Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)

A.P. Martinich's interpretation that in Leviathan Thomas Hobbes believed that the laws of nature are the commands of God and that he did not rely on the Bible to prove this has been criticized by Greg Forster in this journal (2003). Forster uses these criticisms to develop his own view that Hobbes was insincere when he professed religious beliefs. We argue that Forster misrepresents Martinich's view, is mistaken about what evidence is relevant to interpreting whether Hobbes was sincere or not, (...) and is mistaken about some of Hobbes's central doctrines. Forster's criticisms are worth discussing at length for at least three reasons. He takes the debate about Hobbes's sincerity to a new level of sophistication; his misinterpretations of Hobbes may become accepted as correct; and his criticisms raise issues about the proper method of interpreting historical texts. (shrink)

This article delineates the core concerns and motivations of the ontological work of Gilles Deleuze, and is intended as a programmatic statement for a general philosophical audience. The article consists of two main parts. In the first, two early writings by Deleuze are analysed in order to clarify his understanding of ontology broadly, and to specify the precise aim of his understanding of being in terms of difference. The second part of the article looks at the work of Heidegger and (...) Derrida in order to distinguish Deleuze's conceptions of ontology and difference from theirs. A final section clarifies Deleuze's efforts to undertake the construction of an ontology divergent from the dominant tradition and in contrast to the emphasis on the closure of metaphysics in the thought of Heidegger and Derrida. (shrink)

On the philosophy of death in Hindu traditions; study based on Mr̥tyupurāṇa of Svāmī Mr̥tyujayānanda.

Мета. Стаття являє собою філософсько-антропологічну репрезентацію ідеї духовності в трилогії "Фундація" американського письменника-фантаста, філософа, популяризатора науки Айзека Азімова. Теоретичний базис. Дослідження базується на розумінні світоглядних імперативів творчості А. Азімова, які висвітлюють його філософсько-антропологічне бачення духовності як історично усталеної властивості раціонально організованого суспільства і ключову умову його прогресивної еволюції. Емерджентність, стохастичність і евентуальність розвитку сучасного глобального соціуму виводить зміст філософсько-антропологічних ідей А. Азімова на принципово новий рівень розуміння подальшого розвитку людства. Артикуляція А. Азімовим ідеї духовності в трилогії "Фундація" дозволяє визначити філософсько-антропологічну (...) концепцію письменника у всій повноті її соціального, філософського, екзистенціального та аксіологічного вимірів. Наукова новизна. Автори обґрунтували доцільність та актуальність розгляду ідеї духовності в трилогії А. Азімова "Фундація" в смисловому полі філософської антропології. Показано, що філософська антропологія А. Азімова має чітко виражене телеологічне "навантаження". В інтерпретації письменника людина майбутнього – це не "постлюдина" зі зміненою за допомогою спеціальних технологій біологічною природою, а людина, орієнтована на духовний розвиток і самовдосконалення, що базуються на одвічних цінностях, зафіксованих у ментальному коді Homo sapiens – щасті, любові, свободі, гідності, незалежності, патріотизмі. Висновки. "Фундація" – твір багатоплановий, сюжетно насичений, композиційно мозаїчний, поліфонічний, у якому, на перший погляд, важко визначити якусь домінантну ідею. У процесі дослідження встановлено, що в творчості А. Азімова одним із основних змістових центрів є філософсько-антропологічний дискурс, у просторі якого значну увагу приділено духовності людини. (shrink)

Ayn Rand's first novel, We the Living, offers an early form of the author's nascent philosophy—the philosophy Rand later called Objectivism. Robert Mayhew's collection of entirely new essays brings together pre-eminent scholars of Rand's writing. In part a history of We the Living, from its earliest drafts to the Italian film later based upon it, Mayhew's collection goes on to explore the enduring significance of Rand's first novel as a work both of philosophy and of literature.

Hegel’s basic position so far on the various meanings of evil as necessary and thereby intelligible directly in the development of spirit might be summed up as follows. Evil is always a necessary moment of instability which gives impetus in the movement from various meanings of particularity to various meanings of universality; from the more abstract expression of potential unity and truth to the more actualized notion and unity.

The outline of modern macroeconomics took shape in Britain in the early nineteenth century thanks, in part, to David Ricardo, one of the most influential economists of the time. Britain was challenged by monetary inflation, industrial unemployment and the loss of jobs abroad. Ricardo pointed the way forward. As a financier and Member of Parliament, he was well versed in politics and commercial affairs. His expertise is shown by the practicality of his proposals, including the resumption of the gold standard, (...) which was essential given the destabilizing policy of the Bank of England. Ricardo's expertise appears also in his debate with T. R. Malthus about whether an industrial economy can suffer a prolonged depression. Say's Law of Markets and the Quantity Theory of Money figure prominently in his works, but not in an extreme form. He was instead a subtle theorist, recognizing the non-neutrality of money, trade depressions and unemployment. (shrink)

Hindu culture and political ethics in the character of Krishana, Hindu deity as decribed in Bhāgavatapurāṇa and Mahābhārata ; a study.

Upshot: In this response, I address the points raised in the commentaries, in particular those related to the scalability and robustness of the mechanism CALM, to its relation with the CAES architecture, and to the transition from sensorimotor to symbolic.