Studies on end-of-life care reveal different practices regarding withholding and/or withdrawing life-sustaining treatments between countries and regions. Available data about physicians’ practices regarding end-of-life care in ICUs in Egypt is scarce. This study aimed to investigate physicians’ attitudes toward end-of-life care and the reported practice in adult ICUs in Ain Shams University Hospitals, Cairo, Egypt. 100 physicians currently working in several ICU settings in Ain Shams University Hospitals were included. A self-administered questionnaire was used for collection of data. Most of (...) the participants agreed to implementation of “do not resuscitate” (DNR) orders and applying pre-written DNR orders (61% and 65% consecutively), while only 13% almost always/often order DNR for terminally-ill patients. 52% of the participants agreed to usefulness of limiting life-sustaining therapy in some cases, but they expressed fear of legal consequences. 47% found withholding life-sustaining treatment is more ethical than its withdrawal. 16% almost always/often withheld further active treatment but continued current ones while only 6% almost always/often withdrew active therapy for terminally-ill patients. The absence of legislation and guidelines for end-of-life care in ICUs at Ain Shams University Hospitals was the main influential factor for the dissociation between participants’ attitudes and their practices. Therefore, development of a consensus for end-of-life care in ICUs in Egypt is mandatory. Also, training of physicians in ICUs on effective communication with patients’ families and surrogates is important for planning of limitation of life-sustaining treatments. (shrink)

Some recent cognitive-scientific research suggests that a considerable amount of intelligent action is generated not by the systematic activity of internal representations, but by complex interactions involving neural, bodily, and environmental factors. Following an analysis of this threat to representational explanation, we pursue an analogy between the role of genes in the production of biological form and the role of neural states in the production of behaviour, in order to develop a notion of genic representation. In both cases an appeal (...) to normal ecological context is used to balance multi-factoral, interactive causal determination against the intuition that certain aspects of the causal nexus play a special role in promoting adaptive success. Certain worries abut this vision help us to get a better grip on the concept of genic representation itself. We end with a puzzle concerning the relation between cognition and representation. (shrink)

Three experiments explored how hypocrisy affects attributions of criminal guilt and the desire to punish hypocritical criminals. Study 1 established that via perceived hypocrisy, a hypocritical criminal was seen as more culpable and was punished more than a non-hypocritical criminal who committed an identical crime. Study 2 expanded on this, showing that negative moral emotions (anger and disgust) mediated the relationships between perceived hypocrisy, criminal guilt, and punishment. Study 3 replicated the emotion finding from Study 2 using new scenarios where (...) group agents were clearly aware of the hypocrisy of their actions, yet acted anyway. Again, perceived hypocrisy worked through moral emotions to affect criminal guilt and punishment. The current studies provide empirical support for theories relating hypocrisy and moral transgressions to moral emotions, also informing the literature on the role of moral emotions in moral reasoning and legal decision making. (shrink)

Mr. A's physician recommends immediate dialysis. However, Mr. A is in the United States illegally, has no family living in the area, and is unemployed. The Emergency Medical Treatment and Labor Act requires the hospital not only to examine Mr. A, but to provide him with any needed stabilizing treatment without considering his lack of insurance coverage or ability to pay. The needed treatment to stabilize Mr. A is dialysis. Therefore, the physician admits him and starts dialysis. But Mr. A (...) will need to continue dialysis indefinitely. Because he has no insurance and is an illegal immigrant, he is not eligible for any outpatient dialysis units. He is also unable to afford any medical treatments. Once Mr. A is stabilized, should he be discharged? His physician and social worker turn to the hospital ethics committee for help. What should Mercy Hospital do? (shrink)

Changing land-use patterns and amenity-driven migration have brought agriculture back into people’s lives, but there is a disconnection between the realities of production agriculture and romantic images attached to farming. To the extent that “rurality” is attached to farming, people may desire to live in rural places, but they may be unprepared for the realities of living near a working farm. Greater numbers of communities are facing “either/or” outcomes regarding the conversion of “open space” land to residential or commercial uses (...) versus landscape preservation. This study explored the perceptions and preferences of a community regarding the conversion of a hypothetical parcel of open space to a working dairy or to a residential subdivision. Results suggest that the opportunity costs of foregoing open space for residential development are high, with implications for valuing the conservation of traditions that are tied to the land versus conversion of land solely for development purposes. (shrink)

The term ‘nurse’ (hushi—’caring scholar’) did not enter the Chinese language until the early 20th century. Modern nursing—a fundamentally Western notion popularized by Nightingale and introduced to China in 1884—profoundly changed the way care of the sick was practiced. For 65 years, until 1949, nursing developed in China as a transnational project, with Western and Chinese influences shaping the profession of nursing in ways that linger today. Co‐authored by Chinese, Canadian, and American nurses, this paper examines the early stages of (...) nursing in one province of China as an exemplar of the transnational nature of nursing development. By identifying sociopolitical influences on the early development of nursing in Shandong, the authors aimed not only to contribute to the nascent body of knowledge on China nursing history, but also to heighten readers’ sensitivity to the existence of historical echoes, residue, and resonances in their own nursing practices. Tracing current issues, values, or practices back to their roots provides context and helps us to better understand the present. Whether we are aware of the details or not, the gestalt of nursing practice in a particular place has been shaped by its history—including in Shandong province in China. (shrink)

_Advancing Equity and Achievement in America’s Diverse Schools _illustrates how educators, students, families and community partners can work in strategic ways to build on social, cultural, and ethnic diversity to advance educational equity and achievement. By drawing on the latest data on demographic change, constructions of culture and cultural difference, and the politics of school reform in urban, rural, and suburban school communities, this volume looks toward solutions and strategies for meaningful educational improvement. Contributors consider both the diversity of youth (...) and families served in public schools, and the culture of U.S. schooling, highlighting the influence of policy and reform agendas; students’ identities and agency; experiences and approaches of diverse educators; and the workings of effective school partnerships. Chapters also focus on those often overlooked in educational scholarship such as Native Americans, students experiencing poverty and/or homelessness, Muslim students, students with special needs, and students and educators who are lesbian, gay, bisexual, transgender, intersex, or queer. In all, this edited collection stresses the need for high quality education that is inclusive, culturally responsive and unifying so all students can experience academic success. This book is a meaningful resource for educators, policymakers, and community-based leaders interested in doing such transformative work. (shrink)

The article links community resilience – the resilience of the political community, with the process of public policy-making. In the argumentation, the study investigates the formation of community resilience and the importance of individual attitudes, compared to the individualism-collectivism scale. The sample research is conducted among 669 respondents in Bulgaria, aged 15 to 77 years old (M=29.3; SD=13.39). The applied methodology is based on the New Ecological Paradigm (NEP) to measure people’s environmental attitudes, and the Ecological Consumer Behaviour Scale to (...) measure eco-anxiety and pro-environmental behavioural intentions. Empirical study measures self-efficacy, Big Five personality traits, and values orientations. The results confirm that there were gender differences on the NEP scale, including that women show higher environmental attitudes. The research findings provide explanations how human values were positively related to one’s awareness of the environmental crisis. Finally, neuroticism correlated positively with realising the limit to growth. Therefore, it is important, that the design and the implementation of public policies and educational programs, consider various psychological aspects of individual human behaviour. This approach may have key implications for engaging in future sustainable behaviour and increasing the degree of resilience. (shrink)

2. The equal status mentioned in Thesis 2 need not mean, "equally concrete" or "inclusive," but only, "equally real," where "real" means having a character of its own with reference to which opinions can be true or false. But becoming or process is alone fully concrete or inclusive, since if A is without becoming, and B becomes, then the togetherness of AB also becomes. A new constituent means a new totality. In this sense, becoming is the ultimate principle.

Medium- and high-spin states of Pr-134 were populated using the Cd-116(Na-23, 5n) reaction and studied with the GAMMASPHERE spectrometer. Several new bands have been found in this nucleus, one of them being linked to the previously observed chiral-candidate twin-band structure. The ground state of Pr-134 could be determined through establishing a level structure that connects the two previously known long-lived isomeric states. Unambiguous spin-parity assignments for the excited states could be performed based on the known 2(-) spin-parity of the ground (...) state combined with the present experimental data. Intrinsic single-particle configurations have been assigned to the newly observed bands on the basis of the measured B(M1)/B(E2) ratios, alignments, band-crossing frequencies, bandhead spins, the observed single-particle configurations in the neighboring nuclei, and taking into account the predictions of total Routhian surface and tilted-axis cranking calculations. (shrink)

Unfounded—conspiracy and health—beliefs about COVID-19 have accompanied the pandemic worldwide. Here, we examined cross-nationally the structure and correlates of these beliefs with an 8-item scale, using a multigroup confirmatory factor analysis. We obtained a two-factor model of unfounded (conspiracy and health) beliefs with good internal structure (average CFI = 0.98, RMSEA = 0.05, SRMR = 0.04), but a high correlation between the two factors (average latent factor correlation = 0.57). This model was replicable across 50 countries (total N = 13,579), (...) as evidenced by metric invariance between countries (CFI = 0.96, RMSEA = 0.06, SRMS = 0.07) as well as scalar invariance across genders (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03) and educational levels (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03). Also, lower levels of education, more fear of COVID-19, and more cynicism were weakly associated with stronger conspiracy and health beliefs. The study contributes to knowledge about the structure of unfounded beliefs, and reveals the potential relevance of affective (i.e., fear of COVID-19) and cognitive (i.e., cynicism) factors along with demographics, in endorsing such beliefs. In summary, we obtained cross-cultural evidence for the distinctiveness of unfounded conspiracy and health beliefs about COVID-19 in terms of their structure and correlates. (shrink)

Desmond M. Clarke presents new translations, from French and Latin, of three of the first feminist tracts to support explicitly the equality of men and women: Marie le Jars de Gournay's The Equality of Men and Women, Anna Maria van Schurman's Dissertation, and François Poulain de la Barre's Physical and Moral Discourse concerning the Equality of Both Sexes. These works transformed the language and conceptual framework in which questions about women's equality were subsequently discussed. This edition includes new translations, from (...) French and Latin, of these three feminist authors, excerpts from their related writings, together with an extensive introduction to the religious and philosophical context within which they argued against the traditional view of women's natural inferiority to men. (shrink)

Descartes is possibly the most famous of all writers on the mind, but his theory of mind has been almost universally misunderstood, because his philosophy has not been seen in the context of his scientific work. Desmond Clarke offers a radical and convincing rereading, undoing the received perception of Descartes as the chief defender of mind/body dualism. For Clarke, the key is to interpret his philosophical efforts as an attempt to reconcile his scientific pursuits with the theologically orthodox views of (...) his time. (shrink)

This major new study of Descartes explores a number of key issues, including his use of experience and reason in science; the metaphysical foundations of Cartesian science; the Cartesian concept of explanation and proof; and an empiricist interpretation of the _Regulae_ and the _Discourse_. Dr. Clarke argues that labels such as empiricism and rationalism are useless for understanding Descartes because, at least in his scientific methodology, he is very much an Aristotelian for whom reflection on ordinary experience is the primary (...) source of scientific hypotheses. Descartes traditionally has been presented as a classic example of rationalism in science, especially by philosophers who concentrated their attention on the _Meditations_ or the _Discourse_. A different perspective is gained by reading Descartes as a practicing scientist and by examining his scientific work and correspondence with other seventeenth-century scientists. These texts suggest that the author relies very much on experience, and in some cases on scientific experiments to support his theories or to dispute those of others. Descartes scientific practice is even consistent with a less rationalistic interpretation of the _Regulae_ and the _Discourse_ than is normally defended. (shrink)

This book analyses the concept of scientific explanation developed by French disciples of Descartes in the period 1660-1700. Clarke examines the views of authors such as Malebranche and Rohault, as well as those of less well-known authors such as Cordemoy, Gadroys, Poisson and R'egis. These Cartesian natural philosophers developed an understanding of scientific explanation as necessarily hypothetical, and, while they contributed little to new scientific discoveries, they made a lasting contribution to our concept of explanation--generations of scientists in subsequent centuries (...) followed their lead. (shrink)

REIMER‐KIRKHAM S, SHARMA S, PESUT B, SAWATZKY R, MEYERHOFF H and COCHRANE M. Nursing Inquiry 2012; 19: 202–212 Sacred spaces in public places: religious and spiritual plurality in health careSeveral intriguing developments mark the role and expression of religion and spirituality in society in recent years. In what were deemed secular societies, flows of increased sacralization (variously referred to as ‘new’, ‘alternative’, ‘emergent’ and ‘progressive’ spiritualities) and resurgent globalizing religions (sometimes with fundamentalist expressions) are resulting in unprecedented plurality. These shifts (...) are occurring in conjunction with increasing ethnic diversity associated with global migration, as well as other axes of difference within contemporary society. Democratic secular nations such as Canada are challenged to achieve social cohesion in the face of growing religious, spiritual and ethnic diversity. These challenges are evident in the high‐paced, demanding arena of Health care. Here, religious and spiritual plurality enter in, sometimes resulting in conflict between medical services and patients’ beliefs, other times provoking uncertainties on the part of healthcare professionals about what to do with their own religiously or spiritually grounded values and beliefs. In this paper, we present selected findings from a 3‐year study that examined the negotiation of religious and spiritual pluralism in Health care. Our focus is on the themes of ‘sacred’ and ‘place’, exploring how the sacred – that which is attributed as special and set apart as it pertains to the divine, transcendence, God or higher power – takes form in social and material spaces in hospitals. (shrink)

Desmond M. Clarke presents a thematic history of French philosophy from the middle of the sixteenth century to the beginning of Louis XIV's reign. While the traditional philosophy of the schools was taught throughout this period by authors who have faded into permanent obscurity, a whole generation of writers who were not professional philosophers--some of whom never even attended a school or college--addressed issues that were prominent in French public life. Clarke explores such topics as the novel political theory espoused (...) by monarchomachs against Bodin's account of absolute sovereignty; the scepticism of Montaigne, Charron, and Sanches; the ethical discussions of Du Vair, Gassendi, and Pascal; innovations in natural philosophy; theories of the human mind from Jean de Silhon to Cureau de la Chambre and Descartes; and novel arguments in support of women's education and equality. The writers involved were lawyers, political leaders, theologians, and independent scholars who acknowledged the authority of the Bible as a source of knowledge, while raising questions about faith and reason. (shrink)

For years, experimental philosophers have attempted to discern whether laypeople find free will compatible with a scientifically deterministic understanding of the universe, yet no consensus has emerged. The present work provides one potential explanation for these discrepant findings: People are strongly motivated to preserve free will and moral responsibility, and thus do not have stable, logically rigorous notions of free will. Seven studies support this hypothesis by demonstrating that a variety of logically irrelevant (but motivationally relevant) features influence compatibilist judgments. (...) In Study 1, participants who were asked to consider the possibility that our universe is deterministic were more compatibilist than those not asked to consider this possibility, suggesting that determinism poses a threat to moral responsibility, which increases compatibilist responding (thus reducing the threat). In Study 2, participants who considered concrete instances of moral behavior found compatibilist free will more sufficient for moral responsibility than participants who were asked about moral responsibility more generally. In Study 3a, the order in which participants read free will and determinism descriptions influenced their compatibilist judgments—and only when the descriptions had moral significance: Participants were more likely to report that determinism was compatible with free will than that free will was compatible with determinism. In Study 3b, participants who read the free will description first (the more compatibilist group) were particularly likely to confess that their beliefs in free will and moral responsibility and their disbelief in determinism influenced their conclusion. In Study 4, participants reduced their compatibilist beliefs after reading a passage that argued that moral responsibility could be preserved even in the absence of free will. Participants also reported that immaterial souls were compatible with scientific determinism, most strongly among immaterial soul believers (Study 5), and evaluated information about the capacities of primates in a biased manner favoring the existence of human free will (Study 6). These results suggest that people do not have one intuition about whether free will is compatible with determinism. Instead, people report that free will is compatible with determinism when desiring to uphold moral responsibility. Recommendations for future work are discussed. (shrink)

René Descartes is best remembered today for writing 'I think, therefore I am', but his main contribution to the history of ideas was his effort to construct a philosophy that would be sympathetic to the new sciences that emerged in the seventeenth century. To a great extent he was the midwife to the Scientific Revolution and a significant contributor to its key concepts. In four major publications, he fashioned a philosophical system that accommodated the needs of these new sciences and (...) thereby earned the unrelenting hostility of both Catholic and Calvinist theologians, who relied on the scholastic philosophy that Descartes hoped to replace. His contemporaries claimed that his proofs of God's existence in the Meditations were so unsuccessful that he must have been a cryptic atheist and that his discussion of skepticism served merely to fan the flames of libertinism. This is the first biography in English that addresses the full range of Descartes' interest in theology, philosophy and the sciences and that traces his intellectual development through his entire career. (shrink)

Descartes is possibly the most famous of all writers on the mind, but his theory of mind has been almost universally misunderstood, because his philosophy has not been seen in the context of his scientific work. Desmond Clarke offers a radical and convincing rereading, undoing the received perception of Descartes as the chief defender of mind/body dualism. For Clarke, the key is to interpret his philosophical efforts as an attempt to reconcile his scientific pursuits with the theologically orthodox views of (...) his time. (shrink)

What is it to be morally responsible for something? Recent philosophical work reveals considerable disagreement on the question. Indeed, some theorists claim to distinguish several varieties of moral responsibility, with different conditions that must be satisfied if one is to bear responsibility of one or another of these kinds. -/- Debate on this point turns partly on disagreement about the kinds of responses made appropriate when one is blameworthy or praiseworthy. It is generally agreed that these include "reactive attitudes" such (...) as resentment and gratitude, but theorists disagree about the nature of these attitudes. They dispute the connections between moral responsibility, desert, and the justification of punishment as well. -/- Many theorists take it that, whatever the appropriate responses are, they are responses to an agent's "quality of will," but there is no consensus on what this comes to. Are the agent's beliefs about the moral status of her behavior what matter, or is it what she cares about, or what she judges important? -/- This volume presents twelve original essays from participants in these debates. The contributors include prominent established figures as well as influential younger philosophers. A substantive introduction by the editors surveys recent debates and situates the contributions within it. (shrink)

George Berkeley was a university teacher, a missionary, and later a Church of Ireland bishop. The over-riding objective of his long philosophical career was to counteract objections to religious belief that resulted from new philosophies associated with the Scientific Revolution. Accordingly, he argued against scepticism and atheism in the Principles and the Three Dialogues; he rejected theories of force in the Essay on Motion; he offered a new theory of meaning for religious language in Alciphron; and he modified his earlier (...) immaterialism in Siris by speculating about the body's influence on the soul. His radical empiricism and scientific instrumentalism, which rejected the claims of the sciences to provide a realistic interpretation of phenomena, are still influential today. This edition provides texts from the full range of Berkeley's contributions to philosophy, together with an introduction by Desmond M. Clarke that sets them in their historical and philosophical contexts. (shrink)

Marjorie Grene has argued in a number of contexts that any attempt to reduce the explanation of human actions to “mechanistic” explanations is doomed to failure in advance because it is absurd. “This argument examines the status of the reductivist thesis in its own terms and reduces it to absurdity …” ; “the attempt to reduce human purposive, or ‘intentional,‘ action to physiology and ultimately to physics and chemistry is an absurdity rather than simply a confusion”. I wish to show (...) that this argument is fallacious because it involves a petitio principii; and if Plato can be credited with introducing the same argument in the Theaetetus, as she suggests, so much the worse for Plato. (shrink)

René Descartes is best remembered today for writing 'I think, therefore I am', but his main contribution to the history of ideas was his effort to construct a philosophy that would be sympathetic to the new sciences that emerged in the seventeenth century. To a great extent he was the midwife to the Scientific Revolution and a significant contributor to its key concepts. In four major publications, he fashioned a philosophical system that accommodated the needs of these new sciences and (...) thereby earned the unrelenting hostility of both Catholic and Calvinist theologians, who relied on the scholastic philosophy that Descartes hoped to replace. His contemporaries claimed that his proofs of God's existence in the Meditations were so unsuccessful that he must have been a cryptic atheist and that his discussion of skepticism served merely to fan the flames of libertinism. This is the first biography in English that addresses the full range of Descartes' interest in theology, philosophy and the sciences and that traces his intellectual development through his entire career. (shrink)

This investigation examines several key factors believed to promote human flourishing, specifically: Factor 1: Age, Education, & Healthcare, Factor 2: Labor Force Participation, Factor 3: Crime, Factor 4: Income, Factor 5: Youth Unemployment and Factor 6: Voting Behavior. Data was examined at the county level, and collected from a variety of US government and non-governmental organizations. Our investigation into the conditions necessary to promote human flourishing uses internal migration within the United States as the indicator of “unhappy” communities. The findings (...) reveal that all factors are important in emigration somewhere, but the factors vary for different counties. As a result, attempts to address the ills of society require an appreciation of geography and context. (shrink)