L’Ésotérisme shi‘ite: Ses racines et ses prolongements / Shi‘i Esotericism: Its Roots and Developments. Edited by M. A. Amir-Moezzi, M. de Cillis, D. de Smet, and O. Mir-Kasimov. Bibliothèque de l’École des Hautes Etudes, sciences religieuses, vol. 177. Turnhout, Belgium: Brepols, 2016. Pp. v + 870. €95.
Objectives: To assess whether according to healthcare providers, the creation of an ethics service responds to a need; assess the importance of an ethics service for healthcare providers; determine what ethics services should be offered and the preferred formats of delivery; and identify key issues to be initially dealt with by the ethics service.Design: A survey of healthcare providers in Québec’s Centre Local de Services Communautaires , healthcare institutions dedicated to community health and social services.Findings: 96 respondents agreed that an (...) ethics service was needed, and on average the ethics service project was judged to be very important. Preferred formats for ethics consultation and education were identified, as well as key concerns such as the need of respect for the patient as a person, elder abuse and ethical issues in home care.Conclusion: This survey is helping in the implementation of an ethics service and can guide others in similar healthcare institutions. (shrink)
In this path breaking volume, leading researchers from psychology, linguistics, philosophy and primatology offer complementary perspectives on the role of intersubjectivity in the context of human development, comparative cognition and...
The history and genesis of major public clinical ethics controversies is intimately related to the publication of opinions and responses in media coverage. To provide a sample of public response in the media, this paper reports the results of a content analysis of letters to editors published in the four most prolific American newspapers for the Schiavo controversy. Opinions expressed in the letters sampled strongly supported the use of living wills and strongly condemned public attention to the case as well (...) as political interventions. Letters tended to be against withdrawal of life support, proxy consent and associated procedures as well as against court decisions and legal procedures. In comparison with reports written by journalists, letters to editors contained fewer controversial claims about Schiavo''s neurological condition and behavioural repertoire but similar loaded language to describe withdrawal of life support. Distinct public discourses can be encountered in different stakeholders suggesting complex and extensive pluralism even within the media. (shrink)
A recent discussion on cognitive enhancers has caused some controversy in the ethics and neuroscience fields by coming out in favour of making neuropharmaceuticals with enhancing properties available for general consumption. We highlight in this brief commentary why concerns regarding efficacy and safety, demands on resources, and public health are substantive enough to warrant serious reconsideration before pharmaceutical performance enhancement can be widely supported.
Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)
In this article, we analyse content from two recent reports to examine how a public health framework to cognitive enhancement is emerging. We find that, in several areas, these reports provide population-level arguments both for and against the use of cognitive enhancers. In discussing these arguments, we look at how these reports are indicative of potentially innovative frameworks—epidemiological, risk/benefit and socio-historical—by which to explore the public health impact of cognitive enhancement. Finally, we argue that these reports are suggestive of both (...) tensions between the bioethical and public health approaches and are also indicative of how these two frameworks can, in part, be seen as complementary. (shrink)
Stigma can influence the prevention and identification of fetal alcohol spectrum disorder, a leading cause of developmental delay in North America. Understanding the effects of public health practices and policies on stigma is imperative. We reviewed social science and biomedical literatures to understand the nature of stigma in FASD and its relevance from an ethics standpoint in matters of health practices and policies. We propose a descriptive model of stigma in FASD and note current knowledge gaps; discuss the ethical implications (...) of stigma based on two distinct criteria ; and describe two cases and the concerns associated with inadvertent stigmatization by public health initiatives for FASD. We recommend further empirical and ethical analyses to examine whether public health policies and practices inadvertently stigmatize and impact the success of public health initiatives and programs for FASD. (shrink)
Common understandings of neuroethics, i.e., of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics; (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism while the second relies on debatable assumptions about (...) the nature of bioethics specialization and development. Informed by philosophical pragmatism and our experience in neuroethics, we argue that these claims are ill-founded and should give way to pragmatist reconstructions. Namely, neuroscience, much like other areas of empirical research on morality, can provide useful information about the nature of morally problematic situations but it does not need to promise radical and sweeping changes to ethics based on neuroscientism. Furthermore, the rationale for the development of neuroethics as a specialized field need not to be premised on the distinctive nature of the issues it tackles or of neurotechnologies. Rather, it can espouse an understanding of neuroethics as both a scholarly and a practical endeavor dedicated to resolving a series of problematic situations raised by neurological and psychiatric conditions. (shrink)
Concerns about the possibility of a sharp rise in the prevalence of Alzheimer’s disease in Western nations have led to both the significant deployment of resources and the development of national research and healthcare plans. Although often focused on treatment, substantial efforts have also been dedicated toward preventing or delaying AD onset. As a result, recent technological and biomedical advances have greatly improved the understanding of AD pathophysiology. While some new tests can assess only risk ), some tests for certain (...) biomarkers (e.g., amyloid beta accumulation in the brain detected via positron... (shrink)
In the article “Nudging and Informed Consent”, Cohen argues that the use of “nudging” by physicians in the clinical encounter may be ethically warranted because it results in an informed consent where obligations for beneficence and respect for autonomy are both met. However, the author's overenthusiastic support for nudging and his quick dismissal of shared decision-making leads him to assume that “soft” manipulation is un-problematic and that “wisdom” on the side of medical professionals will suffice to guard against abuse. Opposing (...) this view, we propose that: 1) patient preferences and values should not be boiled down to rational or irrational decisions based on cognitive reasoning alone, 2) potential threats to the physician-patient must be mitigated and could be minimized by employing alternative strategies that acknowledge the impact of cognitive heuristics in shaping decision-making but maintain transparency and trust, and 3) patient preferences and values can be legitimately influenced only under specific circumstances. The latter include: (1) exhaustion of other means; (2) evidence that nudging is effective in a specific context; (3) evidence of clear and active public misinformation (e.g., industry promoting smoking); (4) explicit pubic dialogue between various stakeholders including medical professional societies about nudging; (5) upholding shared decision-making as a preferred approach; and (6) a rich understanding of clinical reality beyond the simple dichotomy of beneficence-autonomy. (shrink)
The debate on “cognitive enhancement” has moved from discussions about enhancement in adults to enhancement in children and adolescents. Similar to positions expressed in the adult context, some have argued that pediatric cognitive enhancement is acceptable and even laudable. However, the implications differ between the adult and the pediatric contexts. For example, in the debate over cognitive enhancement in adults, i.e., those who have legal majority, respect for autonomy demands that personal preferences not be overridden in absence of strong arguments (...) because competent adults are in the best position to recognize and protect their own interests. However, the concepts of best interest and autonomy provide a different picture in the case of pediatric enhancement. In the context of decision-making involving minors, it is assumed that the parents are in the best position to promote and protect the interests of their children and this is chiefly why they are granted the authority to make decisions on their behalf. However, we argue in favor of guarding the physical integrity of children from intrusive medical interventions without medical need and with clear and detrimental effects. We also support leaving open other legitimate life trajectory and career choices, as this is in the best interest of the child, even if they are less in line with the expectations of parents or success in educational settings. In addition, parental decision-making in favor of cognitive enhancement suffers from a lack of information about cognitive enhancers and potential biases. Thus, bearing in mind these issues and the development of volitional capacities of children, we argue that pediatric enhancement is not a morally acceptable practice and “inevitability” can be curbed with clear and fair rules that establish duties of state representatives, physicians, and public institutions. We conclude by canvassing evidence-based policy options that could protect the open future of minors and define the parameters of parental decision-making analogous to the cases of nicotine and alcohol. (shrink)
Since the 1960s, scientists, engineers, and healthcare professionals have developed brain–computer interface (BCI) technologies, connecting the user’s brain activity to communication or motor devices. This new technology has also captured the imagination of publics, industry, and ethicists. Academic ethics has highlighted the ethical challenges of BCIs, although these conclusions often rely on speculative or conceptual methods rather than empirical evidence or public engagement. From a social science or empirical ethics perspective, this tendency could be considered problematic and even technocratic because (...) of its disconnect from publics. In response, our trinational survey (Germany, Canada, and Spain) reports public attitudes toward BCIs (N = 1,403) on ethical issues that were carefully derived from academic ethics literature. The results show moderately high levels of concern toward agent-related issues (e.g., changing the user’s self) and consequence-related issues (e.g., new forms of hacking). Both facets of concern were higher among respondents who reported as female or as religious, while education, age, own and peer disability, and country of residence were associated with either agent-related or consequence-related concerns. These findings provide a first look at BCI attitudes across three national contexts, suggesting that the language and content of academic BCI ethics may resonate with some publics and their values. (shrink)
Let f be a function from N to N that can not be computed in polynomial time, and let a be an element of a differential field K of characteristic 0. The problem of large powers is the set of tuples x̄ = (x 1 ,..., x n ) of K so that x 1 = a f(n) , and the problem of large roots is the set of tuples x̄ of K so that x f(n) 1 = a. These (...) are two examples of problems that the use of derivation does not allow to solve quicker. We show that the problem of large roots is not polynomial for the differential field K, even if we use a polynomial number of parameters, and that the problem of large powers is not polynomial for the differential field K, even for non-uniform complexity. The proofs use the polynomial stability (i.e., the elimination of parameters) of field of characteristic 0, shown by L. Blum. F. Cucker. M. Shub and S. Smale, and the reduction lemma, that transforms a differential polynomial in variables x̄ into a polynomial in variables x̄. and their derivatives. (shrink)
Berenicen statim ab urbe dimisit invitus invitam.As for Berenice, he immediately dismissed her from the city against his will, against her will. Suetonius' laconic description of Titus' dismissal of his consort, the Herodian Berenice, after his accession to the Principate has attracted the attention of readers across the centuries. The biographer's use of polyptoton, invitus invitam, to describe the mental states of the Roman princeps and Judaean princess has been read as particularly moving. Perhaps most notably, Racine turned the (...) emperor's banishment of his lover into the central dilemma of his tragedy Bérénice. At the start of his preface to the text of the play, the dramatist amalgamates this sentence with another from earlier in the chapter, retaining the striking repetition, ‘Titus reginam Berenicen cui etiam nuptias pollicitus ferebatur, statim ab Urbe dimisit invitus invitam’. Racine claims that this account of the dismissal of Berenice provides appropriate subject matter for tragic poetry and, to support his case, he compares Virgil's treatment of the separation of Aeneas and Dido to the situation of Titus and Berenice. Suetonius is not normally read as a literarily sophisticated writer, but we should take a cue from Racine's response to this sentence. In this article, I argue that Suetonius himself chose to compare Titus and Berenice with Dido and Aeneas by an allusion in this sentence to Virgil's Aeneid and to Catullus' translation of the Coma Berenices. Within a rather matter-of-fact presentation of the relationship between the Flavian emperor and his Herodian consort, Suetonius evoked a more dramatic model. (shrink)
Que dire à des jeunes de vingt ans pour leur conduite dans ce monde qui part à la dérive? La civilisation s'effondre, les valeurs s'inversent, la culture se rétrécit comme une peau de chagrin, les livres comptent moins que les écrans, l'école n'apprend plus à penser mais à obéir au politiquement correct, la famille explosée, décomposée, recomposée se retrouve souvent composée d'ayants droit égotistes et narcissiques. De nouveaux repères surgissent, qui contredisent les anciens : le racisme revient sous forme de (...) racialisme, la phallocratie sous prétexte de néo-féminisme, l'antisémitisme sous couvert d'antisionisme, le fascisme sous des allures de progressisme, le nihilisme sous les atours de la modernité, l'antispécisme et le transhumanisme passent pour des humanismes alors que l'un et l'autre travaillent à la mort de l'homme, l'écologisme se pare des plumes anticapitalistes bien qu'il soit le navire amiral du capital--il y a de quoi perdre pied. J'ai rédigé une série de lettres à cette jeune génération pour lui raconter les racines culturelles de notre époque : elles ont pour sujet la moraline, le néo-féminisme, le décolonialisme, l'islamo-gauchisme, l'antifascisme, la déresponsabilisation, la créolisation, l'antisémitisme, l'écologisme, l'art contemporain, le transhumanisme, l'antispécisme. L'une d'elles explique en quoi consiste l'art d'être français : d'abord ne pas être dupe, ensuite porter haut l'héritage du libre examen de Montaigne, du rationalisme de Descartes, de l'hédonisme de Rabelais, de l'ironie de Voltaire, de l'esprit de finesse de Marivaux, de la politique de Hugo."--Back cover. (shrink)
Saigle, Dubljevic, and Racine (2018) claim that Libet-style experiments are insufficient to challenge that agents have free will. They support this with evidence from experimen- tal psychology that the folk concept of freedom is consis- tent with monism, that our minds are identical to our brains. However, recent literature suggests that evidence from experimental psychology is less than determinate in this regard, and that folk intuitions are too unrefined as to provide guidance on metaphysical issues like monism. In light (...) of this, it is worthwhile to examine the authors’ insuf- ficiency claim under the assumption that monism is false and dualism true (our minds are not identical to our brains). We conclude that, were dualism true, then Libet- style experiments would tell us no more about freedom and moral responsibility than what the authors initially claimed, thus further bolstering their point that Libet-style experiments are ill-suited to speak to the free will of agents. In what follows we first discuss some of the reasons to be skeptical of using folk intuitions to make claims about the nature of freedom and moral responsibility. We then draw from the work of E. J. Lowe to demonstrate that Libet-style experiments would likely give the same results regardless of the truth of monism or dualism. (shrink)
In “Imaging or Imagining? A Neuroethics Challenge In- The assumption at issue here is the assumption that the formed by Genetics,” Judy Illes and Eric Racine (see this ismind literally is the brain (i.e., is numerically identical to sue) argue that “traditional bioethics analysis” (TBA), as de-.
Thomas Kuhn, dans la _Structure des révolutions scientifiques_, décrit les révolutions scientifiques comme des changements dans la vision scientifique du monde. Or, ce changement de vision du monde semble trouver une partie de ses racines dans la psychologie des formes. La _Gestaltpsychologie_ a permis de remettre en cause certaines conceptions classiques de la psychologie issues de l’empirisme du xviii e siècle et par là même de penser les changements de perception non comme des changements d’interprétation, mais comme des renversements d’une (...) structure à une autre. Ces changements visuels de forme sont particulièrement bien exemplifiés dans les figures ambiguës sur lesquelles Kuhn s’appuie pour analyser le passage d’un paradigme à autre, bien que les gestaltistes, comme Köhler, aient rejeté l’hypothèse selon laquelle il serait possible de « voir » directement une signification. Reste à savoir si ces _Gestalt-switches_ ne concernent pas davantage les historiens des sciences que les scienti... (shrink)
Wittgenstein’s concepts shed light on the phenomenon of schizophrenia in at least three different ways: with a view to empathy, scientific explanation, or philosophical clarification. I consider two different “positive” wittgensteinian accounts―Campbell’s idea that delusions involve a mechanism of which different framework propositions are parts, Sass’ proposal that the schizophrenic patient can be described as a solipsist, and a Rhodes’ and Gipp’s account, where epistemic aspects of schizophrenia are explained as failures in the ordinary background of certainties. I argue that (...) none of them amounts to empathic-phenomenological understanding, but they provide examples of how philosophical concepts can contribute to scientific explanation, and to philosophical clarification respectively. (shrink)
É bem conhecida a oposição estabelecida por Kant entre experiência possível e dialética, na medida em que esta última é caracterizada como a lógica da ilusão. Ao mesmo tempo, o modo de pensar metafísico, que ocorre dialeticamente, em sentido kantiano, é uma tendência inevitável da razão, expressa na exigência formal de completude das categorias. Como o pensar, enquanto exercício livre da razão, é em si mesmo mais amplo do que a atividade de conhecer, própria do entendimento, o pensar contém o (...) conhecimento, embora este se qualifique pelas regras e pelos limites determinantes da objetividade. A pergunta que tentaremos formular é se essa relação continente-conteúdo não poderia configurar também uma dependência da experiência em relação ao raciocínio dialético, que estaria de algum modo indicada na função reguladora das idéias da razão. Nesse caso, a oposição formal entre conhecer e pensar seria inseparável da inclusão estrutural (dependência) da experiência no âmbito da razão. Na raiz do problema estaria talvez a tensão (dialética) entre a aspiração subjetiva de totalidade e as exigências objetivas de limitação e segmentação da experiência e a forma da experiência teria de ser finalmente concebida a partir de um fundo de inteligibilidade problemática. Dialectics and experienceThe separation of possible experience as objective knowledge and dialetics as a non-objective or non-theoretical knowledge is one of the most important aspects of kantian critical philosophy. But Kant also says that the activity of reason, as a pure thinking, has more amplitude than understanding knowledge. So we could say that theoric knowledge would depend on rational ( and non-theoretical) knowledge, as something contained in it. If we accept that, the consequence would be a relation of dependence between the form of objective knowledge and the background of a problematic even doubtful inteligible knowledge. (shrink)
Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)