This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for (...) human performance. Using the ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance. (shrink)

This paper deals with new pharmacological and technological developments in the manipulation and curtailment of our sleep needs. While humans have used various methods throughout history to lengthen diurnal wakefulness, recent advances have been achieved in manipulating the architecture of the brain states involved in sleep. The progress suggests that we will gradually become able to drastically manipulate our natural sleep-wake cycle. Our goal here is to promote discussion on the desirability and acceptability of enhancing our control (...) over biological sleep, by illustrating various potential attendant ethical problems. We draw attention to the risks involved, possible conflicts of interests underlying the development of wake enhancement, and the potential impact on accountability for fatigue related errors. (shrink)

This article focuses on the recent production of sleep as a matter of concern in American society. In it, I draw primarily on fieldwork with sleep researchers and clinicians to understand the means by which ideas about sleep are produced and disseminated, and discuss the rise of sleep medicine since the late 1970s and the ways sleep disabilities have been constructed and mobilized in contemporary allopathic research and practice. The article provides a description of (...) modern sleep medicine practices, and analyses clinical encounters between researchers, clinicians and patients, particularly the ways patient cases are produced and interpreted. I follow these ethnographic observations with textual analysis of the National Sleep Foundation's campaigns to promote sleep awareness, and offer the theoretical concepts of medical abstraction and insistence as a means to understand the production of sleep as a matter of concern, and how it might be made to adhere in particular patients' lives and the practices of clinicians. (shrink)

In this paper I propose that, since the mid-eighteenth century medical science has simultaneously generated and disavowed ‘undead’ bodies, suspended between life and death. Through close analysis of three examples of ‘undeath’ taken from different moments in medical history, I consider what these bodies can tell us about medicine, its history, cultural meaning, scientific status and its role in shaping ideas of embodiment, identity and death. My first example is Edgar Allan Poe’s story ‘The facts in the case of (...) M. Valdemar’ which imagines the possibility of a man mesmerised at the point of death. I read this story as a response to the rise of professional, scientific medicine in the 1840s. I then look at the recurring issue of brain death in order to consider tensions within twentieth-century medical hegemony. Finally I read the Alder Hey scandal as a reactivation of undead anxiety in response to the emergent culture of medical consumerism at the end of the twentieth century. (shrink)

The Sleeping Beauty transposon system is a nonviral DNA transfer tool capable of efficiently mediating transposition‐based, stable integration of DNA sequences of choice into eukaryotic genomes. Continuous refinements of the system, including the emergence of hyperactive transposase mutants and novel approaches in vectorology, greatly improve upon transposition efficiency rivaling viral‐vector‐based methods for stable gene insertion. Current developments, such as reversible transgenesis and proof‐of‐concept RNA‐guided transposition, further expand on possible applications in the future. In addition, innate advantages such as lack of (...) preferential integration into genes reduce insertional mutagenesis‐related safety concerns while comparably low manufacturing costs enable widespread implementation. Accordingly, the system is recognized as a powerful and versatile tool for genetic engineering and is playing a central role in an ever‐expanding number of gene and cell therapy clinical trials with the potential to become a key technology to meet the growing demand for advanced therapy medicinal products. (shrink)

s This article focuses on the recent production of sleep as a matter of concern in American society. In it, I draw primarily on fieldwork with sleep researchers and clinicians to understand the means by which ideas about sleep are produced and disseminated, and discuss the rise of sleep medicine since the late 1970s and the ways sleep disabilities have been constructed and mobilized in contemporary allopathic research and practice. The article provides a description (...) of modern sleep medicine practices, and analyses clinical encounters between researchers, clinicians and patients, particularly the ways patient cases are produced and interpreted. I follow these ethnographic observations with textual analysis of the National Sleep Foundation's campaigns to promote sleep awareness, and offer the theoretical concepts of medical abstraction and insistence as a means to understand the production of sleep as a matter of concern, and how it might be made to adhere in particular patients' lives and the practices of clinicians. (shrink)

This work brings together Philip van der Eijk's previously published essays on the close connections that existed between medicine and philosophy throughout antiquity. Medical authors such as the Hippocratic writers, Diocles, Galen, Soranus and Caelius Aurelianus elaborated on philosophical methods such as causal explanation, definition and division and applied key concepts such as the notion of nature to their understanding of the human body. Similarly, philosophers such as Plato and Aristotle were highly valued for their contributions to medicine. (...) This interaction was particularly striking in the study of the human soul in its relation to the body, as illustrated by approaches to specific topics such as intellect, sleep and dreams, and diet and drugs. With a detailed introduction surveying the subject as a whole and an essay on Aristotle's treatment of sleep, this wide-ranging and accessible collection is essential reading for the student of ancient philosophy and science. (shrink)

In the outpatient ultrasound suite of a major urban medical center, the mood is somber. A young woman lies tense and anxious. Pregnant for the first time, she has experienced early first-trimester bleeding. The radiologist relates the ultrasound findings: there has been a small hemorrhage, but there is a six-week-size fetus with normal cardiac activity. Translation: the baby is alive! The woman quietly sobs, happy but apprehensive.Across the drive, in the main hospital building, a young boy lies unresponsively comatose in (...) the Pediatric Intensive Care Unit. He was hit by a car while riding his bicycle. He is relying on a ventilator to breath, but his cardiovascular system is supporting itself. After a series... (shrink)

In this article, I focus on two moments of Nathaniel Kleitman's career, specifically that of his Mammoth Cave experiment in the 1930s and his consultation with the United States military in the 1940s–1950s. My interests in bringing these two moments of Kleitman's career together are to examine the role of nature and the social in his understanding of human sleep and the legacies these have engendered for sleep science and medicine in the present; more specifically, I am (...) interested in Kleitman's disallowance of napping in his scientific protocols, which may seem incidental until one apprehends the lack of napping as therapeutic treatment in modern sleep medicine. By forwarding a conception of historiography building on Raymond Williams’ “structures of feeling” and Gilles Deleuze and Felix Guattari's philosophy of immanence, I show how the work of William Dement in the 1970s to found a medicine of sleep and the eclipse of biphasic sleeping patterns as a biological and social possibility is indebted to Kleitman's scientific work. The modification of sleep is also the modification of society itself; and, as Kleitman argued, the harnessing of nature can lead to the finer entrenchments of human nature and society. (shrink)

Energy justice literature generally treats its three tenets, distributional justice, procedural justice and recognition justice, as separate and independent issues. These are seen as separate dimensions by which criteria can be formulated for a just state of affairs. And a just state of affairs regarding energy should fulfill all criteria. However, we show, using empirical research on six European energy communities that the tenets of energy justice are interdependent and negotiated in practice. We show this interdependency using three core concerns (...) of justice—risk, effort and power—which we identified through our empirical work. Our findings reveal that community members are often willing to take risks and put in effort, if they are compensated with more power within the community. Similarly, members are willing to compromise power if no effort or risk-taking is required from them. This demonstrates the interdependency of the tenets “procedural justice” and “distributional justice” within energy communities. We reflect on the need for energy justice theory and policymakers to recognize the significance of this interdependency. (shrink)

An ‘Information Centre’ has recently been established by law which has the power to collect, collate and provide access to the medical information forall patients treated by the National Health Service in England, whether in hospitals or by General Practitioners. This so-called ‘care.data’ scheme has given rise to major and ongoing controversies. We will sketch the background of the scheme and look at the responses it has elicited from citizens and medical professionals. In Autumn 2013, NHS England set up a (...) care.data website where citizens could record their concerns regarding the collection of health-related data by the Information Centre. We have reviewed all the comments on this website up until June 2015. We have also analysed the readers’ comments on the coverage of the care.data scheme in one of the main national UK newspapers. When discussing the responses of citizens, we will make a distinction between the problems that citizens detect and the solutions they propose. The solutions that are being perceived as the most relevant ones can be summarized as follows: citizens wish to further the common good without being manipulated into doing it, while at the same time being safeguarded against various abuses. The issue of trust turns out to figure prominently. Our analysis of reactions to the scheme in no way pretends to be exhaustive, yet it provides various relevant insights into the concerns identified by citizens as well as medical professionals. These concerns, moreover, have a more general relevance in relation to other contexts of medical data-mining as well as biobank research. Our analysis also offers important pointers as to how those concerns might be addressed. (shrink)

In terms of medical science and legal responsibility, the sleep disorder category of parasomnias, chiefly REM sleep behavior disorder and somnambulism, pose an enigmatic dilemma. During an episode of parasomnia, individuals are neither awake nor aware, but their actions appear conscious. As these actions move beyond the innocuous, such as eating and blurting out embarrassing information, and enter the realm of rape and homicide, their degree of importance and relevance increases exponentially. Parasomnias that result in illegal activity, particularly (...) violence, are puzzling phenomena for medicine and the law. Via a review of the pertinent medical literature, a general overview of the current scientific knowledge of parasomnias will be provided. Though this knowledge is far from complete, it can provide some neurobiological information about the nature of parasomnia, including conclusions about a sleepwalker’s level of intention as well as factors that predispose one to such episodes. Although a parasomniac’s complete lack of consciousness warrants acquittal from criminal liability, it does not exclude responsibility for subjecting oneself to exacerbating factors that result in these violent parasomnias. Individuals should be held accountable if they could be expected to control these factors. In addition, they should undergo appropriate treatment and management in order to prevent future parasomnia behaviors. Establishing a legal defense for parasomnia will prove difficult due to the strong potential for malingering, so specific criteria will be outlined in order to distinguish between true and fraudulent claims of crimes committed during parasomniac states. (shrink)

BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this (...) trial aims to assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

In this paper I use normative analysis to explore the curious and seemingly singular phenomenon whereby some dog owners deny the physical and moral facts about a situation where it is claimed their dog harmed or irritated others. I define these as epistemic and ethical denial, respectively, and offer a tentative exploration of their implications in terms of relational autonomy and responsible behaviour in public spaces.

Chronobiologists argue that their scientific findings have implications for prevention of sleep problems. They claim that some sleep problems are caused by the fact that people live against their individual body clock rather than adjusted to it. They also claim that by taking the findings of chronobiology seriously in policy-making some sleep problems can be prevented. I investigate applications of chronobiology in two social areas—school schedules and shift work—and show that in order for these applications to be (...) justified certain implicit presumptions have to be justified. The first presumption is explanatory, namely that a chronobiological explanation is an adequate explanation of the sleep problems at hand. In addition I analyse three ethical presumptions. The first ethical presumption is that sleep is of vital value. The second is that sleep is not an exclusively private issue. The third ethical presumption is that the preventive measures to be undertaken are ethically acceptable. My main point is that it is not possible to simply “read off” policy measures from the empirical findings of chronobiology. (shrink)

Standard views of good death in human and veterinary medicine considerably differ from one another. Whereas the good death ideal in palliative medicine emphasizes the positive aspects of non-induced dying, veterinarians typically promote a quick and painless killing with the aim to end suffering. Recent developments suggest a convergence of both professions and professional attitudes, however. Palliative physicians are confronted with patients wishing to be ‘put to sleep’, while veterinarians have begun to integrate principles and practices from (...) hospice care. We will argue that the discourses on good human and animal deaths are not distinct, but that they interact and influence each other. On the one hand, veterinary medicine adapts techniques like chemotherapy or sedation from palliative end-of-life care. On the other hand, philosophers, veterinarians, pet owners, patients and the general public alike make certain assumptions about the analogy of human and animal dying or killing. Unfortunately, these interactions have only scarcely been reflected normatively, especially on the part of human medicine. Conflicts and misattributions with potential serious negative consequences for the patients’ wellbeing are provoked. For these reasons, palliative physicians and veterinarians are invited to engage in the debate around human and animal end-of-life care. (shrink)

This edited volume explores the intersection of medicine and philosophy throughout history, calling attention to the role of quantification in understanding the medical body. Retracing current trends and debates to examine the quantification of the body throughout the early modern, modern and early contemporary age, the authors contextualise important issues of both medical and philosophical significance, with chapters focusing on the quantification of temperaments and fluids, complexions, functions of the living body, embryology, and the impact of quantified reasoning on (...) the concepts of health and illness. With insights spanning from the sixteenth century to the nineteenth century, this book provides a wide-ranging overview of attempts to ‘quantify’ the human body at various points. Arguing that medicine and philosophy have been constantly in dialogue with each other, the authors discuss how this provided a strategic opportunity both for medical thought and philosophy to refine and further develop. Given today’s fascination with the quantification of the body, represented by the growing profusion of self-tracking devices logging one’s sleep, diet or mood, this collection offers an important and timely contribution to an emerging and interdisciplinary field of study. -/- . (shrink)

This paper examines the forms of life established through the visual governance of the Australian social security mobile app —the Express Plus Centrelink app. It is argued that the app exceeds established accounts of juridical and administrative power. The app involves a seeing that is not public, a responding that is not writing and a de-materialisation of an institution and its disciplinary apparatus. It is argued that the app creates proto-literate subjects that are required to respond to a real-time sequence (...) of images in a highly structured and circumscribed manner to become complicit in the digitalisation of their life. (shrink)

This study explores ethnic variations in animal companion attachment among 133 students enrolled in a school of veterinary medicine. The 57 White and 76 African American participants completed surveys that included background information, several questions about their animal companions, and a pet attachment questionnaire .White students had significantly higher PAQ scores than did African American students . White students also had significantly more pets and more kinds of pets and were more likely to allow pets to sleep on (...) their beds . Although keeping pets is a universal cultural phenomenon, how that attachment is expressed may vary from culture-to-culture. This study explores possible explanations and implications for these variations. (shrink)

In his story entitled "Toenails," the surgeon Richard Selzer (1982) warns readers that total immersion in medicine is wrongheaded. Rather, to ensure their own health, doctors should discover other passions that permit them periodically to disconnect from medical practice. Selzer's surgeon character devotes his Wednesday afternoons to the public library, where he joins "a subculture of elderly men and women who gather … to read or sleep beneath the world's newspapers" (p. 69). Among these often eccentric personages is (...) Neckerchief, an arthritic man in his 80s who suffers from severe foot pain. His toenails, never trimmed because of his inability to reach them, have grown so long that they curve beneath his toes and .. (shrink)

Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

Better memory, greater motivation and concentration lead to greater productivity, efficiency and performance, all of which are features that are highly valued in a modern society focused on productivity. In the effort for better cognitive abilities, otherwise healthy individuals use cognitive enhancers, medicines for the treatment of cognitive deficits of patients with various disorders and health problems, such as Alzheimer’s disease, schizophrenia, stroke, Attention Deficit Hyperactivity Disorder or ageing. The use of these is more common in professions with emphasised cognitive (...) abilities, or in occupations that require more attention, focus and alertness. Their use is also associated with the general working population, in that they are supposed to use them to alleviate the effects of sleep deprivation and to cope with increasing workloads. In the paper, we are addressing the ethical issue and the dilemmas of the use of pharmaceutical enhancements by healthy people who have no medical reason for taking such substances, in the context of improving their cognitive functions. (shrink)

Recent approaches in the medical and social sciences have begun to lay stress on “plasticity” as a key feature of human physiological experiences. Plasticity helps to account for significant differences within and between populations, particularly in relation to variations in basic physiological processes, such as brain development, and, in the context of this article, daily sleep needs. This article proposes a novel basis for the redevelopment of institutions in accordance with growing awareness of human variation in physiological needs, and (...) articulates a theory of multibiologism. This approach seeks to expand the range of “normal” physiological experiences to respond to human plasticity, but also to move beyond critiques of medical practice that see medicine as simply responding to capitalist demands through the medicalization of “natural” processes. Instead, by focusing on how the institutions of U.S. everyday life—work, family, and school—structure the lives of individuals and produce certain forms of sleep as pathological, this article proposes that minor alterations in institutions could result in less pathologization for individuals and communities. Multibiologism provides a foundation for shared priorities in the social sciences, in bioethics, and in medical practice, and may lay the groundwork for emergent collaborations in institutional reform. (shrink)

In the Peruvian Amazon, tobacco (Nicotiana rustica) is considered a master plant and is the main curing tool of local healers. Among its several medicinal uses, we find drinking tobacco juice with the purpose of purging in order to heal on a physical, mental, and spiritual level. This specific practice is part of the addiction treatment protocol developed at Takiwasi Center. The goal of this investigation was to focus on the effects of the tobacco purge as reported by therapists at (...) Takiwasi and to elaborate its relevance within the context of addiction treatment. In order to obtain information on this topic, we performed research fieldwork based on a participant-observation approach, and retrospective data analysis on information from interviews conducted by psychotherapists with patients. As alleged effects of the tobacco purge, therapists reported that patients experienced feelings of mental clarity with the greatest frequency (n = 80), followed by noteworthy physical effects including discomfort and intoxication (n = 63). An effect on sleep and dreams was also common (n = 36) and many found the experience directly related to addiction treatment and the desire to consume substances (n = 20). (shrink)

BackgroundThe safety of sleeping pills has increased dramatically during the last 100 years, from barbiturates to bensodiazepines to modern day so-called Z-drugs.MethodsThe circumstances of prescribing sleeping pills in the early 20th century are illustrated by summarizing the main storyline of a novel by Swedish writer Vilhelm Moberg. This is followed by a thought experiment and a theoretical discussion.ResultsIn his 1937 novel Sömnlös (Swedish for sleepless) Vilhelm Moberg portrayed existential and relational distress in relation to insomnia. In a thought experiment, past (...) progresses in sleeping pills safety are projected into the future. Thereby, it is claimed that important issues in the area of philosophy of medicine come to the fore. This leads to a theoretical discussion about broader questions concerning the role of the physician, the goals of medicine (as described by Lennart Nordenfelt), the concept of pharmaceuticalisation (as described notably by sociologist of sleep Simon J. Williams and co-workers), and health enhancement (c.f. Carl Elliott and the alleged wish to be better than well).ConclusionInsomnia is a prism through which important philosophical and sociological questions related to the practice of medicine can be asked. (shrink)

This book deals with some Peripatetic philosophers of the Hellenistic age who were direct and indirect pupils of Aristotle. The main focus of the book is Aristotle's school in the Hellenistic period, a subject not particularly explored by the scholars. Three main issues are addressed in the chapters of the book: the problem of knowledge, the question of time, and the doctrine of the soul. More specifically the topics addressed are: the problem of sense-perception and the method of multiple explanations (...) in the field of meteorology in Aristotle, Theophrastus and Epicurus, the epistemology of Strato, the notion of time in Eudemus and Strato, the conception of sleep in Clearchus, the doctrine of divination in Cratippus. Finally, the Appendix examines the probable influence of the physics of Strato on the medicine of Asclepiades of Bithynia. These themes are investigated by comparing the positions of the Peripatetics with Aristotle's philosophy, but above all by contextualising the doctrines of the Peripatetics within the broader framework of Hellenistic philosophies. (shrink)

Restoring our biological cycles to heal ourselves, our culture, and our planet Shows how, just like the tides and the moon phases, both women and men have biological cycles of growth and renewal necessary for healthy bodies and minds. Explains how the seclusion of women during menstruation and of men during vision quests offers a cleansing process for body and mind to awaken innate creativity and sensitivity, re-attune us with the deeper rhythms of the body and nature, and restore harmony (...) between the divine feminine and divine masculine. Reveals how the need for sacred retreat was forgotten when the divine feminine was suppressed by patriarchal culture. All of life is interwoven into a living system of cycles, from Earth's seasons to the enzymatic pathways that provide energy to a cell. Waxing and waning from times of growth to times of rest, renewal, and healing, cycles map the most auspicious time for everything in life. Both women and men have biological cycles of active growth and quiet renewal, led by our hormones. By understanding how everything in life moves in cycles, you can become more aware of and comfortable with your own cyclic nature, something that has been forgotten by the modern world's linear views of time. Drawing on the wisdom of ancient cultures, the natural cycles of life, and her own groundbreaking research, Pia Orleane, Ph.D., offers a template for how we can restore balance to our emotions and health, ease tensions between the sexes, and heal our fractured culture by honoring divine feminine consciousness and re-embracing natural cycles, including our innate need for rest and retreat. She explains the biology of how our bodies operate by hormones released in cycles and shows how balanced hormones help eliminate anger, depression, insomnia, anxiety, and fatigue. Exploring ancient traditions and rituals surrounding blood and sacred retreat, she explains how the seclusion of women during menstruation and of men during vision quests offered a cleansing process for body and mind, alone time to clear suppressed emotions, awaken our innate creativity and sensitivity, re-attune us with the deeper rhythms of the body and nature, and restore harmony between the genders and balance between the divine feminine and masculine. Outlining the sacred retreat process, the author explores dream cycles, divine sexuality, and practices for reconnecting to nature, increasing creativity and intuition, and clearing suppressed emotions. She also looks at the benefits for women and men of separate sleeping during menstruation. Through this wisdom, we can restore our natural cycles, allow the divine feminine to once again blossom alongside the divine masculine, and, with the return of balance, heal our world and our hearts. (shrink)

BackgroundIn this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored.Research designA qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used.Ethical considerationsApproval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary.FindingsBased on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, (...) coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness.ConclusionMoral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves. (shrink)

Among the ideas and themes in Burton’s Anatomy of Melancholy with apparent bearing on the treatment of depression in our own times, four are the subject of the present chapter. First, these herbal and other remedies were to be taken as part of a broader regimen of which no single part could be omitted. The regulation of exercise, fresh air, sleep, diet, evacuation, and feelings, believed to together keep the bodily humors in healthy balance, demanded habits and practices that (...) were essential accompaniments to one another and to other measures. This was eclectic and holistic healing, only effective when combined. Second, adhering to this regimen was, for the most part, the individual’s own responsibility: it was an extensive self-help program. Third, it was preventive medicine, thought to ward off the symptoms of melancholy before they became entrenched and difficult to treat. And, finally, underlying and reinforcing these practical recommendations were ideas about the causes of, and remedies for, melancholy that are consonant with some recent challenges to the application of mainstream conceptions of disease in today’s medicine when it comes to the treatment of depression. Inasmuch as he seems to eschew “common cause” etiological models, Burton’s account corresponds more closely to the network-based models beginning to be proposed for disorders of mood or affect. (shrink)

In Molière’s comedy The Imaginary Invalid a doctor “explains” that opium reliably induces sleep because it has a “dormitive virtue.” Molière intended this to be a satirical play on the use of opaque scholastic concepts in medicine, and since then the phrase “dormitive virtue” has become a byword for explanatory failure. However, contemporary work on the metaphysics of grounding and dispositions appears to permit explanations with a strikingly similar structure. In this paper I explore competing verdicts on dormitive (...) virtue explanation, using a model of explanation I call Contextualist Pluralist Non-Realist Backing, or CPN Backing. I show that CPN Backing illuminates the puzzle about dormitive virtue explanation, shows what is required for a resolution, and makes sense of conflicting responses to this case. (shrink)

Background In a previous paper in Philos Ethics Humanit Med, the 1937 Swedish novel Sömnlös (Swedish for sleepless) by Vilhelm Moberg was used as background for a thought experiment, in which last century’s progresses concerning the safety of sleeping pills were projected into the future. This gave rise to a theoretical discussion about broad medico-philosophical questions such as (among other things) the concept of pharmaceuticalisation. Methods In this follow-up paper, the theme of insomnia in Sömnlös is complemented by a discussion (...) of the concept of nostalgia. The core of the paper is a theoretical discussion about the benefits and risks of nostalgia, bringing together some aspects of recent psychological research about the construct of nostalgia with the main story line of the novel. Results and Conclusion Nostalgia is portrayed as being, in some sense at least, ultimately beneficial for the protagonist of Sömnlös. This is congruent with recent psychological research. However, the story also shows that nostalgia may lead to problematic behaviours, at least when viewed from a virtue ethics perspective. Hence, nostalgia is both what leads the protagonist into ethically problematic behaviour and that which (paradoxically) ultimately saves him from his initial lack of courage, justice, temperance and practical wisdom. Moreover, the protagonist does not only “grow” ethically but also existentially. Hence, the novel opens up the possibility that insomnia and nostalgia might be viewed as bearers of important existential information (cf. sociologist of religion Peter L. Berger and his concept of “signals of transcendence”). (shrink)

In the third intermède of Le Malade Imaginaire, Molière imagines a sort of medical convention in which "the wisest experts and professors of Medicine" examine whether a bachelor candidate can be deemed to enter the medical profession. As the first question in this examination, the "Chief physician" asks, "What is the cause and reason [causam et rationem] why opium induces sleep?" The candidate answers without the least hesitation: "Because it contains a sleeping virtue [virtus dormitiva], whose nature is (...) to put the senses to sleep." The answer is followed by a jubilant reaction by the choir: "Good, good, good, he answers well, he is worthy of entering in our wise gild."1The scene is intended to be a... (shrink)

Ever since Greek antiquity "disembodied knowledge" has often been taken as synonymous with "objective truth." Yet we also have very specific mental images of the kinds of bodies that house great minds--the ascetic philosopher versus the hearty surgeon, for example. Does truth have anything to do with the belly? What difference does it make to the pursuit of knowledge whether Einstein rode a bicycle, Russell was randy, or Darwin flatulent? Bringing body and knowledge into such intimate contact is occasionally seen (...) as funny, sometimes as enraging, and more often just as pointless. Vividly written and well illustrated, Science Incarnate offers concrete historical answers to such skeptical questions about the relationships between body, mind, and knowledge. Focusing on the seventeenth century to the present, Science Incarnate explores how intellectuals sought to establish the value and authority of their ideas through public displays of their private ways of life. Patterns of eating, sleeping, exercising, being ill, and having (or avoiding) sex, as well as the marks of gender and bodily form, were proof of the presence or absence of intellectual virtue, integrity, skill, and authority. Intellectuals examined in detail include René Descartes, Isaac Newton, Charles Darwin, and Ada Lovelace. Science Incarnate is at once very funny and deeply serious, addressing issues of crucial importance to present-day discussions about the nature of knowledge and how it is produced. It incorporates much that will interest cultural and social historians, historians of science and medicine, philosophers, sociologists, and anthropologists. (shrink)

Due to the outbreak of COVID-19 many families experience the threat of the COVID-19. This study aims to explore the lived experiences, challenges, and coping mechanisms of COVID-19 Family Survivors. The study employed the Interpretative Phenomenological Analysis with ten (10) participants. Based on the findings, the following conclusions were drawn: (1) Most of the participants consulted health professionals for their medications and advised herbal medicines in boosting their immune system. (2) Family survivors had to make adaptations to their daily routines (...) and established stringent health standards in their homes, such as separating the parents' and children's rooms, using disposable utensils, and ensuring that every surface of their homes was clean. (3) They were able to meet their necessities due to the generosity of their neighbors. These people were helped financially by their employers, neighbors, churchmates, and loved ones. Similarly, the government offered a different forum for the COVID-19 Family survivors to receive help and assistance. (4) Despite the hardships they faced, COVID-19 family survivors did not lose hope that they would be cured of COVID-19. These people tried their hardest to maintain their health by eating good meals, sleeping early, obtaining enough sunlight in the morning, and carefully selecting the vitamins they took. (5) Finally, despite the difficult battle against COVID19, these individuals grew resilient by building their spiritual lives, exercising their faith, and being brave for the sake of their loved ones. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Spirometer, Whale, Slave:Breathing Emergencies, c. 1850John Durham Peters (bio)Breath dramatically starts with a slap at birth and ceases with death and yet we typically ignore it until it is under duress. Unlike marine mammals such as whales and dolphins who can never fully automate breathing—they sleep one brain hemisphere at a time so as to keep conscious watch, like yogis, over their respiration—we humans are mostly somnambulists with (...) regard to breath. Unlike our briny cousins, we won't drown if we neglect our breath. Our relatively accommodating habitat at the fold of lithosphere and atmosphere enables a Lethe of oblivion, though many elements of our world are hostile to breath: water, fire, earth, extremes of height, heat, or cold. Nothing could be more fundamental for aerobic terrestrial creatures than breathing. So its routine cloaking in impercipience must somehow be functional and require a great deal of nervous expenditure. (It always takes a lot of work to make an infrastructure invisible.)Breathing is a good test case for the notion, common to many variants of critical theory, that nature for humans is always second nature: what would it mean to find culture, history, and politics in something that is so relentlessly universal and given? The intensity of the urge for drink, food, sex, or sleep pales compared to that of taking a breath withheld or expelling a breath too long held. Here, it seems, desire and need converge. Breathing morphs into awareness, art and artifice when threat, absence or curiosity rouse it from its slumber—when we swim, have a coughing fit, sing, or challenge someone to a breath-holding contest. Under the earth in a mine, high in the air on a mountain or airplane, ill with a respiratory disease, or in other extreme situations, we need techniques and technologies to breathe. Like everything supposedly natural, we can't leave breathing in peace. We mold breath in techniques of speech, song, and prayer and in technologies of diving, medicine, and air travel. A full accounting of such would form a full encyclopedia of human ingenuity.1 [End Page 85]With typical flamboyance, Peter Sloterdijk declared that the atmosphere first ceased to be taken for granted, i.e., became technical, a matter of art, on 22 April 1915, with the German deployment of poison gas in World War I. On a world-historical scale, he takes this weaponization of the environment as an "air-quake" that launched modern air-conditioning in its most literal sense of climatization (as French and German has it) and not just interior cooling (Sloterdijk 89-110 passim). We need a history of comparative breathing emergencies! Every era, like every life, has its encounters with the precarity of breathing, even if not as conveniently dated or climate-change prognostic as 22 April 1915. The urban concentration of human population starting a few thousand years ago, for instance, made people co-breathers (con-spirators) in new ways and thus more prone to the contagious respiratory illnesses that have long ravaged our species.I want to look at one such moment—one marked by a deadly global respiratory illness, new instruments for producing data, worries about radical alterations to the atmosphere, comparative interest in nonhuman forms of life, and the politicization of breathing. 1850, like 2020, was a moment when breath awoke from its autonomic quiet. The nineteenth century was the great age of tuberculosis, the tragic and romantic lung disease. It was a time of fog, smoke, and mud, of climate-changing volcanic eruptions and a year without a summer, and of a mysterious, brooding "storm-cloud" that John Ruskin complained of so bitterly. Medical instruments, the whaling industry, and struggles for the abolition of slavery all brought the lungs into the foreground.SpirometerThe nineteenth century was also the great age of instrumentation. Light and sound were only the two most famous dynamic processes to yield to new graphic methods of inscription such as photography and phonography. The spirometer was one of many devices designed to render visual data of physiological functions, such as the myograph, the flame manometer, sphygmomanometer, and the kymograph. Many of them are still in use. The invention... (shrink)

Dreaming is a communicative activity between the most sensitive archive of the enregistered experience of life on the earth, the brain, and the most plastic medium for the discovery and practice of meaning, the mind or culture. Both love and war have been made on the basis of dreams, not to mention scientific discoveries. In ancient Greece dreams were medicinal parts of curative sleeping or "incubation" rites in the temple of Aesculapius, and many psychoanalytic physicians today still consider dreams as (...) possessing therapeutic potential. The ethnographic literature gives ample testimony to the great significance accorded to dreams by all of the world cultures. Dreams form a rich store of ethnographic evidence, and their indigenous interpretations can often illuminate the central issues and conflicts of a people otherwise hidden from obvious view. Given these facts, plus the physiological facts that the dream process itself involves deeply-rooted material brain functions, and that rapid eye movement, or REM, sleep, which is the key indicator of human dreaming, is shared by all mammals, it remains strange how little attention is given to dreaming as a formative aspect of human evolution and culture. -/- This essay addresses dreaming as a formative aspect of human evolution and culture by viewing dreaming as a borderland between biology and culture, a thoroughly social, yet private experience. Dreaming not only highlights the "cultic" roots of culture—the spontaneous impulse to meaning—but also illustrates one of the ways in which the technics of the biosocial human body itself form the primary source of culture. I show why dreaming, although private, is a thoroughly cultural, biological, communicative activity. -/- Culture and biology are often treated by social scientists as though they were oil and water, not to be mixed. I should inform the culture theorist at the start that I am fully aware of the assumed nature-culture dichotomy, and that I reject it. I do so not because I am a sociobiologist, quite the contrary, rather because I am a semiotician, and my studies of signs have led me toward a critical reconstruction of the concepts of nature and culture. In what follows I beg the reader's patience, since I will draw from diverse materials and project some speculative hypotheses in places in order to make my argument. -/- . (shrink)