Heidegger’s two modes of thinking, calculative and meditative, were used as the thematic basis for this qualitative study of physicians from seven countries . Focus groups were conducted in each country with 69 physicians who cared for the elderly. Results suggest that physicians perceived ethical issues primarily through the lens of calculative thinking with emphasis on economic concerns. Meditative responses represented 24% of the statements and were mostly generated by Canadian physicians whose patients typically were not faced with economic barriers (...) to treatment due to Canada’s universal health care system. (shrink)

As we enter the twenty-first century, a new set of unexamined assumptions that may be labelled managerialism is coming to dominate university life. In spite of the changes that have been taking place, semantics have largely remained stable. As a result, there has been little recognition of a need to examine the transformation carefully and critically. This paper seeks to explicate the changes, show how they express a common managerialist philosophy and critically analyze them. It does so by dividing the (...) topics to be discussed into two sections: People and Program. The first section shows how conceptual assumptions in regard to central components of the university have changed. Students are now thought of as consumers, administrators as managers, trustees as directors and faculty as employee stakeholders. These conceptual renderings are consistent with and support a managerialist philosophy. The second section shows how a previously accepted bright line between education and training has broken down so that what we thought of as education has become little more than ornamentation for what are basically training programs. In addition, the training programs have achieved a semantic victory by persuading us to refer to them as education. The program change is fully consonant with the people changes. The academy has become one more instance of the general management philosophy that dominates our societies. We have lost our role as autonomous critics and uncritically become a component of the larger arrangement. (shrink)

While pain is common among seniors, it is not adequately treated or managed. In particular, pain in seniors with dementia is often undertreated and undermanaged. Although the undertreatment of pain among persons with cognitive impairments represents a serious ethical concern for pain clinicians, most writers in the area explain the undertreatment of pain by focusing on issues related to liability, fears of addiction to opioids, and erroneous beliefs that pain is a normal part of the ageing process. We argue that (...) the philosophical notion of personhood must also be given careful attention when considering the problem of pain undermanagement. In this paper, we consider the undertreatment of pain among seniors with dementia, while focusing on the ontology of relationships and on existential philosophy. Moreover, we outline a series of recommendations to help minimize the probability of pain undertreatment in this population and to encourage considerations relating to personhood when treating people with dementia. (shrink)