Cambridge Quarterly

This paper explores ecological and environmental issues in Andrew Marvell's poem, "The Garden." The purpose of this paper is to subvert the anthropocentric world view by juxtaposing the eco-centric world which provides ultimate pleasure to human beings. This paper employs qualitative and interpretative method to analyze the poem. The researcher has examined the poem from the perspective of eco-criticism. Distancing himself from the anthropocentric world-view, Marvell highlights the eco-centric world in order to valorize the beauty and serenity of nature. Marvell glorifies nature and natural beauty by using metaphysical conceits. The poem displays superiority of nature over trivial human culture. In addition, it shows eternity of nature by contrasting it with the transitory nature of human world. The garden is a place for refreshment and nourishment; it stands for innocence, solitude and recreation. Mistaken by the temptation of the material world, the poet seeks peace and pleasure in the human company. However; he finds such blissful states in the lap of nature. Marvell's critique of anthropocentrism and glorification of biocentrism opens an avenue for the critiques who are interested in integrating literary texts with the Environmental Studies. Thus; the present reading of the poem unveils the eco-conscious elements of the poem from the lens of eco-criticism.

Over the past decade, genetic tests have become available for a wide variety of disorders. As a result we are able to predict, with some degree of certainty, whether or not an individual will develop such diseases as breast cancer, Huntington's disease, polycystic kidney disease, and familial adenomatous polyposis. The ability to predict disease poses several unique ethical considerations for clinical decisionmaking regarding the provision of genetic testing. Patients must be able to comprehend the complexities of genetic testing and the potential meaning of the results. Patients must consider the emotional, social, and economic consequences of revelations regarding their risk status. Also, obtaining information on risk status may have implications for persons other than the individual seeking genetic testing. The decision to test children for risk of genetic disease is further complicated by the fact that, until they reach the age of majority or are deemed emancipated minors, parents must make decisions on their behalf. Children have particular developmental, social, and emotional vulnerabilities that must be considered in any decision to conduct genetic testing and/or impart results to them. Policies regarding genetic testing in children seem to vary according to whether any medical benefit is to be expected from testing. For example, population-based screening for phenylketonuria, hemoglobinopathies, and galactosemia are a routine part of pediatric care. Testing for these conditions has been shown to reduce morbidity and mortality, and there are now few ethical concerns regarding current population-based screening programs. Also, testing children for genetic conditions such as cystic fibrosis and sickle cell anemia is relatively uncontroversial as there are significant benefits to be derived from early diagnosis and medical treatment. However, genetic testing becomes more controversial when there are no or questionable medical benefits to be derived, such as in late-onset autosomal dominant diseases. Consider the case presented by Smith et al. 1 Mr. Crawford's son married a woman at risk for Huntington's Disease (HD). The couple, now divorced, was married for eight years and had a son and daughter. The boy is now eight years old and the girl is six. These children are at 25 percent risk for HD. Mr. Crawford believes that the mother of his former daughter-in-law has been diagnosed with HD; the former daughter-in-law has repeatedly said that she is not interested in testing for herself. Mr. Crawford has other children and grandchildren; a widower of significant means, he has been diagnosed with inoperable cancer. He wishes to treat his grand

An Impromptu by Frédéric Chopin; ‘Au clair de la lune’; Robert Schumann’s ‘Der Nussbaum’; the Victorian ballad ‘Ben Bolt’; Charles Gounod’s ‘Chanson de Printemps’; the French folk song ‘Malbrouck s’en va-t’en guerre’: this is the repertoire dubbed ‘a somewhat incongruous bill of fare’ by the narrator in George Du Maurier’s 1894 novel Trilby, as he casts his eye over the programme for La Svengali’s Paris concert. Du Maurier’s narrator takes umbrage at the placement of classical music – works by composers such as Chopin, Schumann, and Gounod – alongside popular balladry and even a lullaby. Yet the audience within the novel does not seem to share this concern for the distinctions of high and low cultures: instead, it reacts rapturously to La Svengali’s performance (unaware that it is produced by the conductor Svengali’s mesmeric hold over the singer, Trilby). In the lengthy passages describing this performance, Du Maurier mimics and subverts the contours of programme notes, which were an increasingly popular accompaniment to the English concert experience and helped in the establishment of a hierarchy of taste, offering listeners, as Christina Bashford explains, ‘a means to mark themselves as having a superior sensibility’ [...]

The ethical principle of respect for autonomy has come into its own In American medicine since World War II as equal in importance to the traditional medicomoral principles of nonmaleficence and beneficence. Respect for autonomy provides the ethical underpinning for the patient's right to exercise an informed choice – whether to consent to or to refuse recommended medical treatment. However, an informed choice demands a certain level of competence. Typical criteria for patient competence to accept or to refuse medical treatments Include ability to make a choice and ability to comprehend the nature of the treatment, as well as the risks and benefits of accepting or refusing the treatment.

Healthcare ethics committees (HEC) have emerged as institutional forums for addressing bioethical dilemmas. Psychiatrists have important roles to play on these committees. Their skills in group process assessment, mental status examination, and character assessment have diverse applications. Psychiatrists can facilitate communication within the committee and as HEC-based clinical ethics consultants. HECs must be concerned with how they arrive at ethical decisions, guarding against political influence or individual monopolization. Psychiatrists can assist these efforts as organizational consultants to HECs. The perception of psychiatrists as reflective, tolerant of ambiguity, humanizing, and approachable about ethical aspects of health care suggests they would make excellent committee leaders. Psychiatrists also have important committee roles to play as ethics educators and policy makers. More demographic data is needed to investigate psychiatrist participation on HECs. Studies of how they are perceived by their ethics committee colleagues may reveal new roles and potential pitfalls for HEC psychiatrists.

Clinical bioethics is big business. There are now hundreds of people who "do" bioethics in community and university hospitals, nursing homes, rehabilitation and home care settings, and some (though quite a few less) who play the role of clinical ethics consultant to transplant teams, managed care companies, and genetic testing firms. Still, there is as much speculation about what clinically active bioethicists actually do as there was ten years ago. Various commentators have pondered the need for training standards, credentials, "certification" exams, and malpractice insurance for ethicists engaged in clinical consultation. Much of the discussion seems to accept an implicit presumption that all clinical ethics consultation practices look pretty much alike. But is this accurate? What do clinical ethicists do, how and where do they do it, and what kind of clinical ethics is useful in the hospital and in other settings? Comments

This paper presents an analysis of the applicability of a principalist approach for a global, or cross-cultural, bioethics. We focus especially on the principle of individual autonomy, a core value in ethical discourse. We echo some long standing criticisms of other anthropologists, sociologists, and many medical ethicists that the individualistic approach to autonomy is a Euro-American value and cannot be ethically applied in all settings. As a remedy, we suggest an adaptation of Kleinman's Explanatory Model approach to questions of decisionmaking. 1 We argue that the analysis and resolution of ethical dilemmas might also benefit from forms of pedagogy that integrate anthropological and other social science perspectives, and the incorporation of ethnographic tech niques in ethical practice. We begin our discussion with a case. Case 1 Mr. R is an Asian man with seriously compromised lung function, hospitalized for several months, currently on a ventilator. The lCU medical team wants to remove him from life support, but the family, consisting of his wife and two daughters, have so far declined. An ethics consult is arranged to mediate between the lCU personnel and the family. The family has been in the United States for about six years and the wife does not speak English. An interpreter is present. A physician begins by asking the wife, through the interpreter, "00 you think your husband would want to be like this? Do you think he is happy?" He then shows an X ray of the patient's lungs to demonstrate the gravity of his condition. A bilingual friend arrives. The physicians present options: Place the patient on a ward with a DNR order and the understanding that he will not be moved back to the lCU or send him home with a ventilator (although the family has already said that everyone works extensive hours and no one will be available to stay with him). Because he is not a citizen, there are no nursing homes available (in this state) for transferring a ventilator-dependent patient. The family friend translates for his wife: "She is his wife, she cannot say whether he is happy. As his wife, she does not know what he would want. It is not possible for her to decide. Also, she believes that as a Catholic, she cannot choose to We appreciate the extensive efforts of Michelle Amoruso, doctoral candidate in anthropology, who assisted with the preparation of the manuscript.

Academic novels present academic characters in academic contexts in order to comment on and criticize the state of academia. Although academic characters can be found in earlier fiction, the genre dates back to 1950s. This subgenre of Anglo-American modern fiction became a popular part of the literary canon with the novels of Mary McCarthy, Kingsley Amis and David Lodge. American writer Saul Bellow also presents memorable academic characters in his novels. In this study, I will look at Saul Bellow's novels Herzog (1964), The Dean's December (1982), and his latest novel Ravelstein (2000) as academic novels focusing on how Bellow presented his criticism of academia in his construction of these academic characters

The terrorist attacks of 2001 were a reminder that individual and collective safety cannot be taken for granted. Since then, physicians, alongside public health professionals and other healthcare professionals as well as nonhealthcare personnel, have been developing plans to enhance the protection of public health and the provision of medical care in response to various threats, including acts of terrorism or bioterrorism. Included in those plans are strategies to attend to large numbers of victims and help prevent greater harm to even larger populations. 1 It is important to recognize that unique responsibilities beyond planning rest on the shoulders of the medical profession. Indeed, irrespective of the cause of harm-whether it arises from natural disasters or otherwise-physicians are needed to care for victims. In some instances, this will require individual physicians to place their health or their lives at risk. Many physicians demonstrated their sense of duty and courage by participating in the rescue efforts that followed the events of September 11, 2001, and more recently the aftermath of Hurricane Katrina. These and other circumstances, such as the debate regarding smallpox vaccination of front-line responders and the SARS epidemic, require the medical profession and each of its members to reflect anew on ethical responsibilities that arise in the face of adversity. A Brief History of Ethical Obligations in the Face of Risks Prior to the events of 2001, the most recent profession-wide debate regarding a duty to treat despite personal risks arose when there was limited understanding of HIV transmission. Those who believed there was a duty to treat appeared to rely in part on historical evidence of the role physicians had played during epidemics. However, some historians remained cautious in making any claim that such a duty existed. 2 In fact, they pointed to many instances when physicians had fled in times of the plague, 3 and also showed that physicians who had provided care during epidemics had done so not out The Council on Ethical and Judicial Affairs of the American Medical Association formulates ethical policies for the medical profession through its interpretations of the AMA's Principles of Medical Ethics. The Council at the time this report was adopted consisted of Michael S. Goldrich, M.D. (Chair); Priscilla Ray, M.D.

The terrorist attacks of 2001 were a reminder that individual and collective safety cannot be taken for granted. Since then, physicians, alongside public health professionals and other healthcare professionals as well as nonhealthcare personnel, have been developing plans to enhance the protection of public health and the provision of medical care in response to various threats, including acts of terrorism or bioterrorism. Included in those plans are strategies to attend to large numbers of victims and help prevent greater harm to even larger populations. 1 It is important to recognize that unique responsibilities beyond planning rest on the shoulders of the medical profession. Indeed, irrespective of the cause of harm-whether it arises from natural disasters or otherwise-physicians are needed to care for victims. In some instances, this will require individual physicians to place their health or their lives at risk. Many physicians demonstrated their sense of duty and courage by participating in the rescue efforts that followed the events of September 11, 2001, and more recently the aftermath of Hurricane Katrina. These and other circumstances, such as the debate regarding smallpox vaccination of front-line responders and the SARS epidemic, require the medical profession and each of its members to reflect anew on ethical responsibilities that arise in the face of adversity. A Brief History of Ethical Obligations in the Face of Risks Prior to the events of 2001, the most recent profession-wide debate regarding a duty to treat despite personal risks arose when there was limited understanding of HIV transmission. Those who believed there was a duty to treat appeared to rely in part on historical evidence of the role physicians had played during epidemics. However, some historians remained cautious in making any claim that such a duty existed. 2 In fact, they pointed to many instances when physicians had fled in times of the plague, 3 and also showed that physicians who had provided care during epidemics had done so not out The Council on Ethical and Judicial Affairs of the American Medical Association formulates ethical policies for the medical profession through its interpretations of the AMA's Principles of Medical Ethics. The Council at the time this report was adopted consisted of Michael S. Goldrich, M.D. (Chair); Priscilla Ray, M.D.

A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of the Massachusetts General Hospital HEC. Between 1993 and 2012, the average number of committee members per year was 38 ± 3 and the average length of membership was 4.8 ± 0.4 years. During that time, the committee performed 934 consults, averaging 47 ± 3 per year. Attendance rates fell from 61.5 to 23.8 % over the study period and were inversely correlated with the total number of members.

A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of the Massachusetts General Hospital HEC. Between 1993 and 2012, the average number of committee members per year was 38 ± 3 and the average length of membership was 4.8 ± 0.4 years. During that time, the committee performed 934 consults, averaging 47 ± 3 per year. Attendance rates fell from 61.5 to 23.8 % over the study period and were inversely correlated with the total number of members.

I intend to explore Philip Roth’s strategy of affirming youth as core value among his major themes revealing the experience of aging, illness and loss by revealing its particular framing in the novels of his later work. I shall analyze the contexts that connect youth to vitality and survival, revisiting some key moments in the long imaginary biographies of his notorious characters David Kepesh and Nathan Zuckerman. Although central in Roth’s work, youth has been commonly investigated in connection to allegories that anchor the writer’s oeuvre in a territory marked by nostalgia, loss, and a sense of impending vital exhaustion. My aim is to isolate this issue more clearly and focus on its specificity rather than its connectivity.

On April 10, 2001, after extensive committee deliberations, the Second Chamber of the Dutch Parliament passed a bill that was introduced in August 1999 legalizing physician-assisted death. The bill is officially called “The Evaluation of Ending Life on Request and Assistance in Suicide and a Change of the Penal Code and the Burial Act (Law Evaluating Ending Life and Assistance with Suicide).” It was passed by a majority vote in the Second Chamber of Parliament and was supported by the majority parties constituting the present coalition government (i.e., liberals and socialists). Opposition to the law came mainly from a minority of Christian parties. In this report we explore the meaning of this bill and describe some of its problematic and paradoxical items.

ISBN 0 300 05285 5. Yale University Press. £18.95. THE ' DISCOVERY' OF THE NEW WORLD IN 1492 is essential to the self-image of Europeans and of their Creole heirs in the Americas. For most of those Creoles 1492 marks the beginning of their history or, at least, the datable origin of an identity which was grafted upon the longer histories of the native peoples whom the Europeans slaughtered, drove out or absorbed into their own cultures and communities. For Europe, since at least the seventeenth century, the encounter with the Americas has also marked the beginning of modernity. As theorists as disparate as David Hume and Karl Marx agreed, 1492 marked an epoch of expansion in scientific and intellectual understanding as well as economic globalisation and the rise of the west. Such an attitude has attracted attention of late as what Derrida has called a 'white mythology', a timely concern as the west has embarked on a post-imperial age which is also (and not coincidentally) conceived as post-modern. To leave colonialism behind, in this conception, is therefore to abandon modernity itself, and that knowledge makes study of the imperial theme all the more urgent. 'We are at a point when we can no longer ignore empires and the imperial context in our studies', Edward Said has remarked in his recent book, Culture and Imperialism, though neither literary critics nor historians need to be reminded of the importance of the imperial theme. Historians in particular have taken a more chronologically expansive and analytically precise approach to empire than Said, who confines himself to studying the high culture of Britain, France, America and their former colonies in the period after the French Revolution, and so consciously leaves out the earlier Spanish, Portuguese, Dutch, French and British empires. Yet what the early-modern imperial experience meant to these cultures is an unignorable historical question which lies at the heart of the west's perceptions of itself, of history, and of human development.

Hospital ethics committees in The Netherlands have had the unique responsibility of developing euthanasia policies for their institutions. Although each policy necessarily reflects a particular facility, family resemblances necessarily remain. In the interest of ethics committees outside The Netherlands that may soon face the same challenge, two such policies are presented here accompanied by commentary high-lighting their similarities and differences.

The paper entitled "Bioethics Committees/Commissions in Hospitals-The Experience of Other Countries. Where to Start?" touches upon the topic of calling into being bioethics committees in Polish hospitals. The need for creating such advisory bodies, and the range of their competence, is shown on the basis of western publications (especially those from French and English speaking countries) as well as on the basis of the personal experience of the author as a member of the bioethics committee in an English hospital (Tameside Hospital in Ashton-under-Lyne). The existence of bioethics committees in hospitals contributes to the humanization of medicine and to an holistic approach to the patient, who is no longer treated as a "particular clinical case" but as a human being, with a wealth of psychological and spiritual attributes, and also, as the subject of interpersonal relations with other people and with the whole community. Dynamic progress in the area of medicine in recent decades has made bioethics committees a requirement of our times. They are of immense importance when doctors are faced with unusually difficult ethical problems, which they cannot always solve by themselves. These committees should consist of competent representatives from the biomedical, philosophical and legal sciences, as well as a representative from the patient's religious denomination.

This paper presents an analysis of the applicability of a principalist approach for a global, or cross-cultural, bioethics. We focus especially on the principle of individual autonomy, a core value in ethical discourse. We echo some long-standing criticisms of other anthropologists, sociologists, and many medical ethicists, that the individualistic approach to autonomy is a Euro-American value and cannot be ethically applied in all settings. As a remedy, we have suggested an adaptation of Kleinman's Explanatory Model approach to questions of decision-making. 1 We argue that the analysis and resolution of ethical dilemmas might also benefit from forms of pedagogy that integrate anthropological and other social science perspectives, and the incorporation of ethnographic techniques in ethical practice. We begin our discussion with a case. Case 1 Mr. R is an Asian man with seriously compromised lung function. He has been hospitalized for several months and is currently on a ventilator. The ICU medical team wants to remove him from life support but the family, consisting of his wife and two daughters, has so far declined. An ethics consult is arranged to mediate between the ICU personnel and the family. The family has been in the U.S. for about six years and the wife does not speak English. An interpreter is present. A physician begins by asking the wife, through the interpreter, "Do you think your husband would want to be like this? Do you think he is happy?" He then shows an X-Ray of the patient's lungs to demonstrate the gravity of Mr. R's condition. A bilingual friend arrives. The physicians present options: place the patient on a ward with a DNR order and the understanding that he will not be moved back to the ICU; or send him home with a ventilator (although the family has already said that everyone works extensive hours and no one will be available to stay with him). Because he is not a citizen, there are no nursing homes available (in this state) for transferring a ventilator dependent patient. The family friend translates for his wife: "She is his wife, she cannot say whether he is happy. As his wife, she does not know what he would want. It is not possible for her to decide. Also, she believes that, as a Catholic, she cannot choose to withdraw him from life support. She wants him to stay in the ICU on the machine." At this point in the consult, the medical team is visibly angry, stating in English that his condition is irreversible and they need his room for someone who might live. It's an economic issue. They also comment that the family is wrong in their understanding of church policy on withdrawing life support. What can ethnographic or cultural analysis add to our understanding of this or other such cases? There are a variety of issues in this case that easily lend themselves to anthropological exposition. Mutual exploration of the following themes by ethicists and anthropologists might generate rich material to shape the resolution of this dilemma: • Patriarchal family and customary gender roles, • Individual vs family (collective) focus of decisions, • Negotiating religious interpretations, • Discussing death-how appropriate is open discussion, • Truth-telling as acceptable or not, • Issues of distributive justice-(how do and how should we respond to the reality that if this patient lived in New York or Illinois, he could, as a non-citizen, be moved to a nursing home on life support, as his family wishes?). Our fundamental objective in this discussion is to interrogate the problematic biomedical/Euro-American bias toward the individual and over-reliance on a Euro-American bioethics approach.

The extended mind and the intentional stance are different in many ways, but they are both, it could be argued, ways of acknowledging the associative life of the mind, always engaged with other minds, with specific technologies, and with the world in general. This is a framework for an intertextual-style understanding of more than just texts, and it also makes room for the necessary intuitions of agency and intention that make life liveable and make each literary work into a thing in the world. Thus it is tantalising to find these hints of recent steps, or perhaps steps forward, grafted on to what is fundamentally a prehistory. To reiterate, in its main task, which is to demonstrate that we will understand intertextuality better if we take a longer view, this book is very successful. Its main implication is that scholars should stop seeing intertextuality as a violent eruption of the world of French theory, and instead see it as a richly contextualised product of several key currents of modern thought. It does not solve all the problems of intertextuality, in that it does not effect the reconciliations it sometimes points towards: for example, the accommodation of the impression of intention within a dynamic model of textuality and creativity. Not does it yield a model of intertextuality that makes it easier to use it to explain the phenomena of individual works, which is what (perhaps) the defenders of allusion really want. However, it has every chance of enriching the discussion a great deal, and giving further nuances to the fact of indebtedness which is so often a feature of great literature.

Medicine is in a very self-reflective mood. There is a revival of interest not only in medical ethics (a.k.a. bioethics) but also in medical history, the Hippocratic corpus, and various kinds of literature that indicate physicians are reexamining the foundations of medicine and what it is that gives meaning to medicine. That is, they are reexamining the physician's vocation, in the true sense of vocation as a calling. This interest has coincided with the concern of third parties such as accreditation agencies about the professionalism of physicians.

Hospital ethics committees have evolved as a response to complicated legal, ethical, and social dilemmas that accompany modern medicine. In the United States, their growth has been augmented by Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) standards and the Patient Self-Determination Act. There appears to be an implicit presumption that all clinical ethics consultation practices are relatively similar. Finally, there is heightened awareness of the needs for quality standards and assessment of the outcomes of ethics consultations.

Aim To assess the differences in the way how Slovenian and Croatian health care professionals (HCPs) confront ethical dilemmas and perceive the role of hospital ethics committees (HECs). Methods This cross-sectional, survey-based study involved HCPs from three Slovenian and five Croatian university medical centers (UMC). The final sample sizes were 308 (244 or 79.2% women) for Slovenia and 485 (398 or 82.1% women) for Croatia. Results Compared with Croatian physicians, Slovenian physicians reported a higher share of ethical dilemmas regarding waiting periods for diagnostics or treatment, suboptimal working conditions due to interpersonal relationships in the ward, and end-of-life treatment withdrawal, and a lower share regarding access to palliative care and patient information protection. Compared with Croatian nurses, Slovenian nurses reported a lower share of ethical dilemmas regarding the distribution of limited resources, recognizing the patient's best interests, and access to palliative care. Compared with Croatian other HCPs, Slovenian other HCPs reported a lower burden of ethical dilemmas regarding waiting periods for diagnostics or treatment, distribution of limited resources, and access to palliative care. When encountering an ethical dilemma, all HCPs in both countries would first consult their colleagues. Slovenian and Croatian HCPs recognized the importance of the HECs to a similar extent, but viewed their role differently. Conclusion Croatian and Slovenian HCPs are confronted with different ethical dilemmas and perceive the role of HECs differently.

Development of medical students' professional ethical values can be influenced by the quality of role models and the experiences they encounter during their education. Essays from all enrolled 6-year students in Medical Studies in English Program at School of Medicine, University of Zagreb in the academic year 2014/2015 were anonymised and analysed according to acknowledged quantitative analysis methods. Three major themes occurred when reading students' essays: physician patient relationship, inter professional relationships among physicians and nurses and teacher student relationship. Students suggested a need for mandatory workshops on communicational skills for physicians and placing the ethics course earlier in the curriculum. The essays of the students show the importance of hidden curriculum in ethics teaching and how role models play an

Main outcome measurements: Knowledge and attitudes of participants before and after the workshop; everyday functioning of hospital ethics committees. Results: The majority of the respondents came from committees with at least five members. The majority of ethics committees were appointed by the governing bodies of their hospitals. Most committees were founded after the implementation of the law on health protection in 1997. Membership structure (three physicians and two members from other fields) and functions were established on the basis of that law. Analysis of research protocols was the main part of their work. Other important functions-education, case analysis, guidelines formation-were neglected. Members' level of knowledge was not sufficient for the complicated tasks they were supposed to perform. However, it was significantly higher after the workshop. Most respondents felt their knowledge should be improved by additional education. Their views on certain issues and bioethical dilemmas displayed a high level of paternalism and over protectiveness, which did not change after the workshop. Conclusions: The committees developed according to bureaucratic requirements. Furthermore, there are concerns about members' knowledge levels. More efforts need to be made to use education to improve the quality of the work. Additional research is necessary to explore ethics committees' work in Croatia especially in the hospital setting.

Background: The informed consent, if obtained properly, can bring additional value to the physician-patient relationship and in many cases to the patients' safety. The previous research studies done in Croatia show the formality of the process of informed consent which often lacks quality and substance, as well as the poor knowledge of patients' rights. Therefore, the authors sought to elucidate the main issues related to the experience and assess the knowledge of general patient population about informed consent after several years of application of the Act on Protection of Patients' Rights. Methods: A short survey was conducted using an independently created questionnaire on a nationally representative sample of 1023 adult subjects divided into two groups: those who had been or not in a hospital for treatment in the past five years. Results: 60% of respondents had only partial knowledge of patients' rights. The level of knowledge about the informed consent was aver...

Informed consent is a perennial topic in bioethics. It has given the field a place in clinical practice and the law and is often the starting point for introductory instruction in medical ethics. One would think that nearly everything has been said and done on this well-worn topic.

Edmund Pellegrino noted that contemporary medicine is to a large extent a North American product, and so too is the ethics that accompanies it. This was an accurate observation back in the 1980s when he said it. Even today bioethics is to a considerable extent informed by the seminal works of the Anglo-American model, at least seen from the United States. The dissemination of ideas from the Spanish-speaking world has been nearly invisible to the English-speaking world of bioethics, isolated by language and culture from intellectual currents abroad.

Reviews of philosophical books run the risk of being either excessively and unconstructively critical or superficially praiseworthy. To avoid both these risks, we test the approach outlined by Häyry in his book Rationality and the Genetic Challenge: Making People Better? by applying it to an eighth genetic challenge, namely, a variation of the genetic enhancement challenge discussed by Häyry as it applies to sports. We assess whether genetic enhancement in sports should be conceived as an eighth wonder or an eighth cardinal sin that stems from the interaction between genetics and society, question whether Häyry’s nonconfrontational approach is really useful for dealing with these issues, and discuss how his method can be improved.

Clinical bioethics is big business. There are now hundreds of people who “do” bioethics in community and university hospitals, nursing homes, rehabilitation and home care settings, and some (though quite a few less) who play the role of clinical ethics consultant to transplant teams, managed care companies, and genetic testing firms. Still, there is as much speculation about what clinically active bioethicists actually do as there was ten years ago. Various commentators have pondered the need for training standards, credentials, “certification” exams, and malpractice insurance for ethicists engaged in clinical consultation. Much of the discussion seems to accept an implicit presumption that all clinical ethics consultation practices look pretty much alike. But is this accurate? What do clinical ethicists do, how and where do they do it, and what kind of clinical ethics is useful in the hospital and in other settings?

Focusing on Upon Appleton House, this article seeks to illumine Marvell's communication to audiences (or to the idea of audience) and thereby to find an embodied authenticity. Examining the relationship between narrative and surface-level appeals, the article excavates stanzas that represent common hunting practices and thereby figure the interpreter's entrapment. It focuses on the following intertexts: Gervase Markham's Hungers Prevention (1621), a fowling text where Marvell found his "inverted tree"; Culex, a brief mock epic attributed to Virgil that locates Marvell's comedic gestures in grand poetic ambition; and Augustine's Confessions, which in its metaphorical treatment of birdlime helps us to understand Marvell's investment in poetry to be a suspension in the self-conscious pleasure of a recursive embodied process.

The extended mind and the intentional stance are different in many ways, but they are both, it could be argued, ways of acknowledging the associative life of the mind, always engaged with other minds, with specific technologies, and with the world in general. This is a framework for an intertextual-style understanding of more than just texts, and it also makes room for the necessary intuitions of agency and intention that make life liveable and make each literary work into a thing in the world. Thus it is tantalising to find these hints of recent steps, or perhaps steps forward, grafted on to what is fundamentally a prehistory. To reiterate, in its main task, which is to demonstrate that we will understand intertextuality better if we take a longer view, this book is very successful. Its main implication is that scholars should stop seeing intertextuality as a violent eruption of the world of French theory, and instead see it as a richly contextualised product of several key currents of modern thought. It does not solve all the problems of intertextuality, in that it does not effect the reconciliations it sometimes points towards: for example, the accommodation of the impression of intention within a dynamic model of textuality and creativity. Not does it yield a model of intertextuality that makes it easier to use it to explain the phenomena of individual works, which is what (perhaps) the defenders of allusion really want. However, it has every chance of enriching the discussion a great deal, and giving further nuances to the fact of indebtedness which is so often a feature of great literature.