The personhood of the physician is a crucial element in accomplishing the goals of medicine. We review claims made on behalf of the humanities in guiding professional identity formation. We explore the dichotomy that has evolved, since the Renaissance, between the humanities and the natural sciences. The result of this evolution is an historic misconstrual, preoccupying educators and diverting them from the moral development of physicians. We propose a curricular framework based on the recovery of Aristotelian concepts that bridge identity (...) and activity. The humanities and the natural sciences, jointly and severally, can fulfill developmental, characterological and instrumental purposes. (shrink)

The practice of medicine involves continual change, driven by a constant stream of developments in the understanding of biological structure and function relevant to human diseases, and the parallel improvements in pharmacologic and other technological interventions. This change is also driven by evolving social philosophies, ethical trends, and lifestyles. As products of society, doctors absorb contemporary values and norms. Indeed, it would appear that the ethical norms and standards of medical practice are flexible, and that the characteristics of medical practice (...) at any particular point in history may reflect the mores of the times rather than any enduring moral imperatives.However, a common perception .. (shrink)

ABSTRACT:The objective of this essay is to develop the argument that placebos are a species of metaphor and to demonstrate that an analysis of the figurative trope can help us elucidate the power of the placebo response. The cognitive and embodied responses to both metaphors and placebos stem from the transfer of meaning between two domains, each with rich allusive properties that in turn depend on highly ramified and interconnected neural webs. Metaphors and placebos require an appropriate cultural backdrop for (...) their linguistic and cognitive work and are dependent on shared social forms of life. More specifically, metaphors rely on an intersubjective connection and imply that a relational entanglement between doctor and patient is necessary to the effect of placebos in the clinical setting. (shrink)

We studied changes in eligibility criteria--the largest impediment to patient accrual--in two samples of clinical trials. Trials from the NSABP (National Surgical Adjuvant Breast and Bowel Program) and POG (Pediatric Oncology Group) were analyzed. After eliminating duplications, the criteria in each protocol were enumerated and classified according to a novel schema. NSABP trials contained significantly more criteria than POG trials, and added precision criteria (making study populations homogeneous) at a faster rate than POG studies. The difference between NSABP studies (explanatory (...) trials) and POG studies (pragmatic trials) suggest that large numbers of eligibility criteria are not necessary for quality studies. We recommend that: (1) the inclusion/exclusion criteria distinction be abandoned; (2) eligibility criteria be explicitly justified; (3) the need for each criterion be assessed when new trials are planned; (4) criteria in phase III trials restricting patient accrual be minimized; and (5) further research be done to assess the impact of criteria on generalizability. (shrink)

Medical students gather lessons from what they observe and experience in the hospital and the clinic. The daily, generally undocumented events constitute significant formative influences on the developing identities of these nascent physicians. These experiences shape the students' attitudes towards their patients, help form their own identities, and affect their confidence in their chosen profession. And yet, these critical pedagogical forces rarely come to the attention of their teachers, who remain unaware of the powerful formative features of the clinical learning (...) environment. As a result, attending physician-teachers fail to... (shrink)

In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold. Engagement provides an (...) account of clinical practice as a unitary lived experience. This stands in stark contrast to the prevailing notion, referred to as a dual discourse, that describes medicine as the addition of humanism to science. Drawing on Aristotle’s notion of phronesis and Sartre’s definition of the situation, we illustrate how this novel perspective entwines clinical practice, the person of the clinician, and the clinician’s situation. (shrink)

The revelation that data obtained for the US-based National Surgical Adjuvant Breast and Bowel Project (NSABP) from subjects enrolled at Hôpital Saint-Luc in Montreal was falsified has eroded public trust in research. Institutions can educate researchers and help prevent unethical research practices by establishing procedures to monitor research involving human subjects. Research monitoring encompasses four categories of activity: annual reviews of continuing research, monitoring of informed consent, monitoring of adherence to approved protocols and monitoring of the integrity of data. The (...) authors describe characteristics of research projects that may call for monitoring procedures in each category. The form taken by such monitoring depends on the nature of the protocol. Although appropriate research monitoring requires substantial investment of personnel and financial resources, it is required under guidelines regulating research involving human subjects in Canada. Research monitoring is a step forward in re-establishing public confidence in medical research. (shrink)

This article is intended to revive, through a critical reinterpretation, the bio-psychosocial model of George Engel. Engel’s first description in 1977, was very broad, encompassing too many aspects of medicine. In his later work, he focused his model as an epistemology for clinical medicine. However, what medicine mostly retained were minor aspects of the 1977 article, namely a multi-factorial approach to the etiology of diseases and a call to complement biomedicine with a psychosocial concern in order to re-humanize medicine. We (...) suggest that, properly understood as a clinical epistemology, Engel’s model retains its transformative potential for contemporary medicine.Our discussion begins with a.. (shrink)

Reflection has been proclaimed as a means to help physicians deal with medicine’s inherent complexity and remedy many of the shortcomings of medical education. Yet, there is little agreement on the nature of reflection nor on how it should be taught and practiced. Emerging neuroscientific concepts suggest that human thought processes are largely nonconscious, in part inaccessible to introspection. Our knowledge of the world is fraught with uncertainty, ignorance and indeterminacy, and influenced by emotion, biases and illusions, including the illusion (...) of not having illusions. Neuroscience also documents that lifelong learning processes may hone nonconscious cognition to high levels of sophistication, allowing rapid and precise perceptions, judgments and actions in complex situations. We argue that knowledge of mechanisms underlying human thought may be useful in designing educational programs to foster desired attributes such as curiosity, critical self-awareness and intuitive acumen in medical professionals. The juxtaposition of neuroscientific insights with ideas from Kant on reflective judgement, van Manen on tact, and Aristotle on phronésis, supports a concept of reflection that manifests as wise practice. We suggest that reflection in medical education should be an imperative for educators seeking to guide learners to manage the complexity and “messiness” of medical practice, and a role-modelling mode of medical practice characterized by self-correcting behaviors that culminate in good and right professional actions. An example illustrates reflective practice in the teaching and learning of physicianship. (shrink)

The clinical trial is the major investigational tool of clinical medicine. Two recent reports highlight the fact that the most often quoted mechanisms for the protection of research subjects, viz., research ethics board review and eligibility criteria, are insufficient to achieve this end. In this paper, we argue that the prime mechanism for the protection of persons in clinical trials should be the clinical judgement of the physician-investigator. The clinical investigator has a duty to protect subjects from both harm and (...) undue risk. It is argued that the clinical investigator has a duty to screen for, and exclude, potential research subjects who may be unduly vulnerable to the risks of a particular clinical trial. In order to fulfill this obligation, the investigator should personally screen each potential research subject at the time of accrual. In larger trials in which this is not feasible, this task could be delegated to another appropriately qualified health care professional, with the principal investigator retaining personal responsibility. To reinforce and make explicit this legal and moral duty, we propose that the investigator sign a statement, appended to each subject's consent form, to attest that this duty has been responsibly discharged. (shrink)

To what risks may children participating in research be subjected? Institutional review boards can stand surrogate for parents by filtering out studies whose risk is unacceptably high.

OBJECTIVE: Pilot study to characterize treatment differences between patients treated in clinical trials and those treated in a clinical setting. Previous studies have shown higher survival rates for participants in trials of cancer therapy. This difference is observed even after rates are adjusted for important covariates such as age and stage of disease. DESIGN: Retrospective chart review. SETTING: Oncology outpatient department in a tertiary care hospital. PATIENTS: Ninety women 18 to 70 years of age with early-stage breast cancer who were (...) diagnosed in 1990. Fifty-one of the women were treated through clinical trials and 39 were treated outside of clinical trials. OUTCOME MEASURES: Number of blood tests, telephone calls, clinic visits and imaging procedures as well as intensity of chemotherapy and use of radiation therapy. The age of the patient and the stage of disease were important covariates. RESULTS: After the analysis was controlled for patient age and stage of disease, patients treated through a clinical trial were more likely to receive standard-dose chemotherapy (p = 0.020, 95% confidence interval 1.20 to 200.73) and more frequent blood tests (p < 0.001, 95% confidence interval 1.02 to 1.13) than other patients treated in the clinic. CONCLUSIONS: Our results provide a plausible mechanism for the observed survival advantage for participants in clinical trials in oncology. Further study is called for. If these results are confirmed, they have important implications for informed consent to participate in clinical trials and for clinical practice. (shrink)

BackgroundPrevious empirical work among physicians has led us to propose that clinical practice is experienced by clinicians as an engagement-in-the-clinical-situation. In this study, we pursue our exploration of clinical practice ‘on its own terms’ by turning to the experience of patients.MethodsPhenomenological analysis of in-depth individual interviews with 8 patients.ResultsWe describe the patient experience as a set of three motifs: the shock on the realization of the illness, the chaos of the health care environment, and the anchor point provided by an (...) engaged physician. We draw on Heidegger’s notion of solicitude to show that patients are actively ascertaining the physician’s engagement in their care.ConclusionsThese findings lead us to question the classical “dual discourse” of medicine that offers a dichotomous account of clinical practice as the addition of care to cure, art to science, humanism to technique, and person to medical case. We found no such distinctions in our empirical investigation of clinical practice. Rather, in our synthesis, practice appears as a unitary experience. The physician’s solicitude for the patient entrains engagement in the clinical situation. Moreover, the solicitous, engaged physician constitutes an anchor point for the patient. (shrink)

Phronesis is often described as a ‘practical wisdom’ adapted to the matters of everyday human life. Phronesis enables one to judge what is at stake in a situation and what means are required to bring about a good outcome. In medicine, phronesis tends to be called upon to deal with ethical issues and to offer a critique of clinical practice as a straightforward instrumental application of scientific knowledge. There is, however, a paucity of empirical studies of phronesis, including in medicine. (...) Using a hermeneutic and phenomenological approach, this inquiry explores how phronesis is manifest in the stories of clinical practice of eleven exemplary physicians. The findings highlight five overarching themes: ethos (or character) of the physician, clinical habitus revealed in physician know-how, encountering the patient with attentiveness, modes of reasoning amidst complexity, and embodied perceptions (such as intuitions or gut feeling). The findings open a discussion about the contingent nature of clinical situations, a hermeneutic mode of clinical thinking, tacit dimensions of being and doing in clinical practice, the centrality of caring relations with patients, and the elusive quality of some aspects of practice. This study deepens understandings of the nature of phronesis within clinical settings and proposes ‘Clinical phronesis’ as a descriptor for its appearance and role in the daily practice of (exemplary) physicians. (shrink)

OBJECTIVE: To investigate whether eligibility criteria that exclude the elderly, persons with psychiatric disease, and persons with substance abuse problems from participation in randomized controlled trials (RCTs) are subjective and hence a source of variability in enrolment decisions and investigator uncertainty. DESIGN: Survey questionnaire. PARTICIPANTS: Cancer investigators from the United States and Canada. INTERVENTIONS: Investigators were presented with clinical vignettes from 3 patient categories--eligible, ineligible and uncertain--for each of 5 eligibility criteria--3 subjective and 2 objective--and were asked whether they would (...) enrol the patient in a trial and how sure they were of this decision. Demographic characteristics of the investigators were also collected. OUTCOME MEASURES: The difference in enrolment decisions between subjective and objective criteria, and the difference in the certainty associated with these decisions. RESULTS: Of 365 questionnaires sent out, 224 usable ones were returned. Compared with the objective criteria, the subjective criteria were associated with more variable enrolment decisions (p = 0.07 for the "eligible" scenario and p = 0.0001 for the "ineligible" and "uncertain" scenarios), and investigators were less sure about the decisions they made (p = 0.0001 for all scenarios). Demographic characteristics of the investigators failed to explain the observed differences. CONCLUSIONS: Subjective eligibility criteria may interfere with the conduct and interpretation of RCTs and, therefore, their use ought to be justified explicitly in the study protocol. RCT designers, funding agencies and research ethics boards have an important role in reviewing eligibility criteria for their necessity. (shrink)

Even though the Cartesian mind-body dualism has largely been dismissed in contemporary philosophy, the idea that the conscious mind can be a bodiless and non-spatial entity is still held to be possible. This paper examines a series of arguments by Jaegwon Kim, Peter Strawson, and Immanuel Kant against the possibility of a disembodied mind. It is argued that although the concept of a disembodied mind is coherent, it derives from a more fundamental concept in which the mind and the body (...) are originally unified. The unity of mind and body, which can be called a person, is logically prior to the concept of the mind as a disembodied person, and thus the possibility of a disembodied mind turns out to depend on the existence of the physical and spatial world. (shrink)

Excerpt from Rene Descartes Descartes zieht sich in die Niederlande zuruck. Naheres uber die dortigen Zustande. 2. Verwerfung aller dog matiscben Voraussetzungen. Allgemeine metaphysische Grundlegung. 3. Es fehlt ihr noch die systematische Durch bildung. 4. Beschaftigung mit den mannigfachsten natur wissenschaftlichen Problemen. Heitere Stimmung des Philo 80phen. 5. Ausarbeitung einer Weltbildungstheorie. Die Grunde, weswegen das _werk nicht veroffentlicht wird. 6. Uber Descartes' Beurteilung der wissenschaftlichen Ver dienste Galileis 7. Liebesverhaltnis zwischen Descartes und einer Hollanderin. 8. Herausgabe einer Reihe wissenschaft licher (...) Werke. Charakteristik der Abhandlung uber die Methode. 9 Die Dioptrik. Technische Begabung des Philo 80phen. 10. Uber die Meteore. Ll. Geometrie. Uber die Ausdehnung und Grenzen der mathematischen Wissenschaft. Hohere Analysis. Descartes' Verhaltnis zu den abstrakten Problemen der Mathematik. Unvollkommenheit der Natur philosophie. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

Tomas Abraham inicia una pesquisa filosofica y no se detiene ante las impugnaciones que dictan el buen gusto y la conveniencia (la que esconde las contradicciones para simular seriedad y rigor intelectual). Nada lo detiene. Observa, analiza, compulsa. Sus preguntas no interrogan esas zonas del discurso para las cuales se han inventado ya benevolas excusas, sino las otras, las peligrosas.Desde 1989, reflexiona Abraham, el factor economico es la clave que permite descifrar los anhelos y las frustraciones de la (...) sociedad. Por que? Porque el factor economico no se reduce a la economia, no se limita a la produccion y a la distribucion de riquezas sino que acusa la visible emergencia de nuevas formas de vida. El factor economico revela el diagrama de las mutaciones culturales. En este ensayo filosofico en el que coexisten una cantidad asombrosa de estilos y tonos, el autor analiza y discute la empresa como nuevo monumento cultural, la demonizacion del estado, las batallas etico-politicas entre intelectuales y economistas culturales, la tarea de los expertos en calidad de vida y su funcion en una nueva sociedad terapeutica. De las historias de vida de los archimillonarios al encuadre historico de la ideologia empresarial, de la puesta en sorna (con el mayor respeto) de la literatura de autoayuda a la meditacion sobre la moral y el dolor en los campos de exterminio, La empresa de vivir, como los libros anteriores del autor, traza una linea osada y firme e incorpora al pensamiento argentino una nueva manera de hacer las cosas. Una nueva manera capaz de abrir discusiones aparentemente concluidas o censuradas, de expandir los efectos de un conflicto intelectual hacia areas desprestigiadas oignoradas, de inaugurar una pasion para abolir la ironia autoindulgente y los entredichos ufan. (shrink)

In this book, Abraham argues that a theological imagination can expand the contours of postcolonial theory through a reexamination of notions of subjectivity, gender, and violence in a dialogical model with Karl Rahner. She raises the question of whether postcolonial theory, with its disavowal of religious agency, can provide an invigorating occasion for Catholic theology.

Mental state reasoning or theory-of-mind has been the subject of a rich body of imaging research. Although such investigations routinely tap a common set of regions, the precise function of each area remains a contentious matter. With the help of functional magnetic resonance imaging (fMRI), we sought to determine which areas are involved when processing mental state or intentional metarepresentations by focusing on the relational aspect of such representations. Using non-intentional relational representations such as spatial relations between persons and between (...) objects as a contrast, the results ascertained the involvement of the precuneus, the temporal poles, and the medial prefrontal cortex in the processing of intentional representations. In contrast, the anterior superior temporal sulcus and the left temporo-parietal junction were implicated when processing representations that refer to the presence of persons in relational contexts in general. The right temporo-parietal junction, however, was specifically activated for persons entering spatial relations. The level of representational complexity, a previously unexplored factor, was also found to modulate the neural response in some brain regions, such as the medial prefrontal cortex and the right temporo-parietal junction. These findings highlight the need to take into account the critical roles played by an extensive network of neural regions during mental state reasoning. (shrink)

Shared activity is often simply willed into existence by individuals. This poses a problem. Philosophical reflection suggests that shared activity involves a distinctive, interlocking structure of intentions. But it is not obvious how one can form the intention necessary for shared activity without settling what fellow participants will do and thereby compromising their agency and autonomy. One response to this problem suggests that an individual can have the requisite intention if she makes the appropriate predictions about fellow participants. I argue (...) that implementing this predictive strategy risks derailing practical reasoning and preventing one from forming the intention. My alternative proposal for reconciling shared activity with autonomy appeals to the idea of acting directly on another's intention. In particular, I appeal to the entitlement one sometimes has to another's practical judgment, and the corresponding authority the other sometimes has to settle what one is to do. (shrink)

Some of the reasons one acts on in joint action are shared with fellow participants. But others are proprietary: reasons of one’s own that have no direct practical significance for other participants. The compatibility of joint action with proprietary reasons serves to distinguish the former from other forms of collective agency; moreover, it is arguably a desirable feature of joint action. Advocates of “team reasoning” link the special collective intention individual participants have when acting together with a distinctive form of (...) practical reasoning that purports to put individuals in touch with group or collective reasons. Such views entail the surprising conclusion that one cannot engage in joint action for proprietary reasons. Suppose we understand the contrast between minimal and robust forms of joint action in terms of the extent to which participants act on proprietary reasons as opposed to shared reasons. Then, if the team reasoning view of joint intention and action is correct, it makes no sense to talk of minimal joint action. As soon as the reason for which one participates is proprietary, then one is not, on this view, genuinely engaged in joint action. (shrink)

The reasons for which I act are normally my reasons; I represent goal states and the means to attaining them, and these guide me in action. Can your reason ever be the reason why I act? If I haven’t yet taken up your reason and made it mine by representing it for myself, then it may seem mysterious how this could be possible. Nevertheless, the paper argues that sometimes one is entitled to another’s reason and that what one does is (...) to be explained in terms of it. The case for this draws on aspects of the interplay between reasons and intentions in individual agency that have not received the attention they deserve. The paper closes by exploring the limits of interpersonal entitlement to reasons by formulating a hypothesis about which reasons one might be entitled to, and by considering how defeaters can undermine entitlement. (shrink)

What is it for a duty or obligation to be directed? Thinking about paradigmatic cases such as the obligations generated by promises will take us only so far in answering this question. This paper starts by surveying several approaches for understanding directed duties, as well as the challenges they face. It turns out that shared agency features something similar to the directedness of duties. This suggests an account of directedness in terms of shared agency – specifically, in terms of the (...) so-called practical intimacy that holds between individuals when they act together. The final section addresses a challenge to the shared agency approach posed by legal wronging in tort law. (shrink)

There is a way of talking that would appear to involve ascriptions of purpose, goal directed activity, and intentional states to groups. Cases are familiar enough: classmates intend to vacation in Switzerland, the department is searching for a metaphysician, the Democrats want to minimize losses in the upcoming elections, and the US intends to improve relations with such and such country. But is this talk to be understood just in terms of the attitudes and actions of the individuals involved? Is (...) the talk, to take an overly simple proposal as an example, a mere summary of familiar individual attitudes of the group members? Or is the ascription of attitudes and actions to groups to be taken more literally, as suggesting that the group for example believes that P, or intends to A, over and above what the members individually think and do? In short, are there groups with minds of their own? Philip Pettit has deployed the “discursive dilemma” to defend the thesis that there are such group minds. In what follows, I explore the relationship between the group allegedly with a mind of its own and the individuals it comprises, and I consider just how this relationship must be understood in order to give Pettit’s argument for group minds its best chance for success. As I understand it, the discursive dilemma has to be used in conjunction with what might be called an indispensability argument for group minds. It is useful to distinguish two forms of this argument. The explanatory version of the indispensability argument is, very schematically, as follows: there is a compelling explanatory theory T concerning the social, certain indispensable elements of T entail the group mind thesis, so the group mind thesis is true. Several questions immediately arise: What sort of theory is T? In what sense is it indispensable? Are there other forms of indispensability? I don’t have definitive answers to these questions. But how we settle them will have implications for the interaction and support the discursive dilemma provides the indispensability argument. In particular, using the discursive dilemma to defend what I characterize below as a practical version of the indispensability argument commits us to the rationality of individual participants in a way that the explanatory version of the indispensability argument does not. My point in the first part of the paper is that if Pettit wants to avoid the weaknesses of the explanatory indispensability argument and pursue the practical version, then he owes us a story about the rationality of individual participation in groups. Pettit also owes us a story about the agency an individual exercises as part of a group. If it takes the actions of individuals to execute the intentions of the group, how are we to understand those actions in order for the group to count as having a mind of its own? How must group intentions figure in the practical or deliberative perspective of individuals who execute those intentions? I will argue that the proponent of the group mind thesis must proceed with some care here, because some natural ways of answering these questions will undermine the thesis. But in the end, I think that these questions are interesting independently of whether Pettit is right to think that groups do have minds of their own. That’s because investigating Pettit’s arguments might lead to new ideas about how the rationality and agency of individuals can be exercised, and suggests new ways of understanding how individuals can act together, irrespective of whether the groups they compose ever have minds of their own. (shrink)

ישעיהו ליבוביץ, מגדולי האישים שקמו לעם ישראל בדורות האחרונים, השפיע על ההגות היהודית ועל החברה הישראלית בדרכים שונות. דבריו עוררו תמיד דיון ותגובה. הספר כולל מאמרים המתארים והמנתחים את הגותו היהודית והכללית, השקפותיו בתחומי הפילוסופיה ובשאלות תרבות וחברה, לאומיות וציוניות.

Varios teóricos han defendido que lo desagradable se puede explicar apelando a los deseos acerca de que ciertas experiencias no ocurran. En pocas palabras, las experiencias son desagradables porque no las queremos, y no al revés. Una crítica común para este enfoque toma la forma de un dilema de Eutifrón. Incluso si hay una solución para esta crítica, sostengo que este tipo de enfoque está limitado de dos maneras importantes. No puede proporcionar una explicación para: i) la motivación, desde el (...) punto de vista psicológico del que se es consciente, ni ii) una justificación no instrumental, para tener los deseos relevantes. La falta de estas explicaciones es relevante ya que estas son precisamente el tipo de aclaraciones que esperaríamos de una teoría sobre lo desagradable. (shrink)

ḥeleḳ 1. Ḥokhmat ha-ḳodesh (2 v.) -- ḥeleḳ 2. Musar ha-ḳodesh (2 v.).

Abraham Edel addresses the questions of what is meant by "education," how educational institutions and processes are evaluated, and how they can be improved, and what curriculums are best and why. At a time when our ability to provide effective education can spell success or failure for individuals and society alike, Edel clears away old confusions and indicates the conditions that must be satisfied in order for education to be successful for this and future generations.

Foundations of Set Theory discusses the reconstruction undergone by set theory in the hands of Brouwer, Russell, and Zermelo. Only in the axiomatic foundations, however, have there been such extensive, almost revolutionary, developments. This book tries to avoid a detailed discussion of those topics which would have required heavy technical machinery, while describing the major results obtained in their treatment if these results could be stated in relatively non-technical terms. This book comprises five chapters and begins with a discussion of (...) the antinomies that led to the reconstruction of set theory as it was known before. It then moves to the axiomatic foundations of set theory, including a discussion of the basic notions of equality and extensionality and axioms of comprehension and infinity. The next chapters discuss type-theoretical approaches, including the ideal calculus, the theory of types, and Quine's mathematical logic and new foundations; intuitionistic conceptions of mathematics and its constructive character; and metamathematical and semantical approaches, such as the Hilbert program. This book will be of interest to mathematicians, logicians, and statisticians. (shrink)

What makes public history more than just another hill to fight over in culture war politics? In this paper I propose a novel way of understanding the political significance of how public history creates and shapes identities: a contractarian one. I argue that public history can be sensibly understood as representing groups as a society’s contracting parties. One particular value of the contractarian approach is that it helps to elucidate the phenomenon of “signing on,” where a marginalized or oppressed group (...) is offered membership in a society without the social order being meaningfully changed. (shrink)

While studies have investigated the moral issue associated with downsizing, little research attention has been directed to leaders’ behaviors that result in organizational decline and eventually lead them to make a downsizing decision. This study tests a sequence-based model to assess (1) the impact of leaders’ risk-aversion and self-centeredness on organizational decline and downsizing and (2) the impact of organizational and industry decline on organizational downsizing. We address a gap in the decline literature that has only implicitly alluded to leadership (...) characteristics as forerunners of decline. Data collected from 85 firms indicate that both leadership risk-aversion and self-centeredness are significantly related to organizational decline. This results in intensified organizational downsizing. However, industry decline affects downsizing more significantly. (shrink)

That a science of human conduct is possible, that what any man may do even in moments of the most sober and careful reflection can be understood and explained, has seemed to many a philosopher to cast doubt upon our common view that any human action can ever be said to be truly free. This book, first published in 1961, into crucially important issues that are often ignored in the familiar arguments for and against the possibility of free action. These (...) issues are brought to light and examined in some detail. (shrink)

Often the greatest challenges in our relationships with others center on control. Using the Torah wisdom of his heritage and the remarkable insight of his profession, Rabbi Abraham J. Twerski, M. D. once again enlightens us on key issues that.

What are the implications for agency – and in particular, the idea of acting for reasons – if we are to take seriously the notion of collective responsibility? My thesis is that some cases of individuals subject to a collective form of responsibility and blame will force us to make sense of how it is that an individual can be entitled to collective reasons for action, i.e. entitled to a reason had in the first place by a plurality of individuals (...) together rather than any one of them alone. This entitlement makes it possible for the collective reason to be a reason for which one acts, even if one’s contribution on its own makes little or no difference in the collective effort. Although a full defense of this entitlement cannot be undertaken here, I will gesture at how this might work by suggesting that intentions function to preserve reasons for action. . (shrink)

Abraham Pais's Subtle Is the Lord was a publishing phenomenon: a mathematically sophisticated exposition of the science and the life of Albert Einstein that reached a huge audience and won an American Book Award. Reviewers hailed the book as "a monument to sound scholarship and graceful style", "an extraordinary biography of an extraordinary man", and "a fine book". In this groundbreaking new volume, Pais undertakes a history of the physics of matter and of physical forces since the discovery of (...) x-rays. The book attempts to relate not only what has happened over the last hundred years but why it happened the way it did, what it was like for those scientists involved, and how what at the time may have seemed a series of bizarre or unrelated events, now with hindsight emerges as a logical sequence of events. Pais, a noted physicist, was personally involved in many of the developments he describes, and thus Inward Bound, like his earlier book, is filled with unique insights into the world of big and small physics. Between 1895 and 1983, the period he covers, the smallest distances explored have shrunk a hundred millionfold, Pais notes. Along this incompletely traveled "road inward," scientists have established markers that later generations will rank among the principal monuments of the twentieth century. In alternating technical and nontechnical sections, this magisterial survey richly conveys what has been discovered about the constituents of matter, the laws to which they are subject, and the forces that act on them. But the advances have certainly not come smoothly. The book shows that these have been times of progress and stagnation, of order and chaos, of clarity and confusion, of belief and incredulity, of the conventional and the bizarre; also of revolutionaries and conservatives, of science by individuals and by consortia, of little gadgets and big machines, and of modest funds and big money. About the Author: Abraham Pais is Detlev W. Bronk Professor of Physics at the Rockefeller University. The author of the prizewinning biography of Einstein now undertakes a history of modern physics. (shrink)

Introduction Ours is an Age of Criticism. Very few institutions, professions or vocations, modes of life, ways of thought have escaped criticism in the ...

With his unique approach, Rabbi Twerski explores some of the core questions that trouble serious people: What is my function in life? What is my purpose on earth? How can I elevate my soul without harming my body? How can I turn meaning into a practical reality, not a fluffy cliche? Rabbi Twerski's down-to-earth, common sense, real world advice has helped tens of thousands of people. Here he brings his counseling to a new plateau.

We present some techniques in c.c.c. forcing, and apply them to prove consistency results concerning the isomorphism and embeddability relations on the family of ℵ 1 -dense sets of real numbers. In this direction we continue the work of Baumgartner [2] who proved the axiom BA stating that every two ℵ 1 -dense subsets of R are isomorphic, is consistent. We e.g. prove Con). Let K H, be the set of order types of ℵ 1 -dense homogeneous subsets of R (...) with the relation of embeddability. We prove that for every finite model L, : Con iff L is a distributive lattice. We prove that it is consistent that the Magidor-Malitz language is not countably compact. We deal with the consistency of certain topological partition theorems. E.g. We prove that MA is consistent with the axiom OCA which says: “If X is a second countable space of power ℵ 1, and { U 0,\h.;, U n−1 } is a cover of D ▪ X x X -} x,x> ¦ x ϵ X } consisting of symmetric open sets, then X can be partitioned into { X i \brvbar; i ϵ ω } such that for every i ϵ ω there is l such that D ⊇ U l ”. We also prove that MA+OCA [xrArr] 2 ℵ 0 = ℵ 2. (shrink)

Rabbi Abraham J. Twerski, M. D. is the master of showing how mundane events and activities can be saturated with meaning and even holiness. In this era when all sorts of people are searching for spirituality, Rabbi Dr. Twerski shows us how every area of life marriage, job, social life, and dozens more can have a soul and higher purpose. And he gives wise and practical advice on how to do it. The unique Twerski blend of winning story and (...) incisive insight suffuses the entire book. This is a valuable and irresistible volume for everyone! A Shaar Press Publication. (shrink)