In both Plato and Thomas Aquinas, we find proposals to understand piety or religion as justice toward God/the gods. One issue with this proposal is what can be called the problem of human-divine reciprocity: Since justice would seem to require human beings to make a return for what they have received from God/the gods, how can this be done without implying God/the gods lack something that human beings can supply? I outline the account of piety/religion as justice toward the divine (...) in both Plato and Aquinas, noting how the reciprocity problem arises along the way. Then I defend a proposed solution drawn from Aquinas: that glory, or the manifestation of divine goodness, is what God seeks in pious human action, yet without implying any benefit to God thereby. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

We argue that any strong version of a knowledge condition on intentional action, the practical knowledge principle, on which knowledge of what I am doing (under some description: call it A-ing) is necessary for that A-ing to qualify as an intentional action, is false. Our argument involves a new kind of case, one that centers the agent’s control appropriately and thus improves upon Davidson’s well-known carbon copier case. After discussing this case, offering an initial argument against the knowledge condition, and (...) discussing recent treatments that cover nearby ground, we consider several objections. One we consider at some length maintains that although contemplative knowledge may be disconnected from intentional action, specifically practical knowledge of the sort Anscombe elucidated escapes our argument. We demonstrate that this is not so. Our argument illuminates an important truth, often overlooked in discussions of the knowledge-intentional action relationship: intentional action and knowledge have different levels of permissiveness regarding failure in similar circumstances. (shrink)

Benchmarks against which healthcare ethics consultation (HCEC) services can assess their performance are needed. As first-generation benchmarks continue to be developed, it is the obligation of the field to continually evaluate how these measures reflect the performance of any single HCEC service. This will be possible only with widespread reporting of standardized data points. In their article in this issue of The Journal of Clinical Ethics, Glover and colleagues provide a valuable preliminary approach for assessing appropriate consult volumes for a (...) HCEC service. The limitations of their study read as a call to action for the field of clinical ethics to expand and standardize data reporting so that more robust metrics can be developed. In response to this call by Glover and colleagues, the Cleveland Clinic HCEC service provides consult data from 2015 through 2019 for one of its medical centers, and offers an additional volumebased metric, consult-to-ICU-to-bed ratio (CiBR), that may add nuance to any normative assessment of HCEC service consult volume. Given that volume-based metrics are the native language of the clinical environment, efforts to improve such metrics in the field through transparency and standardization are warranted. However, the expositive power of volume-based metrics is limited; additional domains related to quality and outcomes are needed. (shrink)

The article Pragmatismand the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS.

Through the Louisiana Purchase in 1803, the United States expanded its size by over 800,000 square miles. But neither President Thomas Jefferson nor Congress knew exactly what they had bought until 1806, when Meriwether Lewis and William Clark returned from their famous expedition. One of the most significant contributions of the Expedition was a better perception of the geography of the Northwest. Lewis and Clark prepared approximately 140 maps and filled in the main outlines of the previously blank map of (...) the northwestern United States. Robert I. Field has done much the same for the vast territory of U.S. health care regulation.On the front cover of Fields new book, Health Care Regulation in America: Complexity, Confrontation, and Compromise, is a picture of a giant three-dimensional labyrinth. Rarely is cover art so perfectly appropriate. (shrink)

A number of articles and empirical studies over the past decade, most by Paul Robinson and co-authors, have suggested a relationship between the extent of the criminal law's reputation for being just in its distribution of criminal liability and punishment in the eyes of the community – its "moral credibility" – and its ability to gain that community's deference and compliance through a variety of mechanisms that enhance its crime-control effectiveness. This has led to proposals to have criminal liability and (...) punishment rules reflect lay intuitions of justice – "empirical desert" – as a means of enhancing the system's moral credibility. In a recent article, Christopher Slobogin and Lauren Brinkley-Rubinstein (SBR) report seven sets of studies that they argue undermine these claims of empirical desert and moral credibility and instead support SBR's proposed distributive principle of "individual prevention," a view that focuses on an offender's future dangerousness rather than on his perceived desert. -/- The idea that there is a relationship between the criminal law's reputation for justness and its crime-control effectiveness did not originate with Robinson and his co-authors. Rather, it has been a common theme among a wide range of punishment theory scholars for many decades. A particularly important conclusion of recent Robinson studies, however, is their confirmation that this relationship is a continuous one: even small nudges in moral credibility can produce corresponding changes in the community's deference to the criminal law. This is important because it shows that even piecemeal changes or changes at the margin – as in reforming even one unjust doctrine or procedure – can have real implications for crime-control. SBR's studies, rather than contradicting the crime-control power of empirical desert, in fact confirm it. Further, SBR's studies do not provide support for their proposed "individual prevention" distributive principle, contrary to what they claim. -/- While SBR try to associate their principle with the popular "limiting retributivism" adopted by the American Law Institute in its 2007 amendment of the Model Penal Code, in fact it is, in many respects, just the reverse of that principle. With limiting retributivism, the Model Code's new provision sets desert as dominant, never allowing punishment to conflict with it. SBR would have "punishment" essentially always set according to future dangerousness; it is to be constrained by desert only when the extent of the resulting injustices or failures of justice is so egregious as to significantly delegitimize the government and its law. This ignores the fact that even minor departures from justice may have an important cumulative effect on the system as a whole. What SBR propose – essentially substituting preventive detention for criminal justice – promotes the worst of the failed policies of the 1960s, where detention decisions were made at the back-end by "experts," and conflicts with the trend of the past several decades of encouraging more community involvement in criminal punishment, not less. (shrink)

BackgroundThe Freedom of Information Act (FOIA) provides access to unreleased government records that can be used to enhance the transparency and integrity of biomedical research. We characterized FOIA requests to Department of Health and Human Services (HHS) agencies, including request outcomes, processing times, backlogs, and costs.MethodsUsing HHS FOIA annual reports, we extracted data on the number of FOIA requests received and processed by HHS agencies between 2008 and 2017, as well as request outcomes. Processing times were reported in three time (...) increments, < 1–20, 21–60, or 61+ days, and trends in backlog status were also described. Information about costs and fees collected were aggregated.ResultsBetween 2008 and 2017, 69.6% of 530,094 HHS FOIA requests were received by the Centers for Medicare and Medicaid Services (CMS), 18.9% by the Food and Drug Administration (FDA), and 11.6% by all other HHS agencies. During this period, CMS processed 374,728 requests, FDA 114,938, and other HHS agencies 61,890. CMS and FDA reduced backlogged requests by 9396 (89.7%) and 4289 (65.3%), respectively, leaving backlogs of 1081 and 2279 requests at the end of 2017. CMS fully or partially granted 60.3% of requests whereas FDA fully or partially granted 72.4%. Of all requests to CMS, 82.0% were considered simple and 18.0% complex; 82.2% of simple requests and 54.9% of complex requests were processed in 20 days, and 5.6% and 29.9% were processed in 61+ days. In contrast, 60.2% of requests to FDA were considered simple and 39.8% complex; 28.8% of simple requests and 9.0% of complex requests were processed in 20 days, and 58.3% and 81.5% were processed in 61+ days. The costs to HHS associated with FOIA requests totaled $446.4 million ($809 per processed request), increasing from $28.1 million ($423 per request) in 2008 to $53.3 million ($1544 per request) in 2017. In total, HHS collected $8.5 million in fees (1.9% of total costs).ConclusionsFOIA is frequently used to obtain information about HHS and its agencies. With growing costs, minimal fees collected, and lengthy processing times, HHS agencies’ FOIA programs might be made more efficient through greater proactive record disclosure. (shrink)

This chapter argues that SNL tends, with some exceptions, away from the philosophical and satirical areas of the spectrum and more towards the smart‐assical, silly side. Moreover, just like SNL sketches, Aristophanes' plays often subjected contemporary figures, celebrities, and politicians to intense ridicule. The sketch provided SNL a way of criticizing its own network by allowing the writers and actors to adopt a different persona, thus creating a safe distance between critic and target. Setting aside how accurately the scenario sketched (...) at the outset depicts typical SNL performances, it should be noted that it does paint a fair picture of staged satire in Athens, Greece, circa. As in the case of Aristophanes, most of SNL's satirical qualities revolve around political debates, issues, and, most famously, figures. (shrink)

Timon is an ancient Greek skeptic fed up with dogmatic nonsense about the beginnings of the universe. One night, he dreams of a boisterous "Battle of Brains" between history's major religious and philosophical authorities. Highly satirical, IN THE BEGINNING depicts this battle in a clear and readable style, faithfully detailing each contender's cosmology, including wisecracks and barbs aimed at rival sages. Timon himself pulls no punches in attempting to resolve the debate, even bashing belief itself. A simple spectator, however, gets (...) to throw the last punch when he divulges "The Real Truth of Everything.". (shrink)

The temple schematics in the Dead Sea Scrolls (DSS), that is, New Jerusalem and Temple Scroll, has often been comparatively examined with the sanctuary structures in the Hebrew Bible (HB) (Ezk 40-48 and Num 2). Typically, in scholarship, the irreconcilable differences between all accounts (regarding the size, shape, name-gate ordering, etc.) is underscored, thus rendering a literary conundrum. This article argues that New Jerusalem and Temple Scroll drew from both Ezekiel 40-48 and Numbers 2 in different ways, purporting the sect(s)'s (...) theologies and ideologies which accords, further, with the life setting of the Qumran communities; the influence of Numbers in the DSS is underscored. These aspects include (1) the eastern orientation of sacred structures and the compound at Khirbet Qumran, (2) the precise locale of the communities at the Dead Sea vis-à-vis Ezekiel 47 and (3) the desert encampment configuration together with its militaristic overtones in Numbers, which corresponds to the DSS sect(s)'s apocalyptic expectations as indicated in the War Scroll. Consequently, the Qumran sect(s) truly saw itself as an alternative priesthood of the forthcoming restored temple of God, even as in the interim they functioned as an alternative sanctuary (4QFlor; 4QMMT; 1QS). The import of Numbers upon the DSS sect(s)'s temple ideologies and priestly theologies is, therefore, equivalent to that of Ezekiel. CONTRIBUTION: This article traces theological themes of temple and priestly ideologies between and among the Qumran literature and Hebrew Scriptures; both the respective library or canon and methodological approach are core to the historical thought's aim and scope of HTS Teologiese Studies/Theological Studies. (shrink)

It has often been suggested that people’s ordinary folk understanding of morality involves a rejection of moral relativism and a belief in objective moral truths. The results of six studies call this claim into question. Participants did offer apparently objectivist intuitions when confronted with questions about individuals from their own culture, but they offered increasingly relativist intuitions as they were confronted with questions about individuals from increasingly different cultures or ways of life. In light of these data, the authors hypothesize (...) that people do not have a fixed commitment to moral objectivism but instead tend to adopt different views depending on the degree to which they consider radically different perspectives on moral questions. [NOTE: This is a reprint of Sarkissian et al 2011]. (shrink)

Successful therapies to combat microbial diseases and cancers require incorporating ecological and evolutionary principles. Drawing upon the fields of ecology and evolutionary biology, we present a systems‐based approach in which host and disease‐causing factors are considered as part of a complex network of interactions, analogous to studies of “classical” ecosystems. Centering this approach around empirical examples of disease treatment, we present evidence that successful therapies invariably engage multiple interactions with other components of the host ecosystem. Many of these factors interact (...) nonlinearly to yield synergistic benefits and curative outcomes. We argue that these synergies and nonlinear feedbacks must be leveraged to improve the study of pathogenesis in situ and to develop more effective therapies. An eco‐evolutionary systems perspective has surprising and important consequences, and we use it to articulate areas of high research priority for improving treatment strategies. (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)

Many have attempted to respond to arguments for the incompatibility of freedom with divine foreknowledge by claiming that God’s beliefs about the future are explained by what the world is like at that future time. We argue that this response adequately advances the discussion only if the theist is able to articulate a model of foreknowledge that is both clearly possible and compatible with freedom. We investigate various models the theist might articulate and argue that all of these models fail.

BackgroundThe COVID-19 crisis has introduced a variety of stressors, while simultaneously decreasing the availability of strategies to cope with stress. In this context, it could be useful to understand issues that people find most concerning and ways in which they cope with stress. In this study, we explored these questions with a sample of graduate and professional students.MethodUsing open-ended assessments, we asked participants to identify their biggest challenge or concern, their most effective way of handling stress, and their most common (...) way of handling stress. We applied thematic analysis and evaluated whether participants’ strategies corresponded with evidence-based practices.ResultsParticipants frequently reported top problems relating to productivity, physical health, and emotional health. Distraction was the most frequently classified common strategy, whereas behavioral activation was the most frequently identified effective strategy. Participants who reported a common strategy classified as an EBP reported lower depressive and anxiety symptoms. In contrast, there was no evidence of an association between symptom levels and whether or not participants’ effective strategy was an EBP. Participants who reported the same strategy as both their common and effective strategy reported lower depressive symptoms than those whose common and effective strategies were different.ConclusionOur findings highlight stressors that students are experiencing and ways they are coping during the COVID-19 crisis. We discuss how these findings can inform mental health promotion efforts and future research on coping with stressors. (shrink)

BackgroundAn increasing number of studies utilize intracranial electrophysiology in human subjects to advance basic neuroscience knowledge. However, the use of neurosurgical patients as human research subjects raises important ethical considerations, particularly regarding informed consent and undue influence, as well as subjects’ motivations for participation. Yet a thorough empirical examination of these issues in a participant population has been lacking. The present study therefore aimed to empirically investigate ethical concerns regarding informed consent and voluntariness in Parkinson’s disease patients undergoing deep brain (...) stimulator (DBS) placement who participated in an intraoperative neuroscience study.MethodsTwo semi-structured 30-minute interviews were conducted preoperatively and postoperatively via telephone. Interviews assessed participants’ motivations for participation in the parent intraoperative study, recall of information presented during the informed consent process, and participants’ postoperative reflections on the research study.ResultsTwenty-two participants (mean age = 60.9) completed preoperative interviews at a mean of 7.8 days following informed consent and a mean of 5.2 days prior to DBS surgery. Twenty participants completed postoperative interviews at a mean of 5 weeks following surgery. All participants cited altruism or advancing medical science as “very important” or “important” in their decision to participate in the study. Only 22.7% (n = 5) correctly recalled one of the two risks of the study. Correct recall of other aspects of the informed consent was poor (36.4% for study purpose; 50.0% for study protocol; 36.4% for study benefits). All correctly understood that the study would not confer a direct therapeutic benefit to them.ConclusionEven though research coordinators were properly trained and the informed consent was administered according to protocol, participants demonstrated poor retention of study information. While intraoperative studies that aim to advance neuroscience knowledge represent a unique opportunity to gain fundamental scientific knowledge, improved standards for the informed consent process can help facilitate their ethical implementation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What is Fantasy?Brian Laetz and Joshua J. JohnstonWizards, elves, dragons, and trolls—this is certainly the stuff of fantasy, populating the fictions of such giants as Tolkien, no less than the juvenilia of many aspiring writers. However, it is much easier to identify typical elements of fantasy, than it is to understand the category of fantasy itself. There can be little doubt that, in practice, the genre is pretty (...) well defined, concretely manifesting itself in the shelves reserved for it in video shops and bookstores. But stating why a work belongs on these shelves, rather than those in the near vicinity, such as horror and science fiction, or those more remote, like plain old fiction, presents a real challenge. Certainly, a mere few feet could separate fantasy from the other shelves, but the conceptual distance those feet represent appears great indeed. What, if anything, distinguishes this genre from other categories of mass art. In other words, what is fantasy?To begin, fantasy is a transmedia genre, since there are fantasy novels and movies, for instance, as is illustrated by J. R. R. Tolkien's Lord of the Rings saga and its recent cinematic adaptation. It is interesting to note that fantasy includes works from other media as well, such as paintings, which often accompany fantasy narratives, like Frank Frazetta's recognizable illustrations for Robert E. Howard's Conan the Barbarian stories. Forms of entertainment are also affiliated with the genre, such as role-playing games, like Dungeons and Dragons, though one might balk at considering such things even forms of mass art? Nonetheless, despite the variety of media and entertainments associated with fantasy, [End Page 161] narratives occupy a fundamental place within the genre. For paintings, drawings, and the like are only recognizably fantastic given some narrative background that tells us what wizards, trolls, and dragons look like.1 Plausibly, it is what allows us to see that a drawing depicts an elf, for example, rather than a child with odd pointy ears. Thus, even if some works of fantasy are, strictly speaking, non-narrative, fantastic narratives remain fundamental, since these other works would not be classified as fantasy without them. This warrants initially setting aside things like fantasy games and paintings to focus on narratives. What, precisely, makes a narrative fantastic?First, fantastic narratives are essentially fictional. For regardless of how one ultimately understands the nature of fiction, the notion of true fantasy seems patently incoherent, quite unlike, say, true crime. And it must be stressed that this point should be compatible with any theory of fiction. Second, the sort of things that can make a work fantastic, like wizards and dragons, must be prominent in the work—they cannot be minor details. For example, had there been a two-minute scene in Spartacus in which someone cast a spell, the scene would have been fantastic, but ultimately the movie would not be classified any differently; you would still find it on the drama shelf. Moreover, this condition is not peculiar to fantasy.2 For instance, no one who has suffered through a Steven Seagal film would seriously classify it as romance or even action-romance, simply because it has a minor romantic subplot. Fantasy is no different from any other genre in this regard: whatever features define a genre must be prominent in a work in order for it to belong to the relevant genre. Third, the sort of content that can make a work fantastic must not solely be viewed as symbols for things that are not fantastic. In other words, these elements cannot just be taken as allegorical.3 This alone would seem to disqualify George Orwell's Animal Farm from the genre, since most read the intelligent animals as merely symbols portraying various factions in communist Russia. It should be noted that the actual intentions of the author probably matter little here. For example, even if scholars discovered that Tolkien merely intended the Middle Earth saga as an elaborate allegory, it would remain fantasy; few would be tempted to move the books to another shelf. Fourth, the relevant content must not solely be mocked or lampooned within the work.4 This is necessary... (shrink)

The Alternative Model of Personality Disorders integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying (...) therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films. Interpersonal behaviors as well as alliance ruptures were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria ’s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria’s dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria’s dominance and Albert Ellis’s submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session. (shrink)

The COVID-19 outbreak has simultaneously increased the need for mental health services and decreased their availability. Brief online self-help interventions that can be completed in a single session could be especially helpful in improving access to care during the crisis. However, little is known about the uptake, acceptability, and perceived utility of these interventions outside of clinical trials in which participants are compensated. Here, we describe the development, deployment, acceptability ratings, and pre–post effects of a single-session intervention, the Common Elements (...) Toolbox, adapted for the COVID-19 crisis to support graduate and professional students. Participants, who were not compensated, were randomly assigned to two of three modules: behavioral activation, cognitive restructuring, and gratitude. Over 1 week, 263 individuals began and 189 individuals completed the intervention. Participants reported that the intervention modules were acceptable, helpful, engaging, applicable to their lives, and could help them manage COVID-related challenges. Participants reported pre- to post-program improvements in secondary control and in the perceived negative impact of the COVID-19 crisis on their quality of life. On average, differences in their perceived ability to handle lifestyle changes resulting from the pandemic were positive, but small and at the level of a non-significant trend. Our results highlight the acceptability and utility of an online intervention for supporting individuals through the COVID-19 crisis. (shrink)

By introducing the concept of “mental data,” Palermos (2023) highlights an underappreciated aspect of data ethics that policymakers would do well to heed. Sweeping artificial intelligence (AI) legi...

Background 300 million operations and procedures are performed annually across the world, all of which require a patient’s informed consent. No standardised measure of the consent process exists in current clinical practice. We aimed to define a core outcome set for informed consent for therapy. Methods The core outcome set was developed in accordance with a predefined research protocol and the Core OutcoMes in Effectiveness Trials methodology comprising systematic review, qualitative semi structured interviews, a modified Delphi process and consensus webinars (...) to ratify outcomes for inclusion in the final core outcome set.. Participants from all key stakeholder groups took part in the process, including patients and the public, healthcare practitioners and consent researchers. Results 36 outcome domains were synthesised through systematic review and organised into a consent taxonomy. 41 semi-structured interviews were performed with all consent stakeholders groups. 164 participants from all stakeholder groups across 8 countries completed Delphi Round 1 and 125 completed Round 2. 11 outcomes met the ‘consensus in’ criteria. 6 met ‘consensus in’ all stakeholder groups and were included directly in the final core outcome set. 5 remaining outcomes meeting ‘consensus in’ were ratified over two consensus webinars. 9 core outcomes were included in the final core outcome set: Satisfaction with the quality and amount of information, Patient feeling that there was a choice, Patient feeling that the decision to consent was their own, Confidence in the decision made, Satisfaction with communication, Trust in the clinician, Patient satisfaction with the consent process, Patient rated adequacy of time and opportunity to ask questions. Conclusion This international mixed-methods qualitative study is the first of its kind to define a core outcome set for informed consent for intervention. It defines what outcomes are of importance to key stakeholders in the consent process and is a forward step towards standardising future consent research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Acts of Enjoyment: Rhetoric, Žižek, and the Return of the SubjectJames J. Brown Jr. and Joshua GunnActs of Enjoyment: Rhetoric, Žižek, and the Return of the Subject by Thomas Rickert. Pittsburgh: University of Pittsburgh Press, 2007. Pp. x + 252. $24.95, hardcover.Thomas Rickert had a falling-out with his brother, and this distresses him so much that his disrupted relation is described as “traumatic.” Rickert reports that while (...) listening to a portable CD player during a run on an unexpectedly warm winter day, a song by the now defunct jazz/rock band Morphine reminded him of a happy time at a pool hall with his brother (24). Mediated—or better, medicated—by music, the homological happiness of running in the sun and a positive past memory also resurfaced a painful relational rupture, the reason of which Rickert omits to underscore that mysterious, “little detail or object” of the Real that marks his singular finitude as a writing subject (216 n. 11). We’ll want to come back to this curiously deliberate omission, but for the present we note Rickert is not simply an undead author but a human being with relations and feelings. He is not just a gifted scholar or a bundle of reflections, but a nexus of body and movement and words and affect. If there is anything that Rickert’s study can be said to work through with brilliance, humor, and grace, it is the reality of complex personhood.Rickert’s brotherly confession comes in Chapter 1 as a way to introduce a psychoanalytic understanding of subjectivity, and more specifically, to help illustrate how trauma works itself out as an afterwardness or “belatedness” ( Nachträglichkeit ): traumatic events from the past are not reckoned with or worked-through until some coincidence or reminder, such as a similar [End Page 183] sensory experience, reintroduces the event in doubled re-presentation (18–27). This implies the “subject” (a paradigm person) is a kind of timedelay, a self-conscious temporal moving that becomes this way through re-presentation. The rhetorical subject is analogously a retrojected reckoning with events past (not all traumatic) that Rickert identifies as a scene of writing, a locus that has important implications for rhetorical studies in general and writing pedagogy in particular. Rickert’s logic is as follows: if we agree that the subject is a belated one in the psychoanalytic sense, then how we teach rhetoric needs to change. Rickert opens the book with the observation that his students are producing excellent cultural critiques but that such critiques do not lead the students to change their actions (1–7), perhaps evidence enough that something is not quite right in a classroom grounded by “cultural studies pedagogy” and ideology critique—or at the very least, proof that something has changed. The opening gambit is simply that a “postpedagogy” premised on an understanding of rhetorical subjectivity as belatedness is better than a status quo rooted in the rational subject of the Enlightenment.Mostly through a Žižek-filtered, Lacanian lens, Acts of Enjoyment then undertakes a retake of the rhetorical field, frequently scanning from the traumatic ontology of the rhetorical subject to that domain of knowledge that we hold dear, the subject of rhetoric. In Chapter 2, the (primal) scene thus shifts from the slo-mo subject to rhetorical studies, initially through a reassessment of Kinneavy’s “communications triangle,” but ultimately in response to the shock treatment of poststructuralism. The initial theoretical traumas introduced by Victor Vitanza, Diane Davis, Sharon Crowley, and others discussed in Chapter 1 are threaded into an account of “poststructural” redress in Chapter 2: as is true of all forms of trauma, the initial poststructural jolt delivered to the concept of subjectivity was deadened; poststructural theory was eventually used to “shore up rather than challenge Kinneavy’s triangle” (37). To truly work-through our traumatized subject in both senses, we need a second trauma: Lacanian psychoanalysis. Presumably, “poststructuralist thought” is to be opposed because it has no account of the subject (21–24); “Lacan,” after all, “is not a poststructuralist” (48). The remainder of the chapter is then used to deploy Lacan’s conceptual lexicon.Just as... (shrink)

American men experience worse outcomes on a wide range of health and well-being variables compared to women, including disease, educational problems, violence, addiction, suicide, unemployment, and life expectancy. Because of this, organizations have created programs that focus on helping men both psychologically and spiritually; however, it is important to assess the effectiveness of these programs. The Crucible Project, founded in 2002, attempts to facilitate the development of integrity, courage, and grace in men using a weekend retreat format. The purpose of (...) this pilot study was to explore the effect of the weekend retreat on participants’ authenticity, assertiveness, and willingness to forgive. Participants completed measures before the weekend retreat, immediately after the weekend retreat, and at a 1-month follow-up. Results indicate that weekend retreat participants demonstrated a significant increase in scores on measures of authenticity and willingness to forgive and a trend toward increased scores on the measure of assertiveness over time. We conclude by discussing limitations of the study, areas for future research, and implications for spiritual and character development. (shrink)

We examine the following consequentialist view of virtue: a trait is a virtue if and only if it has good consequences in some relevant way. We highlight some motivations for this basic account, and offer twelve choice points for filling it out. Next, we explicate Julia Driver’s consequentialist view of virtue in reference to these choice points, and we canvass its merits and demerits. Subsequently, we consider three suggestions that aim to increase the plausibility of her position, and critically analyze (...) them. We conclude that one of those proposed revisions would improve her account. (shrink)

In a pioneering book, Philosophy of Microbiology, Maureen O’Malley argues for the philosophical importance of microbes through an examination of their impact on ecosystems, evolution, biological classification, collaborative behavior, and multicellular organisms. She identifies many understudied conceptual issues in the study of microbes. If philosophers follow her lead, the philosophy of biology will be expanded and enriched.

As scholars have rushed to either prove or refute cultural group selection, the debate lacks sufficient consideration of CGS's potential moderators. We argue that pressures for CGS are particularly strong when groups face ecological and human-made threat. Field, experimental, computational, and genetic evidence are presented to substantiate this claim.

It is natural to think that at root, agents are beings that act. Agents do more than this, however – agents omit to act. Sometimes agents do so intentionally. How should we understand intentional omission? Recent accounts of intentional omission have given causation a central theoretical role. The move is well-motivated. If some form of causalism about intentional omission can successfully exploit similarities between action and omission, it might inherit the broad support causalism about intentional action enjoys. In this paper (...) I consider the prospects for causalism about intentional omission. I examine two recent proposals: one Carolina Sartorio (2009) defends, and one Randolph Clarke (2010a) defends. I argue these versions fail, and for a similar reason. Reflection on the function of intention for agency brings this reason to light, and motivates a novel causalism about intentional omission. On the account I go on to defend necessarily, an agent J intentionally omits to A only if an intention of J’s with relevant content (or the intention’s acquisition) causes in J a disposition not to A. Though the causal work done by intentions to omit differs in some cases from the causal work done by intentions to act, it turns out that causalism about intentional behavior (i.e., about action and omission) is viable. (shrink)

Some stories of moral exemplars motivate us to emulate their admirable attitudes and behaviors, but why do some exemplars motivate us more than others? We systematically studied how motivation to emulate is influenced by the similarity between a reader and an exemplar in social or cultural background (Relatability) and how personally costly or demanding the exemplar’s actions are (Attainability). Study 1 found that university students reported more inspiration and related feelings after reading true stories about the good deeds of a (...) recent fellow alum, compared to a famous moral exemplar from decades past. Study 2A developed a battery of short moral exemplar stories that more systematically varied Relatability and Attainability, along with a set of non-moral exemplar stories for comparison. Studies 2B and 2C examined the path from the story type to relatively low stakes altruism (donating to charity and intentions to volunteer) through perceived attainability and relatability, as well as elevation and pleasantness. Together, our studies suggest that it is primarily the relatability of the moral exemplars, not the attainability of their actions, that inspires more prosocial motivation, at least regarding acts that help others at a relatively low cost to oneself. (shrink)

This volume is a collection of essays by various contributors in honor of the late Laurence Berns, Richard Hammond Elliot Tutor Emeritus at St. John's College, Annapolis. The essays address the literary, political, theological, and philosophical themes of his life's work as a scholar, teacher, and constant companion of the "great books.".

In this essay, after a brief decolonial analysis of the concept of “poetry” in Indigenous communities, I will investigate the poetic-philosophical implications of Cherokee culture, more specifically the poetic essence of the Cherokee language, the poetic aspects of Cherokee myth (pre-history) and post-myth (history), and the poetic-philosophical powers of Cherokee ritual. My first section analyzes the poetic essence, structure, special features, and historical context of the Cherokee language, drawing on Ruth Holmes and Betty Sharp Smith’s language textbook, Beginning Cherokee. My (...) second section considers poetic aspects of the pre-history and history of the Cherokee Nation considered as a text, using Robert J. Conley’s The Cherokee Nation: A History. And my third section investigates the poetic nature of the Cherokee rituals’ myth-ontological background and its existential psychological implications, via J. T. Garrett & Michael Tlanusta Garrett’s The Cherokee Full Circle: A Practical Guide to Ceremonies and Traditions. Collectively, these analyses will suggest that, just as the Cherokee and other tribes are the slandered, disenfranchised, suppressed and covered-over Indigenous peoples of the North American continent, so poetry writ large (including Indigenous philosophy) is the slandered, disenfranchised, suppressed and covered-over arche of western philosophy (as I have previously explored via a new interpretation of Nietzsche). In short, I will argue that both poetry and Cherokee culture can be understood as indigenous “absences” which are in truth vital and enduring presences. (shrink)

BackgroundObtaining consent has become a standard way of respecting the patient’s rights and autonomy in clinical research. Ethical guidelines recommend that the child’s parent/s or authorised legal guardian provides informed consent for their child’s participation. However, obtaining informed consent in paediatric research is challenging. Parents become vulnerable because of stress related to their child’s illness. Understanding the views held by guardians and researchers about the consent process in Malawi, where there are limitations in health care access and research literacy will (...) assist in developing appropriate consent guidelines.MethodsWe conducted 20 in-depth interviews with guardians of children and research staff who had participated in paediatric clinical trial and observational studies in acute and non-acute settings in the Southern Region of Malawi. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Interviews were compared across studies and settings to identify differences and similarities in participants’ views about informed consent processes. Data analysis was facilitated by NVIVO 11 software.ResultsAll participants across study types and settings reported that they associated participating in research with therapeutic benefits. Substantial differences were noted in the decision-making process across study settings. Guardians from acute studies felt that the role of their spouses was neglected during consenting, while staff reported that they had problems obtaining consent from guardians when their partners were not present. Across all study types and settings, research staff reported that they emphasised the benefits more than the risks of the study to participants, due to pressure to recruit. Participants from non-acute settings were more likely to recall information shared during the consent process than participants in the acute setting.ConclusionThe health care context, culture and research process influenced participants’ understanding of study information across study types and settings. We advise research managers or principal investigators to define minimum requirements that would not compromise the consent process and conduct study specific training for staff. The use of one size fits all consent process may not be ideal. More guidance is needed on how these differences can be incorporated during the consent process to improve understanding and delivery of consent.Trial registration Not applicable. (shrink)

When discussing Eastern philosophy there is often a difficulty since characteristically Eastern ways of thinking do not map well onto Western philosophic categories. Yet, P. J. Ivanhoe suggests that a careful reading of Confucianism can illuminate and expand Western approaches to ethics. Ivanhoe maintains that the best way to understand Confucian ethics is as a hybrid of virtue ethics and consequentialism, a view he calls character consequentialism (CC). The paper will progress in the following way. First, I present Ivanhoe’s conception (...) of character consequentialism. Second, I discuss how CC, particularly as it is developed by Charles Goodman as a way to interpret Mahayana Buddhist ethics, relates to aspects of Mill’s utilitarianism. This suggests that there is nothing especially new about CC. However, the similarities actually underscore the ways that Eastern and Western ethical theories can illuminate each other. Finally, I respond to Damien Keown’s concern that CC is hopeless confused. (shrink)

Thirteen dwarves and a wizard invade the quiet abode of Bilbo Baggins in an effort to recruit him for an expedition, the purported purpose of which is to recover stolen treasure and exact vengeance on Smaug the dragon, the robber who had cruelly killed a large portion of Thorin's family and friends. Although most readers and critics approach J. R. R. Tolkien's The Hobbit as a children's story, an unserious dress-rehearsal-sketch of The Lord of the Rings at best, and in (...) spite of the fact that, as Nicholas Boyle notes, "there is something embarrassing" about discussing Tolkien's work in an academic context, for "it is so obviously not real literature," The Hobbit, with its "Secondary World" of fantastical creatures... (shrink)

This paper aims to extend in two directions the probabilistic dynamic epistemic logic provided in Kooi’s paper (J Logic Lang Inform 12(4):381–408, 2003) and to relate these extensions to ones made in van Benthem et al. (Proceedings of LOFT’06. Liverpool, 2006). Kooi’s probabilistic dynamic epistemic logic adds to probabilistic epistemic logic sentences that express consequences of public announcements. The paper (van Benthem et al., Proceedings of LOFT’06. Liverpool, 2006) extends (Kooi, J Logic Lang Inform 12(4):381–408, 2003) to using action models, (...) but in both papers, the probabilities are discrete, and are defined on trivial σ -algebras over finite sample spaces. The first extension offered in this paper is to add a previous-time operator to a probabilistic dynamic epistemic logic similar to Kooi’s in (J Logic Lang Inform 12(4):381–408, 2003). The other is to involve non-trivial σ -algebras and continuous probabilities in probabilistic dynamic epistemic logic. (shrink)

Consumers do not always follow their ideological beliefs about the need to engage in environmentally friendly consumption. We propose that Commitment to Beliefs —the general tendency to follow one’s value-based beliefs—can help identify who is most likely to follow their environmental ideologies. We predicted that CTB would amplify the effect of beliefs prescribing environmental stewardship, or neglect, on corresponding intentions, behavior, and purchasing decisions. In two studies, CTB amplified the positive and negative effects of relevant EF ideologies on EF purchase (...) decisions, and consumption and conservation attitudes, intentions, as well as future behavior. In each study, only people with higher levels of CTB demonstrated the most ideologically consistent consumption and conservation intentions and behavior. These findings clarify who is most likely to align their decisions and lifestyles according to their sustainable consumption ideologies. The amplification effect of CTB, and the CTB variable itself, present new contributions to consumer behavior research and the domains of sustainable or ethical consumption in particular and offer wide-ranging potential for marketing practitioners and researchers. (shrink)

The gift of death and the new magic of politics: Hegel and Tolkien on sorcery and secondary worlds -- The political theology of catastrophe: Plato's Athenian Atlantis, Tolkien's Númenoran Atalantë, and the Nazi Reich -- Burglar and bourgeois? Bilbo Baggins' dialectical ethics -- Hobbes, Hobbits, and the modern state of Mordor: myths of power and desire in Leviathan and Tolkien's Legendarium -- Middle-earth and the return of the common good -- Epilogue: from apocalypse to eucatastrophe: "The end of history," happy (...) endings, and the politics of narrative form. (shrink)