Brain death has been accepted worldwide medically and legally as the biological state of death of the organism. Nevertheless, the literature has described persistent problems with this acceptance ever since brain death was described. Many of these problems are not widely known or properly understood by much of the medical community. Here we aim to clarify these issues, based on the two intractable problems in the brain death debates. First, the metaphysical problem: there is no reason that withstands critical scrutiny (...) to believe that BD is the state of biological death of the human organism. Second, the epistemic problem: there is no way currently to diagnose the state of BD, the irreversible loss of all brain functions, using clinical tests and ancillary tests, given potential confounders to testing. We discuss these problems and their main objections and conclude that these problems are intractable in that there has been no acceptable solution offered other than bare assertions of an ‘operational definition’ of death. We present possible ways to move forward that accept both the metaphysical problem - that BD is not biological death of the human organism - and the epistemic problem - that as currently diagnosed, BD is a devastating neurological state where recovery of sentience is very unlikely, but not a confirmed state of irreversible loss of all [critical] brain functions. We argue that the best solution is to abandon the dead donor rule, thus allowing vital organ donation from patients currently diagnosed as BD, assuming appropriate changes are made to the consent process and to laws about killing. (shrink)

This paper examines the madness of Gerard de Nerval, the nineteenth-century French writer. It looks at his account of mental disturbance, how he responded to the psychiatric profession and how he reacted to being diagnosed as insane. It considers his autobiographical novella of madness, Aurelia, which he began at the suggestion of his alienist, Dr Emile Blanche, and while he was still an asylum inmate. Nerval's story raises important questions about the nature of madness. Is it, as he contended, a (...) mystical experience revealing truths about spiritual worlds inaccessible to the ‘sane’? Does psychiatry fail to understand it and inappropriately reduce it to the categories of scientific reason? Or are such notions of the spiritual value of madness guilty of the charge that they romanticise insanity? Do they make extravagant claims for an experience that is often disturbing and debilitating? What is the relationship between madness and recovery? Should an individual try to forget their experience of mental disturbance once they recover, or should they examine what the event reveals about themselves? Can the language of madness be decoded to unveil profound truths as Carl Jung and R.D. Laing have suggested, or is it, as the psychiatrist German Berrios maintains, merely a series of ‘empty speech acts’, signifying nothing? And finally, how does one avoid writing about madness, and instead write madness? (shrink)

Thetext of the de Caelo was the subject of an interesting article in the Rivista Storia Antica, N.S. IX, by Dr. R. Rubrichi; he showed that where the manuscriptsdiverge, we ought to bring in the evidence of Simplicius, and that when we look closely into the sense, the commentator's reading is in most cases decidedly preferable; he also established a fact which is familiar from editions of the othér physical treatises, namely that there is some specially close affinity between the (...) text of E and that used by Simplicius. (shrink)

Chantal Mouffe har altid sat spørgsmålet om sociale bevægelser i relation til spørgsmålet om demokratisering. Hendes ideer om agonistisk og radikalt demokrati har fået gennemslag i den europæiske samfundsmæssige debat, men i den sammenhæng glemmer man måske, at hun først og fremmest er engageret i en radikalisering af det liberale demokrati. I hendes nuancerede debatstil kan de mange begreber, nogle af hvilke hun selv er ophavet til, godt få læseren til at fokusere på enkelte træer, som for eksempel netop agonistisk (...) og radikalt demokrati. Dermed kan selve skoven, det liberale demokrati og dets udvikling, forsvinde ud af fokus. Det gør det imidlertid ikke i dette interview, der fandt sted i hendes hjem i Hampstead, Nordlondon, primo 2012, omtrent samtidig med, at hendes seneste bog Agonistics blev afsluttet. (shrink)

The Liverpool Care Pathway for the Dying Patient (LCP) was an integrated care pathway for patients in the final days or hours of life, developed at the Royal Liverpool University Hospital in conjunction with the Marie Curie Palliative Care Institute, Liverpool. The LCP became increasingly the normative style of care for patients in the terminal stage across NHS England from the 1990s onwards. Following significant questions raised in Parliament, by the media and other stakeholders, an independent review panel was established (...) under Baroness Neuberger in 2013 to investigate the LCP. The findings of the panel were published as More Care Less Pathway: a Review of the Liverpool Care Pathway identifying significant failings in the delivery of the LCP thus leading to it being phased out some six months later. Rather than being euthanasia through the backdoor, many of the criticisms of the LCP and its poor implementation are indicative of poor communication, limited knowledge of the dying process and a paucity of death education. (shrink)

Kojève has been known as the most brilliant, profound, controversial, and influential commentator on Hegel in the twentieth century. "Commentator" is perhaps too neutral a word, for Kojève's lectures on Hegel have been a vehicle for articulating and defending a view of what philosophy and wisdom essentially are. Kojève's lectures on the Phenomenology of Spirit at the Ecole des Hautes Etudes from 1933-1939 were primarily responsible for the Hegelian influence on a number of major French intellectuals. The present translation which (...) consists of a selection from the collection of writings edited by Queneau, is certainly not an introduction in any ordinary sense of the term. But for those who have been caught by the power of Hegel's Phenomenology--and their number seems to be growing in the Anglo-Saxon world--an encounter with Kojève, who is clearly one of the most serious readers of Hegel, will prove immensely rewarding. It is a bit surprising that Allan Bloom whose own approach to scholarship places such a high priority on careful textual analysis has edited a rather chopped up version of the French text.--R. J. B. (shrink)

In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines in (...) ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines. (shrink)

Maladapting Minds discusses a number of reasons why philosophers of psychiatry should take an interest in evolutionary explanations of mental disorders and, more generally, in evolutionary thinking. First of all, there is the nascent field of evolutionary psychiatry. Unlike other psychiatrists, evolutionary psychiatrists engage with ultimate, rather than proximate, questions about mental illnesses. Being a young and youthful new discipline, evolutionary psychiatry allows for a nice case study in the philosophy of science. Secondly, philosophers of psychiatry have engaged with evolutionary (...) theory because evolutionary considerations are often said to play a role in defining the concept of mental disorder. The basic question here is: Can the concept of mental disorder be given an objective definition, or is it rather a normative concept? Thirdly and finally, evolutionary thinking in psychiatry has often been a source of inspiration for a philosophical view on human nature. Thus evolutionary psychiatrists have suggested, for example, that man's vulnerability to mental disorders may well be one of the defining features of our species. -/- Written by leading authors in philosophy, psychiatry, biology and psychology, this volume illustrates that many debates in contemporary philosophy of psychiatry are profoundly influenced by evolutionary approaches to mental disorders. Conversely, it also reveals how philosophers can help contribute to the burgeoning field of evolutionary psychiatry. It is important reading for a wide range of readers interested in mental health care and philosophy. (shrink)

Essentialism is one of the most pervasive problems in mental health research. Many psychiatrists still hold the view that their nosologies will enable them, sooner or later, to carve nature at its joints and to identify and chart the essence of mental disorders. Moreover, according to recent research in social psychology, some laypeople tend to think along similar essentialist lines. The main aim of this article is to highlight a number of processes that possibly explain the persistent presence and popularity (...) of essentialist conceptions of mental disorders. One such process is the general tendency of laypeople to essentialize conceptual structures, including biological, social, and psychiatric categories. Another process involves the allure of biological psychiatry. Advocating a categorical and biological approach, this strand of psychiatry probably reinforced the already existing lay essentialism about mental disorders. As such, the question regarding why we essentialize mental disorders is a salient example of how cultural trends zero in on natural tendencies, and vice versa, and how both can boost each other. (shrink)

This paper concentrates on some aspects of the history of the analyticsynthetic distinction from Kant to Bolzano and Frege. This history evinces considerable continuity but also some important discontinuities. The analytic-synthetic distinction has to be seen in the first place in relation to a science, i.e. an ordered system of cognition. Looking especially to the place and role of logic it will be argued that Kant, Bolzano and Frege each developed the analytic-synthetic distinction within the same conception of scientific rationality, (...) that is, within the Classical Model of Science: scientific knowledge as cognitio exprincipiis. But as we will see, the way the distinction between analytic and synthetic judgments or propositions functions within this model turns out to differ considerably between them. (shrink)

The way students perceive a learning climate (e.g. controlling or stimulating) is significantly influenced by feedback and assessment. However, at present much is unclear about the relation between feedback and motivational state. More specifically, the interplay with student characteristics is unclear. Since there is a strong increase of group work, the central research question is what are the effects of positive, neutral or negative feedback presented to collaborating teams of students, on students? intrinsic motivation, performance and on group processes? One (...) hundred thirty?eight higher education students participated in this study. There were no significant differences in performance across conditions. Multi?level analysis enabled a detailed comparison between groups and individual members of groups. Amongst others, it was found that feelings of competence facilitate the effect of positive feedback at the group level, which suggests that positive feedback boosts interest especially in groups of highly competent students. (shrink)

BackgroundHIV molecular epidemiology is increasingly recognized as a vital source of information for understanding HIV transmission dynamics. Despite extensive use of these data-intensive techniques in both research and public health settings, the ethical issues associated with this science have received minimal attention. As the discipline evolves, there is reasonable concern that existing ethical and legal frameworks and standards might lag behind the rapid methodological developments in this field. This is a follow-up on our earlier work that applied a predetermined analytical (...) framework to examine the perspectives of a sample of scientists from the fields of epidemiology, public health, virology and bioethics on key ethical issues associated with HIV molecular epidemiology in HIV network research.MethodsFourteen in-depth interviews were conducted with scientists from the fields of molecular epidemiology, public health, virology and bioethics. Inductive analytical approaches were applied to identify key themes that emerged from the data.ResultsOur interviewees acknowledged the potential positive impact of molecular epidemiology in the fight against HIV. However, they were concerned that HIV phylogenetics research messages may be incorrectly interpreted if not presented at the appropriate level. There was consensus that HIV phylogenetics research presents a potential risk to privacy, but the probability and magnitude of this risk was less obvious. Although participants acknowledged the social value that could be realized from the analysis of HIV genetic sequences, there was a perceived fear that the boundaries for use of HIV sequence data were not clearly defined.ConclusionsOur findings highlight distinct ethical issues arising from HIV molecular epidemiology. As the discipline evolves and HIV sequence data become increasingly available, it is critical to ensure that ethical standards keep pace with biomedical advancements. We argue that the ethical issues raised in this study, whether real or perceived, require further conceptual and empirical examination. (shrink)

Na era das tecnologias digitais, entender vieses algorítmicos por meio das teorias da verdade ajuda a fazer perguntas cujas respostas facilitam a filtragem da informação de forma mais eficaz. O ganho é a compreensão aprofundada da realidade.

Schuklenk and van de Vathorst's paper is a very welcome addition to the literature on the assisted dying debate and will be of great interest to clinicians working in the field of mental health.1 Many psychiatrists will have had patients who have asked them to allow them to die, to desist in their efforts to prevent their suicide, and one of us has had personal experience, outside of professional life, of being asked to aid in someone's attempt to end their (...) life in the context of an episode of mood disorder. The person with depression asking professionals, friends and family members to aid them in ending their life is a very real phenomenon. In their discussion, Schuklenk and van de Vathorst's paper uses two principles that we endorse and add weight to their argument: namely, the reality of suffering in depression and the parity of mental and physical illness. Indeed, the case Schuklenk and van de Vathorst make is a strong one and our commentary will focus on the premise of the argument around choosing death and some empirical clarification about competence in depression and the nature of treatment-resistant depression (TRD) and its prognosis. The conceptual concern we wish to discuss in relation to assisted dying, endorsed by the state and legislature, is not linked to any moral or religious concern, or even on grounds related to ‘slippery slope’ or ‘abuse’ arguments. Rather the worry is how one could operationalise decisions around assisted dying as based on competence and capacity and view such decisions as rational. I think this concern is not limited to depressive illness, but to all decisions regarding choosing non-existence. Schuklenk and van de Vathorst offer the following useful criteria to regulate assisted suicide:1. (shrink)

The proposal that there is an illusion of conscious will has been supported by findings that priming of stimulus location in a task requiring judgements of action-authorship can enhance participants’ experience of agency. We attempted to replicate findings from the ‘Wheel of Fortune’ task [Aarts, H., Custers, R., & Wegner, D. M. . On the inference of personal authorship: enhancing experienced agency by priming effect information. Consciousness and Cognition, 14, 439–458]. We also examined participants’ performance on this task in relation (...) to self-reported passivity experiences and hallucination-proneness. We found a significant effect of priming, with primes being found to increase the experience of agency. An interaction between gender and priming was also found, with priming enhancing feelings of agency in women but not in men. There were no significant correlations between levels of self-reported passivity experiences or hallucination-proneness and participants’ susceptibility to the priming effect on ratings of agency. Implications of these findings are discussed with regard to a prominent model of passivity experiences. (shrink)

Resumo: O objetivo do presente artigo é contrapor à acusação de tecnofóbico, erroneamente dirigida a Hans Jonas, a sua proposta de uma ethical turn da tecnologia, cujas bases estariam na capacidade ética de impor contenções ao avanço utópico do progresso técnico, algo que leva a ética da responsabilidade ao polêmico conceito de “heurística do temor”. Para tanto, parte-se de um exame sobre o projeto jonasiano de uma filosofia da tecnologia, cuja terceira perspectiva seria valorativa, sendo esta a que ele melhor (...) desenvolveu. A partir daí, analisa-se qual seria o valor da tecnologia, com base no ponto de vista da vida para então se examinar, estrategicamente, a posição de Gerard Lebrun, para quem Jonas estaria entre os filósofos tecnofóbicos. O intuito, nesse caso, é demonstrar a incoerência de tal interpretação, precisamente porque o pensador francês, com grande atuação no Brasil, confunde a proposta da reorientação ética com a imposição de um poder exterior, de cunho paralisante.: The purpose of this article is to counter against the accusation of technophobic, wrongly directed to Hans Jonas, his proposal for an ethical turn of technology, whose bases would be on the ethical capacity to impose restraint on the utopian advance of technical progress, something that leads to the ethics of responsibility to the controversial concept of “heuristic of fear”. To do so, we started from an examination of the Jonasian project of a philosophy of technology, whose third perspective would be valuable, which is the one he developed best. From there, we will analyze what would be the value of technology from the point of view of life and then strategically analyze the position of Gerard Lebrun for whom Jonas should be placed among technophobic philosophers. Our aim, in this case, is to demonstrate the inconsistency of such an interpretation, precisely because the French thinker with an important presence in Brazil, confuses the proposal of ethical reorientation with the imposition of an external power, of a paralyzing type. (shrink)