BackgroundDelirium is highly prevalent in the general hospital patient population, characterized by acute onset, fluctuating levels of consciousness, and global impairment of cognitive functioning. Mental capacity, its assessment and subsequent consent are therefore prominent within this cohort, yet under-explored.AimThis study of patients with delirium sought to determine the processes by which consent to medical treatment was attempted, how capacity was assessed, and any subsequent actions thereafter.MethodA retrospective documentation review of patients identified as having a delirium for the twelve months February (...) 2013 to January 2014 was undertaken. Inclusion and exclusion criteria were used; demographic and descriptive data collected. A total of n=1153 patients were identified with n=310 meeting inclusion criteria.ResultA random sample of one hundred patients were subsequently reviewed. One third of patients had documentation relating to consent, while four patients had documentation relating to capacity. Median delirium duration was three days, with treatment refusal occurring in twenty-two patients and “duty of care” being used as an apparent beneficent related treatment framework in twelve patients.ConclusionsWhile impaired decision-making was indicated, the review was unable to indicate what patient characteristics flag the need for capacity assessment. Documentation relating to consent processes appeared deficient for this cohort. (shrink)

A growing body of empirical evidence suggests that positive emotions, engagement, relationships, meaning, and accomplishments may be a robust framework for the measurement, management and development of wellbeing. While the original PERMA framework made great headway in the past decade, its empirical and theoretical limitations were recently identified and critiqued. In response, Seligman clarified the value of PERMA as a framework for and not a theory of wellbeing and called for further research to expand the construct. To expand the framework (...) into organizational contexts, recent meta-analyses and systematic literature reviews showed that physical health, mindset, physical work environments and economic security could be seen as essential contextually relevant building blocks for work-related wellbeing and are therefore prime candidates to expand the PERMA framework for use within organizational contexts. Through expanding the original PERMA framework with these four factors, a new holistic approach to work-related wellbeing and work performance was born: the PERMA+4. As such, the purpose of this brief perspective paper is to provide a conceptual overview of PERMA+4 as holistic framework for work-related wellbeing and work performance which extends beyond the predominant componential thinking of the discipline. Specifically, we aim to do so by providing: a brief historical overview of the development of PERMA as a theory for wellbeing, a conceptual overview of PERMA+4 as a holistic framework for work-related wellbeing and work performance, empirical evidence supporting the usefulness of PERMA+4, and charting a course for the second wave of positive organizational psychological research. (shrink)

A central and integral feature of Mill's version of Utilitarianism is the necessity for moral agents to empathize with others, for without such empathy one has little or no motivation to pursue the general good. Mill believed that Benthamite Utilitarianism failed to provide a sufficient mechanism to induce would-be moral agents to empathize with others. Mill located the requisite mechanism when reading English Romantic poetry and theory: in particular, Mill believed that to empathize completely with others requires a special kind (...) of imagination. I argue that the theory of imagination adopted by Mill was essentially Wordsworthian. The importance of this conception of imagination has far reaching effects in Mill's thought: for example, Mill's infamous proof of the principle of utility is plausible only when considered in the context of the Mill's Romantic theory of imagination. ;Mill's initiation into aesthetics occurred in the late 1820s and early 1830s when Mill was also first exposed to Continental, and particularly to French, sociologists, especially to Saint-Simon and Auguste Comte. I investigate the nature and extent of their influence on Mill. Interestingly, there are some important parallels between this group and the English Romantics. Though widely divergent in political theory, all were, in some sense, conservatives and elitists. Both Comte and Coleridge, for example, thought that society ought to be run by a clerisy constituted primarily by the intellectual elite of society. This posed a serious problem for Mill both as an empiricist and as a liberal. Indeed, some have argued that, at least for some periods of his life, Mill abandoned both his empiricist heritage and his liberalism. I examine these issues in detail arguing that, in typical fashion for Mill, he attempted an amalgam of these various doctrines. In the final analysis, however, Mill remained firmly committed both to empiricism--and the reductionist and mechanistic view it implied--as well as to liberalism, though it is a liberalism with definite elitist strains within it. (shrink)

Business majors were tested for their attitudes toward the teaching of business ethics in university business education. Respondents indicated that they considered ethics an important part of a business curriculum and that they preferred integrating ethics into a number of different courses rather than taking a separate compulsory or elective ethics course. Ethical business practices were seen by respondents as increasing profit and return on investment and creating a positive work environment and public perception of the organization.

All cells have electric potentials across their membranes, but is there really compelling evidence to think that such potentials are used as instructional cues in developmental biology? Numerous reports indicate that, in fact, steady, weak bioelectric fields are observed throughout biology and function during diverse biological processes, including development. Bioelectric fields, generated upon amputation, are also likely to play a key role during vertebrate regeneration by providing the instructive cues needed to direct migrating cells to form a wound epithelium, a (...) structure unique to regenerating animals. However, mechanistic insight is still sorely lacking in the field. What are the genes required for bioelectric‐dependent cell migration during regeneration? The power of genetics combined with the use of zebrafish offers the best opportunity for unbiased identification of the molecular players in bioelectricity. BioEssays 29:1133–1137, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Aristotle provides two extended discussions on the subject of pleasure within the Nicomachean Ethics. The first, which comprises the last four chapters of Book 7, produces a definition of pleasure in which pleasure is identified with activity (energeia). But in the second discussion of pleasure—provided in the first five chapters of Book 10-this position is characterized as "strange" or "absurd" (1175b 35). Instead of an identification between the two, pleasure is now said to "supervene" upon activity "as the bloom of (...) youth does on those in the flower of their youth" (1174b 33). Why this difference in the characterization of pleasure? Is Aristotle here committing the simple inconsistency of which he appears to be guilty? In the first section of this paper I shall argue that he is not. In the second section of this paper I shall suggest some reasons as to why Aristotle's interests in the subject of pleasure changed in the relatively short interim between Book 7 and Book 10. (shrink)

This paper begins by distinguishing between two levels at which ethics has been applied in the past half century. Typically, ethics gets applied at the level of public debate and policy. Much less often, applied ethics centers on the personal level. As a literature search reveals, this is true of recent philosophic discussions of divorce. This paper seeks to begin an alternative philosophic discussion of divorce and separation by considering it at a personal level. I begin this discussion by analyzing (...) two different conceptions of love-eros and agape-and suggest a synthesis of the two. The conception of love that I endorse suggests that the value of the parties in a loving relationship is constructed within the relationship itself. It is this feature of love that helps to explain why so many feel sueh a sense of worthlessness when experiencing a divorce or separation. Namely, that much of the positive value they had within their relationship has little or no value outside the context of that relationship. (shrink)

This paper argues first that claims that we are in the midst of a global obesity epidemic are vastly overblown and hardly new since we can find such calls to alarm for over a century at least. Second, we suggest that claims made about the possibility of losing weight are, for most people, simply false. Bluntly stated, there is lots of evidence to suggest that diets don’t work for the vast majority of people: even for those who lose weight, their (...) reprieve from fat tends to be short lived with 90% regaining their lost weight. Third, we maintain that claims made that obesity is either itself a disease or is causally and directly linked to harmful and sometimes lethal diseases are also misguided. Finally, we discuss the ways in which the construction of obesity as an epidemic disease has affected various parties, including fat people themselves. In particular, we discuss two approaches that have been made to the general anti-fat attitudes of contemporary western societies: the ‘fat and fit’ and ‘fat and proud’ movements. (shrink)

The doctrine of consent is built upon presumptions of mental capacity. Those presumptions must be tested according to legal rules that may be difficult to apply to COVID-19 patients during emergency presentations. We examine the principles of mental capacity and make recommendations on how to assess the capacity of COVID-19 patients to consent to emergency medical treatment. We term this the CARD approach.

“That is no country for old men” is the famous first line of Yeats’s “Sailing to Byzantium,” which reflects upon aging, art, and immortality. Yeats sug­gests in his poem that the aged ought to move from the sensual, physical world of their youth to a world of intellect and timeless beauty. We em­ploy this poem and that line to explore the aging male protagonists in two recent novels: Cormac McCarthy’s No Country For Old Men, and J.M. Coetzee’s Disgrace. We suggest (...) that though both of the novel’s pro­tagonists have aspirations to ’sail to Byzantium’, various factors ranging from their characters to the problematic realities of contemporary south­west America and South Africa make such a wholesale, successful journey impossible even though some progress is made. (shrink)

Debate concerning virtual reality is often drawn in terms of sharply defined dichotomies--for example, between "real" (or "actual") and "virtual," "authentic" and "inauthentic," and "natural" and "artificial." In this paper we offer an alternative approach by suggesting a conception of a virtual world that highlights a continuity and commonality with our sense of everyday reality. We accomplish this in part by an examination of the English picturesque garden as if it were a virtual world partially constructed out of ideas and (...) objects collected during travels to foreign lands on the Grand Tour. Such foreign travel transformed not only the English person's sense of self, but also altered the English landscape. We conclude that in one sense the "real" England is also a "virtual" reality. (shrink)

Australian prisons are overpopulated with people suffering from numerous health problems. COVID-19 presents a significant threat to prisoner health. This article examines the current regulatory responses from Australian state and territory governments to COVID-19 and a recent case which tested the human rights of prisoners during a pandemic.

This paper begins by distinguishing between two levels at which ethics has been applied in the past half century. Typically, ethics gets applied at the level of public debate and policy. Much less often, applied ethics centers on the personal level. As a literature search reveals, this is true of recent philosophic discussions of divorce. This paper seeks to begin an alternative philosophic discussion of divorce and separation by considering it at a personal level. I begin this discussion by analyzing (...) two different conceptions of love-eros and agape-and suggest a synthesis of the two. The conception of love that I endorse suggests that the value of the parties in a loving relationship is constructed within the relationship itself. It is this feature of love that helps to explain why so many feel sueh a sense of worthlessness when experiencing a divorce or separation. Namely, that much of the positive value they had within their relationship has little or no value outside the context of that relationship. (shrink)

This paper employs Ian Hacking’s notion of interactive kinds to examine the recent construction of the kind, “depressed adolescent.” I examine first how adolescents themselves were constructed. I then trace how, in North America, we have moved in the past thirty-odd years from a situation of virtually no adolescent depression to the current situation where it is estimated that approximately one in four adolescents is depressed. I offer some reasons why we should be uncomfortable both with the exponential increases in (...) this kind and with the way in which depressed adolescents are being treated at present. In conclusion, I tentatively suggest some ways of proceeding in the future. (shrink)

This paper employs Ian Hacking’s notion of interactive kinds to examine the recent construction of the kind, “depressed adolescent.” I examine first how adolescents themselves were constructed. I then trace how, in North America, we have moved in the past thirty-odd years from a situation of virtually no adolescent depression to the current situation where it is estimated that approximately one in four adolescents is depressed. I offer some reasons why we should be uncomfortable both with the exponential increases in (...) this kind and with the way in which depressed adolescents are being treated at present. In conclusion, I tentatively suggest some ways of proceeding in the future. (shrink)

Ancient Greek philosophers, medieval theologians, Enlightenment thinkers, and contemporary humanists alike have debated all aspects of human sexuality, including its purpose, permissibility, normalcy, and risks. _Philosophizing About Sex_ provides a philosophical guide to those longstanding and important debates. Each chapter takes a general issue and shows how ongoing public discussions of sexuality can be illuminated by careful philosophical investigation. Debates over topics such as sexual assault, sexual orientation, sex education, prostitution, and “sexting” involve larger questions about morality, law, science, and (...) politics and cannot be intelligently discussed in isolation from broader issues. By asking deceptively simple questions, this book shows how difficult but important it is to arrive at satisfying answers. (shrink)

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

In lieu of an abstract, here is a brief excerpt of the content:Scott Joplin and the Quest for IdentityEarl Stewart and Jane DuranIn his innovative work I Wanna Be Me: Rock Music and the Politics of Identity, Ted Gracyk does much to dismantle notions of cultural authenticity and theft as they are currently articulated by some critics. Explaining that such concepts are less monolithic than some have claimed, Gracyk writes:While popular musicians often "pick up" the music of other (...) cultures, such practices are culturally, politically, and morally complex. In discussing such issues, I hope to show that they are even more complex than is typically thought. Here, I borrow an insight from Michelle Moody-Adams, who argues that prevailing positions in social and cultural anthropology assume that cultures are internally integrated wholes and that each culture is fundamentally a set of self-contained and discrete practices and beliefs. The same assumptions infest discussions of appropriation in cultural studies, folk-lore studies, and ethnomusicology. But these assumptions are highly questionable.1Gracyk's overall point is that what has frequently been simplified as "theft" or "inauthentic" is not susceptible to such easy formulation; indeed, Gracyk contends there is scarcely such a thing as a pure musical tradition.Gracyk's sophisticated argument is one, however, that itself admits of gradations and emendations. While it is no doubt accurate that there is very little that might count as artistically or culturally pure (hence, very little that can justifiably be claimed to have been stolen), some work is much more evocative of a cultural point of view than other efforts, and some work is much more centrally located within a given culture and its traditions than other musical work. In this article we shall make the twofold argument that much of the work of Scott Joplin is located in a tradition that is manifestly African derived, and that the composition of such work had, as one of its motivators, the desire to make a cultural statement. Thus, more so than some of Gracyk's exemplars, Joplin's work is strongly culturally attached, and its attachment needs to be duly noted.IThe origins of Joplin's work speak to the concerns of the nineteenth century and of the period immediately subsequent to emancipation. Most of [End Page 94] the black leadership of the time was united in its belief that a nationalist art would serve in the reconstruction of the image of African Americans. During the latter part of the nineteenth century many of these leaders saw the spiritual as the ideal folkloric basis for a serious black artistic expression. In music this notion was given strong support as a result of a concurrent interest on the part of European composers in African American music—an interest fed by the aesthetic of romanticism, which encouraged artistic investment in the strange, unusual, primitive, and exotic.Most classically trained African American composers attempted to comply with the vision of these black leaders by constructing a more or less European-style music tinctured with African American folk elements. The result would be a set of works that to this day has failed to be adopted by the African American community at large.Scott Joplin tried a different approach. He sought to create an African American musical expression that would be predicated upon an African American vernacular style—ragtime. Joplin essentialized his music in many ways. First, by choosing ragtime as a stylistic paradigm he assured the preservation of black rhythm. Second, to promote continuity and coherence he often employed rhythmic relationships between contrasting sections. Third, he frequently employed African American folk idioms like pentatonicism and call-and-response (antiphony) as interregnal devices in the structure of his melodies. Fourth, to assure an intrastructural linkage with the African American vernacular music of his day, he frequently used phrase structures that were consistent with those employed in folk music, particularly the black spiritual, for example, aaab. In his opera, Treemonisha, he based his libretto largely on black dialect, thus linking it with black literary tradition. These are but a few of the devices Joplin employed to assure a strong cultural essentialism to his music. As a result, Joplin has been acknowledged as one of the great icons of... (shrink)

The contributors in _Expanding and Restricting the Erotic_ offer a multidisciplinary perspective on the ways in which what is considered acceptable within the realm of the erotic has altered over time to the current situation where the erotic is being both expanded and restricted.

'...a new and important reading of Mill that bridges several disciplines. It is essential reading for anybody concerned about the delicate fabric of our republican tradition....The work is scholarly, insightful, and written at a level that makes its important message accessible to student, scholar, and layperson.'-Scott G. McNall, University of Toledo.

In lieu of an abstract, here is a brief excerpt of the content:PrefaceScott Paeth and Kevin CarnahanThis issue of the Journal of the Society of Christian Ethics is organized around the theme of structural evil. Each of the essays deals with some dimension of the problem of how we can conceive of evil beyond the question of simple human volition, and understand it as embedded in the institutions and cultural assumptions that we often take for granted as societal givens.Cristina Traina's (...) presidential address, "This Is the Year," takes as its starting point the aftermath of the 2016 US presidential election, arguing that it exposes the way in which liberal narratives of progress have failed to address the deeply embedded structural evil within American society. She argues that this political moment provides an opportunity for liberals to engage in a critical self-examination with respect to their complicity in these structures by embracing a form of "utopian praxis."Ryan Darr's essay considers the intersection of structural evil and individual responsibility, arguing, on the one hand, for a distinction between sin and moral wrongdoing and, on the other, for an approach to both concepts that is social in form. Esther Reed's essay, meanwhile, offers an analysis of responsibility in light of the question of structural evil, using the theology of Dietrich Bonhoeffer to aid in understanding the connection between individual responsibility and distant harm.David Cloutier continues the examination of the tension between individual agency and structural evil in his critique of the "neo-Franciscan" and "Junian" approaches to issues of violence and racism, arguing that a "critical realist" approach to structural evil provides greater resources for Christian ethics.Elizabeth Sweeny Block offers a different approach to the question in her consideration of the role of conscience in grappling with crises on a global scale, such as climate change and the Zika virus. She contrasts the "reflexive conscience" predominant in Christian ethics with a model of "engaged conscience," which may provide a better approach to large-scale structural evil and its consequences.Stewart Clem uses Thomas Aquinas's conception of virtue to understand the problems inherent in striving for moral clarity in a "post-truth" context. In [End Page vii] light of Harry Frankfurt's philosophical analysis of the concept of "bullshit," he argues that Christian ethics needs to develop a way of speaking about truth as a virtue in order to respond to the structural problem of truth indifference in contemporary political discourse.Looking at the problem from a different perspective, Christopher Jones and Conor Kelly examine the sin of sloth from a structural point of view. Critiquing individualist conceptions of the idea, they make the case for retrieving the classical definition of sloth as a vice against charity and consider how sloth can be overcome through a reinvigoration of forms of civic virtue.Another dimension of structural evil is considered by Ryan Newson in his examination of the role that Confederate monuments play in the American South. For many, they stand as a symbol of the glorification of evil that should be removed, but Newson suggests that there may be reasons to keep at least some of these monuments as reminders of the failure of justice and the judgment of God.Wonchul Shin and Elizabeth Bounds consider these questions from the perspective of how "ordinary" experiences of moral harm need to be analyzed as dimensions of structural evil, and they call for an examination of structural responsibility and the ethics of repair as a means of addressing these questions.Finally, Willa Swenson-Lengyel looks at the connection between structural evil and environmental ethics, arguing that the "moral paralysis" often experienced in light of the ecological crisis exposes certain forms of privilege that need to be addressed from the perspective of Christian ethics. In many ways, she argues, privileged inaction can be a manifestation of "works righteousness" that can be addressed through a Lutheran conception of the doctrine of justification.________This year the JSCE is retiring the demographic survey that has been used since 2008 and adopting a new demographic survey. With the transition comes an apt time for reflection on what the data from the last nine years show.The first piece of data to... (shrink)

Sharrad, Scott; Bartholomeusz, David; Henderson, Stewart.

Consider the following epistemological principle:KR: A knowledge source K can yield knowledge for subject S only if S knows K is reliable.Traditional epistemologists face a dilemma: either reject KR and confront what Stewart Cohen calls “the Problem of Easy Knowledge” or embrace KR and deny that unreflective beings can possess knowledge. In order to avoid this dilemma, an epistemological theory must allow for knowledge on the part of unreflective beings without falling prey to the problem of easy knowledge. I (...) argue that the epistemology of the dying Wittgenstein, presented posthumously in On Certainty, avoids the dilemma. (shrink)

Open peer commentary on the article “A Cybernetic Computational Model for Learning and Skill Acquisition” by Bernard Scott & Abhinav Bansal. Upshot: The Computational Theory of Mind suffers from an inherent weakness owing to its difficulty in taking semantics and embodiment properly into account. It is suggested that these difficulties could be alleviated if it were recognized that the fact that the model presented here employs a computer as a tool, to highlight certain key features of its dynamics, does (...) not necessarily involve assuming that the underlying processes that are modelled are themselves strictly computational in nature. (shrink)

Upshot: I thank Mallen for providing some historical background concerning the origin of the Typist models and for helping clarify the theoretical issues addressed and motivations for creating the models. Whilst de Zeeuw acknowledges the Typist models as a useful contribution to first-order cybernetics, he questions their relevance for second-order cybernetics. I argue that, in the context of research on human learning, de Zeeuw’s characterisation is third- rather than second-order. Stewart questions the status of the model with respect to (...) the CTM and is concerned by our cursory treatment of “consciousness,” “semantics” and “embodiment.” We point out that the Typist models are digital models of cognitive processes rather than part of the CTM tradition. Franchi raises challenging questions about cognition and its embodiment. We acknowledge the contradiction implied when we talk about “implementing” the Typist models in a different form of processor, one that accommodates concurrency, as a processor of that kind would not be “programmable” in a conventional sense. (shrink)

Jon Stewart often delivers the satire himself, but nearly every episode also features at least one of The Daily Show's numerous correspondents. This chapter focuses on Larry Wilmore, who as Senior Black Correspondent is able to discuss issues of race in ways that a white correspondent probably could not. For example, Wilmore has discussed how the election of Barack Obama could be perceived by the African‐American community in the United States, proposing that peer pressure creates a monolithic voting block (...) among African‐Americans. Other issues discussed by Wilmore include the Trayvon Martin case, whether the Congressional Black Caucus has “maxed out” the race card, and how Obama should “go blacker” in response to the US credit downgrade. (shrink)

This ambitious, interdisciplinary book seeks to explain the origins of religion using our knowledge of the evolution of cognition. A cognitive anthropologist and psychologist, Scott Atran argues that religion is a by-product of human evolution just as the cognitive intervention, cultural selection, and historical survival of religion is an accommodation of certain existential and moral elements that have evolved in the human condition.