy, such extreme turns lie at the surface. Among such extremes, I would include, in particular, the article "The Suppression of Philosophy in the USSR" [Podavlenie filosofii v SSSR], which appeared in Russian Philosophy. A Concise Encyclopedic Dictionary [Russkaia filosofiia. Malyi entsiklopedicheskii slovar'] . (...) I do not wish to say that one should not write about the suppression of Soviet philosophy. The problem is to maintain the necessary proportions. (shrink)

In the contemporary spiritual and moral situation, a question reverberates—sometimes obscurely, sometimes more distinctly—which may be phrased as follows: Will each of the nations of the world perform its singular part in the symphony of human history, or will unison, pale uniformity, the impotence of mankind's cultural forces prevail? This question, put bluntly, leaves no room for dubious speculations, since uniqueness is an inseparable component of the values that are currently being affirmed as universal human values in the contemporary consciousness. (...) But the concrete realities of the world situation are such that they inevitably make the task of preserving this uniqueness extremely complicated. Hence, a self-awareness of one's own specific nature remains relevant. That awareness cannot, of course, establish itself without turning to history, without an in-depth development of the conception of the cultural-historical process that would answer the questions of the place and the tasks of a particular community within the universal whole. (shrink)