ObjectiveCochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation.Data sourcesWe address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community.Review methodsA systematic review using (...) three scientific online databases was performed. Included articles addressed the benefits and/or complications of cochlear implantation in young children, CI explantation with or without revision surgery and the ethical debate between the medical and Deaf communities on cochlear implantation and explantation.ConclusionsThe medical and audiological perspectives identify a host of risks related to implant removal without reimplantation, including risk from surgery, general anaesthesia, cochlear ossification and poor audiometric outcomes. The member of the deaf community and bioethicist argue that physicians need to guide the principles of beneficence, non-maleficence and patient autonomy. Taken together, patient desires should be seen as paramount, if the patient is otherwise fit for surgery and well informed.Implications for practiceSimilar to the case of device implantation, device explantation should be a multidisciplinary and collaborative decision with the patient and the family’s desires at the centre. While every case is different, we offer a CI explantation discussion to assist in clinical decision-making, patient counselling and education. (shrink)

The consent and community engagement process for research with Indigenous communities is rarely evaluated. Research protocols are not always collaborative, inclusive or culturally respectful. If participants do not trust or understand the research, selection bias may occur in recruitment, affecting study results potentially denying participants the opportunity to provide more knowledge and greater understanding about their community. Poorly informed consent can also harm the individual participant and the community as a whole. Invited by local Aboriginal community leaders of the Fitzroy (...) Valley, the Kimberley, Western Australia, The Picture Talk project explores the consent process for research. Focus groups of Aboriginal community members were conducted to establish preferences for methods of seeking individual consent. Transcripts were analysed through NVivo10 Qualitative software using grounded theory with inductive and deductive coding. Themes were synthesised with quotes highlighted. Focus groups with Aboriginal community members were facilitated by a Community Navigator as a cultural guide and interpreter and a researcher. Participants were recruited from all main language groups of the Fitzroy Valley – Gooniyandi, Walmajarri, Wangkatjungka, Bunuba and Nikinya. Participants were aged ≥18 years, with 5 female groups and one male group. Themes identified include: Reputation and trust is essential; The Community Navigator is key; Pictures give the words meaning – milli milli versus Pictures; Achieving consensus in circles; Signing for consent; and Research is needed in the Valley. Aboriginal communities of the Fitzroy Valley recommend that researchers collaborate with local leaders, develop trust and foster a good reputation in the community prior to research. Local Aboriginal researchers should be employed to provide cultural guidance throughout the research process and interpret local languages especially for elders. Pictures are preferred to written text to explain research information and most prefer to sign for consent. The Fitzroy Valley welcomes research when collaborative and for the benefit of the community. Future research could include exploring how to support young people, promote health screening and improve understanding of medical knowledge. (shrink)

Researchers are required to seek consent from Indigenous communities prior to conducting research but there is inadequate information about how Indigenous people understand and become fully engaged with this consent process. Few studies evaluate the preference or understanding of the consent process for research with Indigenous populations. Lack of informed consent can impact on research findings. The Picture Talk Project was initiated with senior Aboriginal leaders of the Fitzroy Valley community situated in the far north of Western Australia. Aboriginal people (...) were interviewed about their understanding and experiences of research and consent processes. Transcripts were analysed using NVivo10 software with an integrated method of inductive and deductive coding and based in grounded theory. Local Aboriginal interpreters validated coding. Major themes were defined and supporting quotes sourced. Interviews with Aboriginal leaders were facilitated by a local Aboriginal Community Navigator who could interpret if necessary and provide cultural guidance. Participants were from all four major local language groups of the Fitzroy Valley; aged 31 years and above; and half were male. Themes emerging from these discussions included Research—finding knowledge; Being respectful of Aboriginal people, Working on country, and Being flexible with time; Working together with good communication; Reciprocity—two-way learning; and Reaching consent. The project revealed how much more there is to be learned about how research with remote Aboriginal communities should be conducted such that it is both culturally respectful and, importantly, meaningful for participants. We identify important elements in community consultation about research and seeking consent. (shrink)

BackgroundWhen conducting research with Indigenous populations consent should be sought from both individual participants and the local community. We aimed to search and summarise the literature about methods for seeking consent for research with Indigenous populations.MethodsA systematic literature search was conducted for articles that describe or evaluate the process of seeking informed consent for research with Indigenous participants. Guidelines for ethical research and for seeking consent with Indigenous people are also included in our review.ResultsOf 1447 articles found 1391 were excluded (...) ; 56 were relevant and included. Articles were categorised into original research that evaluated the consent process or publications detailing the process of seeking consent and guidelines for ethical research. Guidelines were categorised into international ; national and state/regional/local guidelines. In five studies based in Australia, Canada and The United States of America the consent process with Indigenous people was objectively evaluated. In 13 other studies interpreters, voice recording, videos, pictures, flipcharts and “plain language” forms were used to assist in seeking consent but these processes were not evaluated. Some Indigenous organisations provide examples of community-designed resources for seeking consent and describe methods of community engagement, but none are evaluated. International, national and local ethical guidelines stress the importance of upholding Indigenous values but fail to specify methods for engaging communities or obtaining individual consent. In the ‘Grey literature’ concerns about the consent process are identified but no solutions are offered.ConclusionConsultation with Indigenous communities is needed to determine how consent should be sought from the community and the individual, and how to evaluate this process. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

I want to explore what happens to two philosophical issues when we assume that the mind, a functional device, is to be understood by the same sort of functional analysis that guides biological investigation of other organismic systems and characteristics. The first problem area concerns the concept of rationality, its connection with reliability and reproductive success, and the status of rationality hypotheses in attribution of beliefs. It has been argued that ascribing beliefs to someone requires the assumption that that person (...) is rational. It also has been argued that evolutionary theory can account for the capacity we have for rational thought by appealing to the idea that rational methods for constructing beliefs are reliable and therefore represented a selected advantage. Both of these claims about rationality are critically examined. In the second part of the paper, I turn to some criticisms that have been advanced against "functionalist" solutions to the mind/body problem. These criticisms are defused when that doctrine is understood in terms of a Teleological (rather than a Turing Machine) notion of function. However, functionalism does not emerge totally unscathed. Voltaire's Dr. Pangloss saw everything in terms of its function and its perfect performance of its function. In the philosophy of mind, his influence lives on in the form of two ideas: (i) that we must possess rational methods for constructing beliefs, since our minds are the product of natural selection, and (ii) that psychological states and properties are individuated by their psychological functions. Contemporary biology provides the resources for avoiding Pangloss's wideeyed teleology in the study of adaptation. It is to be hoped that progress in psychology will loosen the grip of Panglossian assumptions in the study of mind. (shrink)

A truly inclusive democratic politics must be understandable, or cognitively tractable, for ordinary people busy with the rest of their lives. This extends not only to everyday politics and policy, but to constitutional politics as well—non-specialist democratic citizens should be able to grasp the fundamental law that governs them and imagine their own role in shaping it as political agents. Yet these requirements raise a difficulty: in many countries, including the United States, constitutions are treated as the exclusive domain of (...) lawyers and judges. As a result, constitutional matters are typically discussed using legalistic jargon that is inscrutable even to non-specialist lawyers, let alone ordinary citizens. How then can constitutional politics be made legible to ordinary citizens? In this essay, I argue this challenge is partly one of political ideas—specifically, the ideas ordinary citizens use to think about their constitutions, or their folk constitutionalism. This may sound strange because insofar as constitutions are treated as lawyers’ exclusive turf, the problem may seem to be one of practice, not merely ideas. But popular practices of what scholars like John Finn and Elizabeth Beaumont call popular or civic constitutionalism involve citizens and social movements in transforming constitutions. These transformations often occur behind the backs of everyone involved, as new frames and understandings come to gradually transmute constitutional meaning, which in turn pervades the public political culture and reshapes the public’s constitutional imagination. I suggest we need ideas that more closely reflect what democratic citizens already do in democratic constitutional politics, so that they can do it more self-consciously and dispel the impression of an anti-democratic lack of control that recent constitutional innovations reveal to be illusory. I explore the utility of ideas of unwrittenness and functional multi-textuality to the end of a folk constitutionalism appropriate for democracy. (shrink)

Preoccupation with language is a notable feature of modern philosophy. Indeed, it is not too much to say that the influence of language on thought, and particularly its influence on philosophical thought, is a leading topic of philosophical discussion in this century. Every philosopher of any note, no matter what his general interests may be, has found it necessary to define his attitude to this problem. The attitude usually adopted consists of an admission that language does have a great influence (...) on thought, and on philosophical thought in particular. More accurately, it is claimed that the structure and grammatical categories, and perhaps the vocabulary, natural to a particular language, determine the lines of thought and speculation open to any thinker who uses that language .This determination is unimportant in many cases, because the results of our thinking are usually subject to check by appeal to empirical facts. In philosophical thinking, however, no such check is available by the very nature of the case. Accordingly, we cannot tell if the difficulty or apparent insolubility of a philosophical problem is due to the problem itself, or simply due to inadequacies in our language. In a different language, so it is suggested, the problem which is difficult for us might very easily be solved. Indeed, there might not then be any such problem, or its solution might be self-evident in this other language. This is the moderate attitude to the language difficulty in philosophy, and it is fair to say that it is almost universally adopted at the present day. In some circles it has acquired the prestige of an indisputable dogma. (shrink)

What does it take to be a good democratic citizen? Many scholars emphasize that being a good citizen is difficult because there is so much citizens should know to participate responsibly in politics. These critics implicitly assume that citizens should aspire to be “omnicompetent citizens:” fully informed about the issues of the day, candidates’ stances on them, and relevant scientific knowledge. In this article, I advance an alternative, less demanding standard of good citizenship in which citizens focus their political concern (...) on just a few issues, or even a single one. I defend this model of specialized citizenship from the objection that it licenses myopic and irresponsible decision making by citizens with two complementary arguments. The first draws from the work of Bernard Williams to demonstrate the ethical permissibility of citizens making decisions based on even single issues when they implicate citizens’ fundamental commitments. The second argument suggests that such seemingly blinkered decision-making may, when operating systemically, improve democratic decision making via a division of labor between citizens specializing in different issues. I conclude that there may be less of a tension between the demands of ordinary life and those of a flourishing democracy than previously thought. (shrink)

Multiple -conclusion logic extends formal logic by allowing arguments to have a set of conclusions instead of a single one, the truth lying somewhere among the conclusions if all the premises are true. The extension opens up interesting possibilities based on the symmetry between premises and conclusions, and can also be used to throw fresh light on the conventional logic and its limitations. This is a sustained study of the subject and is certain to stimulate further research. Part I reworks (...) the fundamental ideas of logic to take account of multiple conclusions, and investigates the connections between multiple - and single - conclusion calculi. Part II draws on graph theory to discuss the form and validity of arguments independently of particular logical systems. Part III contrasts the multiple - and the single - conclusion treatment of one and the same subject, using many-valued logic as the example; and Part IV shows how the methods of 'natural deduction' can be matched by direct proofs using multiple conclusions. (shrink)

This article aims at linking empirical research to legal theories, in a way that could enhance the benefits of this synergy. Jurisprudence, until recently the usual term for theoretical approaches to law, is now often replaced by the term legal theory. Difference between legal theory and empirical research is reflected in their consideration of subject matters, aims, and methods of research. However, there also exist commonalities between the two, i.e. both aim at comprehending law and legal systems. While legal theory (...) uses philosophical tools, its subject matter still remains a social phenomenon, for social ends. And since empirical research is a means to gather information about law, it could act as a prime source of information for legal theory. While empirical research has its own end to follow, what is missing is, attention to some legal theory, not just general legal theory, but which can also critique philosophical discourses to legality. (shrink)

Some tradition historical perspectives on Psalm 83 Psalm 83 forms a poetical unit and is the well constructed poem of an artist. It could be divided into two stanzas which contains a cry for help (2), lament (3-9) and several petitions (10-19). This work reflects different tradition historical allusions. The use of prophetic language is immanent, while the faces of the prophets Isaiah, Jeremiah and Ezekiel are elusively present. Two episodes from the history of the Judges (Judges 4-5; 7-8) are (...) utilised to expose its independent function in this psalm. The occurence of a well known Canaanite tradition is further obvious, while the question into the psalm's apocalyptic relationships is negatively assessed. Single motives like the upliftment of the head (3) and the shepherd/flock image (13) fulfil a definite Junction within the psalm’s context. The poet clearly applied historical traditions, motives and images to express an independent function within its context. (shrink)

Does South Africa need a common moral language? Many people are of the opinion that South Africa finds itself 'after Babel’ and needs a common moral language (1). The author considers some of the arguments of people who disagree with this analysis, because they do not define the problem in this way (2); because they find the language- or Babel-methaphor confusing (3); because they agree with the description of the problem, but not with the suggested solution, namely a common moral (...) language (4); or because they accept the solution, but do not regard it as the proper task of the Christian church to be involved in this search for a common moral language (5). (shrink)

In his 1922/1923 articles for the Japanese magazine _Kaizō_, Edmund Husserl identifies a particular “humanity” or human culture by the purposeful idea [_Zweckidee_] consciously embraced by the community. This purposeful idea is attained through rational self-formation on the part of the community in a manner analogous to the rational self-formation of the individual human being. Thereafter, it can be referenced to distinguish different cultures (or stages of cultural development) from one another through its objective manifestation in communal groups and cultural (...) products, as Husserl retraces in a historical account of the development of Western history. This paper explores the essential character of this conception of the purposeful idea from both an exegetical and a systematic perspective, examining in particular the relationship between such an idea and the values experienced by individual subjects within a culture (which are, according to Husserl, also available at the level of objective culture in relation to a communal subject). The paper argues that Husserl’s basic conception of the purposeful idea is a good model for understanding certain essential characteristics of cultural constitution in general, although some of his fundamental assumptions—especially the strict identity he attempts to establish between a purposeful idea as such and the specific goal of universal, rational self-understanding—turn out to be somewhat more questionable in light of the connection between the purposeful idea and the genuinely felt values underlying it. (shrink)