Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 (...) editions. This update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

For decades, transgender people have been fighting for the right to participate in sports leagues consistent with their gender identity. Much of this fight has played out on the federal stage, but recently both the federal government and federal courts have become hostile to transgender rights broadly, and transgender rights in sports in particular. This Comment examines an alternate but increasingly promising avenue for the vindication of transgender rights in sports: state law. Using a New York lawsuit brought by a (...) women’s roller derby team, Long Island Roller Rebels v. County of Nassau, as a case study, this Comment argues that state preemption and broad anti-discrimination statutes can protect transgender rights, shielding against federal overreach. Specifically, it demonstrates how advocates can leverage New York’s Municipal Home Rule Law, Human Rights Law, and Civil Rights Law to create a template for future transgender rights litigation. (shrink)

Star Wars Episode VII: The Force Awakens is not the hero’s journey as George Lucas previously conceptualized it. Instead, the story line of The Force Awakens leads me to believe that it creates a new iteration of the hero myth. It follows the contemporary heroine’s journey while conforming to the essential construct of the hero monomyth. First, the contemporary heroine’s journey focuses primarily on the greater good and secondarily on her own personal journey, which is the converse of the traditional (...) hero’s journey. Second, the contemporary heroine’s self is awakened and called to adventure in a different way than the traditional hero. Third, the traditional hero receives guidance on his journey, while the contemporary heroine pushes ahead alone, striving to save her society from despair. (shrink)

In the acquisition of verbal knowledge, the Nyāya school outlines four conditions of a linguistic utterance that must be met: āsatti (temporal proximity), ākāṅkṣā (syntactic expectancy), tātparya (speaker intention), and yogyatā (semantic fitness). I will follow the traditional Nyāya view that is it one of the four necessary conditions that enable a hearer to gain verbal knowledge. The reasoning behind retaining tātparya as a condition (or cause) of verbal knowledge, is that it provides a resource with which to clarify ambiguity (...) when contextual factors cannot. It also provides a context for a hearer so that the primary (abhidhā) or secondary (lakṣaṇā) meaning of the word, or sentence is understood. In this sense, tātparya imparts the meaning of a work. Examples such as “Bring saindhava” or “Hari” make the case for the importance of tātparya in that the meanings of these terms are ambiguous unless the context is provided or the speaker intends to mean one referent rather than another. In this paper, I present the case that tātparya is the most important component of an accurate paraphrase, and it must be retained in order to preserve the original intention of the work. In other words, tātparya should be the primary constraint of an acceptable paraphrase. As a side comment to my aim, I discuss the notion of why paraphrase only needs to be sufficiently similar to the original work. (shrink)

As a Madhyamaka philosopher, Taktsang Lotsawa Sherab Rinchen 1 is perhaps most widely known for his claim to have identified eighteen major contradictions in the thought of Tsongkhapa Losang Drakpa, a polemic discussion that appears in the Madhyamaka chapter of his encyclopedic Freedom from Extremes through Comprehensive Knowledge of Philosophy.2 In this article we will not pursue this critique, both renowned and infamous, but instead focus on Taktsang Lotsawa's own pragmatic hermeneutics of emptiness in context. Taktsang Lotsawa argues that *Svātantrika (...) 3 Mādhyamikas, in their drive to furnish the two... (shrink)

In the Nyāya school of Classical Indian Philosophy, the concept of word meaning is described in detail; however, the theory of metaphor seems to clash with the theory of word meaning. This paper explores the theory of meaning in the early Nyāya theory and whether metaphor is compatible with it. The Nyāya theory of meaning is a 'basis for application' (pravrttinimitta) model: words pick out references because of the conventions and practices of use. Yet, these words can come to refer (...) to something completely different by pushing off its conventional usage and taking on a metaphorical meaning. If the referent is determined on the basis of the properties it possesses, how it is possible that only some properties are applied to a referent in metaphorical cases when, conventionally, a referent must possess all of the properties before the word is applied to it? This paper will investigate three main questions: 1) what is the nature of a referent according to the Nyāya?; 2) what is the mechanism for metaphorical transfer that allow some properties to transfer and not others?; and 3) what are the philosophical implications of the Naiyāyikas understanding of meaning? (shrink)

This chapter suggests that Sellars' account of subjectivity as socially constructed, and hence conceptual at its illusory roots, presents a crisp and compelling perspective on cognitive life that captures Buddhist conceptions of transformative non-duality.

In this case-study, I examine examples which fall within the five categories of the re-use of texts in the Nyāya Sūtra, Nyāya Bhāṣya, and Nyāya Vārttika and note the form of quoting and embedment. It is found that the re-use of texts is prominent and that the category and method of embedding the re-used passages varies from author to author. Gautama embeds the most interlanguage quotations without acknowledging his sources and Uddyotakara re-uses the most quotations and paraphrases while acknowledging his (...) sources. Vātsyāyana re-uses the most direct quotations but only acknowledges his sources about half the time. Each author re-uses textual material for two reasons: to demonstrate his authority in this field; and to support his own arguments and to critique objections and opposing theories. Differences crop up in the methodologies of Gautama, Vātsyāyana, and Uddyotakara as the concept of an authority shifts over time, as the body of literature grows, and as new objections and opponents arise. (shrink)

Based on newly discovered texts, this book explores the barely known but tremendously influential thought of the Tibetan Buddhist teacher, Mabja Jangchub Tsöndrü (d. 1185).This Tibetan Buddhist master exercised significant influence on the interpretation of Madhyamaka thinking in Tibet during the formative phase of Tibetan Buddhism and plays a key role in the religious thought of his day and beyond. The book studies the framework of Mabja’s philosophical project, holding it up against the works of both his own Madhyamaka teachers (...) as well as those of central authors of the later "classical period". The emerging account of the evolution of Madhyamaka in Tibet reveals a striking pattern of transformative appropriations. This, in turn, affords us insights into the nature and function of tradition in Tibetan religious culture and Mahāyāna Buddhism at large. Innovation is demanded for both the advancement and consolidation of tradition. This ground-breaking book is an invaluable contribution to the study of Tibetan philosophy. It is of great interest to Buddhist practitioners, specialists in Buddhist philosophy and Tibetan Buddhism. (shrink)

This article discusses food as a formative experience in early childhood, articulating the cultural, sensory, social, and political dimensions of eating. Considering the contemporary transformations in food systems and the increasing consumption of ultra-processed foods, it problematizes the growing distance between children and culinary practices, as well as the loss of their educational potential. Grounded in perspectives from the human sciences, Food and Nutrition Education (FNE), and decolonial approaches, the study proposes the concept of the “pedagogy of the spoon and (...) of gathering,” which understands the acts of harvesting, preparing, and sharing food as pedagogical practices. The article presents empirical evidence from the Cozinhas & Infâncias Program, highlighting how culinary experiences can strengthen social bonds, expand sensory repertoires, and promote situated learning. It concludes that integrating food into educational processes constitutes a powerful pathway for fostering critical subjects who are sensitive to food culture, territory, and social relations. (shrink)

Best known for his contributions to the development of contemporary intersubjectivity theory, Bernard Brandchaft has dedicated a career to the advancement of psychoanalytic theory and practice. Continually searching for a theoretical viewpoint that would satisfactorily explain the clinical phenomena he was encountering, his curiosity eventually led him to the work of Heinz Kohut and the then-emerging school of self psychology. However, seemingly always one step ahead of the crowd, Brandchaft constantly reformulated his ideas about and investigations into the intersubjective nature (...) of human experiences. Many of the chapters in this volume have never before been published. Together, they articulate the evolution of Brandchaft's thinking along the road toward an emancipatory psychoanalysis. Moreover, commentary from Shelley Doctors and Dorienne Sorter – in addition to Bernard Brandchaft himself – examines the clinical implications of the theoretical shifts that he advocated and provides a contemporary context for the case material and conclusions each paper presents. These theoretical shifts, both clear and subtle, are thereby elucidated to form the grand narrative of a truly visionary psychoanalytic thinker. (shrink)

Within a context of rapid growth and diversification in higher degree research programs, there is increasing pressure for the results of doctoral research to be made public. Doctoral students are now being encouraged to publish not only after completion of the doctorate, but also during, and even as part of their research program. For many this is a new and challenging feature of their experience of doctoral education. _Publishing Pedagogies for the Doctorate and Beyond_ is a timely and (...) informative collection of practical and theorised examples of innovative pedagogies that encourage doctoral student publishing. The authors give detailed accounts of their own pedagogical practices so that others may build on their experiences, including: a program of doctoral degree by publication; mentoring strategies to support student publishing; innovations within existing programs, including embedded publication pedagogies; co-editing a special issue of a scholarly journal with students; ‘publication brokering’, and writing groups and writing retreats. With contributions from global leading experts, this vital new book: explores broader issues pertaining to journal publication and the impacts on scholarly research and writing practices for students, supervisors and the academic publishing community takes up particular pedagogical problems and strategies, including curriculum and supervisory responses arising from the ‘push to publish’ documents explicit experiences and practical strategies that foster writing-for-publication during doctoral candidature. _Publishing Pedagogies for the Doctorate and Beyond_ explores the challenges and rewards of supporting doctoral publishing and provides new ways to increase research publication outputs in a pedagogically sound way. It will be a valued resource for supervisors and their doctoral students, as well as for program coordinators and managers, academic developers, learning advisors, and others involved in doctoral education. (shrink)

Este estudio busca indagar en la relación entre las concepciones sobre la escritura que tienen estudiantes de doctorado y su relación con la calidad textual y argumentativa que poseen textos redactados por ellos. Se revisaron 31 textos producidos por los doctorandos y se evaluó la calidad textual y la calidad argumentativa; luego, se aplicó un cuestionario de procesos de escritura, lo que permitió conocer las concepciones de los estudiantes sobre las dos variables mencionadas. Se encontró que las dimensiones ‘bloqueo’ y (...) ‘procrastinación’ inciden en la calidad de la escritura, mientras que ‘transformación del conocimiento’ se relaciona con la calidad argumentativa. (shrink)

In the United States, the field of bioethics has expanded over the last two decades. Several institutions offer graduate-level training at both the masters and doctoral level. However, a lack of published literature on the outcomes of doctoral training in bioethics from the perspective of graduates exists. Researchers conducted an online survey of doctoral students who had finished all doctoral requirements but their dissertation, as well as doctoral graduates, of four US-based institutions to ascertain their perspectives on a number of (...) items regarding their doctoral training and their perception of how that training prepared them for their current role in the workforce. Responses from 34 participants were assessed. Respondents had positive overall views on the utility of a bioethics doctorate and the educational training they received in their respective programs. A number of areas for improvement were identified, including better structured clinical ethics training, greater opportunities for research and publishing, and having the ability to teach during their doctoral program, as well as formal pedagogy training. Greater exposure to clinical ethics consultation during the doctoral program was associated with feeling fully prepared as a clinical ethics consultant. This is the first study to assess the perspectives of bioethics doctoral graduates and ABD students regarding the utility of a bioethics doctorate. Per the perspectives of graduates and ABD students, bioethics doctorates are important and effective to train professional bioethicists. We recommend that a few key changes to these programs’ curricula can further bolster their effectiveness. (shrink)

Each year, many young professionals forego advanced education in the traditional doctoral programs of medicine, law, and philosophy in favor of pursuing a PhD or professional doctorate in bioethics or healthcare ethics that is offered by several major institutes of higher education across the United States. These graduates often leverage their degrees into careers within the broader field of bioethics. As such, they represent a growing percentage of professional bioethicists in both academia and healthcare nationwide. Given the significant role (...) that doctoral bioethics programs play in the training of future professional bioethicists, it is imperative that programs conferring bioethics degrees are attuned to the knowledge and skills students will need as they transition to professional positions, especially where this training substantially differs from more traditional doctoral degree tracks. Yet, even given this need, there is nothing in the professional literature regarding doctoral bioethics graduates’ perspectives or the overall efficacy of a bioethics doctorate as compared to more traditional doctoral degree tracks for future professional bioethicists. This paper then gives the perspective of five recent doctoral bioethics graduates on the utility of a bioethics doctorate and areas where the doctorate prepared or underprepared them in their roles as early-career professional bioethicists. (shrink)

Nel corso degli ultimi 20 anni c’è stata una espansione globale in materia di istruzione dottorale e in particolare di ‘dottorati professionali’. Difficoltà nell’avanzamento e nel completamento diventano sempre più il centro dell’attenzione per tutti i tipi di dottorato. È stato riconosciuto che una serie di fattori al di là di quelli prettamente demografici potrebbe influire sulla possibilità di completare gli studi. C’è ancora molto da imparare sul motivo per cui l’avanzamento e il completamento del dottorato sono così impegnativi. In (...) questo articolo vorremmo mettere in evidenza un settore che sembra trascurato dalla ricerca: l’esperienza emotivamente complessa del percorso di dottorato.Offriamo un contributo al dibattito su ciò che è necessario per facilitare il successo e intrinsecamente un soddisfacente avanzamento all’interno di un programma di dottorato professionale. Noi sosteniamo che una maggiore attenzione debba essere prestata al cammino esperienziale di studenti di dottorato dal momento che essi hanno il difficile compito di integrare la loro vita personale, professionale e accademica. Il nostro interesse per le risorse emotive di cui gli studenti possono avvalersi durante il loro percorso di dottorato è iniziato con la progettazione e lo sviluppo del nostro primo dottorato professionale in materia di sanità e cura. Attraverso la nostra iniziale esperienza con due gruppi di studenti, abbiamo riflettuto sullo sviluppo del dottorato professionale, in generale, e trasversalmente a diverse altre discipline, per comprendere meglio come facilitare una buona esperienza di dottorato e una conclusione nei tempi.L’importanza di partecipare all’esperienza emotiva all’interno del complesso percorso di dottorato professionale ci ha portato al concetto di ‘nourished scholarship’. Si definisce la nozione di ‘nourished scholarship’ come un percorso di apprendimento che lega i valori personali, significativi e attuali, allo sviluppo e al contributo professionale. Tale nutrimento emotivo è caratterizzato da una soddisfacente esperienza di scambio tra il sé, l’apprendimento e la comunità di pratica/studio. La nostra opinione è che tale nutrimento emotivo sia una risorsa fondamentale da cui gli studenti attingono al momento di negoziare le sfide complesse del percorso professionale di dottorato. Al fine di illustrare il significato di ‘nourished scholarship’ descriviamo alcune delle sue dimensioni emotive chiave. Queste dimensioni possono essere agevolate in vari modi, ma qui ne segnaliamo uno in particolare: il sostegno reciproco e la supervisione di gruppo facilitata. Al fine di illustrare le dimensioni della ‘nourished scholarship’ quindi noi riflettiamo su un caso specifico, quello di una coorte di studenti di dottorato professionale. Sono state estratte alcune loro esperienze per illustrare sette dimensioni che sono importanti per contribuire all’esperienza di ‘nourished scholarship’ come una risorsa di sostegno:- Sperimentare i benefici di appartenenza- Aiutarsi vicendevolmente a contenere l’ansia- Vivere la crescente fiducia- Accettare comunanza e unicità- Miglioramento personale, identità professionale e accademica attraverso la chiarificazione dei valori- Sperimentare i benefici di relazionarsi ad una più ampia comunità scientifica- Accettare i ritmi dei tempi in cui ricevere dei tempi attivi.Inoltre, in questo articolo si riflette su come la particolare struttura del programma di dottorato è stata in grado di sostenere lo sviluppo di queste risorse. Ci sono state tre caratteristiche chiave che crediamo siano state fondamentali nel modo in cui il programma è stato progettato e realizzato:a) ‘Cohortness’ in cui gli studenti si impegnano con il programma come un gruppo in viaggio.b) Supervisione di coorte: anche se tutti studiavano diversi argomenti, si è formato un gruppo insieme a due facilitatori accademici per discutere il processo, l’esperienza del percorso e il loro apprendimento.c) Una strategia di valutazione flessibile che permette agli studenti di progredire in modo personale e non lineare.Il valore potenziale di questo articolo per i programmi educativi è che fornisce un quadro per focalizzare l’attenzione sull’importanza del percorso emotivo e sui modi per sostenere la motivazione degli studenti e la resilienza. Noi crediamo che questo quadro abbia un potenziale trasferibile ad altre situazioni in cui tali risorse emotive possono essere importanti.During the past 20 years there has been a global expansion in doctoral education and in particular professional doctorates. Difficulties with progression and completion have increasingly become the focus of attention within both academic and professional contexts. It has been acknowledged that a range of factors, beyond demographics, could be influential in whether students are able to sustain their studies to completion. In this paper we stress the importance of conceptualising professional doctoral studies as a personal, professional and academic journey that is sustained by emotional factors that may need more explicit attention. As such, our contribution is the delineation of a phenomenon that we call ‘nourished scholarship’. We wish to illustrate how such ‘nourished scholarship’ functions as a resource for sustaining motivation and integration through the doctoral journey. We offer seven dimensions that a doctoral programme needs to embody in order to facilitate ‘nourished scholarship’: belonging, containing anxiety, growing confidence, commonality and uniqueness, values clarification, scholarly community, and negotiating the rhythms of receptive and active times. We illustrate these dimensions in the context of a professional doctorate programme that emphasises ‘cohort supervision’ as the primary resource for facilitating such nourished scholarship. We believe that this notion has transferable potential to other provisions where such emotional resources may be important. (shrink)

Hispanics are grossly underrepresented in the receipt of STEM Ph.Ds. The National Science Foundation Science and Engineering Indicators suggest that only 7.8% of S and E doctoral recipients are Hispanic while their representation in the population is more than twice that, and that figure goes even higher if restricted to those within the college-age range. To address this gap, the NSF has awarded a grant to the City College of New York and the University of Texas at El Paso to (...) work with Hispanic STEM doctoral students to provide teaching training and preparation for academic positions so they can become role models for Hispanic community college undergraduates. In working to understand the career-decision making of our Fellows, in-depth interviews were conducted to understand what put them on the path to defy the odds and become a STEM doctoral recipient. Interview results suggest that isolated, critical incidents and chance events were responsible for a number of our students entering into doctoral programs. This research suggests that for some Hispanic STEM doctoral students the experience of chance events meant the path to a STEM doctorate was not assured from a young age and further, that the provision of “planned” critical incidents may support an increase in Hispanic STEM doctoral enrollment. (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire. Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine. Main outcome measure—Doctors' and nurses' attitude towards and practices of VE. Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). A total (...) of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE. (shrink)

Doctor Stephen Strange was a renowned neurosurgeon in his “previous life”, but after his time in Kamar‐Taj he is mostly associated with his mastery of the mystic arts. In Doctor Strange people learn that mastery of physical skills is critical for mastery as a mystic. In addition to the physical skills of martial arts, the portrayal of Doctor Strange is reminiscent of many aspects of Eastern philosophical traditions. Ironically, the reason that Strange originally gave for seeking the elixir is that (...) he swore the Hippocratic Oath, which requires him to prescribe medical treatments for the good of his patients. One problem with applying the Hippocratic Oath to Strange's choice is that it's meant to apply to the doctor‐patient relationship. Perhaps Stan Lee and Steve Ditko, the creators of Doctor Strange, meant to show that, by losing his skill as a surgeon, Strange finally learned what it means to be a good physician. (shrink)

Doctor Stephen Strange, the Master of the Mystic Arts, not only chose to live the life of a hero, but did so in such a way that links him to one of the most important philosopher‐heroes of all time. In making the choice to pursue the Mystic Arts and dedicating himself to living a life devoted to seeking wisdom, acting rightly, and improving society, Doctor Strange set out on a trail blazed more than 2000 years ago by the original philosopher (...) and hero, Socrates. In order to learn the truth of wisdom, virtue, and beauty, Socratic Heroes must step outside themselves and engage in deep self‐examination. While intellectual humility and the examined life shine the spotlight directly on the “wannabe” philosopher, Socratic Heroism also includes a social component that looks outward. Strange transformed into a sorcerer supreme, and a true Socratic Hero, by accepting his own limitations and looking for wisdom in the right place. (shrink)

This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral (...) considerations that are overlooked by other approaches to ethical analysis. (shrink)

A lively topic of debate in decision theory over recent years concerns our understanding of the different risk attitudes exhibited by decision makers. There is ample evidence that risk-averse and risk-seeking behaviours are widespread, and a growing consensus that such behaviour is rationally permissible. In the context of clinical medicine, this matter is complicated by the fact that healthcare professionals must often make choices for the benefit of their patients, but the norms of rational choice are conventionally grounded in a (...) decision maker’s own desires, beliefs and actions. The presence of both doctor and patient raises the question of whose risk attitude matters for the choice at hand and what to do when these diverge. Must doctors make risky choices when treating risk-seeking patients? Ought they to be risk averse in general when choosing on behalf of others? In this paper, I will argue that healthcare professionals ought to adopt a deferential approach, whereby it is the risk attitude of the patient that matters in medical decision making. I will show how familiar arguments for widely held anti-paternalistic views about medicine can be straightforwardly extended to include not only patients’ evaluations of possible health states, but also their attitudes to risk. However, I will also show that this deferential view needs further refinement: patients’ higher-order attitudes towards their risk attitudes must be considered in order to avoid some counterexamples and to accommodate different views about what sort of attitudes risk attitudes actually are. (shrink)

American doctors in the 1990s are being asked to serve as "double agents," weighing competing allegiances to patients' medical needs against the monetary costs to society. This situation is a reaction to rapid cost increases for medical services, themselves the result of the haphazard development since the 1920s of an inherently inflationary, open-ended system for funding and delivering health care. The answer to an inefficient system, however, is not to stint on care, but rather to restructure the system to remove (...) the inflationary pressures. As long as we are spending enormous resources on an inherently inefficient and inflationary system we cannot justify asking doctors to withhold beneficial care to save money for third-party payers. Doing so serves a largely political agenda and endangers the patient-centered ethic that is central to medicine. (shrink)

Doctor Stephen Strange and Leo Tolstoy both experienced significant changes in mid‐life, though, that affected their worldviews and led them to reconsider the meaning of life. For his part, Tolstoy developed a strong opposition to violence, even when used in resistance to evil. A central focus of Tolstoy's newfound philosophy is the evil of the violence practiced by humans throughout history. The metaphysical nature of evil is reflected in the amount of time Doctor Strange spends in such realms as the (...) Dream Dimension, fighting the darkness that tries to take over human minds and souls. If Tolstoy were in the world of Doctor Strange, he might open the sacred Book of Vishanti, don the Eye of Agamotto, and become a sorcerer‐defender of our planet from demonic evil. (shrink)

This article reports the results of a survey, by mailed questionnaire, of the attitudes, values and practices of doctors in Singapore with respect to the doctor-patient relationship. Questionnaires were sent to a random sample of 475 doctors (261 general practitioners and 214 medical specialists), out of which 249 (52.4%) valid responses were completed and returned. The survey is the first of its kind in Singapore. Questions were framed around issues of medical paternalism, consent and patient autonomy. As the doctors were (...) exposed to Western ethical concepts in their training, we were not surprised to find that they would mostly allow patients some say in decision-making and keep patients reasonably informed. In respecting patient autonomy, they would usually seek to influence patient choice by persuasion. However, the residual "Asian-ness" of doctors in Singapore gives rise to some inconsistencies between values and practices. Many doctors still believe that a number of their patients are incapable of rational choice. There is some lack of openness in telling patients the whole truth. When patients choose to refuse treatment, many doctors are prepared to involve family members in making a consensus decision. Doctors were also asked how they made ethical judgements in the face of dilemmas, and how they would like disputes with patients to be resolved. By and large, the doctors prefer to make their own judgements rather than to rely on rules. They also wish to keep the law courts out of disputes with patients, preferring less public ways of settling disputes. (shrink)

In an article in this journal, Christopher Cowley argues that we have ‘misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors’.1 We have not. It is Cowley who has misunderstood the role of personal values in the profession of medicine. We argue that there should be better protections for patients from doctors' personal values and there should be more severe restrictions on the right to conscientious objection, particularly in relation to assisted dying. We argue (...) that eligible patients could be guaranteed access to medical services that are subject to conscientious objections by: (1) removing a right to conscientious objection; (2) selecting candidates into relevant medical specialities or general practice who do not have objections; (3) demonopolizing the provision of these services away from the medical profession. (shrink)

Regulation in healthcare has often been accused of protecting the professions and neglecting patients. ‘Public protection appeals’, used to challenge fitness to practise decisions considered to be ‘insufficient’ for the ‘protection of the public’, have created a welcome space for judicial scrutiny. Focusing on doctors, the present study of public protection appeals examines the contours of that scrutiny. It frames these appeals as a recalibration of the metaphorical ‘regulatory bargain’, finding that many of the resulting judgments signal a departure from (...) traditional postures of ‘deference’ in professional regulation jurisprudence and a steady judicial assertion of jurisdiction over the core issue of ‘seriousness’ in doctor misconduct. Further exploration of that heightened scrutiny identifies several strands of new doctrine which fortify the regulatory regime in a variety of directions. This exploration also, however, isolates and critiques the emergence of a ‘Bolton gloss’—a seam of cases which tilt decision making towards censure and risk disrupting regulatory strategies which have cultivated a commitment to rehabilitative approaches in the disciplinary process. (shrink)

Doctor's Dilemmas, a fascinating study of the moral dilemmas confronting health professionals and patients alike, examines areas of health care where ethical conflicts often arise. Gorovitz illuminates these conflicts by clearly explaining and applying a broad range of philosophical concepts. He lays the groundwork for informed ethical decision-making and provides the general reader with a lucid overview of the complexities of medical practice. Written in accessible, conversational style and making extensive use of anecdotes, examples, and references to literature, Doctor's Dilemmas (...) offers profound insights into medical ethics for all those involved with the health professions--be they doctors, nurses, administrators, or patients. (shrink)

_Just Doctoring_ draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way to (...) a new, more aware and engaged medical ethics. The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems—from informed consent to care rationing and the repercussions of the HIV epidemic—and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century. (shrink)

Doctors form an essential part of an effective response to the COVID-19 pandemic. We argue they have a duty to participate in pandemic response due to their special skills, but these skills vary between different doctors, and their duties are constrained by other competing rights. We conclude that while doctors should be encouraged to meet the demand for medical aid in the pandemic, those who make the sacrifices and increased efforts are owed reciprocal obligations in return. When reciprocal obligations are (...) not met, doctors are further justified in opting out of specific tasks, as long as this is proportionate to the unmet obligation. (shrink)

In the Marvel Cinematic Universe (MCU), according to the Ancient One, magic is created by drawing energy from the other dimensions of the multiverse. This sounds like a concept from science fiction, but the idea that people are living in a vast multiverse is very possibly science fact. A recurring and especially important theme in Doctor Strange is the role that human beings are supposed to play in the universe. The concept of the multiverse is well established in the Marvel (...) comics and has officially been introduced into the MCU, and the way it is introduced touches on central issues in the philosophy of physics. Quantum mechanics is hands‐down one of the greatest accomplishments of science. Understanding the apparent collapse of the wave function upon observation is the core of the measurement problem. There are different ways of explaining this, which are called “interpretations” of quantum mechanics. (shrink)

As Sorcerer Supreme, Doctor Stephen Strange has had several occasions in which he had to deal with the concept of a personal God. Despite his lack of traditional faith, there are important instances in which Doctor Strange acknowledges the Creator God using expressions drawn from the Western monotheistic traditions. In his Metaphysics, the ancient Greek philosopher Aristotle presents the idea of God, or more specifically a god among the gods, who is responsible for the origin and operation of the whole (...) universe. A more helpful image of God can be found in the writing of Saint Thomas Aquinas, who formed a theological synthesis of Aristotelian philosophy and Christian revelation. According to Aquinas, the all‐good Creator of the universe is the author of the moral law. In the Chronicles of Narnia, author and English professor C. S. Lewis refers to the eternal law of God as the “deep magic” that comes from the “Emperor Beyond the Sea”. (shrink)

RATIONALE, AIM AND OBJECTIVE: Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in (...) prescribing drugs, using a qualitative approach. (shrink)