Deep brain stimulation — a novel surgical procedure — is emerging as a treatment of last resort for people diagnosed with neuropsychiatric disorders such as severe obsessive-compulsive disorder. The US Food and Drug Administration granted a so-called humanitarian device exemption to allow patients to access this intervention, thereby removing the requirement for a clinical trial of the appropriate size and statistical power. Bypassing the rigors of such trials puts patients at risk, limits opportunities for scientific discovery, and gives device manufacturers (...) unique marketing opportunities. We argue that Congress and federal regulators should revisit the humanitarian device exemption to ensure that it is not used to sidestep careful research that can offer valuable data with appropriate patient safeguards. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Precision targeting of specific white matter bundles that traverse the subcallosal cingulate has been linked to efficacy of deep brain stimulation for treatment resistant depression. Methods to confirm optimal target engagement in this heterogenous region are now critical to establish an objective treatment protocol. As yet unexamined are the time-frequency features of the SCC evoked potential, including spectral power and phase-clustering. We examined these spectral features—evoked power and phase clustering—in a sample of TRD patients with implanted SCC stimulators. Electroencephalogram was (...) recorded during wakeful rest. Location of electrical stimulation in the SCC target region was the experimental manipulation. EEG was analyzed at the surface level with an average reference for a cluster of frontal sensors and at a time window identified by prior study. Morlet wavelets generated indices of evoked power and inter-trial phase clustering. Enhanced phase clustering at theta frequency was observed in every subject and was significantly correlated with SCC-EP magnitude, but only during left SCC stimulation. Stimulation to dorsal SCC evinced stronger phase clustering than ventral SCC. There was a weak correlation between phase clustering and white matter density. An increase in evoked delta power was also coincident with SCC-EP, but was less consistent across participants. DBS evoked time-frequency features index mm-scale changes to the location of stimulation in the SCC target region and correlate with structural characteristics implicated in treatment optimization. Results also imply a shared generative mechanism between evoked potentials evinced by electrical stimulation and evoked potentials evinced by auditory/visual stimuli and behavioral tasks. Understanding how current injection impacts downstream cortical activity is essential to building new technologies that adapt treatment parameters to individual differences in neurophysiology. (shrink)

Background: Electroconvulsive therapy is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging. This study aims to compare rs-fMRI of depressive disorder patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states.Method: Resting-state functional magnetic resonance imaging data were (...) collected from 119 patients with depression or depressive disorder, and 61 healthy participants, with an age mean of 52.25 years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode and cognitive control network were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called “occupancy rate” or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants.Results: The main findings include depressive disorder patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network and default mode network was relatively higher than other states, Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes. This means that those DEP patients who spent less time in this state showed more HDRS change, and The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2.Conclusion: Our finding suggests that dynamic functional network connectivity features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients. (shrink)

This is the first complete, one-volume English translation of the ancient Chinese text Xunzi, one of the most extensive, sophisticated, and elegant works in the tradition of Confucian thought. Through essays, poetry, dialogues, and anecdotes, the Xunzi articulates a Confucian perspective on ethics, politics, warfare, language, psychology, human nature, ritual, and music, among other topics. Aimed at general readers and students of Chinese thought, Eric Hutton’s translation makes the full text of this important work more accessible in English than ever (...) before. Named for its purported author, the Xunzi has long been neglected compared to works such as the Analects of Confucius and the Mencius. Yet interest in the Xunzi has grown in recent decades, and the text presents a much more systematic vision of the Confucian ideal than the fragmented sayings of Confucius and Mencius. In one famous, explicit contrast to them, the Xunzi argues that human nature is bad. However, it also allows that people can become good through rituals and institutions established by earlier sages. Indeed, the main purpose of the Xunzi is to urge people to become as good as possible, both for their own sakes and for the sake of peace and order in the world. In this edition, key terms are consistently translated to aid understanding and line numbers are provided for easy reference. Other features include a concise introduction, a timeline of early Chinese history, a list of important names and terms, cross-references, brief explanatory notes, a bibliography, and an index. (shrink)

In 'Een handvol filosofen' staan de filosofen centraal die sinds de oprichting van de Vrije Universiteit in 1880 aan deze instelling verbonden zijn geweest. Het gaat hierbij niet alleen om de inhoud van hun werk, maar ook om de personen zelf. Er waren filosofiedocenten die zich met de universiteit identificeerden en zich volledig konden ontplooien. Er waren er echter ook voor wie dit niet gold, die geïsoleerd of in gewetensnood raakten. Veel filosofiestudenten waren actief betrokken bij wat er in hun (...) faculteit gebeurde. Zij namen initiatieven, protesteerden soms tegen de gang van zaken en kozen partij in conflictsituaties. Sinds het eind van de jaren zestig van de twintigste eeuw verloor de Vrije Universiteit geleidelijk haar christelijk karakter. Tegenwoordig werken alle stafleden vanuit hun eigen motivatie mee aan een hoofdzakelijk seculier geworden universiteit, die ruimte biedt voor religieuze en levensbeschouwelijke diversiteit. (shrink)

What role does the wild duck play in Ibsen's famous drama? I argue that, besides mirroring the fate of the human cast members, the duck is acting as animal subject in a quasi-experiment, conducted in a private setting. Analysed from this perspective, the play allows us to discern the epistemological and ethical dimensions of the new scientific animal practice (systematic observation of animal behaviour under artificial conditions) emerging precesely at that time. Ibsen's play stages the clash between a scientific and (...) a romantic understanding of animals that still constitutes the backdrop of most contemporary debates over animals in research. Whereas the scientific understanding reduces the animal's behaviour, as well as its environment, to discrete and modifiable elements, the romantic view regards animals as being at one with (or violently disconnected from) their natural surroundings. (shrink)

Introduction: Platonic dramatology -- The political and philosophical problems. Using pre-Socratic philosophy to support political reform: the Athenian stranger ; Plato's Parmenides: Parmenides' critique of Socrates and Plato's critique of Parmenides ; Becoming Socrates ; Socrates interrogates his contemporaries about the noble and good -- Paradigms of philosophy. Socrates' positive teaching ; Timaeus-Critias: completing or challenging Socratic political philosophy? ; Socratic practice -- The trial and death of Socrates. The limits of human intelligence ; The Eleatic challenge ; The trial (...) and death of Socrates -- Conclusion: Why Plato made Socrates his hero. (shrink)

Advances in neuroscience have revolutionized our understanding of the central nervous system. Neuroimaging technologies, in particular, have begun to reveal the complex anatomical, physiological, biochemical, genetic, and molecular organizational structure of the organ at the center of that system: the human brain. More recently, neuroimaging technologies have enabled the investigation of normal brain function and are being used to gain important new insights into the mechanisms behind many neuropsychiatric disorders. This research has implications for psychiatric diagnosis, treatment, and risk assessment. (...) However, with some exceptions, neuroimaging is still a research tool—not ready for use in clinical psychiatry. (shrink)

This article presents a response to Richard Rorty's paper "Is Philosophy Relevant to Business Ethics?" The author questions Rorty's views on the depreciation of the role of philosophy in applied ethics, and outlines four reasons why philosophy retains its relevance. The author addresses the role of moral reasoning in the development of the moral imagination. The author also concludes that humans have the means necessary to make moral progress and are capable of moral reasoning, and need only to develop a (...) strong moral imagination. (shrink)

In this paper, I will reread the history of molecular genetics from a psychoanalytical angle, analysing it as a case history. Building on the developmental theories of Freud and his followers, I will distinguish four stages, namely: (1) oedipal childhood, notably the epoch of model building (1943–1953); (2) the latency period, with a focus on the development of basic skills (1953–1989); (3) adolescence, exemplified by the Human Genome Project, with its fierce conflicts, great expectations and grandiose claims (1989–2003) and (4) (...) adulthood (2003–present) during which revolutionary research areas such as molecular biology and genomics have achieved a certain level of normalcy—have evolved into a normal science. I will indicate how a psychoanalytical assessment conducted in this manner may help us to interpret and address some of the key normative issues that have been raised with regard to molecular genetics over the years, such as ‘relevance’, ‘responsible innovation’ and ‘promise management’. (shrink)

In this philosophically sophisticated and historically significant work, John H. Zammito reconstructs Kant's composition of The Critique of Judgment and reveals that it underwent three major transformations before publication. He shows that Kant not only made his "cognitive" turn, expanding the project from a "Critique of Taste" to a Critique of Judgment but he also made an "ethical" turn. This "ethical" turn was provoked by controversies in German philosophical and religious culture, in particular the writings of Johann Herder and the (...) Sturm und Drang movement in art and science, as well as the related pantheism controversy. Such topicality made the Third Critique pivotal in creating a "Kantian" movement in the 1790s, leading directly to German Idealism and Romanticism. The austerity and grandeur of Kant's philosophical writings sometimes make it hard to recognize them as the products of a historical individual situated in the particular constellation of his time and society. Here Kant emerges as a concrete historical figure struggling to preserve the achievements of cosmopolitan Aufkl-rung against challenges in natural science, religion, and politics in the late 1780s. More specifically Zammito suggests that Kant's Third Critique was animated throughout by a fierce personal rivalry with Herder and by a strong commitment to traditional Christian ideas of God and human moral freedom. "A work of extraordinary erudition. Zammito's study is both comprehensive and novel, connecting Kant's work with the aesthetic and religious controversies of the late eighteenth century. He seems to have read everything. I know of no comparable historical study of Kant's Third Critique."-Arnulf Zweig, translator and editor of Kant's ;IPhilosophical Correspondence, 1759-1799;X "An intricate, subtle, and exciting explanation of how Kant's thinking developed and adjusted to new challenges over the decade from the first edition of the Critique of Pure Reason to the appearance of the Critique of Judgment. "--John W. Burbidge, Review of Metaphysics "There has been for a long time a serious gap in English commentary on Kant's Critique of Judgment Zammito's book finally fills it. All students and scholars of Kant will want to consult it."--Frederick Beiser, Times Literary Supplement. (shrink)

The present piece focuses on the influence of Plotinus' understanding of time and eternity as articulated in Plotinus' third and fifth Enneads upon Mīr Dāmād's (d. 1631–2) conception of eternity, perpetuity, and time found in his Book of Blazing Brands (Kitab al‐Qabasāt). Although Mīr Dāmād's conception of eternity, perpetuity, and time resembles that of Plotinus' cosmology and ontology, he departs from Plotinus' hypostases in establishing strict parameters for each domain. Unlike Plotinus, Mīr Dāmād argues that the realm of eternity is (...) reserved for God alone, while the realm of Perpetuity contains the Platonic Forms. For Mīr Dāmād, the realm of time is an effect of the realm of Perpetuity and a tool for human beings to understand how to measure events in the temporal world. Unlike many other Shī'ite philosophers, Mīr Dāmād's articulation of these three cosmological realms incorporates thought found in the works of both prominent Sunni and Shī'ite scholars such as Ibn Sīnā, Abū Ḥāmid al‐Ghāzālī, Suhrawardī, and Naṣīr al‐Dīn Ṭūsī. Although his most successful student, Mullā Ṣadrā Shirazī, had ultimately disagreed with his teacher's cosmological doctrine, he remained influenced by the multitude of sources that his teacher had used. (shrink)

Commentators disagree about the extent to which Kant’s ethics is compatible with consequentialism. A question that has not yet been asked is whether Kant had a view of his own regarding the fundamental difference between his ethical theory and a broadly consequentialist one. In this paper I argue that Kant does have such a view. I illustrate this by discussing his response to a well-known objection to his moral theory, namely that Kant offers an implicitly consequentialist theory of moral appraisal. (...) This objection was most famously raised by Mill and Schopenhauer, but also during Kant’s time by Pistorius and Tittel. I show that Kant’s response to this objection in the second Critique illustrates that he sees the fundamental difference between his moral theory and a broadly consequentialist one to be one that concerns methodology. (shrink)

Abstract:During recent years, the principle and practice of employment-at-will have been under attack. While progress has been made in eroding the practice, the principle still governs the philosophical assumptions underlying employment practices in the United States, and, indeed, EAW has been promulgated as one of the ways to address economic ills in other countries. This paper will briefly review the major critiques of EAW. Given the failure of these arguments to erode the underpinnings of EAW, we shall suggest new avenues (...) for approaching employment issues to achieve the desirable goal of employee dignity and respect. (shrink)

This groundbreaking volume casts light on the long shadow of naturalistic monism in modern thought and culture. When monism's philosophical proposition - the unity of all matter and thought in a single, universal substance - fused with scientific empiricism and Darwinism in the mid-nineteenth century, it led to the formation of a powerful worldview articulated in the work of figures such as Ernst Haeckel. The compelling essays collected here, written by leading international scholars, investigate the articulation of monism in science, (...) philosophy, and religion and its impact on a range of social movements, from socialism and early feminism to imperialism and eugenics. The result is a broad and comprehensive chronological, disciplinary, and geographic map of a century of monism, as well as a bellwether for innovative new directions in the interdisciplinary study of science, religion, philosophy, and culture. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from an ethical (...) perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)

What happens at the end of a clinical trial for an investigational neural implant? It may be surprising to learn how difficult it is to answer this question. While new trials are initiated with increasing regularity, relatively little consensus exists on how best to conduct them, and even less on how to ethically end them. The landscape of recent neural implant trials demonstrates wide variability of what happens to research participants after an neural implant trial ends. Some former research participants (...) continue to receive support for their devices (e.g., battery and component replacements, software updates, etc.). Others, when safe, have their neural implants removed through surgical explantation. Still others continue to live with a deactivated neural implant embedded in their body. In the United States, there are no uniform requirements to provide services, of any kind, after an neural implant study ends, and other nations are similarly facing this challenge. The existence of a post-trial gap in an expanding neural implant research ecosystem invites obvious questions: What is owed to neural implant research participants post-trial, and why has providing it been so difficult to accomplish in practice? To take a step forward on this difficult issue, we assembled one group of stakeholders – researchers funded for neuroethics grants by the National Institutes of Health – to explore possible starting points on one topic: ethical guidance for post-trial care of research participants in neural implant trials. Based on shared concerns discussed in the expert workshop the current paper is a call to action. It reports the key areas of convergence from the meeting and highlights important next steps towards developing much needed guidance. (shrink)

This is the first sustained, whole-Bible treatment on the theme of meeting God face to face. Starting with Genesis and ending with Revelation, the author systematically covers the major events in salvation history, all of which reveal the beauty of encountering God's grace in abundance.

In this book, Phillip Wiebe examines religious, spiritual, and mystical experiences, assessing how these experiences appear to implicate a spiritual order. Despite the current prevalence of naturalism and atheism, he argues that experiences purporting to have a religious or spiritual significance deserve close empirical investigation. Wiebe surveys the broad scope of religious experience and considers different types of evidence that might give rise to a belief in phenomena such as spirits, paranormal events, God, and an afterlife. He demonstrates that there (...) are different explanations and interpretations of religious experiences, both because they are typically personal accounts, and they suggest a reality that is often unobservable. Wiebe also addresses how to evaluate evidence for theories that postulate unobservables in general, and a Theory of Spirits in particular. Calling for more rigorous investigation of these phenomena, Wiebe frames the study of religious experience among other accepted social sciences that seek to understand religion. (shrink)