The doctrine of ‘the consent of the governed in Plato

In Ploto today, R.H Crossman conclude that Plat would have abjured the three major forms of government on which the Greek philosopher was invited to comment during his imaginary tour of the twentieth century. Plato was seen to reject Anglo-American democracy, soviet communism, and European fascism. He rejected these ideals for on basic reason; they all assumed that happiness and social well-being were attained by all men in material security and political equality. A “dictatorship of the best which displaced political equality by benevolent paternalism was more in keeping with Plato’s own ideal. Crossman implied that Plato’s model for social well-being was more akin to the English squirearchy of the eighteenth centry, or, indeed, to feudal models than to anything we know in present history. Plato’s ‘squirearchy’, of course, would not be a landed gentry. It would be an aristocracy, - but an aristocracy of the mind. But –we hear Crossman wondering –are we then forbidden from identifying Plato’s model with anything we know from our own past? While it is true that Pluto’s idealism forces us to place his model outside actual history, it is also true that he little supposed that his ideal aristocracy could emerge from any social class but the old Athenian ‘gentry’ whose political influence had been eroded away by the rise of democratic life and the instability that marked it. Crossman thus observed an element in Plato’s thinking that would be root and branch of K.R Popper’s indictment: Plato’s unwonted distrust of the ordinary man. But what Crossman saw as a romantic pessimism akin to the worst fears of W.B Yeats, Popper saw as a high flown cynicism, hateful to fellow feeling and detestable to all moral goodness. Crossman wrote on the eve of the storm that was to break in Europe in the late 1930’s. Popper, driven by racial mania from his own land, wrote at the height of the storm’s violence. In The Open Society and its enemies, Popper saw Plato as the avowed enemy of the moral sanction and trust that must underlie a responsible and free society. He saw Plato as one who sacrificed individual dignity to a groundless theory of ‘natural kinds’. In so doing, Popper believed, Plato was setting up a wholly unverifiable theory of historical destiny –a theory that was not only unverifiable but morally repugnant as well. Popper’s critique was incisive, topical, and passionate. What Crossman had seen as an out-moded paternalism which was insufficient to the needs either of Plato’s time or of our own, Popper conceded as the ferocious megalomania born of a small man’s distrust and selfish conceit. In their different ways, both authors believed that Plato had wholly misunderstood the piety and the profound bravery of Socrates, a man whom both regarded as a martyr to moral conscience. In the deepest sense possible, Socrates was indeed both martyr prejudice to shame. For Crossman he was an inevitable figure, a hero who will always be with us. For Popper he was a stalwart and unflinching man whose very goodness was disgracefully converted by Plato to the vilest of ends. This thesis does not intend either to dispose of or to prove the well considered beliefs beliefs of either Crossman or Popper, two of this century’s most incisive critics of Plato. My object in presenting this theses is more humble. I intend only to consider the growth and the Socratic provenance of Plato's doctrine of political consent. Plato's doctrine of the consent of the governed will be seen to grow from an ideal of personal commitment to moral obligation to an ideal of the perfected state. I believe that we find in Socrates' notion of consent every element basic to the choice a free man makes in obeying laws. But the Socratic teaching would, with whatever result, inspire Plato toward a theory of political idealism which exalts the free man, in imagined historical time, above his fellows. This thesis will have accomplished its purpose if we can trace out Plato's metamorphosis of Socrates from citizen to ruler, while giving due attention at the same time to the theory of political consent which accompanied the change we mention here. While no subject In the Platonic corpus receives more attention than the humanity or the Inhumanity of Plato's politics, I know of no sustained attempts to describe the growth and development of his doctrine of political consent. That doctrine must be basic to all judgements of value we choose to pass upon its author

Stationarity-conservation laws for certain linear fractional differential equations

The Leibniz rule for fractional Riemann-Liouville derivative is studied in algebra of functions defined by Laplace convolution. This algebra and the derived Leibniz rule are used in construction of explicit form of stationary-conserved currents for linear fractional differential equations. The examples of the fractional diffusion in 1+1 and the fractional diffusion in d+1 dimensions are discussed in detail. The results are generalized to the mixed fractional-differential and mixed sequential fractional-differential systems for which the stationarity-conservation laws are obtained. The derived currents are used in construction of stationary nonlocal charges.Comment: 28 page

Survival Rates in Trauma Patients Following Health Care Reform in Massachusetts

IMPORTANCE: Massachusetts introduced health care reform (HCR) in 2006, expecting to expand health insurance coverage and improve outcomes. Because traumatic injury is a common acute condition with important health, disability, and economic consequences, examination of the effect of HCR on patients hospitalized following injury may help inform the national HCR debate. OBJECTIVE: To examine the effect of Massachusetts HCR on survival rates of injured patients. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 1,520,599 patients hospitalized following traumatic injury in Massachusetts or New York during the 10 years (2002-2011) surrounding Massachusetts HCR using data from the State Inpatient Databases. We assessed the effect of HCR on mortality rates using a difference-in-differences approach to control for temporal trends in mortality. INTERVENTION: Health care reform in Massachusetts in 2006. MAIN OUTCOME AND MEASURE: Survival until hospital discharge. RESULTS: During the 10-year study period, the rates of uninsured trauma patients in Massachusetts decreased steadily from 14.9% in 2002 to 5.0.% in 2011. In New York, the rates of uninsured trauma patients fell from 14.9% in 2002 to 10.5% in 2011. The risk-adjusted difference-in-difference assessment revealed a transient increase of 604 excess deaths (95% CI, 419-790) in Massachusetts in the 3 years following implementation of HCR. CONCLUSIONS AND RELEVANCE: Health care reform did not affect health insurance coverage for patients hospitalized following injury but was associated with a transient increase in adjusted mortality rates. Reducing mortality rates for acutely injured patients may require more comprehensive interventions than simply promoting health insurance coverage through legislation

Impact of date stamping on patient safety measurement in patients undergoing CABG: Experience with the AHRQ Patient Safety Indicators

<p>Abstract</p> <p>Background</p> <p>The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) provide information on hospital risk-adjusted rates for potentially preventable adverse events. Although designed to work with routine administrative data, it is unknown whether the PSIs can accurately distinguish between complications and pre-existing conditions. The objective of this study is to examine whether the AHRQ PSIs accurately measure hospital complication rates, using the data with present-on-admission (POA) codes to distinguish between complications and pre-existing conditions</p> <p>Methods</p> <p>Retrospective cohort study of patients undergoing isolated CABG surgery in California conducted using the 1998–2000 California State Inpatient Database. We calculated the positive predictive value of selected AHRQ PSIs using information from the POA as the gold standard, and the intra-class correlation coefficient to assess the level of agreement between the hospital risk-adjusted PSI rates with and without the information contained in the POA modifier.</p> <p>Results</p> <p>The false positive error rate, defined as one minus the positive predictive value, was greater than or equal to 20% for four of the eight PSIs examined: decubitus ulcer, failure-to-rescue, postoperative physiologic and metabolic derangement, and postoperative pulmonary embolism or deep venous thrombosis. Pairwise comparison of the hospital risk-adjusted PSI rates, with and without POA information, demonstrated almost perfect agreement for five of the eight PSI's. For decubitus ulcer, failure-to-rescue, and postoperative pulmonary embolism or DVT, the intraclass-correlation coefficient ranged between 0.63 to 0.79.</p> <p>Conclusion</p> <p>For some of the AHRQ Patient Safety Indicators, there are significant differences in the risk-adjusted rates of adverse events depending on whether the POA indicator is used to distinguish between pre-existing conditions and complications. The use of the POA indicator will increase the accuracy of the AHRQ PSIs as measures of adverse outcomes.</p

Towards a framework for critical citizenship education

Increasingly countries around the world are promoting forms of "critical" citizenship in the planned curricula of schools. However, the intended meaning behind this term varies markedly and can range from a set of creative and technical skills under the label "critical thinking" to a desire to encourage engagement, action and political emancipation, often labelled "critical pedagogy". This paper distinguishes these manifestations of the "critical" and, based on an analysis of the prevailing models of critical pedagogy and citizenship education, develops a conceptual framework for analysing and comparing the nature of critical citizenship