Background and PurposeMany critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients’ preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission (...) and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process.Project and MethodsThe study was to determine if early use of a simple method of identifying a patient’s surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N=203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer. The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients’ surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool.ResultsSignificant differences were found between pre- and post-groups in terms of hospital LOS (F=6.39, p=.01) and total hospital charges (F=7.03, p=.009).ConclusionsProject findings indicate that the use of a simple admission assessment tool, supported by staff education about its completion, use, and available resources, can decrease LOS and lower total hospital charges. The reasons for the difference between the pre- and post-intervention groups remain unclear. Further research is needed to evaluate if the quality of communications between patients, their legally authorized representatives, and clinicians—as suggested in the literature—may have played a role in decreasing LOS and total hospital charges. (shrink)

MEDIEVAL LOGICS LAMBERT MARIE DE RIJK (ed.), Die mittelalterlichen Traktate De mod0 opponendiet respondendi, Einleitung und Ausgabe der einschlagigen Texte. (Beitrage zur Geschichte der Philosophie und Theologie des Mittelalters, Neue Folge Band 17.) Miinster: Aschendorff, 1980. 379 pp. No price stated. THE SEVENTEENTH CENTURY MARTA FATTORI, Lessico del Novum Organum di Francesco Bacone. Rome: Edizioni dell'Ateneo 1980. Two volumes, il + 543, 520 pp. Lire 65.000. VIVIAN SALMON, The study of language in 17th century England. (Amsterdam Studies in the Theory (...) and History of Linguistic Science, Series 111: Studies in theHistory of Linguistics, Volume 17.) Amsterdam: John Benjamins B.V., 1979.x + 218 pp. Dfl. 65. Theoria cum Praxi. Zum Verhaltnis von Theorie und Praxis im 17. und 18. Jahrhundert. (Akten des 111. Internationalen Leibnizkongress, Hannover, 12. bis 17.November 1977, Band 111: Logik, Erkenntnistheorie, Wissenschaftstheorie, Metaphysik, Theologie.) Wiesbaden: Franz Steiner Verlag, 1980. vii + 269 pp. DM 48. CLASSICAL AND NON-CLASSICAL LOGICS MICHAEL CLARK, The place of syllogistic in logical theory. Nottingham: University of Nottingham Press, 1980. ix + 151 pp. £3.00. A.F. PARKER-RHODES, The theory of indistinguishables. Dordrecht, Boston and London: D. Reidel Publishing Company, 1981. xvii + 216 pp. Dfl.90.00/$39.50. NICHOLAS RESCHER and ROBERT BRANDOM, The logic of inconsistency. Oxford:Basil Blackwell, 1980. x + 174 pp. f 11.50. MISCELLANEOUS J. ZELENY, The logic of Marx. Translated from the German by T. Carver. Oxford: Basil Blackwell, 1980. xcii + 247 pp. £12.50. FELIX KAUFMANN, The infinite in mathematics. Edited by Brian McGuinness. Introduction by E. Nagel. Translation from the German by Paul Foulkes. Dordrecht: Reidel, 1978. xvii + 235 pp. Dfl 85/$39.50 (cloth); Dfl 45/$19.95 (paper). PAMELA MCCORDUCK, Machines who think. San Francisco: W.H. Freeman and Company, 1979. xiv + 275 pp. $14.95. J. MITTELSTRASS (ed.), Enzyklopadie Philosophie und Wissenschaftstheorie Bd. 1 : A-G. Mannheim, Wien, Ziirich: Bibliographisches Institut, 1980. 835 pp. DM 128. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bibliography of Resources by and about André E. Hellegers*Compiled by Doris Mueller Goldstein (bio)This bibliography is derived from the holdings of the National Reference Center for Bioethics Literature and the BIOETHICSLINE© database (both of which are at the Kennedy Institute of Ethics and supported by the National Library of Medicine); the archives of Lauinger Library, Georgetown University; the Medline databases of the National Library of Medicine; the WorldCat database (...) of OCLC, Dublin, Ohio, and selected Internet sites.Primarily comprised of writings by Dr. Hellegers, the list also includes interviews and media programs in which he participated, as well as writings about him that were written following his death. The arrangement within each section is by date. The 231 authored pieces reflect the transition from Dr. Hellegers’s early career as a researcher in fetal physiology at Johns Hopkins Medical School, where he published his first research report at the age of 29, to the early years of the Kennedy Institute, where he produced so many provocative columns on bioethical issues that influenced the growth of the field.Due to the diversity of sources and the 40-year time span covered, there are some variations in bibliographic style. Time and availability constraints precluded verifying all of the citations with the original documents. Any additions or corrections should be submitted to the compiler.Works Authored by André E. HellegersNo Date Ethical Issues in Sterilization of the Retarded. Unpublished paper.1956Vitamin B12 Serum Level and Pregnancy. American Journal of Clinical Nutrition 4: 440+, 1956. [With Bacon F. Chow and Kunio Okuda] [End Page 89]1957Vitamin B12 Absorption in Pregnancy and in the Newborn. American Journal of Clinical Nutrition 5: 327+, 1957. [With Bacon F. Chow, Robert E. L. Nesbitt, Kunio Okuda, and David W. Smith]1958The Effects of Acute Hypoxia on the Osmotic Pressure of the Plasma. Quarterly Journal of Experimental Physiology 43: 197+, 1958. [With Donald H. Barron, Frederick C. Battaglia, and Giacomo Meschia]Studies on the Absorption of Vitamin B12 in Human Pregnancy with Especial Reference to the Effect of D-Sorbitol. American Journal of Obstetrics and Gynecology 76: 91+, 1958. [With Bacon F. Chow, Harry Prystowsky, and Vernon Wong]1959The Alveolar PCO2 and PO2 in Pregnant and Nonpregnant Women at Altitude. Proceedings of the Society for Clinical Investigation 38: 1010+, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky]A Comparison of the Oxygen Dissociation Curves of the Bloods of Maternal and Fetal Goats at Various pHs. Quarterly Journal of Experimental Physiology 44: 215–21, July 1959. [With Donald Barron, Giacomo Meschia, Harry Prystowsky, and A. Stark Wolkoff]Fetal Blood Studies. XII. On the Relationship Between the Position of the Oxygen Dissociation Curve of Human Fetal Blood and Adult Fetal Hemoglobin. American Journal of Obstetrics and Gynecology 77: 585+, 1959. [With Paul D. Bruns, Julian Cotter, and Harry Prystowsky]Fetal Blood Studies. XIV. A Comparative Study of the Oxygen Dissociation Curve of Nonpregnant, Pregnant and Fetal Human Blood. American Journal of Obstetrics and Gynecology 78: 489–93, September 1959. [With Paul D. Bruns and Harry Prystowsky]Fetal Blood Studies. XVI. On the Changes in Total Osmotic Pressure and Sodium and Potassium Concentration of Amniotic Fluid During the Course of Human Gestation. Surgery, Gynecology and Obstetrics 109: 509–12, October 1959. [With Frederick Battaglia, Paul D. Bruns, Harry Prystowsky, and Clayton Smisson]Further Observations on the Metabolism of Vitamin B12 in Human Pregnancy. American Journal of Obstetrics and Gynecology 77: 1+, 1959. [With Bacon F. Chow, Harry Prystowsky, Bruno Ranke, and Elma Ranke]The Oxygen Dissociation Curves of the Bloods of Adult and Fetal Llamas. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky] [End Page 90]Transfer of Oxygen Across the Sheep Placenta at High Altitude. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, and Harry Prystowsky]Uterine Blood Flow and Metabolism in Pregnant Sheep at High Altitude. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky]Uterine Blood Flow and Metabolism in Unanesthetized Pregnant Sheep. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo... (shrink)

This article takes a speculative and design fiction approach to the critical analysis of the role of smart and autonomous vehicles (AVs) in the context of smart cities. The article explores arguments that these cars of the future will have decisive impacts on mobility, sustainability and road safety. The article examines the main parameters of smart city and smart car developments and then focuses on the visions of increasing AI-driven autonomy. The article demonstrates how these debates are linked to speculative (...) design as full autonomy does not currently exist but takes a speculative position as to what the critical issues are that face smart/autonomous city visions (enhanced surveillance and data mining) and considers the potentially hazardous ethical dilemmas that AVs may encounter once fully rolled out onto city roads. From a design fiction perspective, the article envisions the viability of AV prioritizing public rather than private transport as a means by which the ‘techno-utopic’ visions of smart city/AV integration can be realized and make positive impacts to enhance urban living in rendering future cities as more sustainable, efficiently mobile and safer urban spaces. (shrink)

Anthony Barron explores the relationship between the philosophy of Schopenhauer and the forms and themes of Beckett's critical and creative writings. He shows that Beckett's aesthetic preoccupations are consonant with some of Schopenhauer's seminal arguments regarding the arational basis of artistic composition and appreciation and the impotence of reason in human affairs. While Beckett's critical writings are, in places, formidably opaque, this work examines the ways in which such texts can be elucidated when their intertextual affinities with Schopenhauer's arguments (...) are revealed. Using Schopenhauer's thought as a presiding interpretative framework, Barron demonstrates how the widespread presence of philosophical and theological ideas in Beckett's creative texts signifies less about his personal convictions than it does about his authorial aims. He thereby highlights the ways in which discursive ideas were appropriated and manipulated by Beckett for purely literary ends -- Back cover. (shrink)

The second International Knowledge and Discourse Conference, held at the University of Hong Kong in June 2002, was the forum for the long-awaited debate between Bruno Latour and Steve Fuller. Bruno Latour counts beyond two. He places the blame for the emphasis in academia on the subject-object distinction on Kant. Latour wants academics to acknowledge that things act, and suggests we look at other traditions, e.g. the Chinese, for alternatives to the subject-object dichotomy. Steve Fuller concentrated on the moral project (...) of science, which is to draw a distinction between the human and the non-human and, to highlight the fact that, as the culmination of the sciences, social science has a particular responsibility to make this distinction. He accused Bruno Latour of evading the moral issue. The debate can be read as a reiteration of the postions of Bruno Latour and Steve Fuller on the question of heterogeneity at the theoretical level, but it did not address the topic at the practical or research level. (shrink)

Barron discusses not only the deep spirituality within Aquinas' theological writings, but also the saint's little known spiritual writings on prayer and more. Throughout, Barron applies these teachings to daily life. (Catholic).

The rapid recent expansion of copyright law worldwide has sparked efforts to defend the ‘public domain’ of non-propertized information, often on the ground that an expansive public domain is a condition of a ‘free culture’. Yet questions remain about why the public domain is worth defending, what exactly a free culture is, and what role (if any) authors’ rights might play in relation to it. From the standard liberal perspective shared by many critics of copyright expansionism, the protection of individual (...) expression by means of marketable property rights in authors’ works serves as an engine of progress towards a fully competitive ‘marketplace of ideas’ – though only if balanced by an extensive public domain from which users may draw in the exercise of their own expressivity. This article shows that a significantly different, and arguably richer, conception of what a free culture is and how authors’ rights underpin it emerges from a direct engagement with the philosophy of Immanuel Kant. For Kant, progress towards a fully emancipated (i.e. a ‘mature’ or ‘enlightened’) culture can only be achieved through the critical intellectual activity that public communication demands: individual expressive freedom is only a condition, not constitutive, of this ‘freedom to make public use of one’s reason in all matters’. The main thesis defended in this article is that when Kant’s writings on publicity (critical public debate) are read in relation to his writings on the legal organization of publishing, a necessary connection emerges between authors’ rights – as distinct from copyrights – and what Jürgen Habermas and others have named the public sphere. I conclude that it is the public sphere, and not the public domain as such, that should serve as the key reference point in any evaluation of copyright law’s role in relation to the possibility of a free culture. (shrink)

Nathaniel J.P. Barron offers the first book length account in English of Ernst Bloch's contribution to a Marxist philosophy of language. It is ambitious both in situating Bloch's ideas in the broader Marxist engagement with language as it currently exists, and in using Bloch's utopian categories to challenge that engagement. In particular, Barron reads Voloshinov's insights into language through Bloch's categories, and argues that Bloch advances on Voloshinov by offering an understanding of the social materiality of language which (...) is more useful for challenging fascist forms of utterance. (shrink)

IN examining Herodotos' account of the Samian tyranny, historians have long been disturbed by two considerations. First, it seems strange that the period of settled tyranny should have begun no earlier than the rise of Polykrates and his two brothers c. 533 B.C., even though Samos was among the most advanced cities in Ionia. Yet it seems equally impossible to revise this accession date in an upward direction, at least by any significant margin. Furthermore, there had been at work in (...) Samos from c. 600 or earlier many of the factors which elsewhere in Ionia did in fact lead to a comparatively stable period of tyranny at that date, for instance at Miletos and Ephesos. Secondly, though Herodotos knows of no tyrant before Polykrates, it has been observed that the policies ascribed to him as characteristic were very largely the continuation of policies initiated a generation or more previously. (shrink)

This article seeks to identify and address the normative void that resides at the heart of postmodernist-feminist theory, and to propose a philosophical framework – beyond postmodernism, but incorporating its central insights – for thinking through the normative questions with which feminists are inevitably confronted in their engagements with positive law. Two varieties of postmodernist-feminism are identified and critically analysed: the ‘corporeal feminism’ of Elizabeth Grosz and Judith Butler, which seeks to ground feminist critical practice in the irruptive capacities of (...) the material body considered as an arte fact of social construction; and the deconstructionist feminism of Drucilla Cornell, for whom ‘the feminine’ is an indeterminate but disruptive force beyond its construction in law and in other social sites. The first component of the argument elaborated here is that each of these approaches ultimately reduces to a form of aestheticism which is incapable of generating a worthwhile and workable feminist approach to the restructuring of politics and law. The second component of the argument involves a return to aesthetics, in particular to the philosophical aesthetics of Kant’s Critique of Judgement. Kant’s aesthetic philosophy, it will be suggested, yields a framework of concepts which, duly re-manipulated, could speak to the very concerns that have inspired postmodernist-feminism: how to attend to (bodily) particularity while avoiding the dangers associated with ‘essentialism’; and how to theorise the propensity of the unrepresentable power of the feminine to exceed both embodied human capacities and the confining rein of socially privileged rationalities. Crucially, however it also responds to a set of preoccupations – those of the feminist lawyer – that cannot be accommodated by postmodernism: how to translate embodied experience into (legal) norms; generalise from the particular; seek consensus; and codify an endless potentiality in the form of law. (shrink)

A close reading of Mary Robinson’s late-eighteenth-century poem “London’s Summer Morning,” which captures all the noises and smells of a busy London street, is not enough to convince the reader that it isn’t all a dream. But whose dream? René Descartes and Wallace Stevens suggest that it may not matter.

Although the demographics on male versus female death-row prisoners suggest that males are the criminal justice system’s primary targets, the author argues that the system still discriminates against women. Utilizing postmodern scholarship, he argues that female prisoners are punished primarily for violating dominant norms of gender correctness.

The influence of surrealism and Philippe Soupault on William Carlos Williams' poetry.

Forms characteristic of the earth itself are inherent in the design of man. Man's being emerged out of a cosmic matrix whose morphic aspects man himself expresses. These forms and their functional interrelationships are the very conditions of consciousness. This paper proposes that the relationship between human consciousness and its complete environment should be the subject matter of an emerging discipline, the ecology of consciousness. Constructs useful in the ecology of plants and animals should be coordinated to psychological constructs. These (...) coordinating constructs should be based upon study of the most pervasive morphic regularities at the biophysical level. An analysis of the design of man suggests many possibilities, especially when one considers the known neurophysiological and biochemical conditioners of consciousness. Educational (experiential) strategies for the transformation of consciousness should also be explored. These might include the manipulation of variables such as volume, duration, and intensity of sensory stimulation, including various combinations of modalities. A systematic effort should be made to state the fundamental problems to which a scientific ecology of consciousness might address itself. New methods must be devised. A preliminary program for an ecology of consciousness is proposed. (shrink)

The first Dr. Lerner -- Super doctor -- Illness hits home -- The second Dr. Lerner -- Forging my own path -- Treating the whole patient -- Family practitioner -- Growing disillusionment -- Slowing down -- Epilogue.

This dissertation offers and defends a phenomenological account of personal identity. It does so critically in conversation with Anglo-analytical traditions and varieties of other philosophical traditions from around the world, especially Zen Buddhism. Chapter One brings together three areas of philosophy: the multiple realizability thesis from philosophy of science, the logical pluralist position from philosophical logic, and the various conceptions of personhood from metaphysics. I argue that even though the divide in the literature on the metaphysics of personal identity is (...) unresolved, there is a core notion, “person,” that is understood to be the target of explanation in each of the traditions. The multiple-realizability of personhood entails the multiple realizability of identity. Because "person" is an unsettled term, "personal identity" is also unsettled. Chapter Two examines those metaphysics traditions in more detail. After outlining the claims of body continuity theorists, psychological continuity theorists, and narrative continuity theorists, I raise objections to each of the theories. In Chapter Three, I propose that all three categories of metaphysics approaches to identity face a unified objection: they presume a level of objectivity that belies the negotiation of our identities. This chapter examines the limits of methodological naturalism and examines the work of two Indigenous scholars from North and South America who present theories of identity that embrace contradictory beliefs and goals. Chapter Four proposes that phenomenology offers a new and more promising approach to studying personal identity. In this chapter, I point out that there is a disciplinary divide over whether identity is a thing (something of substance) or a way of understanding. By shifting the approach to identity from metaphysics to epistemology, I demonstrate that phenomenology avoids the objections that the metaphysics theories face. In this chapter, I also raise objections that arise in Buddhist traditions. The chapter concludes with close readings of Keiji Nishitani's critique of Western philosophy from Religion and Nothingness and Jean-Paul Sartre's defense of phenomenology, which appears in Being and Nothingness. Chapter Five defends the phenomenological analysis of identity against Nishitani’s critique. I show that the phenomenological approach to identity entails that identities are distributed within contexts. I adopt a deflationary account of identity grounded in the term existence—all that can be said about one's identity is that it is whatever makes them stand out against a background. No amount of precision that is added to the various accounts will settle whether the metaphysics or epistemic approach to identity is better. Therefore, the deflationary understanding of identity allows us to continue talking about the core notion even if the term remains unsettled. In the end, I offer an account of personal identity that suggests that identity is a distributed phenomenon. If one’s identity is intelligible only in the context of the world, then my circumstances are part of my identity. (shrink)

This book provides an accessible introduction to jurisprudence and legal theory. It sets out a course of study that offers a highly effective series of introductions into a wide variety of theories and theoretical perspectives, from traditional approaches such as Natural Law to modern ones such as Feminist Theory, Economic Analysis of Law and Foucault and Law, The book is designed for students of jurisprudence and legal theory, but it will also assist those studying law and legal systems within courses (...) on Political Science, Philosophy and Sociology. (shrink)