Recognising a diminution in his emotional response to patients’ deaths, the author analyses in detail his internal reactions in an attempt to understand what he believes is a common phenomenon among doctors. He identifies factors that may erode the connection between patient and physician: an instinct to separate oneself from another’s suffering, professional unease in the case of therapeutic failure, the atrophying effect of perceived hopelessness, insincerities in the establishment of the initial relationship, and an inability to imbue the sedated (...) or unconscious patient with human qualities. He concludes that recognition of these negative influences, without necessarily changing behaviours that are natural, may be a first step towards protecting doctors against what might be an otherwise insidious process of dehumanisation. (shrink)

A terminally ill man requests that his life be brought to a peaceful end by the doctor overseeing his care. The doctor, an atheist, regretfully declines. The patient, unsatisfied by the answer and increasingly desperate for relief, presses the doctor for an explanation. During the ensuing dialogue the philosophical, ethical and emotional arguments brought to bear by both the doctor and the patient are dissected.

The motives behind the author’s decision to resuscitate a patient are examined. This is prompted by the realisation that he ignored the man’s apparent wish not to be saved for fear of criticism from both relatives and colleagues. The way in which decisions are made when the interests of the doctor and the patient clash are briefly explored. Self interest may play a more significant role than is commonly accepted.

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

This study investigates factors impacting perceptions of ethical conduct of peers of 293 students in four US universities. Self-reported ethical behavior and recognition of emotions in others (a dimension of emotional intelligence) impacted perception of ethical behavior of peers. None of the other dimensions of emotional intelligence were significant. Age, Race, Sex, GPA, or type of major (business versus nonbusiness) did not impact perception of ethical behavior of peers. Implications of the results of the study for business schools and industry (...) professionals are discussed. (shrink)

Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response. A range of post-traumatic sequelae have been found to mediate the relationship between trauma and psychotic experiences, including the “traditional” symptoms of post-traumatic stress disorder (PTSD). The International Classification of Diseases-11th Edition recognizes a more complex post-traumatic presentation, complex PTSD (cPTSD), which captures both the characteristic symptoms of PTSD alongside more pervasive post-traumatic sequelae known as ‘disturbances in (...) self-organization’ (DSOs). The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored. In the first study of this kind, 144 participants with psychosis recruited from North West United Kingdom mental health services completed measures assessing trauma, PTSD and cPTSD symptoms and symptoms of psychosis. Forty-percent of the sample met criteria for cPTSD, compared to 10% who met diagnostic criteria for PTSD. PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership. Both PTSD and DSOs mediated the relationship between trauma and affective symptoms but did not explain a significant proportion of variance in negative symptoms. Cognitive and excitative symptoms of psychosis did not correlate with trauma, PTSD or DSO scores. These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In Which Henry James Strikes BedrockRalph M. BerryIn Stanley Cavell’s account of Wittgenstein’s later philosophy, everything we know depends upon what Wittgenstein calls grammatical criteria. These criteria are what we go on when judging that something counts as an instance of our concept of a “chair,” “ardent love,” “headache,” etc. For the arts, Wittgenstein’s focus on criteria leads in two, apparently opposite, directions. First, by making the activity of (...) judging constitutive for language and culture, Wittgenstein makes aesthetics (or what is traditionally called aesthetics) a model for all philosophical activity. Determining the basis on which a phenomenon will count as an instance of any concept turns out to involve capacities that formerly seemed relevant only in cases of aesthetic judgment.But Wittgenstein’s focus on criteria also works against this centrality of aesthetics, for it makes an exceptional or limiting case of the art contemporary with Wittgenstein. According to Cavell, what modernist art reveals is that judging what counts as a novel, painting, sculpture, etc., is no longer determined by grammatical criteria, or none to which we have access as we do our criteria for “chair,” “ardent love,” “headache,” etc. This does not mean, or not quite, that nobody knows any longer what a novel is. It comes closer to meaning that the experience of modern art is of finding out what we know, what our criteria for sculptures, paintings, novels are. And it makes modernism the disclosure of a new artistic necessity: not merely to create a new work, but to create a new basis for work, a new medium for fiction. 1In what follows my aim is to see how this necessity arises. My focus is on a particular period of Henry James’s career, roughly from his review of Eliot’s Middlemarch in 1873 to his essay on Maupassant in 1888, a [End Page 61] period that surrounds his now famous response to Walter Besant in “The Art of Fiction.” I do not insist that this moment in James’s career is a founding moment for modernist fiction. My only insistence is that, whatever conditions do give rise to modernism—either for a whole culture or for an individual—they look like this moment.INear the end of “The Art of Fiction,” Henry James takes issue with Walter Besant (and the critic Andrew Lang) over the use of the word “story.” 2 His stated provocations are, first, that Besant (in his lecture) has distinguished between “a part of a novel which is the story and part of it which... is not” (“AF,” p. 178) and, second, that Besant and Lang (in his review of Besant’s lecture) have made “adventure” a defining feature of any story (p. 179). James’s procedure in the first case is to give examples of “the only [sense of ‘story’] that I see” in which it can be spoken of as different from the novel as a whole. His procedure in the second case is to give examples of what constitutes an adventure “for me” (or what “I should say” is an adventure) and to confess that he is “utterly at a loss to see why” the plot of his own novella “An International Episode” does not count as an adventure if the other examples cited by Lang and Besant do. James gives no reasons why anyone ought to use the words “story” and “adventure” as he does. If we see senses of “story” other than the ones that James sees, if the fact that he is “utterly at a loss” makes no impression on us, or if we just do not care what Henry James considers adventurous, nothing he says seems designed to change our minds. His whole case rests on nothing stronger than the likelihood that, in the circumstances he describes, we too will call or judge or find what he calls/judges/finds “a story,” “an adventure,” “exciting,” etc. If we don’t, of course, we just don’t, but the surprise is how often we do. 3Contrary to what James maintains, the problem with Besant and Lang’s definition of “story” is not that it is “altogether arbitrary” (p. 179... (shrink)

We show the existence of Lorentz invariant Berry phases generated, in the Stueckelberg–Horwitz–Piron manifestly covariant quantum theory (SHP), by a perturbed four dimensional harmonic oscillator. These phases are associated with a fractional perturbation of the azimuthal symmetry of the oscillator. They are computed numerically by using time independent perturbation theory and the definition of the Berry phase generalized to the framework of SHP relativistic quantum theory.

Problematic substance use (PSU) among nurses has wide‐ranging adverse implications. A critical integrative literature review was conducted with an emphasis on building knowledge regarding the influence of structural factors within nurses' professional environments on nurses with PSU. Five thematic categories emerged: (i) access, (ii) stress, and (iii) attitudes as contributory factors, (iv) treatment policies for nurses with PSU, and (v) the culture of the nursing profession. Conclusions were that an overemphasis on individual culpability and failing predominates in the literature and (...) that crucial knowledge gaps exist regarding the influence of structural factors on driving and shaping nurses' substance use. (shrink)

I examine the views of the renowned Catholic environmentalist, Thomas Berry, C.P., by comparing them with those of Thomas Aquinas, an author Berry frequently references. I intend to show that while the two share a number of views in common, ultimately the two diverge on many foundational issues, resulting in differing conclusions as to how we should regard and treat the environment. Aquinas upholds divine transcendence, whereas Berry regards the notion of divine transcendence to lead to the (...) exploitation of creation and locates the divine in the universe itself. Berry accordingly thinks that we should revere all natural things, whereas Aquinas thinks we should revere God and creatures in God’s image. Aquinas maintains that the human soul is created by God and is in God’s image. He sees our rational soul as placing us above other natural things, and from it follows our responsibility to care for nature. Berry, to the contrary, sees this affirmation of discontinuity between humans and the rest of nature to be the root of our environmental woes, as providing a justification for human exploitation of nature. For Berry, humans have no special status, but are one member alongside others in the earth community. Rather than being created by God, “humans have nothing but what they receive from the universe.” By highlighting both the similarities and differences between these authors, I hope to contribute to the project of formulating a sound environmental ethics. (shrink)

The paper considers the intellectual computer mathematics system InparSolver, which is designed to automatically explore and solve basic classes of computational mathematics problems on multi-core computers with graphics accelerators. The problems of results reliability of solving problems with approximate input data are outlined. The features of the use of existing computer mathematics systems are analyzed, their weaknesses are found. The functionality of InparSolver, some innovative approaches to the implementation of effective solutions to problems in a hybrid architecture are described. Examples (...) of applied usage of InparSolver for processes mathematical modeling in various subject areas are given. Nowadays, new more complex objects and phenomena in many subject areas are constantly emerging, which are subject to mathematical research on a computer. This encourages the development of new numerical methods and technologies of mathematical modeling, as well as the creation of more powerful computers for their implementation. With the advent and constant development of supercomputers of various architectures, the problems of their effective use, expansion of tasks range should be solved, ensuring the reliability of computer results and increasing the level of intellectual information support for users ‒ specialists in various fields. Today, the issues of solving these problems are given special attention by many specialists in the fields of information technology and parallel programming. The world's leadingscientists in the field of computer technology see the solution to the problems of efficient usage of modern supercomputers in algorithmic software creation that easily adapts to different computer architectures with different types of memory and coprocessors, supports efficient parallelism on millions of cores etc. In addition, improving the efficiency of high-performance computing on modern supercomputers is provided by their intellectualization, transferring to the computer to perform a significant part of the functions. The industry of development and usage of intelligent computer technologies is one of the main directions of science and technology development in modern society. (shrink)

Integrated information theory (IIT) is a candidate theory of consciousness that highlights the role of complex interactions between parts of a system as the basis of consciousness – and, due to its general information-theoretic formulation, is capable of making statements about consciousness in neural and non-neural systems alike. Here, we argue that a system radically different to a human brain, host to complex physiological and functional structures capable of integrating information, can be found in the meristems and vascular system of (...) higher plants. Following a pragmatic and ontologically innocent approach, neither taking for granted that plants are conscious nor dismissing the possibility that they are, we argue that the time is ripe to apply analysis tools inspired by IIT to plants, taking advantage of recent developments in both plant imaging and information theory. We introduce and discuss the relevant literature, and pro information and integration in plant behaviour, assessing the plausibility of plant sentience. If successful, these experiments could position plants as the next frontier in consciousness science, and urge us to rethink our perspectives on consciousness, how to measure it, and its prevalence amongst living beings. (shrink)

В книге отражена деятельность ведущих ученых, специалистов, руководителей, внесших большой вклад в развитие Философского факультета МГУ имени М. В. Ломоносова.

Studies in Stoicism contains six unpublished and seven republished essays, the latter incorporating additions and changes which Brunt wished to be made. The papers have been integrated and arranged in chronological order by subject matter, with an accessible lecture to the Oxford Philological Society serving as Brunt's own introduction.