Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

This collection of essays on themes in the work of John Locke , George Berkeley , and David Hume , provides a deepened understanding of major issues raised in the Empiricist tradition. In exploring their shared belief in the experiential nature of mental constructs, The Empiricists illuminates the different methodologies of these great Enlightenment philosophers and introduces students to important metaphysical and epistemological issues including the theory of ideas, personal identity, and skepticism. It will be especially useful in courses devoted (...) to the history of modern philosophy. (shrink)

Whereas most current theories on emotions posit a central position to goals, direct tests of associations between emotions and goals have been sparse. We investigated such relations by comparing ratings of value importance and frequency of emotional experiences in daily life. The results confirmed our general expectation that associations would be found between values and emotions related to corresponding goals. We argue that data like these are fundamental to further development of emotion theory.

The Oregon Basic Health Services Act of 1989 seeks to establish universal access to basic medical care for all currently uninsured Oregon residents. To control the increasing cost of medical care, the Oregon plan will restrict funding according to a priority list of medical interventions. The basic level of medical care provided to residents with incomes below the federal poverty line will vary according to the funds made available by the Oregon legislature. A rationing plan such as Oregon's which potentially (...) excludes medically necessary procedures from the basic level of health care may be just, for the right to publically-sponsored medical care is restricted by opposing rights of private property. However, the moral acceptability of the Oregon plan cannot be determined in the absence of knowing the level of resources to be provided. Finally, Oregon to date has failed to include the individuals being rationed in discussions as to how the scarce resources are to be distributed. (shrink)

Habeşistan Prensi Rasselas Bir Hikâye, Dr. Samuel Johnson’ın (1709-1784) eserlerinin en popüler olanlarından biridir. Eserin ilk okuyucuları onu felsefî ve pratik açıdan önemli bir eser olarak görmüş ve bir roman olarak sınıflandırmanın zor olduğunu düşünmüştür. Johnson, eserini yaklaşık 250 yıl önce yazmasına rağmen bugün de okuyucuya hayatın, ölümün, evliliğin, öğrenmenin, eyleme karşı eylemsizliğin anlamını ve diğer birçok konuyu keşfettirmeye çalışmaktadır. Johnson, ahlak teorilerinden hareketle mutluluğu ele almamaktadır. Ahlakî failin kendisinden, insandan ve insanın yaşadığı hayat ve bunun koşullarından hareketle konuyu anlatmaktadır. (...) Mutluluk anlamında temele alınacak olan fail ve onun içinde bulunduğu şartları değerlendirmektedir. Mutluluk, elde edilenden veya elde etmekten çok arama ve başarmada bulunabilir. Habeşistan Prensi, Voltaire’in (1694-1778) iyimserlik sistemini çürütmek için yazdığı Candide adlı esere, planı ve yapısı bakımından benzerlik göstermektedir. Fakat vardıkları sonuç birbirlerinden oldukça farklıdır. İnsanların mutluluğu bulmayı düşündükleri hemen her unsur ele alınıp bunların istenileni veremeyeceğinin belirtildiği Habeşistan Prensi, yöneticilerden hizmetçilere, yaşlılardan gençlere, bilgelerden cahillere varıncaya kadar her kesimden insanı örneklemektedir. Bütün olaylar mutluluk umuduyla başlamış fakat hayal kırıklığıyla sona ermiştir. Sonuçta romanda kurgusal bir yolculuk aracılığıyla ahlakî bir gerçeklik ortaya konulmaya çalışılmıştır. Johnson, Türkiye'de çok fazla tanınmadığı için makalenin giriş kısmında hayatı ve eserlerinin Habeşistan Prensi ile ilgili olan yönlerine kısaca değindik. Çalışmada yöntem olarak nitel araştırmanın imkanlarından yararlanılmış, literatür ve doküman analizi metotları kullanılarak Habeşistan Prensi’nde mutluluk, kötümserlik, iyimserlik konuları incelenmiştir. (shrink)

Since the last decades of the 20th century the meaning and content of knowledge has dramatically changed. This necessitates adopting a historical perspective in ap­proa­ching the questions of knowledge. But so far all the efforts of putting knowledge in a historical perspective since Hegel’s historization of Spirit either suffer from the limitations of the presupposition of the One or fail to ground the historicity of knowledge on the history of coming-to-be and passing-away. Moving from Heidegger’s ‘history of Being’ toward the (...) Aristotelian understanding of coming-to-be and passing away as a process of becoming has the potential to open up new avenues in approaching the historical question of knowledge as well as establishing its relation with the never com­plete ground of the entities as its historical a priori condition of possibility. (shrink)

In list-method directed forgetting, reexposure to forgotten List 1 items has been shown to reduce directed forgetting. proposed that reexposure to a few List 1 items only during a direct test of memory reinstates the entire List 1 episode. In the present experiments, part-list reexposure in the context of indirect as well as direct memory tests reduced directed forgetting. Directed forgetting was reduced when 50% or more of the items were reexposed, and was intact when only 25% were reexposed. Furthermore, (...) part-list reexposure appeared to reinstate only reexposed items-not the entire List 1 episode. (shrink)

Few residency training programmes explicitly require substantive exposure to issues in medical ethics and fewer still have a formal curriculum in this area. Traditional undergraduate medical ethics courses teach preclinical students to identify ethical issues and analyse them at a theoretical level. Residency training, however, is the ideal time to establish the critical behavioural link which makes ethics truly useful in clinical medicine. The General Internal Medicine Residency Training Program at Rhode Island Hospital has developed an integrated, three-year curriculum with (...) the goals of helping residents to perceive ethical issues in clinical practice, to utilise basic philosophical principles in resolving ethical dilemmas and to communicate these issues clearly and sensitively to patients. The curriculum has been well received by residents and has had a hospital-wide impact. We believe that training residents in medical ethics and communication skills is an effective approach to developing physicians' humane qualities. (shrink)

This paper describes an intelligent algorithm for traffic sign recognition which converges quickly, is accurate in its segmentation and adaptive in its behaviour. The proposed approach can segment images of traffic signs in different lighting and environmental conditions and in different countries. It is based on using Kohonen's Self-Organizing Maps as a clustering tool and it is developed for Intelligent Vehicle applications. The current approach does not need any prior training. Instead, a slight portion, which is about 1% of the (...) image under investigation, is used for training. This is a key issue to ensure fast convergence and high adaptability. The current approach was tested by using 442 images which were collected under different environmental conditions and from different countries. The proposed approach shows promising results; good improvement of 73% is observed in faded traffic sign images compared with 53.3% using the traditional algorithm. The adaptability of the system is evident from the segmentation of the traffic sign images from various countries where the result is 96% for the nine countries included in the test. (shrink)