Background and objective: Assuming the hypothesis that the general practitioner can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs’ role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed.Design: Questionnaire survey.Setting: Urban and rural areas.Participants: GPs.Results: The response rate was 32.2% , and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed that (...) the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills and enough time to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% of respondents, of whom only 40.0% believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP’s strong belief that his or her participation was essential , information on admission of the patient given to the GP by the hospital department , rural practice , visit to the patient dying in hospital and a request by the family to be kept informed about the patient .Conclusion: Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients’ families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients. (shrink)

We formalize what it means to have permission to say something. We adapt the dynamic logic of permission by van der Meyden (J Log Comput 6(3):465–479, 1996 ) to the case where atomic actions are public truthful announcements. We also add a notion of obligation. Our logic is an extension of the logic of public announcements introduced by Plaza ( 1989 ) with dynamic modal operators for permission and for obligation. We axiomatize the logic and show that it is decidable.

This paper explores the philosophical aspects of the "Great Introduction" of Abū Ma'šar, one of the great figures of Arabic astrology and an associate of al-Kindī, the great 9th century philosopher. I argue that the following points of philosophical interest may be found in this text: 1. Astrology is described as a "master science" along the lines proposed by Aristotle, i.e. it provides principles for lower sciences. Also he supplies arguments to ground astrology on methodological grounds, such as the use (...) of empirical evidence and testimony. 2. Abū Ma'šar broadly follows al-Kindī's explanation of how the stars influence the sublunary world, by heating the elements. This agrees with al-Kindī's work "On the Proximate Agent Cause of Generation and Corruption," and I identify some parallels between the two works. 3. Finally, Abū Ma'šarr considers whether human freedom is compatible with this causal account. He holds that human actions do fall under the class of the "possible" and not the "necessary," but only because for him the "possible" is what happens sometimes, not always. Thus he seems tacitly to hold that genuine choice is compatible with causal necessitation. (shrink)

We locate winning strategies for various ${\mathrm{\Sigma }}_{3}^{0}$ -games in the L-hierarchy in order to prove the following: Theorem 1. KP+Σ₂-Comprehension $\vdash \exists \alpha L_{\alpha}\ models"\Sigma _{2}-{\bf KP}+\Sigma _{3}^{0}-\text{Determinacy}."$ Alternatively: ${\mathrm{\Pi }}_{3}^{1}\text{\hspace{0.17em}}-{\mathrm{C}\mathrm{A}}_{0}\phantom{\rule{0ex}{0ex}}$ "there is a β-model of ${\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}\text{\hspace{0.17em}}\text{\hspace{0.17em}}+\text{\hspace{0.17 em}}{\mathrm{\Sigma }}_{3}^{0}$ -Determinacy." The implication is not reversible. (The antecedent here may be replaced with ${\mathrm{\Pi }}_{3}^{1}\text{\hspace{0.17em}}\text{\hspace{0.17em}}\left({\mathrm{\Pi }}_{3}^{1}\right)-{\mathrm{C}\mathrm{A}}_{0}:\text{\hspace{0.17em}}{\mathrm{\Pi }}_{3}^{1}$ instances of Comprehension with only ${\mathrm{\Pi }}_{3}^{1}$ -lightface definable parameters—or even weaker theories.) Theorem 2. KP +Δ₂-Comprehension +Σ₂-Replacement + ${\mathrm{\Sigma }}_{3}^{0}\phantom{\rule{0ex}{0ex}}$ -Determinacy. (Here AQI (...) is the assertion that every arithmetical quasi-inductive definition converges.) Alternatively: $\Delta _{3}^{1}{\rm CA}_{0}+{\rm AQI}\nvdash \Sigma _{3}^{0}$ -Determinacy. Hence the theories: ${\mathrm{\Pi }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0},\text{\hspace{0.17em}}{\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}+\text{\hspace{0.17em}}{\mathrm{\Sigma }}_{3}^{0}-\mathrm{D}\mathrm{e}\mathrm{t}\phantom{\rule{0ex}{0ex}}$ -Det, ${\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}+\mathrm{A}\mathrm{Q}\mathrm{I}$ , and ${\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}\phantom{\rule{0ex}{0ex}}$ are in strictly descending order of strength. (shrink)

Jewish law takes an approach to self-defense that differs dramatically from the conventional assumptions of Western secular legal systems. The central theme of Talmudic jurisprudence is that self-defense rests on a duty not to stand idly by while one's neighbor suffers. “Do not stand on the blood of one's neighbor,” as the point is cryptically put in Leviticus 19:16. This way of thinking about self-defense departs in two significant ways from common Western assumptions. First, it stresses that the roots of (...) self-defense are a duty rather than a right to act; second, it treats the case of third-party defense as logically prior to the first-party case of self -defense. (shrink)

This discussion paper is drawn from a qualitative research project comparing the effect of special and ordinary schools on the lives of children, young people and their families. Special schools are recommended by health professionals who seldom know how ineffective these schools are. We question the beneficence and justice of health professionals' advice on education for children with disabilities and other difficulties. Cooperation with local education authorities (LEAs) plays a considerable part in the work of community paediatricians, clinical medical officers, (...) therapists and other health professionals encountering children with "special needs". The "needs" range from physical disability and sensory impairment to learning difficulties and emotional or behavioural difficulties. This cooperation involves routine administrative problems, but it raises broad ethical issues too, particularly in respect of current tendencies in state schooling towards the integration or inclusion of these children in mainstream schools and classes. (shrink)

The author clarifies the existential philosophy that is implicit in Kurt Goldstein's philosophy of organism (Goldstein, 1963; 1995). Situated in response to the growing trend that psychological phenomena are reducible to the nervous system, the author argues for the reverse: that the significance of nervous system activity can only be understood by viewing it as background to foreground performances. Like the organization of perception into meaningful figure-- ground Gestalts, the existential modes of embodiment, sociality, temporality, spatiality, and attunement are organized (...) together to accomplish foreground performances. It is only within this context that the activity of the nervous system may be understood as significant or insignificant. Speech is given as an example. The article concludes with a commentary on how the trend of reducing psychological phenomena to neurological phenomena has impaired our understanding of brain disorders and psychological disorders. (shrink)

Even for persons who hold to the ethical acceptance of abortion practices in general, questions of detail often arise. If you assume the distinction between the physical human organism alone and the person that is associated with that organism, then you must face the question of whether it is permissible to abort a fetus if the corresponding person has come into being. We take the position that the abortion of a fetus that has achieved this level of development should be (...) declared unethical except in special circumstances. Our purpose here is to identify the point in the development of the fetus that serves as the marker for this level. (shrink)

We consider notions of truth and logical validity defined in various recent constructions of Hartry Field. We try to explicate his notion of determinate truth by clarifying the path-dependent hierarchies of his determinateness operator.

It is widely accepted that EinstcinRi7;s general theory of relativity is an satisfactory description of gravity 0nly in the macroscopic limit, where quantum eiTcc1;s may be neglected. Presumably this theory is inapplicable at the Planck length, but recently much attention has been devoted to gravitational theory at intermediate length scales where quantum affects 0f matter are inescapable, but where there is an general assumption that the gravitational Held may bc treated as a classical background, augmented if necessary by quamtizcd linearized (...) pertur-. (shrink)

The clinical decision is supposed to be based on evidence. In fact, what counts as evidence is far from being established. Some definition of "proof" is needed to distinguish between scientific medicine and charlatanism. My thesis is that unfortunately a clear-cut boundary between evidence and lack of evidence cannot be found, for several reasons that I summarise in the paper. Evidence in medicine very often has fuzzy boundaries, and dichotomising fuzziness and uncertainty can have serious consequences. Physicians and patients should (...) accept the irreducible fuzziness of many of the concepts they use when dealing with health and disease. (shrink)

These are details of research conducted in November and December 2007. The file is meant as a supplement to publication, and I have not attempted here to provide any analysis of the results.