Remarks on Penrose’s “New Argument”

It is commonly agreed that the well-known Lucas–Penrose arguments and even Penrose’s ‘new argument’ in [Penrose, R. (1994): Shadows of the Mind, Oxford University Press] are inconclusive. It is, perhaps, less clear exactly why at least the latter is inconclusive. This note continues the discussion in [Lindström, P. (2001): Penrose’s new argument, J. Philos. Logic 30, 241–250; Shapiro, S.(2003): Mechanism, truth, and Penrose’s new argument, J. Philos. Logic 32, 19–42] and elsewhere of this question.     

Implications of evidence-based practice for community health

Evidence-based practice, developed in clinical medicine, is being applied to community health programs. Barriers to implementation of evidence-based practice noted in clinical medicine are likely to exist in community health settings and may be complicated by the nature of community health programs. These barriers include accessibility and availability of relevant data, social and political considerations of program decision-making, and conflicting expectations for evaluation research. This paper discusses barriers to both amassing evidence for practice and using evidence for decision-making in community health. The potential for conflict between practice goals set by evidence-based thinking and those set by community health organizations is also discussed. Implications for evaluations of community health programs are raised and recommendations for improving access to and use of evaluation information are made.     

Conflicts of interest in science and medicine: the physician's perspective

The various statements and declarations of the World Medical Association that address conflicts of interest on the part of physicians as (1) researchers, and (2) practitioners, are examined, with particular reference to the October 2000 revision of the Declaration of Helsinki. Recent contributions to the literature, notably on conflicts of interest in medical research, are noted. Finally, key provisions of the American Medical Association’s Code of Medical Ethics (2000–2001 Edition) that address the various forms of conflict of interest that can arise in the practice of medicine are outlined. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002. The World Medical Association (WMA) is a global federation of National Medical Associations representing the millions of physicians worldwide. Acting on behalf of patients and physicians, the WMA endeavours to achieve the highest possible standards of medical care, ethics, education and health-related human rights for all people.     

用“三个代表”重要思想统领伦理学研究工作——学习十六大报告的体会

党的十六大将“三个代表”重要思想和马克思列宁主义、毛泽东思想、邓小乎理论一道确立为我们党的指导思想,并提出必须坚持马克思列宁主义、毛泽东思想和邓小平理论在意识形态的指导地位,用“三个代表”重要思想统领社会主义文化建设。以“三个代表”重要思想为统领,是十三年来我国社会主义文化建设取得重大成就的基本经验。十六大报告提出的关于社会主义文化建设的一系列新的科学论断体现了马克思主义与时俱进的理论品质。作为文化建设战线上的广大伦理学工作者学习和贯彻十六大精神,就是要更加自觉地以“三个代表”重要思想为统领,与时俱进,努力促进伦理学研究工作的开拓创新。     

A Work in Progress

After expressing gratitude to each contributor, and briefly commenting on each, I probe several main themes of my work, addressing the question of the apparent difference between my earlier philosophical and later clinical writings. Central to both is the reflexivity of the human agent, and that each exhibits a form of practice regardless of the specific aims embedded in each. I then address the theme of narrative writing as my work has developed over the past several decades – at the heart of which are questions of self and integrity.     

Medicine and pharmacy — facts and myths about the development of an innovative pharmaceutical industry in Poland

Innovation is fundamental to the pharmaceutical industry and a key to improvements in healthcare. Its effectiveness depends on huge, constant investments in research. This innovative industry directly affects the course of studies in healthcare and medicine. Its efforts translate directly into the length and quality of our lives. For several years now, the progress underway in pharmaceutical industry has produced measurable benefits. Doctors have new pharmaceuticals at their disposal, including many types of antibiotics and anti-viral drugs, vaccines and a wide range of drugs which save lives or make them more comfortable. In the near future, ever more efficient cures for neoplastic, rheumatic, neurological, psychic, metabolic, circulatory or respiratory diseases can be expected. Innovation is necessary. The human population is ageing, and the task of an innovative pharmaceutical industry is to keep it in a good condition. The use of innovative drugs can translate directly into lowering the costs of illness. A continuous reduction in spending on healthcare has been observed. The costs of inventing an innovative drug are enormous though (US$ 800 million), and studies on a new drug last between 10 and 13 years. An essential element in recovering the incurred costs and ensuring funds needed for new research is protection by patent. Innovative pharmaceutical companies in Poland are committed to increasing the competitiveness and sustaining the development of not only the market, but also the entire pharmaceutical sector. It is a group of companies of crucial importance to the Polish healthcare system, as it influences improvement in the quality of medical services. Through their investments and spending on research and development, innovative companies accelerate economic growth. In Poland, the innovative pharmaceutical industry is represented by the Association of Pharmaceutical Companies Representatives in Poland (SPFFwP). An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

Segmentation and Selection of Appropriate Chinese Characters in Writing Place Names in Japanese

This paper explores the relation between an unknown place name written in hiragana (a Japanese syllabary) and its corresponding written representation in kanji (Chinese characters). We propose three principles as those operating in the selection of the appropriate Chinese characters in writing unknown place names. The three principles are concerned with the combination of on and kun readings (zyuubako-yomi), the number of segmentations, and the bimoraicity characteristics of kanji chosen. We performed two experiments to test the principles; the results supported our hypotheses. These results have some implications for the structure of the Japanese mental lexicon, for the processing load in the use of Chinese characters, and for Japanese prosody and morphology.     

Using Estimates of the Output Productivity Ratio (SDp) to Improve the Accuracy and Managerial Acceptance of Utility Analysis Estimates

This study compared nursing supervisors' percentile estimates (15th, 50th, and 85th) of staff nurse performance made in terms of dollar value and two alternative metrics—output (number of patients cared for) and staffing (number of nurses required to staff a unit). Of the three estimation procedures, nursing supervisors were most confident in the accuracy of their output-based estimates and least confident in the accuracy of their dollar value-based estimates. Estimates of the standard deviation of performance as a percentage of mean performance (SDp) ranged from 19% for the staffing-based estimate to 29% for the output-based estimate. Contrary to expectations, dollar value-based SDp estimates were only minimally correlated with staffing- and output-based SDp estimates. I conclude that allowing supervisors to make percentile estimates in terms of familiar metrics has potential value for improving the accuracy and managerial acceptability of utility analysis.     

The Use of Communication Technology in Private Practice: Ethical Implications and Boundary Dilemmas in Therapy

This study investigates the use of communication technology (CT) by therapists in private practice. CT has exploded in the last decade and therapists have begun to implement this technology in their work. It is important to understand better the types of technology therapists are using and how they decide which devices are most useful for clinical practice. Additionally, the availability of the therapist has long been debated and CT provides media to make therapists readily available. Results show that therapists have boundary concerns and ethical dilemmas regarding CT and often feel unprepared to handle inappropriate out-of-session contacts when they occur.     

人口老龄化呼唤老年医疗保障

我国人口老龄化进程加快,迫切需要建立健全老年人的医疗保障体系。简述了人口老龄化与老年人医疗卫生问题与支付能力,说明了在我国建立老年医疗保障制度的重要性及意义,并提出：针对社区老年人医药费用的不同负担形式与经济承受能力,建立不同收入、不同需求、不同形式的老年医疗保障制。