Since the Nuremberg trials (1947–1949), informed consent has become central for ethical practice in patient care and biomedical research. Codes of ethics emanating from the Nuremberg Code (1947) recognize the importance of protecting patients and research subjects from abuses, manipulation and deception. Informed consent empowers individuals to autonomously and voluntarily accept or reject participation in either clinical treatment or research. In some cases, however, the underlying mental or physical condition of the individual may alter his or her cognitive abilities and (...) compromise the informed consent process. This is particularly true in chronic psychiatric conditions such as Treatment-Resistant Depression (TRD), where individuals may fail to respond to traditional antidepressant treatments (e.g., psychotherapy, pharmacotherapy). Moreover, it may raise further concerns for an individual’s motivation to consent and the level of understanding of the treatment or research procedure. This paper focuses on the informed consent process for Vagus Nerve Stimulation (VNS) in the treatment of individuals diagnosed with TRD. Specifically, the paper addresses how depression may affect the decision-making capacity of an individual and the potential ethical and legal impact of failure to appreciate the seven elements of the consenting process (competence, voluntariness, disclosure, recommendation, understanding, decision, and authorization). To ensure the protection of vulnerable individuals with psychiatric disorders such as TRD and promote ethical behavior in biomedical research and patient care while avoiding potential legal pitfalls, we propose a paradigm that requires a stringent evaluation process of decision-making capacity for informed consent. (shrink)

Objectives: The objective of this post hoc exploratory analysis was to examine the relationship between age and measures of cortical excitability and inhibition. Methods: Forty-six participants (24 with major depressive disorder and 22 healthy controls) completed MT, SICI, ICF, and CSP testing in a cross-sectional protocol. Of these 46 participants, 33 completed LICI testing. Multiple linear robust regression and Spearman partial correlation coefficient were used to examine the relationship between age and the TMS measures. Results: In the overall sample of (...) 46 participants, age had a significant negative relationship with motor threshold in both the right (rs = -0.49, adjusted p =.007; β= -0.08, adjusted p=.001) and left (rs = -0.42, adjusted p =.029; β= -0.05, adjusted p=.004) hemispheres. This significant negative relationship of age with motor threshold was also observed in the sample of depressed youth in both the right (rs = -0.70, adjusted p =.002; β= -0.09, adjusted p=.001) and left (rs = -0.54, adjusted p =.034; β= -0.05, adjusted p=.017) hemispheres, but not in healthy controls. In the sample of the 33 participants who completed LICI testing, age had a significant negative relationship with LICI (200 millisecond interval) in both the right (rs = -0.48, adjusted p =.05; β= -0.24, adjusted p=.007) and left (rs = -0.64, adjusted p =.002; β= -0.23, adjusted p=.001) hemispheres. This negative relationship between age and LICI (200 millisecond interval) was also observed in depressed youth in both the right (rs = -0.76, adjusted p =.034; β= -0.35, adjusted p=.004) and left (rs = -0.92, adjusted p =.002; β= -0.25, adjusted p=.001) hemispheres. Conclusion: These findings suggest that younger children have higher motor thresholds. This is more pronounced in depressed youth than healthy controls. LICI inhibition may also increase with age in youth. (shrink)

L’éthique de la vertu d’Annas est confrontée à l’objection de la circularité. Annas affirme qu’une âme juste est disposée à poser des actes justes. On contourne l’objection de la circularité si l’on ne définit l’âme juste ni en termes d’actes bons, ni en termes de règles. En m’appuyant sur les récents travaux de Korsgaard, je démontre que l’argument d’Annas se heurte de nouveau à l’objection de la circularité. Ensuite, j’examine de quelle façon Annas tente une fois de plus d’éviter l’objection (...) de la circularité en faisant appel à la communauté des vertueux. Je soutiens que cette démarche ne préserve sa théorie ni du relativisme, ni de l’objection de la circularité. (shrink)

Cet article est fondé sur deux principes : le principe de partialité et le principe d’impartialité. M’appuyant sur un argument relativement peu connu de Kant, j’énonce et je défends le second principe. Je démontre ensuite que le premier principe est lié à la thèse présentée par Annas dans sa théorie sur l’éthique de la vertu, selon laquelle aucun adulte mûr ne souhaite qu’on lui dise quoi faire, ainsi qu’à son récit sur l’enseignement et l’apprentissage de la vertu. Je soutiens que (...) la théorie d’Annas sur l’éthique de la vertu est susceptible, contrairement à celle de Kant, de donner prise soit à l’objection de la circularité, soit à l’objection du relativisme. (shrink)

In the paper I examine (Section I) the best defense for the claim that methodologies shouldnot function heuristically (thesis-LW) as it appears in John Worrall. I then evaluate (Section II) his proposal of a criterion* M which is offered as a criterion for evaluating competing methodologies such as falsificationism, conventionalism, methodology of research programmes. etc. Finally, I consider (Section III) the consequences of arguments presented earlier (Section I and II) as they bear on the problem of selecting a historiographical model.I (...) argue, among other things, (I) that thesis-LW is defended on some very dubious assumptions; (II) that Worrall's criterion* M falters under three clear cases two of which at least*M should accomodate, and that part of* M's failure can be linked to its being hooked to thesis-LW. By arguments analogous to the ones which serve* M, I show thatcontra John Worrall and John Watkins, thesis-LW is testable; finally, (III) if we accept arguments for thesis-LW and* M we are left with a skeptical conclusion with respect to the choice of a historiographical model which Worrall by parity of reasoning should accept, but does not. (shrink)

Philosophy of history; the idea of the not-being and the history, by K. M. Jamil.--Philosophy of history, by Khwaja Ashkar Husain.--Philosophy of history, by A. H. Kamali.--Philosophy of history, by B. H. Siddiqi.--Philosophy of history: explanation in history, by Kazi A. Kadir.

Few modern artists so consistently embodied a fuzzy logic of their own as did the Indian painter Maqbool Fida Husain (1915 – 2011). His critics tried to define him as a reckless defamer of Hindu values, but another way to define him is as a dutiful devotee of a vision that was inclusive, rather than exclusive, and that understood all boundaries and identities as fluid or blurry, rather than as fixed and immutable. Or one might say that Husain (...) strove to project what Ashis Nandy has called “Indian-style secularism,” celebrating creation, humanity, and beauty in the multiple religious forms of the subcontinent. Having lived and painted in India all his life, he was forced into exile in his nineties by right-wing Hindu politicians. In London, he continued to work on a new interpretation of Indian civilization as universally relevant, in a sequence of paintings with themes from the Mahabharata, while, in Doha, a royal patron commissioned him to paint a series relating Islamic and Christian civilization. The two series are shown, in this essay, to best exhibit Husain's view of “all distinctions” as “political, artificial.”. (shrink)

Sometimes metaphysicians appeal to simplicity as a reason to prefer one metaphysical theory to another, especially when a philosophical dispute has otherwise reached a state of equilibrium. In this paper, I show that given a Quinean conception of metaphysics, several initially plausible justifications for simplicity as a metaphysical criterion do not succeed. If philosophers wish to preserve simplicity as a metaphysical criterion, therefore, they must radically reconceive the project of metaphysics.

We argue that thoughts are structures of concepts, and that concepts should be individuated by their origins, rather than in terms of their semantic or epistemic properties. Many features of cognition turn on the vehicles of content, thoughts, rather than on the nature of the contents they express. Originalism makes concepts available to explain, with no threat of circularity, puzzling cases concerning thought. In this paper, we mention Hesperus/Phosphorus puzzles, the Evans-Perry example of the ship seen through different windows, and (...) Mates cases, and we believe that there are many additional applications. (shrink)

Norm entrepreneurs have made significant strides in advancing sexual orientation and gender identity resolutions at the UN Human Rights Council. However, these advancements are being fiercely contested. This paper examines the development of SOGI at the Council including how states advocate for and contest SOGI and the extent to which their positions are mutable. Resolution 32/2 of 2016, which created an independent expert, is the central focus of the paper. Participant interviews and content analysis of documents and statements are used (...) to provide an in-depth analysis of how states advocate their positions on SOGI. The paper finds that framing is the primary tool used by states. Both proponents and opponents of SOGI believe their own positions are universal and adhere to prior international law, while their opponents’ positions are relativist and revisionist. The paper further finds that deadlock on SOGI resolutions is imminent until Member States’ domestic legislation changes. (shrink)

Retributivists are often thought to give 'deontological' theories of punishment, arguing that we should punish not for the beneficial consequences of doing so such as deterrence or incapacitation, but purely because justice demands it. Kant is often regarded as the paradigmatic retributivist. In some passages Kant does appear to give a deontological theory of punishment. For example, Kant insists that on an island where all the people were to leave the next day, forever dissolving and dispersing the community, the last (...) murderer in jail would have to have his execution carried out before the diaspora--justice demands it. In other passages, however, Kant defends punishment by appealing to its beneficial consequences. For example, after supposing that one man on a life raft pushes the other off to save his own life, Kant says that the former man should not be legally punished "because that punishment would have to be death, and it would be an absurd law that threatened death to one who refuses to die voluntarily in a dangerous situation." In this passage Kant's reasoning is that state laws, by threatening us with sanctions, are intended to prevent us from violating rights--the point of these laws is to deter. A law that imposes a punishment that could not deter is an absurd law. I argue that while Kant rejects consequentialism in thinking about moral actions, he distinguishes law and morality, and in the sphere of law, an action we take is to be justified by appealing to the good it yields. The point of legal punishment is to deter violations of rights and protect us from a state of nature in which no one's freedom is assured. Kant's theory of legal (as opposed to moral) punishment is not deontological. Nevertheless we can characterize his consequentialist theory of legal punishment as retributive in some sense. The paper then considers how the passages about punishment in which Kant invokes consequentialist thinking can be reconciled with other passages where he insists on punishment regardless of the consequences. (shrink)

The involuntary admission or treatment of a mentally ill individual is highly controversial, as it may be argued that such intervention infringes on individual autonomy and the right to choose a particular treatment. However, this argument must be balanced with the need to provide immediate healthcare services to a vulnerable person who cannot or will not make a choice in his or her own best interests at a particular time. A study carried out in Gauteng Province, South Africa, highlighted the (...) fact that the annual rate of involuntary admissions increased by almost double from 2007 to 2008. This could indicate that healthcare providers are not treating patients without their consent only when this is absolutely necessary. Alternatively, it could indicate that healthcare professionals are more aware of the provisions of the Mental Health Care Act and relevant national policy guidelines. Or it could suggest that more patients are presenting with mental illnesses or disorders that require their involuntary admission. It remains for strategies to be developed that change negative perceptions and inequities for individuals with mental illness. Above all, the strategies should be underpinned by inalienable respect for mentally ill individuals – a concept that was blatantly disregarded in the Life Esidimeni case. In this article, we highlight the functions of mental health review boards and their accountability where involuntary admissions are concerned, while emphasising the protections for mentally ill persons as a vulnerable population group, as set out in the SA Constitution. (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Business versus Ethics?. The authors of these commentaries seek to transcend the age-old separation fallacy :409–421, 1994) that juxtaposes business and ethics/society, posing a forced choice or trade off. Providing a contemporary take on (...) the classical question “if it’s legal is it ethical?”, David Hess explores the role of the law in promoting or hindering stakeholder-oriented purpose and governance structure. Jeffrey Harrison encourages scholars to move beyond the presupposition that businesses are either strategic or ethical and explore important questions at the intersection of strategy and ethics. The proposition that business models might be inherently ethical or inherently unethical in their design is developed by Sheila Killian, who examines business systems, their morality, and who they serve. However, the conundrum that entrepreneurs are either lauded for their self-belief and risk-taking, or loathed for their self-belief and risk-taking, is discussed by M. Tina Dacin and Julia Roloff using the metaphor of taboos and totems. These commentaries seek to explore positions that advocate multiplicity and tensions in which business ethics is not either/or but both. (shrink)

I take it as my assignment to criticize the Gauthier enterprise. At the outset, however, I should express my general agreement with David Gauthier's normative vision of a liberal social order, including the place that individual principles of morality hold in such an order. Whether the enterprise is, ultimately, judged to have succeeded or to have failed depends on the standards applied. Considered as a coherent grounding of such a social order in the rational choice behavior of persons, the enterprise (...) fails. Considered as an extended argument implying that persons should adopt the moral stance embodied in the Gauthier structure, the enterprise is, I dunk, largely successful. Considered as a set of empirically falsifiable propositions suggesting that persons do, indeed, choose as the Gauthier precepts dictate, the enterprise offers Humean hope rather than Hobbesian despair. (shrink)

The term ‘organizational development’ is defined in management textbooks as a ‘collection of planned change interventions built on democratic–humanistic values that seek to improve organizational effectiveness and well–being’. But we use the term in a simpler and broader sense as the evolution and development of an organization towards its highest potential. In this article we present the broad outlines of a strategic vision of organizational development based on the aims and principles of yoga. The word ‘yoga’ has now become well (...) known all over the world. But the popular conceptions of yoga conjure up images of a hatha–yogi standing upside down or a hermit in the Himalayas. The deeper psychological and pragmatic significance of yoga is not fully understood. ‘Yoga,’ says Sri Aurobindo, ‘is nothing but practical psychology’. It contributes to the psychological and spiritual development of the human organism. Yoga is the scientific, psychological process or discipline by which the inner development of the human being is triggered and can be accelerated. (shrink)

Dementia accompanies aging in certain susceptible individuals. The chemical function of the brain remains normal, but certain neurotransmitter-selective diseases, such as Parkinson's disease, Huntington's disease, and Alzheimer's disease occur more commonly with age.There are at least two issues troubling researchers of senile dementia at the moment. One is the contribution of cell death, as opposed to selective neuronal atrophy, to the pathology of degenerative disorders. The other is how early the onset of dementia might be detected. The resolution of such (...) issues is important for the design of therapies for the common and most serious chronic, rather than acute, neurodegenerative disease.Alzheimer's disease is one of the most devastating neurological disorders. The ethical debate is often related to when human biological life ceases or when a person ceases to exist. If the elder is still a person, he/she is no more the same person. Huntington's disease is inherited as a highly penetrant, autosomal dominant neuronal disorder. A genetic test can accurately predict a person's risk and that of the children. As the knowledge of the genetic basis is increasing and prenatal diagnosis gets easier, the possibilities to avoid child disorders will become greater, but genetic testing raises problematic ethical issues. Ethical action involves the right to know and the right not to know, it involves freedom of choice and freedom implies knowledge. It is ethical that relatives in age of procreation should be informed. In any case, efficacy and safety of the procedure, the risk-benefit ratio for a particular disease must be judged to be acceptable and understood through informed consent by the patient or the family or both. (shrink)

The law and society occasionally impute consent to an agent despite a clear lack of actual consent. A common type of such ‘fictitious consent’ is constructive consent. In this practice, we treat an agent as if she consented to Φ because she did Ψ. By examining how constructive consent operates in law and daily life, I show that our treatment of agents in these cases bears no normatively relevant resemblance to consent because it is grounded in values and concerns other (...) than autonomy. Thus, the practice may diminish the very autonomy consent proper seeks to promote. Hiding this potential for conflict creates the risk moral concerns will not be appropriately balanced when deciding on the permissibility of an action. We thus ought to be explicit that such cases don’t involve consent and its common justification. (shrink)

"OLD TESTS ARE BEST FORGOTTEN!" Ay least that is what most students believe. "You finish your test, your teacher 'gives' you your grade and you'll never have to remember that stuff again!" It's too bad that students regard tests to narrowly. But aren't such attitudes cultivated by the popular treatment of tests as ends in themselves? For example, when is the last time you studied the traffic safety rules for your state? Probably it was thefirst time you studied them in (...) preparation for your driver's license exam. When you passed the test, did you seek out the correct answers to the ones you missed? Probably not; it would have seemed unnecessary, since you "passed." Ever wonder about the questions that surgeons or airplane pilots missed, but failed to inquire about afterwards? (shrink)

It is easy to create classroom discipline problems. By following the ten simple rules listed below you should be able to substantially improve your skill at this popular teacher pastime.

In this paper, I will discuss why in some circumstances people express their intentions indirectly: the use of Indirect Speech Acts. Based on Parikh’s games of partial information and Franke’s IBR model, I develop game-theoretic models of ISAs, which are divided into two categories, namely non-conventional ISAs and conventional ISAs. I assume that non-conventional ISAs involve two types of communication situations: communication under certain cooperation and that under uncertain cooperation. I will analyse the cases of ironical request and implicit bribery (...) as typical instances of non-conventional ISAs of each situation type, respectively. I then apply the models to analyse the use of conventional ISAs from an evolutionary perspective, which is inspired by Lewisian convention theory. The models yield the following predictions: the use of non-conventional ISAs under certain cooperation relies on the sympathy between interlocutors, which blocks their evolution towards conventional ISAs; in unc... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:332 BOOK REVIEWS lier Christian dualism into a balanced, theological whole. As a protreptic device, Jackson's book may be, in a certain way, part of a collective movement that may form a prolegomenon for a new synthesis-informed by the patristic authors but written as a vademecum for contemporary inquiry. The Catholic University ofAmerica Washington, D.C. ROBIN DARLING YOUNG Ministry: Lay Ministry in the Roman Catlwlic Church, Its History and (...) Theology. By KENAN B. OSBORNE, 0.F.M. (New York: Paulist Press, 1993). Pp. 722. $29.95 (paper). In his Lay Ministry, Fr. Kenan Osborne, O.F.M., sustains his effort to introduce a program of reform in ecclesial self-understanding inaugurated in his earlier Priestlwod: A History of the Ordained Ministry in the Roman Catlwlic Church (New York: Paulist Press, 1988). The project undertaken in this second installment aims primarily to undermine those traditional patterns of distinguishing klerikos/laikos and ordained/non-ordained that locate "lay ministry" at a lower latitude on the ontological map, and in this way to clear a path for a more adequate understanding of the place of the laity in the ministry of the Church. Of the 609 pages of text, 548 are dedicated to genealogical analysis of the transmission of Christian understanding of ministry. The author's narrative might be condensed as follows. The first millennium was a period marred by theological definitions of ministry and order derived from the terms of debate that emerged in the conflict between temporal and spiritual rulers. Necessary for successful participation in this cultural debate was the embrace of a hierarchical view of reality, a view destined to obscure the truth about the distinctively egalitarian Christian form of life in common (48-332). The second millennium is interpreted as a period of the gradual reemergence of a vision and practice of evangelical life that had been surrendered to alien philosophical and religious doctrines. The primary historical moments in this recovery, treated in three successive chapters, include the late medieval vita evangelica movements (333-90), the Protestant Reformation (391-463), and the French and American Revolutions (464-517). The Second Vatican Council, where it treats of lay ministry, consolidated these post-medieval insights gained into the Christian religion and the nature of man (518-95) and advanced the conclusion : Equality of discipleship is primary in the Christian religion and differences in ministerial function serve only to promote this fundamental good. Osborne is aware that this basic line of thought was that taken by the Reformers and found inadequate by the Council of Trent. But Osborne does BOOK REVIEWS 333 not present his position as an instance of theological dissent. Rather, he argues that the magisterium acting in the Second Vatican Council teaches that there exists no meaningful sense in which "lay ministry" can be understood as subordinate (ontologically) to "ordained ministry" in the sacramental life of the Church. This review will focus on this latter aspect of Osborne's argument which, while limited in scope, appears to be the more original and important element of the book. Osborne himself provides a further narrowing of scope with his selection of two key sources upon which he relies: Lumen Gentium and the 1983 Code of Canon Law. In his interpretation of Lumen Gentium, Osborne argues that the rejection of the preparatory documents signaled the majority bishops' desire to distance themselves from a "hierarchical approach" and move toward "a new form of ecclesiology" (516). This new form is rooted in the primacy of Jesus, and it is He (and not the Church) who is the sole lumen gentium, from which it follows immediately that there can be only one form of "gospel discipleship " (530). "All Church ministry, whether ordained or non-ordained, is relativized by the identical christological base" (528), Jesus, who transcends the distinction between clerical and lay (558). Osborne argues further that Lumen Gentium supports this position in its identification of the Church as "the people of God," "christifidelis," and "priesthood of all believers" (530-40). On the basis of this recovery of the "foundational and most sacred level of discipleship " (541), at which level the distinction between ordained and nonordained "makes no difference" (39), Osborne maintains... (shrink)

I argue that, If one adopts a minimal naturalism (of a kind rejected by moore, Hare, "et al".), One would adopt a methodology which yields conclusions identical to that yielded by intuitionistic methodology (of a kind employed by ross, Prichard, "et al".). I dilate upon the advantages which thus accrue to each theory, And I defend my minimal naturalism against a variety of objections.