Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Views of the self may be plotted on a set of coordinates. On the axis that runs from fragmentation to unity, Rorty and Rorty's Freud champion the decentered self while Wallwork, Taylor, and Ricoeur argue for a sovereign, unified self. On the other axis, which runs from the disengaged, inward-turning self to the engaged and "sedimented" self, Wallwork, would be positioned near Rorty, defending self-creation against the narrative identity affirmed by Taylor and Ricoeur. Despite his skepticism concerning the communitarian agenda (...) of the narrativists, Flanagan grants that the self is social and relational--a position further explored by Oliver, Stendahl, Deutsch, and Mack in "Selves, People, and Persons". (shrink)

Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

Functional MRI shows promise as a candidate prognostication method in acutely comatose patients following severe brain injury. However, further research is needed before this technique becomes appropriate for clinical practice. Drawing on a clinical case, we investigate the process of obtaining informed consent for this kind of research and identify four ethical issues. After describing each issue, we propose potential solutions which would make a patient’s participation in research compatible with her rights and interests. First, we defend the need for (...) traditional proxy consent against two alternative approaches. Second, we examine the impact of the intensive care unit environment on the informed consent process. Third, we discuss the therapeutic misconception and its potential influence on informed consent. Finally, we deal with issues of timing in recruiting participants and related factors which may affect the risks of participation. (shrink)

Charles Hodge engaged the leading thinkers of his day to defend the human ability to know God. This involved him in affirming the importance of both orthodoxy and piety in the life of a Christian. His work involved expanding on the insights of the Westminster Confession of Faith as it applied to the theory of salvation and the role of Christ.

The topic of recognition has come to occupy a central place in debates in social and political theory. Developed by George Herbert Mead and Charles Taylor, it has been given expression in the program for Critical Theory developed by Axel Honneth in his book The Struggle for Recognition. Honneth's research program offers an empirically insightful way of reflecting on emancipatory struggles for greater justice and a powerful theoretical tool for generating a conception of justice and the good that enables (...) the normative evaluation of such struggles. This 2007 volume offers a critical clarification and evaluation of this research program, particularly its relationship to the other major development in critical social and political theory; namely, the focus on power as formative of practical identities proposed by Michel Foucault and developed by theorists such as Judith Butler, James Tully, and Iris Marion Young. (shrink)

Recovering Reason: Essays in Honor of Thomas L. Pangle is a collection of essays composed by students and friends of Thomas L. Pangle to honor his seminal work and outstanding guidance in the study of political philosophy. These essays examine both Socrates' and modern political philosophers' attempts to answer the question of the right life for human beings, as those attempts are introduced and elaborated in the work of thinkers from Homer and Thucydides to Nietzsche and Charles Taylor.

One of the predominant iterations of the metaphor of entanglement in the nineteenth century is found in the closing paragraph of Charles Darwin’s On the Origin of Species. Darwin’s image of an “entangled bank, clothed with many plants of many kinds, with birds singing on the bushes, with various insects flitting about,” serves as a synecdoche for the patterns of biological interdependence and variation that animate the evolutionary process of natural selection.1 The “entangled bank” is both the scene and (...) the symbolic illustration of creaturely increase and multiplication. We cannot escape the influence of heredity in Darwin’s schema, just as surely as the imagined bank of vegetation will wreathe and entwine.. (shrink)

I provide a précis of The Bodhisattva's Brain: Buddhism Naturalized (), and then respond to three critics, Christian Coseru, Charles Goodman, and Bronwyn Finnigan.

This article examines Nietzsche’s influence on analytic philosophy, focusing on the field of analytic ethics. It presents some key rationales motivating his re-evaluation of values and, in particular, his critique of modern morality. To demonstrate his influence on the work of Charles Taylor, Alasdair Macintyre, and Bernard Williams, the role of Nietzsche’s genealogical method in his re-evaluative project is considered. This is followed by a discussion of Nietzsche’s critique of the value of moral values and its relation to similar (...) objections developed by more recent morality critics. (shrink)

Owen Flanagan's important book The Bodhisattva's Brain presents a naturalized interpretation of Buddhist philosophy. Although the overall approach of the book is very promising, certain aspects of its presentation could benefit from further reflection. Traditional teachings about reincarnation do not contradict the doctrine of no self, as Flanagan seems to suggest; however, they are empirically rather implausible. Flanagan's proposed “tame” interpretation of karma is too thin; we can do better at fitting karma into a scientific worldview. The relationship between (...) eudaimonist and utilitarian strands in Buddhist ethics is more complex than the book suggests. Flanagan is right to criticize incautious and imprecise claims that Buddhism will make practitioners happy. We can make progress by distinguishing between happiness in the sense of a Buddhist version of eudaimonia, and happiness in the sense of attitudinal pleasure. Doing so might result in an interpretation of Buddhist views about happiness that was simultaneously philosophically interesting, historically credible, and psychologically testable. (shrink)

The Post-Modern Reader edited by Charles Jencks An Anthology of a World Movement Post-Modernism has been debated, attacked, and defended for a generation, but only in the last few years has it come into focus as a coherent way of thought embracing all areas of culture. This is the first anthology that presents the synthesising trend in all its diversity, a convergence in architecture and literature, film and cultural theory, sociology, feminism and theology, science and economics. It is however, (...) a synthesis with a difference; it is one which stresses a contested pluralism, the ‘dialogic' that underlies the growth of sciences as well as the development of other art forms such as the novel. Some of the key historical texts are reprinted in part - those of Daniel Bell on the post-industrial society and Jean-François Lyotard on the post-modern condition. The new cultural logic of contested pluralism is analysed in seminal papers by Andreas Huyssen and Jim Collins. The fundamental ideas on post-modern literature are defined by Umberto Eco, John Barth and David Lodge and the theories they present challenge the notion of post-modernism as an ultra avant-garde movement and the expression of a consumer society. New Cultural Theory Late Modernism Literature, Art, Architecture and Film Sociology, Politics and Geography Feminism Science and Religion Tito Arecchi, John Barth, Jean Baudrillard, Daniel Bell, Charles Birch, David Bohm, Jim Collins, Norman K Denzin, Umberto Eco, Edward Goldsmith, David Ray Griffin, Jürgen Habermas, David Harvey, Ihab Hassan, Linda Hutcheon, Andreas Huyssen, Charles Jencks, Heinrich Klotz, Hans Küng, David Lodge, Jean-François Lyotard, Robin Murray, Craig Owens, Paolo Portoghesi, Margaret Rose, Susan Rubin Suleiman, Edward W Soja. (shrink)

Fisher recognized that the evolution of social insect colonies needed explaining, a point which Charles Darwin had avoided discussing in detail. Fisher, in his 1930 book The Genetical Theory of Natural Selection, outlined in detail how eusociality could evolve, and developed a verbal model by connecting selection on fecundity with the sterility of workers. Fisher saw social insect colonies as harmonious units, in contrast to human societies that exhibit intra-communal conflict. Fisher’s development of the model was strongly influenced by (...) his correspondence with Leonard Darwin, and so I call it the Fisher-Darwin model. However, Fisher was not influenced by Lamarckian views on the evolution of social insects that were common at that time. The Fisher-Darwin model presages almost exactly the mathematical model recently proposed by Nowak and colleagues. (shrink)

With the exception of the occasional Damn-you-to-Hell types such as Mr Owen Burke of Timaru (ODT, 7/7/04), most opponents of the Civil Unions Bill like to pretend that they are not doing it out of hostility to homosexuals (who they sometimes, rather patronizingly, claim to love as people) but out of zeal for the institution of marriage. If civil unions are allowed, marriage will be damaged, and that is why they are against the Bill. The problem with this rationale (...) is that it is obviously false. Civil unions won’t damage marriage. And this so very obvious that it calls into question either the good sense or the good faith of those (like the Catholic Bishops and the members of the United Party) who proclaim that it is a zeal for holy matrimony rather than a dislike of a deviant minority that dictates their political conduct. (shrink)

The purpose of the article is to offer a detailed exegetical analysis of the argument in chapter four of "de ente et essentia" in which aquinas argues for a distinction between "esse" and essence and to develop an interpretation of it on the basis of the analysis. I argue that the reconstructed argument shows that aquinas argues for a real distinction and that he establishes it earlier in the argument than some commentators have thought. I criticize a rival interpretation of (...) the argument defended recently by joseph owens. (shrink)

O'Donnell, J. R. Anton Charles Pegis on the occasion of his retirement.--Conlan, W. J. The definition of faith according to a question of MS. Assisi 138: study and edition of text.--Spade, P. V. Five logical tracts by Richard Lavenham.--Maurer, A. Henry of Harclay's disputed question on the plurality of forms.--Brown, V. Giovanni Argiropulo on the agent intellect: an edition of Ms. Magliabecchi V 42.--Synan, E. A. The Exortacio against Peter Abelard's Dialogus inter philosophum, Iudaeum et Christianum.--Fitzgerald, W. Nugae Hyginianae.--Sheehan, (...) M. M. Marriage and family in English conciliar and synodal legislation.--Shook, L. K. Riddles relating to the Anglo-Saxon scriptorium.--Boyle, L. E. The De regno and the two powers.--Colledge, E. A Middle English Christological poem.--Gough, M. R. E. Three forgotten martyrs of Anazarbus in Cilicia.--Häring, N. Chartres and Paris revisited.--Hayes, W. Greek recentiores, (Ps.) Basil, Adversus eunomium, IV-V.--Owens, J. The physical world of Parmenides. (shrink)

This paper describes one style of functional analysis commonly used in the neurosciences called task-bound functional analysis. The concept of function invoked by this style of analysis is distinctive in virtue of the dependence relations it bears to transient environmental properties. It is argued that task-bound functional analysis cannot explain the presence of structural properties in nervous systems. An alternative concept of neural function is introduced that draws on the theoretical neuroscience literature, and an argument is given to show that (...) this alternative concept of may help to overcome the explanatory limitations of task-bound functional analysis. (shrink)

Though some doubts about the principle that every proposition is either true or false were entertained even by Aristotle, both the number and the vigor of criticisms of this principle have been increasing in recent years. This paper attempts a restatement and a re-examination of the issues involved in this dispute, and in particular an evaluation of the effects on the argument of such recent discoveries as that of the “many-valued logics.”.

A recent article in this journal describes certain mathematical and philosophical controversies which occurred in Prussia during the middle decades of the 18th century. The article pays particular attention to the position of Christian Wolff and to the views of some of his followers. Both Wolff and the Wolffians are shown to have supported some of Leibniz's doctrines against those of the Newtonian camp. As a result, or perhaps in part as a premise, there is a strong tendency throughout the (...) article to identify Wolff himself with Leibniz. The reader will naturally conclude that Wolff (and, in turn, the Wolffians) must have been a faithful student and expositor of his master, Leibniz. My purpose in the present investigation is to contribute to an examination of the accuracy of this portrayal. (shrink)

In this paper, I have two primary goals. First, I show that the causal-based story approach in A hybrid formal theory of arguments, stories and criminal evidence is ill suited to negative causation. In the literature, the causal-based approach requires that hypothetical stories be causally linked to the explanandum. Many take these links to denote physical or psychological causation, or temporal precedence. However, understanding causality in those terms, as I will show, cannot capture cases of negative causation, which are of (...) interest to the Law. In keeping with this, I also discuss some of the difficulties Hybrid Theory invites by remaining silent on the nature of the causal links. In my second aim, I sketch a way for Hybrid Theory to overcome this problem. By replacing the original, underlying causal structure with contrastive causation in the law, Hybrid Theory can represent reasoning in which the evidence that is appealed to is causally linked via negative causation to the explananda. (shrink)

Charles A. Baylis; VII—Foundations For a Presentative Theory of Perception and Sensation, Proceedings of the Aristotelian Society, Volume 66, Issue 1, 1 June 19.