ObjectiveBulimia nervosa and binge eating disorder are eating disorders characterized by recurrent binge eating episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our objective was to examine (...) the neural responses to both low energy and high energy food images in three emotive categories in BN and BED participants.MethodsNineteen females with BN or BED, comprising the binge eating group, and 19 age-matched healthy control ’s completed thorough clinical assessment prior to functional MRI. Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate.ResultsIn response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC’s, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC’s had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images.ConclusionResults in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI’s except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode. (shrink)

Die Reihe Monographien und Texte zur Nietzsche-Forschung (MTNF) setzt seit mehreren Jahrzehnten die Agenda in der sich stetig verändernden Nietzsche-Forschung. Die Bände sind interdisziplinär und international ausgerichtet und spiegeln das gesamte Spektrum der Nietzsche-Forschung wider, von der Philosophie über die Literaturwissenschaft bis zur politischen Theorie. Die Reihe veröffentlicht Monographien und Sammelbände, die einem strengen Peer-Review-Verfahren unterliegen. Die Buchreihe wird von einem internationalen Redaktionsteam geleitet.

During an initial palliative care assessment, a dying man discloses that he had killed several people whilst a young man. The junior doctor, to whom he revealed his story, consulted with senior palliative care colleagues. It was agreed that legal advice would be sought on the issue of breaching the man’s confidentiality. Two legal opinions conflicted with each other. A decision was made by the clinical team not to inform the police.In this article the junior doctor, the palliative medicine specialist, (...) a medical ethicist, and a lawyer consider the case from their various perspectives. (shrink)

Volume 3, Issue 1, March 2019, Page 95-99.

In New Zealand an advance directive can be either an oral statement or a written document. Such directives give individuals the opportunity to make choices about future medical treatment in the event they are cognitively impaired or otherwise unable to make their preferences known. All consumers of health care have the right to make an advance directive in accordance with the common law. When we consider New Zealand's rapidly ageing population, the fact that more people now live with and die (...) of chronic rather than acute conditions, the importance given to respecting autonomous decision-making, increasing numbers of individuals who require long-term residential care, and financial pressures in the allocation of medical resources, there would seem to be a number of compelling reasons to encourage individuals to write or verbalise an advance directive. Indeed the promotion of advance directives is encouraged. However, caution should be exercised in promoting advance directives to older people, especially in light of several factors: ageist attitudes and stereotypes towards them, challenges in the primary healthcare setting, and the way in which advance directives are currently focused and formulated. This paper considers some of the specific challenges that need to be addressed if the promotion of advance directives are to improve outcomes of patient treatment and care near the end of life. (shrink)

This case concerns aspects of the treatment of a post-surgical patient in a major public hospital in New Zealand during the author's experiences as a fourth year medical student. This case is used to consider the interlinked ethical issues of sympathy, moral virtue, dignity and how the medical environment can realign these values.

:This article describes the well-developed and long-standing medical ethics teaching programs in both of New Zealand’s medical schools at the University of Otago and the University of Auckland. The programs reflect the awareness that has been increasing as to the important role that ethics education plays in contributing to the “professionalism” and “professional development” in medical curricula.

One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) completed a (...) questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the ‘four principles’ determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in ‘real’ settings and this information may help educators prepare students for these clinical ethical dilemmas. (shrink)

Evolutionary science (ES) and contextual behavioral science (CBS) have developed largely independently during the last half century. However, the earlier histories of these two bodies of knowledge are thoroughly entwined. ES provides a unifying theoretical framework for the biological sciences, and is increasingly being applied to human-related sciences. Meanwhile, CBS is concerned with influencing human behavior in a practical sense. This groundbreaking volume seeks to integrate ES and CBS to promote real, positive change in peoples' lives. Evolution and Contextual Behavioral (...) Science offers a unique glimpse into the histories of ES and CBS, shows how they are intrinsically linked, and outlines why their integration--or, reunification--is essential. By examining these two schools of thought side by side, you'll gain an understanding of why functional and contextual approaches in CBS need to be combined with ES for both fields to advance more rapidly. Finally, rather than the sequential relationship that is typically imagined between ES and CBS, you'll discover how an integrated relationship between these two sciences will result in a better framework for understanding predicting, and influencing human behavior--back cover. (shrink)

Schmidt and Egler's critique of Christianity's exclusivist claim to truth rests on two suppositions: (a) that inter-religious pastoral care for dying patients requires a respect for their cultural backgrounds which necessitates accepting the equal validity of their respective (non-Christian) religions, and (b) that exclusivism is incompatible with the Christian love-of-neighbor commandment. In opposition to this critique, (a) the authors' own “pluralist” understanding of Christianity is refuted on two levels. First, it leads to inconsistencies in the authors' own (and very adequate) (...) understanding of pastoral care, especially with regard to their notion of intolerance, and second, it is irreconcilable with explicit New and Old Testament claims to absoluteness. In addition, (b) the authors' understanding of the way in which “exclusivism” justifies intolerance and missionary violence is shown to rest, first, on a secularized reduction of Christianity, i.e., of Christians' own “religious identity” as well as of the Christian way of “helping those in need,” and second, on a merely theoretical (rather than also practical) view of Christians' commitment to God. As a corollary to that refutation, a reconsideration of the truly Christian sources of obedience and charity is recommended. (shrink)

Corinna Delkeskamp-Hayes; Christian Credentials for Roman Catholic Health Care: Medicine versus the Healing Mission of the Church, Christian bioethics: Non-Ecum.

Patristic teaching about sin and disease allows supplementing well-acknowledged conditions for a Christian medicine with further personal challenges, widely disregarded in Western Christianities. A proper appreciation of man's vocation toward (not just achieving forgiveness but) deification reveals the need to cooperate with the Holy Spirit's offer of grace toward restoring man's prefallen nature. Ascetical exercises designed at re-establishing the spirit's mastery over the soul distance persons from (even supposedly harmless) passion. They thus inspire the struggle towards emulating Christ's (self-crucifying) kenotic (...) love, and to accept even secularly “undeserved” suffering as spiritually deserved in view of his (forever) lacking fervor in that struggle. Only in the spirit of that love can the evil Adam's sin brought into this world work its therapeutic impact, the eschatological purpose of which explains God's lovingly permitting that evil. This therapeutic impact is physically manifested already in this life through the transforming energies granted the saints of the church. (shrink)

This introduction explores the relationship between Europe and its Christianities. It analyses different diagnostic and evaluative approaches to Europe's Christian or post-Christian identity. These are grouped around the concepts of diverse traditional, and, on the other hand, post-Enlightenment Christianities. While the first revolves around a liturgical and mystical account of the church, a Christ-centred humanism, an emphasis on man's future life, noetic theology and a foundationalist claim to universal truth, the second endorses a moralization of the “Christian message,” political implementation (...) of “Christian goals,” rationalism, a this-worldly humanism, and tolerance for religious diversity. Since even the concepts of “traditional” and “post-Enlightenment” Christianity turn out to be deeply ambiguous, the essay concludes with exploring the different ways in which the Christianity of the Apostolic Church, the Enlightenment (along with the “Western” Christianities it shaped), and contemporary liberalism each conceive of their respective endorsements of human freedom as either normative, that is obligatory, value-laden, or contingent, and arbitrary. In each case, a different notion of “tradition” (as well as familial and church authority) is placed either in harmony or in opposition to such freedom. As a result of this conceptual analysis, the deeply fractured identity of Europe, as exemplified by the diverse bioethical positions adopted by the authors in this issue, becomes visible. (shrink)

Paternal authority is recommended as a valid Christian resource for conflict resolution in biomedical (and other inner-familial) decision making. Its bases are explored in view of the two-fold creation account in Genesis, interpreted in the light of the Pauline theology. In addition, a theological account is proposed that portrays the taxis between husband and wife as a condition under which humans can seek to emulate the inner-Trinitarian love. The relationship between that love (as portrayed in St. Basil’s On the Holy (...) Spirit), the love between God and man, and the love between the sexes (as further extended to the children in a family that constitutes a “small church”), is described in terms of an interplay between the Divine offer of grace and the human response of obedience. In framing their marital love according to the model of Christ and His Church, couples can also profit from the ascetical therapy predicted for their fallen nature in the “curse” that drove our forefathers from Paradise. (shrink)

Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

Corinna Delkeskamp-Hayes; Sin and Disease: An Introduction, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 12, Issue 2, 1 January 2006.

In this paper I argue that, in addition to having an obligation to resist the oppression of others, people have an obligation to themselves to resist their own oppression. This obligation to oneself, I argue, is grounded in a Kantian duty of self-respect.

One of the lamentable characteristics of our contemporary age is the way in which abortion has been adopted as a natural part of the culture. This essay describes this adoption as a symptom of that culture’s profound de-Christianization. As that culture sheds its once Christian commitments, persons change the way in which they relate to their body in its sexually differentiated physiology, its physical drives and impulses. They refashion their sense of human flourishing, their vision of women’s social role, the (...) value they place on education, career, and economic well-being, and their understanding of reproductive responsibility. This de-Christianization is not sufficiently appreciated in a nominally still “Christian culture.” Such blindness reflects an inability to distinguish Christian commitments from moral commitments, which, although framed in terms that are compatible with Christian meanings, are equally open to meanings affirming the idolatry informing secular humanism. De-Christianization is not the same as de-moralization. This essay explores the way in which the new moral norms about sexuality, about education and career opportunities for women, authority within marriage, the role of this-worldly well-being and human suffering all contribute to our culture’s complacency in view of abortion. The underlying concern is to illustrate how a morality (even a morality of human sympathy and solidarity) that is not anchored in a genuine Tradition-affirming Christian conduct of life leads away from Christ, and how only a return to that conduct can heal our “culture of death.”. (shrink)

Humans possess great capacity for behavioral and cultural change, but our ability to manage change is still limited. This article has two major objectives: first, to sketch a basic science of intentional change centered on evolution; second, to provide examples of intentional behavioral and cultural change from the applied behavioral sciences, which are largely unknown to the basic sciences community.All species have evolved mechanisms of phenotypic plasticity that enable them to respond adaptively to their environments. Some mechanisms of phenotypic plasticity (...) count as evolutionary processes in their own right. The human capacity for symbolic thought provides an inheritance system having the same kind of combinatorial diversity as does genetic recombination and antibody formation. Taking these propositions seriously allows an integration of major traditions within the basic behavioral sciences, such as behaviorism, social constructivism, social psychology, cognitive psychology, and evolutionary psychology, which are often isolated and even conceptualized as opposed to one another.The applied behavioral sciences include well-validated examples of successfully managing behavioral and cultural change at scales ranging from individuals to small groups to large populations. However, these examples are largely unknown beyond their disciplinary boundaries, for lack of a unifying theoretical framework. Viewed from an evolutionary perspective, they are examples of managing evolved mechanisms of phenotypic plasticity, including open-ended processes of variation and selection.Once the many branches of the basic and applied behavioral sciences become conceptually unified, we are closer to a science of intentional change than one might think. (shrink)

Belgium's policy of not permitting Catholic hospitals to refuse euthanasia services rests on ethical presuppositions concerning the secular justification of political power which reveal the paradoxical character of European liberalism: In endorsing freedom as a value (rather than as a side constraint), liberalism prioritizes first-order intentions, thus discouraging lasting moral commitments and the authority of moral communities in supporting such commitments. The state itself is thus transformed into a moral community of its own. Alternative policies (such as an explicit moral (...) diversification of public healthcare or the greater tolerance for Christian institutions in the Netherlands) are shown to be incompatible with Europe's liberal concern with securing social and material freedom resources, as well as the concern with equality of opportunity, as embodied in the European Union's anti-discrimination labor law. The essay's argument for the preferability of a libertarian solution closes with the challenge that only if the provision of public healthcare can be shown to be rationally indispensable for a morally justified polity, could the exposed incoherence of modern European liberalism be generously discounted. (shrink)

The intimate connection, within Christianity, of theology and ethics is invoked, and the ethical differences between Christian denominations are exposed, as they present themselves inMellon's case studies, in order to call attention to the unsolvable dilemma in which hospital chaplains find themselves, if they understand their role in a merely conciliatory fashion as that of a “comforter, mediator, educator, ethicist, and counselor”. As witnessed by the Calvinist and Anabaptist traditions Mellon introduces, concepts such as “the patient's good” can mean radically (...) different things in these theological contexts. Attempting to merely mediate between such positions in a spirit of merely generic prayer and on the basis of a merely psychological notion of well-being poses a risk to chaplains' spiritual integrity and faithfulness to their mission. (shrink)

Corinna Delkeskamp-Hayes; Bioethics for Thresholders: A Brief Introduction, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 8, Issue 3.

Corinna Delkeskamp-Hayes; Sin and Disease in a Post-Christian Culture: An Introduction, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume.

Corinna Delkeskamp-Hayes; The Spiritual Claim of a Dying Mother – A Complement to Paul's Report, Christian bioethics: Non-Ecumenical Studies in Medical Morality.

The rise of progressive education -- John Dewey -- Other pioneers in the progressive education movement -- The progressive education movement during the first half of the twentieth century -- The fifties -- The sixties and seventies -- A nation at risk (1983) -- The eighties and nineties -- No child left behind -- Maria Montessori -- Teacher education programs -- Middle schools -- Choice -- Education of the gifted and talented -- Progressive education today -- The future of progressive (...) education. (shrink)

At a time when monuments are falling, learning processes and discourses accelerating, it seems apposite to pay attention also to artworks commissioned by established institutions in order to give form to good intentions. This essay focuses on a commissioned portrait of female professors, on art education, Dutch art policy / politics and the former colonial site that the University of Amsterdam occupies, in order to aide this institution’s desired process to become more inclusive. It proposes Art Research as a realm (...) that can contribute a differentiated and thoughtful positioning of research and universities in visual and public domains: a necessary ally. Since the essay was written in Summer 2019, much has happened: the Faculty in question has been found to be the locus of ongoing sexual harassment. The student victims did not feel that the complaints procedures were safeguarding them sufficiently. They went to the media. The university’s ombudsperson asked to investigate found no systemic deficiencies. Since George Floyd’s death, such a conclusion is no longer possible, and the Board of the university has admitted shameful and systemic failures.[1] We now know better what “systemic” means. This essay’s case study is meant to show that art and philosophy can jointly analyze systems and organizations as a basis for necessary conversations, followed by a broad range of people taking responsibility and acting accordingly. In Covid lock-down times, it became deceptively obvious how unimportant art is. Through an essay such as this, it is hopefully also evident how art can be an indicator of institutional culture: e.g. in relation to how embedded the principle to consult specialists is, even if this seems to be unimportant. And that is a matter of life and death. [1] https://www.folia.nl/actueel/138876/fred-weerman-en-geert-ten-dam-dit-is-ongehoord-beschamend. (shrink)

Belongingness is a central biopsychosocial system. Challenges to belongingness (i.e. exclusion/ostracism) engender robust negative effects on affect and cognitions. Whether overinclusion – getting more than one’s fair share of social attention – favourably impacts affect and cognitions remains an open question. This pre-registered meta-analysis includes twenty-two studies (N = 2757) examining overinclusion in the context of the Cyberball task. We found that the estimated overall effect size of overinclusion on positive affect was small but robust, and the effect on fundamental (...) needs cognitions (belongingness, self-esteem, meaningful existence and control) was moderate in size and positive in direction. Notably, the effect sizes of overinclusion were smaller than the corresponding effects of exclusion. Finally, the effects of overinclusion on positive affect were greater for high, as compared to low, socially anxious individuals. Exploring the sequelae of the full range of inclusion experiences – from exclusion to overinclusion – may enrich our understanding of the functioning of the belongingness system as well as its interaction with another central biosocial system – the social status system. (shrink)