You Can\u27t Be Any Poorer Than Dead : Difficulties in Recognizing Artificial Nutrition and Hydration as Medical Treatments

The President\u27s Commission Report Deciding to Forego Life-Sustaining Treatment comes down squarely in favor of two propositions: 1) artificial provision of nutrition and hydration are medical treatments, and 2) as such, these medical treatments may be foregone by certain categories of patients or their proxies. This latter conclusion is based on roughly consequentialist grounds; the former is more assumed than argued. There is a school of thought opposed to both of these conclusions. After first demonstrating that nourishment is not medicine, a non-consequentialist or natural law argument is employed to show that nourishment may not be foregone insofar as it violates the principle, First, do no harm. I was once a member of this school, and this paper was to argue its position. In the end, however, this paper adopts the position that artificial provision of nourishment and hydration can be medical treatments, and as such may be foregone by certain categories of patients, without violating a natural law understanding of First, do no harm. Still, exposing my retained sympathies for my former position, the paper attempts to argue for a very careful standard for non-treatment. As a result, the argument of the paper takes four steps. First, I present the argument that artificial provision of nutrition is never medical treatment, giving as much strength to that argument as possible. Second, I show how the focus of that argument leads it astray, and that artificial provision of nourishment is medical treatment. Third, I try to show by what standard patients (or proxies) can legitimately forego this medical treatment. Fourth, I point out where my former position has valid criticisms of certain arguments used by those who hold that such treatment may be withdrawn, and urge great caution in deciding to forego treatment

Evaluation of commercially supplied silver coated Teflon for spacecraft temperature control usage

A series of tests are described which were performed to evaluate the acceptability of a commercially supplied silver backed teflon thermal control coating relative to teflon previously coated at GSFC. Optical measurements made on numerous samples indicate that the commercial material possesses an average solar absorptance of 0.085, an emittance of 0.76 and an average alpha/epsilon equal to 0.112, all of which are equivalent to the GSFC coated teflon. The emittance of the protective inconel backing was found to be 0.037. The coating is shown to have good adhesion at the Ag-teflon interface and exposure to UV irradiation uncovered no coating irregularities. Temperature cycling over the range -135 C to +200 C produced crazing in the evaporated Ag layer as expected but no delamination was observed. The suitability of Mystik no. 7366 and 3M no. 467 adhesives as bonding agents for the metallized polymer is demonstrated. Various problems associated with production reproducibility and selection of a proper bonding process are discussed

The effects of particle size on the optical properties and surface roughness of a glass-balloon-filled black paint

The effects of particle size on the optical properties and surface roughness of a glass-balloon-filled, carbon-pigmented paint were studied in order to develop a diffuse-reflecting, low-total-reflectance, low-outgassing black paint. Particle sizes ranged between 20 microns and 74 microns. Surface roughness was found to increase with increasing particle size. Relative total reflectance at near-normal incidence (MgO standard) of the filled paints was less than for the unfilled paint between 230 nm and 1800 nm. Total absolute reflectance at 546 nm decreased with increasing particle size at grazing angles of incidence. Near-normal, total emittance was greater for the filled paints than for the unfilled paint. Specularity decreased with increasing particle size over the range studied

The experience of community first responders in co-producing rural health care : in the liminal gap between citizen and professional

Non peer reviewedPublisher PD

New spin squeezing and other entanglement tests for two mode systems of identical bosons

For any quantum state representing a physical system of identical particles, the density operator must satisfy the symmetrization principle (SP) and conform to super-selection rules (SSR) that prohibit coherences between differing total particle numbers. Here we consider bi-partitite states for massive bosons, where both the system and sub-systems are modes (or sets of modes) and particle numbers for quantum states are determined from the mode occupancies. Defining non-entangled or separable states as those prepared via local operations (on the sub-systems) and classical communication processes, the sub-system density operators are also required to satisfy the SP and conform to the SSR, in contrast to some other approaches. Whilst in the presence of this additional constraint the previously obtained sufficiency criteria for entanglement, such as the sum of the ˆSx and ˆSy variances for the Schwinger spin components being less than half the mean boson number, and the strong correlation test of |haˆm (bˆ†)ni|2 being greater than h(aˆ†)maˆm (bˆ†)nbˆni(m, n = 1, 2, . . .) are still valid, new tests are obtained in our work. We show that the presence of spin squeezing in at least one of the spin components ˆSx , ˆSy and ˆSz is a sufficient criterion for the presence of entanglement and a simple correlation test can be constructed of |haˆm (bˆ†)ni|2 merely being greater than zero.We show that for the case of relative phase eigenstates, the new spin squeezing test for entanglement is satisfied (for the principle spin operators), whilst the test involving the sum of the ˆSx and ˆSy variances is not. However, another spin squeezing entanglement test for Bose–Einstein condensates involving the variance in ˆSz being less than the sum of the squared mean values for ˆSx and ˆSy divided by the boson number was based on a concept of entanglement inconsistent with the SP, and here we present a revised treatment which again leads to spin squeezing as an entanglement test

How Should Catholics Vote? Bringing Moral Principles to Life

As a follow-up to Pope John Paul II’s encyclical Evangelium vitae (The Gospel of Life), the Bishops of the United States released, in 1998, a remarkable (yet little remarked) document entitled “Living the Gospel of Life: A Challenge to American Catholics.” In November of 2002, the Congregation for the Doctrine of the Faith published a “Doctrinal Note on some questions regarding the participation of Catholics in political life,” which, after a momentary flurry, also slipped to the back of people’s minds. These documents contain centuries of wisdom, not only practical but speculative, on the nature of participation in the life of our cities, regions and nations. Of particular interest is their statement of the principles which should govern the participation of citizens--both directly as lawmakers, and indirectly through their representatives--and the clear assertion of the primacy of the protection of human life, and of those rights and freedoms necessary to our living humanly

The cost of systemic corticosteroid-induced morbidity in severe asthma : a health economic analysis

The study data-set was supported by the Respiratory Effectiveness Group through their academic partnership with Optimum Patient Care. Ciaran O'Neill was funded under a HRB Research Leader Award (RL/13/16).Peer reviewedPublisher PD