The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their liberty. We found that (...) no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

This paper ethically analyses arising out the proposed changes to the Mental Health Act for England and Wales. It looks in particular at thea shift in philosophy that the author claims has occurred with the proposals away from rights-focused principles to more utilitarian or outcome-focused principles. It gives examples of these changes and explores itstheir consequences.

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A questionnaire analysis (...) was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

Internet usage data from around the globe show that adolescents are the most frequent Internet users, but mostly for leisure activities and maintaining social contacts. In the present study, we focused on Internet use for e-services, which could improve youth efficiency in the financial domain and bridge the online divide in youth. Specifically, we explored how societal constructs influence the use of the Internet for online shopping, e-banking and communication with providers of goods and services online. We used a representative (...) sample of adolescents from 10 countries of Southeast Europe where a great variability in Internet use is present, and where the use of e-services is generally lower than the EU average. This also allowed for meaningful cross-country comparisons. We tested a structural equation model of values predicting the use of the Internet through institutional trust which was grounded in social capital theory, cultural theory and Schwartz human values model. The model exhibited a good fit to the data but the strengths of regressional paths were rather modest. Looking into the cross-country stability of the model, however, revealed some notable differences: while the relationship between trust and use of the Internet for e-services was modest in some countries, the relationship was insignificant in other countries, where Internet usage is lower in general. This suggests that strategies aimed at leveraging e-services and digital technology potential in youth should also account for cultural specificities in the transitional economies and cultural settings with sub-optimal adoption of digital services. (shrink)

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral (...) dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making. (shrink)

The incredible achievements of modern scientific theories lead most of us to embrace scientific realism: the view that our best theories offer us at least roughly accurate descriptions of otherwise inaccessible parts of the world like genes, atoms, and the big bang. In Exceeding Our Grasp, Stanford argues that careful attention to the history of scientific investigation invites a challenge to this view that is not well represented in contemporary debates about the nature of the scientific enterprise. The historical record (...) of scientific inquiry, Stanford suggests, is characterized by what he calls the problem of unconceived alternatives. Past scientists have routinely failed even to conceive of alternatives to their own theories and lines of theoretical investigation, alternatives that were both well-confirmed by the evidence available at the time and sufficiently serious as to be ultimately accepted by later scientific communities. Stanford supports this claim with a detailed investigation of the mid-to-late 19th century theories of inheritance and generation proposed in turn by Charles Darwin, Francis Galton, and August Weismann. He goes on to argue that this historical pattern strongly suggests that there are equally well-confirmed and scientifically serious alternatives to our own best theories that remain currently unconceived. Moreover, this challenge is more serious than those rooted in either the so-called pessimistic induction or the underdetermination of theories by evidence, in part because existing realist responses to these latter challenges offer no relief from the problem of unconceived alternatives itself. Stanford concludes by investigating what positive account of the spectacularly successful edifice of modern theoretical science remains open to us if we accept that our best scientific theories are powerful conceptual tools for accomplishing our practical goals, but abandon the view that the descriptions of the world around us that they offer are therefore even probably or approximately true. (shrink)

The place of the emotions among the passions -- The analytic of the emotions I -- The analytic of the emotions II -- The dialectic of the emotions -- Pride, arrogance, and humility -- Shame, embarrassment, and guilt -- Envy -- Jealousy -- Anger -- Love -- Friendship -- Sympathy and empathy.

The concept of normal is so familiar that it can be hard to imagine contemporary life without it. Yet the term entered everyday speech only in the mid-twentieth century. Before that, it was solely a scientific term used primarily in medicine to refer to a general state of health and the orderly function of organs. But beginning in the middle of the twentieth century, normal broke out of scientific usage, becoming less precise and coming to mean a balanced condition to (...) be maintained and an ideal to be achieved. In Normality, Peter Cryle and Elizabeth Stephens offer an intellectual and cultural history of what it means to be normal. They explore the history of how communities settle on any one definition of the norm, along the way analyzing a fascinating series of case studies in fields as remote as anatomy, statistics, criminal anthropology, sociology, and eugenics. Cryle and Stephens argue that since the idea of normality is so central to contemporary disability, gender, race, and sexuality studies, scholars in these fields must first have a better understanding of the context for normality. This pioneering book moves beyond binaries to explore for the first time what it does—and doesn’t—mean to be normal. (shrink)

An Interdisciplinary Approach to Cognitive Modelling presents a new approach to cognition that challenges long-held views. It systematically develops a broad-based framework to model cognition, which is mathematically equivalent to the emerging 'quantum-like modelling' of the human mind. The book argues that a satisfactory physical and philosophical basis of such an approach is missing, a particular issue being the application of quantization to the mind for which there is no empirical evidence as yet. In response to this issue, the book (...) adopts a COM (classical optical modelling) approach, broad-based but mathematically equivalent to quantum-like modelling while avoiding its problematic features. It presents a philosophically informed and empirically motivated mathematical model of cognition, mainly concerning decision making processes. It also deals with applications to different areas of the social sciences. It will be of interest to scholars and research students interested in the mathematical modelling of cognition and decision making, and also interdisciplinary researchers interested in broader issues of cognition. (shrink)

This study concerns the ideas of one particular philosopher, Henri Bergson, whose views of time, intuition, and creativity have had a significant impact on art, literature, and the humanities, both in his time and in our own. Although it is generally recognized that Bergson's ideas have significantly impacted the arts and the humanities, it has not been recognized how they have also had a creative influence on the sciences as well. Nor has it been realized that this was one of (...) his most basic contentions. Bergson's conception of intuition--his fundamental insight into reality--was not limited to fugitive insights into human existence. By realizing previously unsuspected possibilities for research and discovery, his endeavors were also meant to make possible new advances in the sciences. If it enabled his cousin by marriage, Marcel Proust, to explore human memory in depth, it also inspired psychologists like Daniel Schachter to use Bergson's ideas to make real contributions to contemporary memory science. If his notion of creative evolution brought many thinkers to a belief in human creative freedom, it brought others (notably Alexis Carrel and Pierre Lecomte de Noüy) to a scientific study of biological time. Among his successful speculations was the theory of the Big Bang cosmology. 'Getting Bergson Straight' shows many points at which Bergson's ideas anticipated future developments in the sciences. This was seen clearly by the Nobel Prize-winning physicist Luis de Broglie who viewed Bergson's physics as presaging quantum physics. Thus, the text is well situated for arts, humanities, social science, and natural science classrooms studying creative thinking and/or intellectual history. (shrink)

Profoundly important ethical and political controversies turn on the question of whether biological life is an essential aspect of a human person, or only an extrinsic instrument. Lee and George argue that human beings are physical, animal organisms - albeit essentially rational and free - and examine the implications of this understanding of human beings for some of the most controversial issues in contemporary ethics and politics. The authors argue that human beings are animal organisms and that their personal identity (...) across time consists in the persistence of the animal organisms they are; they also argue that human beings are essentially rational and free and that there is a radical difference between human beings and other animals; criticize hedonism and hedonistic drug-taking; present detailed defenses of the prolife positions on abortion and euthanasia; and defend the traditional moral position on marriage and sexual acts. (shrink)

Do the ethical features of an artwork bear on its aesthetic value? This movie endorses misogyny, that song is a civil rights anthem, the clay constituting this statue was extracted with underpaid labor—are facts like these the proper bases for aesthetic evaluation? I argue that this debate has suffered from a false presupposition: that if the answer is yes (for at least some such ethical features), such considerations feature as pro tanto contributions to an artwork's overall aesthetic value, i.e., as (...) merits or flaws which make something have more or less overall aesthetic value. As the case of ethically laden, aesthetic evaluation makes clear, however, good aesthetic judgement is irreducibly multi-dimensional, e.g., "the movie has an engaging soundtrack, tasteful camera work, and takes a misogynistically prurient perspective on its female lead.'' Such a "non-summative" judgement refuses to reduce those various dimensions of aesthetic value to a single aggregate aesthetic evaluation, like "it's a 6/10" or "it's a pretty good movie!" I defend both the modest claim that such non-summative evaluations are not mistaken and the extremist claim that summative (i.e., unidimensional) aesthetic evaluation is defective by considering other domains of normative assessment in which summing seems inappropriate, notably including evaluations of people's character. (shrink)

This practical and essential text, co-authored by an engineer and an ethicist, covers ethical dilemmas that any engineer might encounter on the job, emphasizing the responsibility of a practicing engineer to act in an ethical manner. To illustrate the complexities involved, the authors present characters who encounter situations that test the engineering code of ethics. The dialogue between the characters highlights different perspectives of each dilemma. As they proceed through the book, students see how the code of ethics can help (...) in decision making, as well as the implications of various decisions. The philosophical theory that supports the ethical situations encountered is presented as boxed material following each section. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

In worlds that lack life, there is no value. For all that, there is no mystery about 'the existence of values in a world of facts'. The world does not consist of facts, rather true descriptions of the world consist of statements of fact. It is as much a fact concerning the world that there are things that are of value to living things, that human beings value things and possess valuable characteristics, perform valuable deeds, stand in valuable relationships to (...) others, as it is a fact that there is life on earth. (shrink)

A critical note on Christopher Bartel and Jack M. C. Kwong, ‘Pluralism, Eliminativism, and the Definition of Art’, Estetika 58 (2021): 100–113. Art pluralism is the view that there is no single, correct account of what art is. Instead, art is understood through a plurality of art concepts and with considerations that are different for particular arts. Although avowed pluralists have retained the word ‘art’ in their discussions, it is natural to ask whether the considerations that motivate pluralism should lead (...) us to abandon art talk altogether; that is, should pluralism lead to eliminativism? This paper addresses arguments both for and against this move. We ultimately argue that pluralism allows one to retain the word ‘art’, if one wants it, but only in a loose, conversational sense. The upshot of pluralism is that talk of art in general cannot be asked to do theoretical and philosophical work. (shrink)

" In a book that seeks to shift the ground of debate within theory of knowledge, William P. Alston finds that the century-lo.

In lieu of an abstract, here is a brief excerpt of the content:Burma’s Healthcare Under Fire: My Experience as an Exiled Medical ProfessionalP. P. KyawI used to work as a medical doctor in a less developed state than many big cities in Burma1 that experienced prolonged civil wars and current similar atrocities decades before the urban areas of the country experienced them. Before everything started, I was responsible for the medical management of the most vulnerable communities and had been struggling (...) with pandemic-related medical activities. Those were the happiest years of my life. I was with one of the best international organizations, where every effort I made was directly delivered to the patients with no unnecessary paperwork. The system was efficient, my colleagues were supportive, and I had a good work-life balance. I supported my family and whoever needed temporary financial support, played music weekly, met good friends who I hung out with every weekend, and [End Page 164] found hobbies like gardening and crocheting. I was content and happy. I even postponed my plans to get registered as a doctor in the Western world.Before moving to this beautiful ethnic state in 2019, I previously worked as a government medical doctor in Yangon, the capital. As much as I loved working in those civilian hospitals, I could not support myself with a monthly pay of $100-$150 USD. It was a hard decision to leave the service because it meant I could not pursue the medical specialty that I had always longed for and had to leave like-minded supportive colleagues. In Myanmar, unless you are a civil servant, you cannot pursue further clinical specialties. However, after leaving the government’s service to work in humanitarian medical assistance in hard-to-reach areas of Burma, I learned that life is still beautiful outside my comfort zone, until February 2021 when the coup began. Democratically elected members of the country’s ruling party were overthrown by the military, which then bestowed power in a military junta.I expected the election prior to the coup in November 2020 to be an uphill battle for Burma, but nothing more. I was still in denial when I first heard the news from one of the town’s NGO staff. The person had to travel on a motorbike to inform everyone that the junta had staged the coup. No telephone or internet was working at that time. My colleagues and I cried in our office, saying, “We are so young, and the future is still ahead. I don’t think this is going to last long. Maybe it will be over in a few days or, at most, a few weeks.” Once the peaceful protests started nationwide, my friends and I provided medical cover for the protesters, initially for minor medical problems such as low sugar, low blood pressure, injuries from accidental minor slips and falls, etc. Never in my life had I imagined that I would be taking care of bullet wounds and people injured by live rounds. While learning about gunshot wounds in forensic medicine, I thought, “Oh, this is not going to be very useful because Burma is not America, and I am not going there.” Then suddenly, it became too real and more useful than I would’ve liked it to be.I always think back to one especially bloody day when many people in the town were shot with live rounds. We assisted many patients. Usually, we would go around with the protest groups until they were over in the late afternoon. The protesters were always peaceful. There were no riots, no harmful acts, or vandalism. Only when the protesters were cruelly dispersed with tear gas, high-pressure pumps, rubber bullets, and live rounds (to the head) did they decide to defend themselves while still making their voices heard. The only defenses people had to counteract the live rounds were things like metal covers, firecrackers, and slingshots.One afternoon in March 2021, my team and I took an early break for lunch—unaware that some people would lose their lives that afternoon. We followed the local protests through Facebook Live while having lunch and started to hear firecracker sounds. A few seconds later, we knew... (shrink)

This book examines the relationship between law and scientific advancement, with a particular focus on the theory of evolution and medical innovation. Historically, the law has struggled to keep pace with modern medical advances. The authors demonstrate that the laws that govern human behaviour must evolve in response to such advances."--Provided by publisher.

The author asks to what extent a knowledge of the concepts of yoga may prepare the way to a better understanding of Indian archaeology. The yoga at the basis of this study is that which forms the core of the Tantras. In the first chapter the author surveys the system of Tantrik yoga. He then continues with a discussion of the various forms of yantras, that is all the means employed by yogis in their meditational exercises as aids to the (...) concentration of thought. The author provides in-depth studies of ritual objects of the Lamaistic cult in Tibet and Nepal, the sacred cemeteries of Nepal, and pantheons in Java and Bali. (shrink)

Did the Greeks believe in their mythology? The answer is difficult, for “believe” means so many things… Not everyone believed that Minos continued to be a judge in Hell or that Theseus defeated the Minotaur, and they knew that poets “lie.” Nevertheless, their manner of not believing gave reason for concern, for Theseus was no less real in their eyes. It is simply necessary to “purify myth with reason’“ and to reduce the biography of the companion of Hercules to its (...) historic kernel. As for Minos, after a prodigious mental effort, Thucydides extracts the same kernel from his subject: “Of all those whom we know only by hearsay, Minos was the first to have a fleet.” The father of Phaedra, the husband of Pasiphaë is nothing more than a king who was master of the sea. The purification of the mythical by the logos is not an episode in the eternal struggle, from the beginning to Voltaire and Renan, between superstition and reason, a struggle which was the glory of Greek genius. The myth and the logos, despite Nestle, are not simple opposites like truth and error. Myth was a subject of serious reflections, and the Greeks had not yet finished with it six centuries after the Sophist movement which has been called their Aufklärung. Far from being a triumph of reason, the purging of myth by logos is a very dated program whose absurdity is surprising. Why did the Greeks make themselves unhappy for nothing by seeking to separate the wheat from the chaff instead of rejecting in one gesture the fantasy of both Theseus and the Minotaur, the very existence of a fabulous Minos as well as the implausible qualities with which the myth endows this Minos? (shrink)

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

In this engaging and spirited text, Michael Lynch argues that truth does matter, in both our personal and political lives. He explains that the growing cynicism over truth stems in large part from our confusion over what truth is.

Our aim in this entry is to articulate the state of the art in the moral psychology of personal identity. We begin by discussing the major philosophical theories of personal identity, including their shortcomings. We then turn to recent psychological work on personal identity and the self, investigations that often illuminate our person-related normative concerns. We conclude by discussing the implications of this psychological work for some contemporary philosophical theories and suggesting fruitful areas for future work on personal identity.

This chapter contains section titled: Baker's New Conception Waismann and Wittgenstein Wittgenstein on the Psychoanalytic Analogy Wittgenstein's Methodology Reconsidered Wittgenstein and Ryle 1: Categorial Confusions Wittgenstein and Ryle 2: Logical Geography Baker's Wittgenstein.

Dit boek is een inleiding in het denken over recht en staat met een zwaar accent op de vraag hoe de staat om moet gaan met religie. 0Paul Cliteur en Afshin Ellian zijn hoogleraar encyclopedie van de rechtswetenschap aan de universiteit van Leiden.