Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)

This book is an eye-opening account of transnational advocacy, not by environmental and rights groups, but by conservative activists. Mobilizing around diverse issues, these networks challenge progressive foes across borders and within institutions. In these globalized battles, opponents struggle as much to advance their own causes as to destroy their rivals. Deploying exclusionary strategies, negative tactics and dissuasive ideas, they aim both to make and unmake policy. In this work, Clifford Bob chronicles combat over homosexuality and gun control in the (...) UN, the Americas, Europe and elsewhere. He investigates the 'Baptist-burqa' network of conservative believers attacking gay rights, and the global gun coalition blasting efforts to control firearms. Bob draws critical conclusions about norms, activists and institutions, and his broad findings extend beyond the culture wars. They will change how campaigners fight, scholars study policy wars, and all of us think about global politics. (shrink)

Experiments are commonly thought to have epistemic privilege over simulations. Two ideas underpin this belief: first, experiments generate greater inferential power than simulations, and second, simulations cannot surprise us the way experiments can. In this article I argue that neither of these claims is true of experiments versus simulations in general. We should give up the common practice of resting in-principle judgments about the epistemic value of cases of scientific inquiry on whether we classify those cases as experiments or simulations, (...) per se. To the extent that either methodology puts researchers in a privileged epistemic position, this is context sensitive. (shrink)

Current thinking suggests that dissociation could be a significant comorbid diagnosis in a proportion of schizophrenic patients with a history of trauma. This potentially may explain the term “schizophrenia” in its original definition by Bleuler, as influenced by his clinical experience and personal view. Additionally, recent findings suggest a partial overlap between dissociative symptoms and the positive symptoms of schizophrenia, which could be explained by inhibitory deficits. In this context, the process of dissociation could serve as an important conceptual framework (...) for understanding schizophrenia, which is supported by current neuroimaging studies and research of corollary discharges. These data indicate that the original conception of “split mind” may be relevant in an updated context. Finally, recent data suggest that the phenomenal aspects of dissociation and conscious disintegration could be related to underlying disruptions of connectivity patterns and neural integration. (shrink)

According to deontological approaches to justification, we can analyze justification in deontic terms. In this paper, I try to advance the discussion of deontological approaches by applying recent insights in the semantics of deontic modals. Specifically, I use the distinction between weak necessity modals and strong necessity modals to make progress on a question that has received surprisingly little discussion in the literature, namely: ‘What’s the best version of a deontological approach?’ The two most obvious hypotheses are the Permissive View, (...) according to which justified expresses permission, and the Obligatory View, according to which justified expresses some species of obligation. I raise difficulties for both of these hypotheses. In light of these difficulties, I propose a new position, according to which justified expresses a property I call faultlessness, defined as the dual of weak necessity modals. According to this view, an agent is justified in \-ing iff it’s not the case that she should [/ought] not \. I argue that this ‘Faultlessness View’ gives us precisely what’s needed to avoid the problems facing the Permissive and Obligatory Views. (shrink)

In this paper, I discuss the recent discovery of alleged arsenic bacteria in Mono Lake, California, and the ensuing debate in the scientific community about the validity and significance of these results. By situating this case in the broader context of projects that search for anomalous life forms, I examine the methodology and upshots of challenging biochemical constraints on living things. I distinguish between a narrower and a broader sense in which we might challenge or change our knowledge of life (...) as the result of such a project, and discuss two different kinds of projects that differ in their potential to overhaul our knowledge of life. I argue that the arsenic bacteria case, while potentially illuminating, is the kind of constraint-challenging project that could not—in spite of what was said when it was presented to the public—change our knowledge of life in the deeper sense. (shrink)

According to recent evidence, neurophysiological processes coupled to pain are closely related to the mechanisms of consciousness. This evidence is in accordance with findings that changes in states of consciousness during hypnosis or traumatic dissociation strongly affect conscious perception and experience of pain, and markedly influence brain functions. Past research indicates that painful experience may induce dissociated state and information about the experience may be stored or processed unconsciously. Reported findings suggest common neurophysiological mechanisms of pain and dissociation and point (...) to a hypothesis of dissociation as a defense mechanism against psychological and physical pain that substantially influences functions of consciousness. The hypothesis is also supported by findings that information can be represented in the mind/brain without the subject’s awareness. The findings of unconsciously present information suggest possible binding between conscious contents and self-functions that constitute self-representational dimensions of consciousness. The self-representation means that certain inner states of own body are interpreted as mental and somatic identity, while other bodily signals, currently not accessible to the dominant interpreter’s access are dissociated and may be defined as subliminal self-representations. In conclusion, the neurophysiological aspects of consciousness and its integrative role in the therapy of painful traumatic memories are discussed. (shrink)

Later works of C.G. Jung contain comprehensive descriptions of the relationship between psychological and physical research. These considerations described in Jung’s works and in his correspondence with Wolfgang Pauli represent interesting philosophical ideas that are related to interpretation of psychological data. The so-called “collective unconscious” studied by Jung in analysis of dream material, mythology, psychopathological symptoms, and several cultural manifestations led him to postulate complementarity and unity of scientific principles, and to define the psyche as complementary to physical reality. Likewise (...) recent neuroscientific studies and physical analyses on the role of the observer in physical reality led to the study of “quantum consciousness.” This review compares the philosophical postulates by Roger Penrose with Jung’s and Pauli’s studies, and suggests novel links of these concepts to recent findings of chaos theory in the brain. (shrink)

Previous work employing graph theory and nonlinear analysis has found increased spatial and temporal disorder, respectively, of functional brain connectivity in schizophrenia. We present a new method combining graph theory and nonlinear techniques that measures the temporal disorder of functional brain connections. Multichannel electroencephalographic data were windowed and functional networks were reconstructed using the minimum spanning trees of correlation matrices. Using a method based on Shannon entropy, we found elevated connection entropy in gamma activity of patients with schizophrenia; however, gamma (...) connection entropy remained elevated in patients with schizophrenia even after a reduction in symptoms due to treatment with antipsychotics. Our results are consistent with several possibilities: aberrant functional connectivity is epiphenomenal to schizophrenia, aberrant functional connectivity is a central feature but antipsychotics reduce symptoms by an independent mechanism, or connection entropy is not an appropriately sensitive measure of brain abnormalities in schizophrenia. (shrink)

Previous research on associative learning has uncovered detailed aspects of the process, including what types of things are learned, how they are learned, and where in the brain such learning occurs. However, perceptual processes, such as stimulus recognition and identification, take time to unfold. Previous studies of learning have not addressed when, during the course of these dynamic recognition processes, learned representations are formed and updated. If learned representations are formed and updated while recognition is ongoing, the result of learning (...) may incorporate spurious, partial information. For example, during word recognition, words take time to be identified, and competing words are often active in parallel. If learning proceeds before this competition resolves, representations may be influenced by the preliminary activations present at the time of learning. In three experiments using word learning as a model domain, we provide evidence that learning reflects the ongoing dynamics of auditory and visual processing during a learning event. These results show that learning can occur before stimulus recognition processes are complete; learning does not wait for ongoing perceptual processing to complete. (shrink)

Francesco Redi’s seventeenth-century experiments on insect generation are regarded as a key contribution to the downfall of belief in spontaneous generation. Scholars praise Redi for his experiments demonstrating that meat does not generate insects, but condemn him for his claim elsewhere that trees can generate wasps and gallflies. He has been charged with rejecting spontaneous generation only to change his mind and accept it, and in the process, with failing as a rigorous experimental philosopher. In this paper I defend Redi (...) from both of these charges. In doing so, I draw some broader lessons for our understanding of spontaneous generation. ‘Spontaneous generation’ does not refer to a single theory, but rather a landscape of possible views. I analyze Redi’s theoretical commitments and situate them within this landscape, and argue that his error in the case of insects from plants is not as problematic as previous commentators have said it is. In his research on gall insects Redi was addressing a different question from that of his experiments on insect generation—the question was not “Can insects come from nonliving matter?,” but rather, “Can insects come from living organisms which are not their parents?” In the latter case, he gave an answer which we now know to be false, but this was not due to any failure in his rigor as an experimental philosopher. (shrink)

There is preserved in Suidas' Lexicon a story about Polycrates of Samos and the island of Delos. It is offered by the lexicographer as an explanation of the phrase τατ σοι κα πύθια κα δλια , when used in a colloquial sense to mean ‘it's all the same to you’. Polycrates had instituted a festival on Delos and asked the Pythia whether to call it by the one name or the other. The phrase, which was supposed to have been the (...) Pythia's reply, was taken to mean that it was all the same to Polycrates whatever he called it, and the death of Polycrates, coming soon after, was interpreted as the fulfilment of the prophecy. Suidas cites Epicurus and Menander for the phrase itself, which was therefore in familiar use by the end of the fourth century B.C. As for the story about Polycrates, it is quite likely that Suidas' ultimate source was some writer of about that period, such as Demon, περ παροιμιν. It is very much in the manner of his fragments. (shrink)

The historical background of the discovery of adverse health effects of medicines, food additives, pesticides, and other chemicals is reviewed, and the development of national and international regulations and testing procedures to protect the public against the toxic effects of these drugs and chemicals is outlined. Ethical considerations of the safety evaluation of drugs and chemicals by human experimentation and animal toxicity studies, ethical problems associated with clinical trials, with the falsification of clinical and toxicological data, and with inadequate experimental (...) methodology, are reviewed, and the ethics of the marketing of drugs and their post-marketing surveillance, are similarly considered. These ethical problems are illustrated with many specific examples, including the drugs neoarsphenamine, chloramphenicol, thalidomide, diethyl stilboestrol and benoxaprofen. (shrink)

In a recent number Mr. O. J. Todd has discussed the clumsy scansion of a line in a Delphic oracle, and has called fresh attention to the problem of the Pythia's prophesyings in verse. The chief difficulty consists in the differences between the indications on this subject as given by our various sources. The conventional phrases in most authors from Pindar and Herodotus until late periods describe the responses as uttered by the Pythia herself. This picture seems to imply that (...) the Pythia originated the verse form of the oracle. But this view would take no account of the existence of the official known as the προφήτης whose business was evidently to deliver the response to the inquirer. (shrink)

Plutarch in his Life of Agis describes the plots by which Lysandrus the ephor contrived to depose King Leonidas II. He meant to use against him one of the Spartan laws which forbade a member of the royal houses from begetting children by a foreign woman, and another by which he who went out of Sparta with a view to settling abroad was liable to the death penalty. But though apparently a case could be made out against Leonidas under these (...) charges, Lysandrus did not simply proceed with the prosecution. After instructing confederates who would bring the case, he with his fellow ephors ‘waited for the sign’. What this meant Plutarch explains in these words: στι δ τοινδε· δι' τν1 ννα1 λαβντες ο οροι νκτα καθαρν κα σληνον, σιωπ καθζονται πρς τν ορανν ποβλποντες. ν ον κ μρους τινς ες τερον μρος στρ διξ, κρνουσι τος βασιλες, ς περ τ θεον ξαμαρτνοντας, κα καταπαουσι τς ρχς, μχρις ν κ Δελν ἢ λυμπας χρησμς λθτος λωκσι τν βασιλων βοηθν. (shrink)

Our chief evidence for the days on which the Delphic oracle could be consulted comes, as is well known, from a passage in the Quaestiones Graecae of Plutarch . He is explaining the name of the Delphic month Bysios, which he derives from the verbs for inquiry , and adds the comment: ν т μην γρ тούт χρησтήριον γίγνεο, κα έβδóμην таüтην νομίζουσι тο θεο γενέθλιο, κα πολύθοον νομάζουσι, ο δι тò πέттεσθαι θóïς λλ πολυπευθ κα πολυμάνтευтον οσαν. ψ γŰρ (...) νείθησαν ακαтŰ μνα μανтεᔞᔦ тος δεομένοις, πóтεπον δ' ᾰπαξ θεμίσтευεν Пυθία тο νιαυтο καтŰ тαύтην тν μέραν, ώς Кαλλισθένης κα 'Ạναξανδρίης ίςтρήκασι. (shrink)

The historical background of the discovery of adverse health effects of medicines, food additives, pesticides, and other chemicals is reviewed, and the development of national and international regulations and testing procedures to protect the public against the toxic effects of these drugs and chemicals is outlined. Ethical considerations of the safety evaluation of drugs and chemicals by human experimentation and animal toxicity studies, ethical problems associated with clinical trials, with the falsification of clinical and toxicological data, and with inadequate experimental (...) methodology, are reviewed, and the ethics of the marketing of drugs and their post-marketing surveillance, are similarly considered. These ethical problems are illustrated with many specific examples, including the drugs neoarsphenamine, chloramphenicol, thalidomide, diethyl stilboestrol and benoxaprofen. (shrink)

Recent findings indicate that complex cognitive functions are organized at a global level in the brain and rely on large-scale information processing requiring functional integration of multiple disparate neural assemblies. The critical question of the integration of distributed brain activities is whether the essential integrative role can be attributed to a specific structure in the brain or whether this ability is inherent to the cognitive network as a whole. The results of the present study show that mean values of the (...) running correlation function in frontal-temporal EEG pairs with one electrode in the anterior cingulate cortex are significantly higher than the same values in other frontal-temporal pairs. These findings indicate a particular role of the ACC in large-scale communication, which could reflect its unique integrative functions in cognitive processing. (shrink)

Zosimus, after recording the foundation and immense growth of Constantinople, introduces a digression directed towards his purpose of justifying paganism against Christianity. ‘It has often indeed occurred to me to wonder how, when the city of the Byzantines has grown, so that no other can compare with it for prosperity and size, there was no prophecy delivered from the gods of our predecessors about its development to a better fortune. With this thought in mind I have turned over many volumes (...) of histories and collections of oracles, and with difficulty I happened upon one oracle said to be of the Sibyl of Erythrae or of Phaennis of Epirus. Nicomedes, the son of Prusias, put his confidence in this oracle, and interpreting it in an advantageous sense he took up war against his father, Prusias, at the persuasion of Attalus.’ Zosimus proceeds to quote twenty-one lines of hexameter verse, which have come down in a rather corrupt state, but of which the general sense is reasonably clear. They consist mainly of an obvious post eventum forecast of the Gallic invasion of Asia Minor in the third century B.C. (shrink)

In the for 1952 , pp. 33 ff., Nikolaos M. Kontoleon published a most interesting inscription from the shrine of Archilochos on Paros. It was inscribed, as preserved, on two orthostats, which probably formed part of the structure of the hearth or bothros where offerings to the hero were made. There is much of interest to scholars in this new discovery, which is very fully and carefully interpreted by Kontoleon, and has been further discussed by Werner Peck . In this (...) article the present writer wishes to confine himself to some comments on the new evidence about responses of the Delphic oracle supplied by the inscription. This material is all found on the first of the two orthostats, and falls into two categories: responses connected with the setting up of the shrine, and responses connected with the life of Archilochus. (shrink)