Since the publication of Edmund Gettier's challenge to the traditional epistemological doctrine of knowledge as justified true belief, Roberts and Wood claim that epistemologists lapsed into despondency and are currently open to novel approaches. One such approach is virtue epistemology, which can be divided into virtues as proper functions or epistemic character traits. The authors propose a notion of regulative epistemology, as opposed to a strict analytic epistemology, based on intellectual virtues that function not as rules or even as skills (...) but as habits of the heart. To that end, they divide the task of clarifying and expounding their notion in the book's two parts.In the first part, Roberts and Wood examine various components that constitute their notion of regulative epistemology. The first are the epistemic goods or goals that drive the epistemic process. What is needed, claim Roberts and Wood, is an enriched notion of these goods rather than the restricted notion of justified true belief. Epistemic agents are more than calculating devices in that …. (shrink)

Let us say that an extended object is “composed wholly of simples” just in case it is an aggregate of absolutely unextended parts spread throughout an extended region—that is, just in case there is a set S such that: every member is a point-sized part of the object, and for every x, x is part of the object if and only if it has a part in common with some member of S. Could a truly extended substance be composed entirely (...) of unextended parts? Reflection upon the fact that it must be at least possible for extended objects to touch one another suggests that the answer to this question is: No. (shrink)

The traditional doctrine of God's universal causality holds that God directly causes all entities distinct from himself, including all creaturely actions. But can our actions be free in the strong, libertarian sense if they are directly caused by God? W. Matthews Grant argues that free creaturely acts have dual sources, God and the free creaturely agent, and are ultimately up to both in a way that leaves all the standard conditions for libertarian freedom satisfied. Offering a comprehensive alternative to existing (...) approaches for combining theism and libertarian freedom, he proposes new solutions for reconciling libertarian freedom with robust accounts of God's providence, grace, and predestination. He also addresses the problem of moral evil without the commonly employed Free Will Defense. Written for analytic philosophers and theologians, Grant's approach can be characterized as “neo-scholastic” as well as “analytic,” since many of the positions defended are inspired by, consonant with, and develop resources drawn from the scholastic tradition, especially Aquinas. (shrink)

Physical boundaries and the earliest topologists. Topology has a relatively short history; but its 19th century roots are embedded in philosophical problems about the nature of extended substances and their boundaries which go back to Zeno and Aristotle. Although it seems that there have always been philosophers interested in these matters, questions about the boundaries of three-dimensional objects were closest to center stage during the later medieval and modern periods. Are the boundaries of an object actually existing, less-than-three-dimensional parts of (...) the object—that is, are solids bounded by two-dimensional surfaces, surfaces by one-dimensional “edges” or “physical lines”, edges by dimensionless “simples”? If not, how does a perfectly spherical object manage to touch a perfectly flat object—what part of the sphere is in immediate contact with the plane, if the sphere has no unextended parts? But if such parts be admitted, are we not then saddled with “actual infinities” of simples, lines, and surfaces spread throughout each continuous object—the boundaries of all the object’s internal parts? Does it help to say that these internal boundaries exist only “potentially”? (shrink)

This book addresses two basic questions: What is the proper philosophical analysis of the concept of substance? and What kinds of compound substances are there? The second question is mainly addressed by asking what relations among objects are necessary and sufficient for their coming to compose a larger whole. The first 72 pages of the book contain a short history of attempts to answer the first question, and a brief presentation of the analysis the authors defend at length in their (...) earlier book, Substance Among Other Categories. In the remaining 119 pages, the authors take up the second question. This order of presentation makes sense; but it may help to create a false impression in those who only glance at the first few pages—that this book is just a simplified version of the earlier one, with a little bit of history thrown in. It would be quite unfortunate, however, if very many potential readers get this impression; for it might discourage them from looking closely at the bulk of the book, which is new. The issues discussed in the later chapters are at the center of one of the most lively debates in contemporary metaphysics; and the position Hoffman and Rosenkrantz stake out is appealing and carefully articulated. Their views deserve careful attention from philosophers working on the metaphysics of persistence through time, personal identity, artifact identity, and mereology. (shrink)

I defend an alternative to the two traditional accounts of the relationship between metacognition and social cognition: metacognition as primary versus social cognition as primary. These accounts have complementary explanatory vices and virtues. They also share a natural assumption: that interpretation in terms of mental states is “spectatorial”, aiming exclusively for an objective description of the mental facts about self and others. I argue that if one rejects this assumption in favor of the view that interpretation in terms of mental (...) states also plays important regulative roles with respect to minds and behavior, a new and superior conception of the relationship between metacognition and social cognition comes into view. On this conception, person-level metacognitive concepts are socio-cognitive tools that shape us into better cognitive agents and more predictable cognitive objects, thereby enhancing our abilities at social coordination. Mastery of these metacognitive concepts relies on subpersonal, non-conceptual, procedural metacognition. This reconceptualization of the relationship between metacognition and social cognition combines the complementary explanatory virtues of the two traditional conceptions, while avoiding their complementary explanatory vices. (shrink)

This is a study that investigated the extent of use of the three principles of ethics – utility, morality, and justice – in managerial ethical decision making, in addition to the personal attitude towards them. It involved undergraduate and graduate business students (total N=163) from the Olayan School of Business in the American University of Beirut, Lebanon. Two kinds of measurements were done: self assessment, and testing with the Saschkin’ s Managerial Value Profile (1997). It showed that morality was the (...) overriding ethical principle used, especially in the graduate group (professionals). Business students still believed in the justice system despite the weakness of the country’s law. Utility was the least used, although males were found to be more utilitarian than females. Finally there was no relation between personal attitudes toward the three ethical principles, and the intentional behavior when faced with ethical dilemmas. The findings were discussed and recommendations were given. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our Pain• (...) Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

Although the same environmental regulations apply to all regions in China, legal enforcement can be different due to local economic development priorities. There is still a lack of knowledge about how regional disparities affect the operating performance results of the implementation of corporate environmental management practices, thus providing little information for foreign companies when they invest and develop their production base in China. To fill this research gap, this paper collects data from the Fortune 500 Chinese firms to investigate the (...) moderating role of regional disparities in affecting the performance results of corporate environmental management efforts based on the institutional theory. The disclosed corporate environmental responsibility practices serve as proxy to represent corporate environmental management practices. Content analysis approach was applied to collect and analyze CER practices published in the corporate reports of Chinese manufacturers. The results show that CER has a positive impact on operating income, while regional disparities influence the relationship between CER and corporate operating income. Specifically, CER and operating income are positively related in Eastern China; on the contrary, they are negatively related in Western China. This paper adds to the body of knowledge about environmental discrepancies in the same emerging economy, and provides insights for systematic consideration in terms of the issues of government environmental regulations and corporate environmental strategies. (shrink)

Claims about ‘the meaning of life’ have tended to be made and discussed in conjunction with bold metaphysical and theological affirmations. For life to have meaning, there must be a comprehensive divine plan to give it meaning, or there must be an intelligible cosmic process with a ‘telos’ that a man needs to know if his life is to be meaningfully orientated. Or, it is thought to be a condition of the meaningfulness of life, that values should be ultimately ‘conserved’ (...) in some way, that no evil should be unredeemable and irrational. And it may be claimed that if death were to end our experience, meaninglessness would triumph. (shrink)

Although the notion of spatiality has always lurked in the background of discussions of literary form, the self-conscious use of the term as a critical concept is generally traced to Joseph Frank's seminal essay of 1945, "Spatial Form in Modern Literature."1 Frank's basic argument is that modernist literary works are "spatial" insofar as they replace history and narrative sequence with a sense of mythic simultaneity and disrupt the normal continuities of English prose with disjunctive syntactic arrangements. This argument has been (...) attacked on several fronts. An almost universal objection is that spatial form is a "mere metaphor" which has been given misplaced concreteness and that it denies the essentially temporal nature of literature. Some critics will concede that the metaphor contains a half-truth, but one which is likely to distract attention from more important features of the reading experience. The most polemical attacks have come from those who regard spatial form as an actual, but highly regrettable, characteristic of modern literature and who have linked it with antihistorical and even fascist ideologies.2 Advocates of Frank's position, on the other hand, have generally been content to extrapolate his premises rather than criticize them, and have compiled an ever-mounting list of modernist texts which can be seen, in some sense, as "antitemporal." The whole debate can best be advanced, in my view, not by some patchwork compromise among the conflicting claims but by a radical, even outrageous statement of the basic hypothesis in its most general form. I propose, therefore, that far from being a unique phenomenon of some modern literature, and far from being restricted to the features which Frank identifies in those works , spatial form is a crucial aspect of the experience and interpretation of literature in all ages and cultures. The burden of proof, in other words, is not on Frank to show that some works have spatial form but on his critics to provide an example of any work that does not. · 1. Frank's essay first appeared in Sewanee Review 53 and was revised in his The Widening Gyre . Frank's basic argument has not changed essentially even in his most avante-garde statements; he still regards spatial form "as a particular phenomenon of modern avante-garde writing." See "Spatial Form: An Answer to Critics," Critical Inquiry 4 : 231-52. A useful bibliography, "Space and Spatial Form in Narrative," is being complied by Jeffrey Smitten .· 2. This charge generally links the notion of spatial form with Wyndham Lewis and Ezra Pound, the imagist movement, the "irrationality" and pessimistic antihistoricism of modernism, and the conservative Romantic tradition. Frank discusses the complex motives behind these associations in the work of Robert Weimann and Frank Kermode in his "Answer to Critics," pp. 238-48. W. J. T. Mitchell, editor of Critical Inquiry, is the author of Blake's Composite Art, and The Last Dinosaur Book: The Life and Times of a Cultural Icon. The present essay is part of Iconology: The Image in Literature and the Visual Arts. "Diagrammatology" appeared in the Spring 1981 issue of Critical Inquiry. Leon Surette responds to the current essay in "‘Rational Form in Literature’". (shrink)

Despite clinical evidence of drug superiority, therapeutic modalities, like combination immunotherapy, are mostly considered cost-ineffective due to their high costs per life year(s) gained. This paper, taking an ethical stand, reevaluates the standard cost-effectiveness analysis with that of the more recent justice-enhanced methods and concludes by pointing out the shortcomings of the current methodologies.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Painting Outside the Lines: Patterns of Creativity in Modern ArtMatthew ZiffPainting Outside the Lines: Patterns of Creativity in Modern Art, by David W. Galenson. Cambridge: Harvard University Press, 2001, 272 pp., $29.95.The relationship between the market value of paintings and the chronological point in an artist's working life when the paintings were produced is the driving mechanism for exploring creativity and innovation in David W. Galenson's book "Painting (...) Outside the Lines: Patterns of Creativity in Modern Art. The working thesis of this book is that Modern artists have worked creatively and innovatively in one of two distinctly different manners. The terminology Galenson uses to describe these distinct ways of working are "finders" and "seekers." Finders are artists like Pablo Picasso, who at age 26, make startling and important innovations with little advance indication that such a burst is about to take place. Seekers are artists like Paul Cezanne, whospend their entire working lives engaged in the pursuit of a singular approach or achievement. The differences between these methodologies are carefully presented through the details of the working lives of a variety of Modern artists. French nineteenth century and early twentieth-century artists and mid-twentieth-century American artists are used as the source data for these comparisons.Early in the book Galenson presents lists of chronological events within the lives of artists and market valuation of their work within this chronology. The dramatic clarity of the relationships presented in this data sets the stage for the detailed information that follows. Factors that in some cases only partly, and in others nearly completely, explain an artist's way of working are offered through biographic information, information about the aesthetic and cultural milieu, and about the economic and educational structures that are predominant during the relevant time in the life of the artist.The relationship between the aesthetic and cultural milieu surrounding an artist and the capacity or inclination of an artist to be innovative is an important aspect of the book's analysis. The scope of the book is limited to Modern artists because of the shift that took place at the outset of Modern art, during the mid 1860s, that brought a strong emphasis on innovation and change for their own sake as an important characteristic within a work of art. This emphasis "created incentives for painters to produce new approaches to art" (p. 111). Prior to the time of Modern art, innovation and change were often unnecessary for an artist to be successful. Modern art introduced the demand that innovation and change be necessary ingredients in art, and therefore the search for innovation became a significant element within the work of many artists. The manner in which this search took place, as presented through the data at hand, reveals how individual artists viewed the need for innovation and change within their own [End Page 123] work. Paul Cezanne, for example, was aware of the impact that his painting was having on the art world, but he insisted that he was not yet finished with discoveries that would reveal the truest expression of his beliefs about aesthetic expression.In the American movement, "Abstract Expressionism," Galenson finds a useful counter example to the art scene in Paris. In the United States, especially during the 1940s and 1950s — the peak years of creative output by Abstract Expressionist artists — the demand for their work was quite low. There were few economically viable outlets for the work of de Kooning, Pollack, Rothko, and the others of this group. Consequently there is a shift in the chronological point at which these artists achieve market value success. Nearly all of these artists receivedrecognition at an older age than the French artists of the late nineteenth and early twentieth centuries.The thesis of the book, that there are two fundamentally different ways of working to produce works of art, is directly applicable to, and useful in, exploring issues of teaching and learning in design education. As a teacher of interior architecture I was interested to follow the details that Galenson presented in support of his analysis of the careers of numerous Modern artists. The methodological differences between seeking and... (shrink)

No one who cares about equal opportunity can derive much comfort from the present occupational distribution of working women. In the various industrial societies of the West, women comprise between one quarter and one-half of the national labor force. However, they tend to clustered in employment sectors – especially clerical, sales, and service J occupations – which rank relatively low in remuneration, status, autonomy, and other perquisites. Meanwhile, the more prestigious and rewarding managerial and professional positions, as well as the (...) major categories of blue-collar labor, remain largely a male preserve. In the same societies the average income earned by full-time female workers is one-half to two- J thirds that of their male counterparts. Although this disparity owes much to i other factors, including lower pay for work similar or even identical to that r standardly done by men, much of it can be explained only by the concentration of working women in traditional female job ghettos. (shrink)

The dead donor rule (DDR) has facilitated the saving of hundreds of thousands of lives. Recent advances in heart donation, however, have exposed how DDR has limited donation of all organs. We propose advancing the moment in the dying process at which death can be determined to increase substantially the supply of organs for transplantation. We justify this approach by identifying certain flaws in the Uniform Determination of Death Act and proposing a modification of that law that permits earlier procurement (...) of healthier organs in greater numbers. (shrink)

Prison work creates ethical challenges for which a training program was initiated for Dutch prison staff to foster their Moral Craftsmanship (MCS). The concept of MCS is not yet defined and operationalized in literature. This explorative study aims to 1) define MCS, 2) identify conceptual elements of MCS, and 3) develop a measurement tool for MCS. A document and literature study provided input for the definition and selection of conceptual elements related within DCIA policy documents, identifying three conceptual levels of (...) MCS: individual (cognition, attitude, and actions), team, and leadership. This first MCSQ consists of seventy-one items distributed across the domains: values and norms, judgment and reasoning, consultation, implementation, looking back, interactions, and leadership. We tested its usability via ‘think-aloud interviews.’ Validation of the current version of the MCS-Questionnaire and consensus among experts about what to include or exclude in the concept of MCS are needed for further development. (shrink)

This essay provides a systematic as well as chronological account of Schiller's concepts of freedom and autonomy. Its main thesis is that the duality of Schiller's moral/aesthetic ideal in the Letters on the Aesthetic Education of Man - of beauty and the sublime, of play and the moral law - is a result of his use of conflicting concepts of autonomy. While it is widely accepted that Schiller took over Kant's concept of autonomy, I argue that he simultaneously employed another (...) concept of autonomy, that of the contemporary philosopher Karl Leonhard Reinhold, whose criticism of Kant's concept of free will and alternative formulation of the concept of a neutral will influenced Schiller. (shrink)

Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

If I lead a life of virtue, that may well be good for you. But will it also be good for me? The idea that it will—or even must—is an ancient one, and its appeal runs deep. For if this idea is correct then we can provide everyone with a good reason—arguably the best reason—for being virtuous. However, for all the effort which has been invested in defending the idea, by some of the best minds in the history of philosophy, (...) it remains unproven. Worse, in this skeptical age hardly anyone really believes it. I don't really believe it either, at least not in its strongest forms, but I think that the question is nonetheless worth examining. Even if we cannot show that virtue and self-interest coincide, we can at least measure the breadth of the gap between them. (shrink)

We affirm the utility of integrative modeling, according to which it is advantageous to move beyond “one-at-a-time binary paradigms” through studies that position themselves within realistic multidimensional design spaces. We extend the integrative modeling approach to a target domain with which we are familiar, the consequences of bilingualism on mind and brain, often referred to as the “bilingual advantage.” In doing so, we highlight work from our group consistent with integrative modeling.

In order to study early human development while avoiding the burdens associated with human embryo research, scientists are redirecting their efforts towards so-called human embryo-like structures (hELS). hELS are created from clusters of human pluripotent stem cells and seem capable of mimicking early human development with increasing accuracy. Notwithstanding, hELS research finds itself at the intersection of historically controversial fields, and the expectation that it might be received as similarly sensitive is prompting proactive law reform in many jurisdictions, including the (...) Netherlands. However, studies on the public perception of hELS research remain scarce. To help guide policymakers and fill this gap in the literature, we conducted an explorative qualitative study aimed at mapping the range of perspectives in the Netherlands on the creation and research use of hELS. This article reports on a subset of our findings, namely those pertaining to (the degrees of and requirements for) confidence in research with hELS and its regulation. Despite commonly found disparities in confidence on emerging biotechnologies, we also found wide consensus regarding the requirements for having (more) confidence in hELS research. We conclude by reflecting on how these findings could be relevant to researchers and (Dutch) policymakers when interpreted within the context of their limitations. (shrink)

This essay constitutes an attempt to probe the very idea of a saying/showing distinction of the kind that Wittgenstein advances in the Tractatus—to say what such a distinction consists in, to say what philosophical work it has to do, and to say how we might be justified in drawing such a distinction. Towards the end of the essay the discussion is related to Wittgenstein’s later work. It is argued that we can profitably see this work in such a way that (...) a saying/showing distinction arises there too. In particular, in the final sub-section of the essay, it is suggested that we can see in Wittgenstein’s later work an inducement to say what we are shown. (shrink)

Can poem and picture collaborate successfully in a composite art of text and design? Or does one art inevitably dominate the other? W.J.T. Mitchell maintains that Blake's illuminated poems are an exception to Suzanne Langer's claim that "there are no happy marriages in art—only successful rape." Drawing on over one hundred reproductions of Blake's pictures, this book shows that neither the graphic nor the poetic aspect of his composite art consistently predominates: their relationship is more like an energetic rivalry, a (...) dialogue between vigorously independent modes of expression. W.J.T. Mitchell is Professor of English and Art and Design at the University of Chicago and editor of Critical Inquiry. Originally published in 1978. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

Despite the growing interest in societal impact in the business and society literature, there remains a notable gap in research on the impact of health interventions on physical and mental health and social welfare. To address this gap, we shift the unit of analysis to the intervention, akin to the level of analysis used in health research. Drawing on a curated subset of health interventions in the workplace from the public health literature, we argue that management scholars can adopt the (...) methods used by public health scholars to design and assess health interventions. By tapping into the rich insights gained from these studies, management scholars can propose evidence-based interventions and policies that can enhance health outcomes, improve productivity, and cultivate a healthier workplace atmosphere. Collaborating with public health researchers, business and society scholars can help create a new field of research on corporate health policy. (shrink)

Introducing students to the core philosophical issues surrounding modern physics and the ideas, which have shaped our current understanding of the subject, the book is based on lectures by H. W. Watson and sets out to illuminate and implicate the inextricably entwined nature of philosophy and physics and the importance of logic.

From the beginning of history sounds have played a fundamentally important role in humanity’s development as ways of expression and of communication. However in contemporary western society, and indeed globally, we are experiencing an excess of speech and a relentless encouragement to expression. Such excess indicates a misunderstanding about what expression and dialogue should be. This condition encourages us to think about silence, solitude and contemplation and the role they might play in restoring the realm of personal understanding of the (...) Self and of one’s authentic experience of the Other. The purpose of this article is to explore the potency of a silence that arises from our participation in the world. We present first some ideas about silence as a human phenomenon. This is followed by an examination of silence and language, an investigation of silence in dialogue, and of its educational implications. The article concludes by emphasising the value of silence as potency in itself, assisting in recovering the expressive powers of language. We argue that it is important to understand the positive status of silence in order to recognise and avoid repressive speech and to introduce its potential for reflective learning. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

Research suggests that institutions affect the levels of corruption in a country. We take these arguments a step further and examine whether it is the presence of inclusive institutions and/or the credible and consistent implementation of institutions that matter, as regards corruption. We use a novel approach to theoretically conceptualise and empirically operationalise institutions along two analytically distinct dimensions: the nature of the institutions (the de jure dimension), and the extent to which they are credibly and consistently implemented over time (...) (the de facto dimension), using a panel dataset for 148 countries covering 2012 to 2018. We find that formal institutions are most effective in reducing corruption when the rules are credibly and consistently implemented. Furthermore, this effect appears to operate differently at different levels of national income. The nature of the formal institutions appears important across income levels, but particularly so at the upper middle income level, while the credible and consistent implementation of these institutions is primarily influential at upper middle income levels. We explain why this may be the case and elaborate on the policy implications. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

This paper presents a qualitative study investigating the application of physiotherapists’ professional ethics in practice with respect to touch, intimacy, and corporeality during therapy, based on the experiences of elderly patients. As the relationship in a physiotherapy session is multidimensional, the study considered three levels: physical contact, verbal contact, and the conditions in which the therapy took place. The aim of this study was to find out what values are of importance to older people during a physiotherapy session, with emphasis (...) on the categories of touch, corporeality, and intimacy. The studied group consisted of sixteen male and female physiotherapy patients aged between sixty-six and ninety-two years. The study was conducted according to the grounded theory methodology. The research material consisted of transcriptions of free targeted interviews, which were subjected to a process of coding and analysis. As a result of data analyses, three superior categories have been identified—safety, anxiety, interpersonal relationship—and three a priori categories stemming from the characteristic features of the study area—touch, corporeality, and intimacy. The a priori categories did not appear independently in statements made by the respondents, but instead seemed to be components of superior categories. The most important values indicated by the respondents concerned the interpersonal relationship with their physiotherapist and the feeling of safety and care. In terms of touch, corporeality, and intimacy, the respondents indicated, among others, the importance of predictability, a sense of security, privacy, and acceptance of the body. (shrink)

In this article we frame a set of important issues in the emerging field of Mind, Brain, and Education in terms of three broad headings: methods, models, and morality. Under the heading of methods we suggest that the need for synthesis across scientific and practical disciplines entails the pursuit of usable knowledge via a catalytic symbiosis between theory, research, and practice. Under the heading of models the goal of producing usable knowledge should shape the construction of theories that provide comprehensive (...) accounts of human learning and development spanning multiple levels of analysis. Under the heading of morality usable knowledge must be put to good use: Its application and dissemination ought to be infused with moral considerations gleaned from dialogue among all those potentially affected. Generally, the field should be shaped not only by its constituent scientific disciplines but also by its applications to education and learning. Thus we argue for the adoption of a kind of pragmatism that would be best actualized by building research‐school collaborations between researchers and practitioners. (shrink)