To identify motivational factors linked to child health status that affected the likelihood of parents’ allowing their child to participate in pediatric research.

The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics (...) that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probablyin lieuof robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS. (shrink)

We argue that a fashionable interpretation of the theory of natural selection as a claim exclusively about populations is mistaken. The interpretation rests on adopting an analysis of fitness as a probabilistic propensity which cannot be substantiated, draws parallels with thermodynamics which are without foundations, and fails to do justice to the fundamental distinction between drift and selection. This distinction requires a notion of fitness as a pairwise comparison between individuals taken two at a time, and so vitiates the interpretation (...) of the theory as one about populations exclusively. (shrink)

This book is a unique introductory overview of decision theory. It is completely non-technical, without a single formula in the book. Written in a crisp and clear style it succinctly covers the full range of philosophical issues of rationality and decision theory, including game theory, social choice theory, prisoner's dilemma and much else. The book aims to expand the scope and enrich the foundations of decision theory. By addressing such issues as ambivalence, inner conflict, and the constraints imposed upon us (...) by our attachments to others, Frederic Schick reveals that our thinking is often more subtle than standard theories of rationality allow. Only a theory that respects that subtlety can illumine what is otherwise puzzling. The book contains many examples drawn from history and literature dealing with subjects such as love, war, friendship, and crime. (shrink)

This is an important new book about human motivation, about the reasons people have for their actions. What is distinctively new about it is its focus on how people see or understand their situations, options, and prospects. By taking account of people's understandings, Professor Schick is able to expand the current theory of decision and action. The author provides a perspective on the topic by outlining its history. He defends his new theory against criticism, considers its formal structure, and shows (...) at length how it resolves many currently debated problems: the problems of conflict and weakness of will, Allais' problem, Kahneman and Tversky's problems, Newcomb's problem, and others. The book will be of special interest to philosophers, psychologists, and economists. (shrink)

In this book Frederic Schick develops his challenge to standard decision theory. He argues that talk of the beliefs and desires of an agent is not sufficient to explain choices. To account for a given choice we need to take into consideration how the agent understands the problem, how he sees in a selective way the options open to him. The author applies his new logic to a host of common human predicaments. Why do people in choice experiments act so (...) often against expectations? Why do people cooperate in situations where textbook logic predicts that they won't? What exactly is weakness of will? What are people reporting when they say their lives have no meaning for them? This book questions the foundations of technical and philosophical decision theory and will appeal to all those who work in that field, be they philosophers, economists and psychologists. (shrink)

The article Deflating the "DBS causes personality changes" bubble, written by Frederic Gilbert, J. N. M. Viaña and C. Ineichen, was originally published electronically on the publisher’s internet portal on 19 June 2018 without open access.

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced self-estrangement. (...) Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights (...) from patients’ subjective perceptions of postoperative self-change provides a potent explanation of potential DBS-induced self-estrangement. (shrink)

Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson’s disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number of domains: psychological, (...) behavioural, affective and social. In many cases, patients express difficulty adjusting from being chronically ill to their new status as ‘treated’ or ‘seizure free’. This postoperative response adjustment has been described in the literature on epilepsy as the ‘Burden of Normality’ (BoN) syndrome. Most of the discussion about DBS postoperative changes to self is focused on abnormal side effects caused by the intervention (ie, hypersexuality, hypomania, etc). By contrast, relatively little attention is paid to the idea that successfully ‘treated’ individuals might experience difficulties in adjusting to becoming ‘normal’. The purpose of this paper is (1) to articulate the postoperative DBS psychosocial adjustment process in terms of the BoN syndrome, (2) to address whether the BoN syndrome illustrates that DBS treatment poses a threat to the patient’s identity, and (3) to examine whether the current framework for rehabilitation after DBS procedures should be updated and take into account the BoN syndrome as a postoperative self-change response. (shrink)

The goal of this article is to shed light on Deep Brain Stimulation (DBS) postoperative suicidality risk factors within Treatment Resistant Depression (TRD) patients, in particular by focusing on the ethical concern of enrolling patient with history of self-estrangement, suicide attempts and impulsive–aggressive inclinations. In order to illustrate these ethical issues we report and review a clinical case associated with postoperative feelings of self-estrangement, self-harm behaviours and suicide attempt leading to the removal of DBS devices. Could prospectively identifying and excluding (...) patients with suicidality risk factors from DBS experimental trials—such as history of self-estrangement, suicide attempts and impulsive–aggressive inclinations—lead to minimizing the risk of suicidality harm? (shrink)

This is _the_ leading introduction 200to professional values and ethics in social work. Frederic G. Reamer provides social workers with a succinct and comprehensive overview of the most critical issues relating to professional values and ethics, including the nature of social work values, ethical dilemmas, and professional misconduct. Conceptually rich and attuned to the complexities of ethical decision making, _Social Work Values and Ethics_ is unique in striking the right balance between history, theory, and practical application. For the third edition, (...) Reamer has updated the content and strengthened the relevance of the case material. Also new to the third edition: o Discussion of the moral dialogue between practitioner and cliento Coverage of virtue ethicso Practical discussion of concepts underlying social work ethicso Expanded application of the National Association of Social Workers Code of Ethics to ethical dilemmas in the professiono A look at the historical evolution of ethical standards in social worko New vignettes, illustrating difficult ethical decisionso More guidance on informed consent and termination of serviceso Discussion questions at the end of each chaptero A section on how to conduct a social work ethics audit. (shrink)

One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...) sais quoi despite clear motor improvement. Despite the growing number of cases in the DBS literature, there is currently no accepted or standardized tool in neuroethics specifically designed to capture the phenomenological postoperative experience of patients implanted with DBS or BCI devices. Given potential risks of postoperative maladaptation, it is important for the field of neuroethics to develop a qualitative instrument that can serve as a shared method for capturing postoperative variations in patient experience of identity and agency. The goal of this article is to introduce an instrument we have developed for this purpose and call for further neuroethical efforts to assess the phenomenology of implantable brain device use. (shrink)

The intersection of AI and neurotechnology has resulted in an increasing number of medical and non-medical applications and has sparked debate over the need for new human rights, or “neurorights,”...

Although being generally safe, the use of Deep Brain Stimulation has been associated with a significant number of patients experiencing postoperative psychological and neurological harm within experimental trials. A proportion of these postoperative severe adverse effects have lead to the decision to medically prescribe device deactivation or removal. However, there is little debate in the literature as to what is in the patient’s best interest when device removal has been prescribed; in particular, what should be the conceptual approach to ethically (...) guide the decision to remove or maintain implants. The purpose of this article is to examine the ethical issues raised when patients refuse brain device explantation despite medical prescription. In order to illustrate these issues, we report and discuss a clinical case involving a patient suffering from treatment resistant depression who experienced forms of postoperative self-estrangement, as well as suicidal attempts, but who resists giving consent to device explantation. (shrink)

Two different kinds of collections have been used to anticipate influenza pandemics: viral strains and bird specimens. These collections have been organized in museums and data banks to fill the gaps when specimens were decaying or when viral strains were missing. This article asks how collecting practices changed when such collections integrated specimens from China, considered a reservoir of influenza viruses and bird species, following a recurrent critical trope that Chinese specimens were missing. The article shows that techniques for hunting (...) viruses and birds were used to accumulate information so as to mitigate the global threat of species extinction. It suggests that in sentinel territories, museums transform samples and specimens into signs and images of future catastrophic events. (shrink)

Why and how do norms emerge? Which norms emerge and why these ones in particular? Such questions belong to the ‘problem of the emergence of norms’, which consists of an inquiry into the production of norms in social collectives. I address this question through the ethnographic study of the emergence of ‘norms against violence’ in the political collective Occupy Geneva. I do this, first, empirically, with the analysis of my field observations; and, second, theoretically, by discussing my findings. In consequence (...) of two episodes categorized as sexual assaults that occurred in their camp, the members of Occupy Geneva decided to tackle those issues in a general assembly. Their goal was to amend their first charter of good conduct in order to reform its norms and complete it with norms aiming to regulate ‘facts’ of ‘unjustified violence’. During a collective deliberation, new norms were devised, debated and consensually adopted. The writing of the new charter took place in a second general assembly during which the wording of the written norms was collectively decided. I show that indignation over the sexual assaults was the main motive that led to the collective deliberation, and that the entire process of the making of these norms was characterized by different collective emotions. Indeed, indignation, contempt and fear played major roles in the emergence of norms prohibiting violence, allowing punishment and exclusion of wrongdoers, and prescribing collective intervention against an aggressor to neutralize the threat represented. These findings prompt me to hypothesize that social norms emerge from emotions thanks to the latters’ internal structure; and that emotions provide causal and grounding explanations for this emergence. Thus, emotions allow us to answer the questions: ‘Why do norms emerge?’ and ‘Why do they have their specific forms?’ In short, I argue that social norms have emotional foundations. (shrink)

Owing to an oversight, we noted that the acknowledgement section was missing from the original published version of this paper.

The article resituates critical realism within critical theory and proposes a tripartite articulation of British critical realism, German critical theory and French anti-utilitarianism. It suggests that the critique of positivism has to be enhanced with a critique of utilitarianism and makes the case that both critiques have to be grounded in a hermeneutic approach to social life. By taking the symbolic constitution of the world seriously, critical realist hermeneutics offers a via media between naturalism and anti-naturalism, explanation and interpretation, universalism (...) and relativism, materialism and idealism, realism and constructivism. (shrink)

The traditional international law of self-defense provides little indication about how far states should be willing to defend. That choice is better understood as constrained, beyond the jus in bello and the jus ad bellum, by human rights norms that implicate responsibilities of the sovereign vis-à-vis its own population. Different conceptions of human rights, however, underscore different possible theories of the extent of self-defense. The main polarity is between a conception of self-defense as protecting bare life and a conception of (...) self-defense as protecting collective self-determination. In the practice of justifying particular uses of self-defense, these foundations are constantly and dynamically rearticulated to justify fighting on, surrendering, or negotiating. This raises questions about the impact of conditions of uncertainty, different conceptions of agency, and the role of the international community. Ultimately, the article suggests that self-defense radicalizes anxieties about the foundation and finality of rights. (shrink)

In this article, we explore the implications of a Rawlsian theory for intergenerational issues. First, we confront Rawls's way of locating his `just savings' principle in his Theory of Justice with an alternative way of doing so. We argue that both sides of his intergenerational principle, as they apply to the accumulation phase and the steady-state stage, can be dealt with on the bases, respectively, of the principle of equal liberty and of the difference principle. We then proceed by focusing (...) on the implications of applying maximin to his steady-state stage. One central claim is that, in principle, Rawlsians should consider not only generational dissavings, but also generational savings, as unfair. This principle suffers a series of exceptions on which we focus in the fourth section of the article. In some cases, growth can be maximin compatible. (shrink)

This book, first published in 1997, is an introductory overview of decision theory. It is completely non-technical, without a single formula in the book. Written in a crisp and clear style it succinctly covers the full range of philosophical issues of rationality and decision theory, including game theory, social choice theory, prisoner's dilemma and much else. The book aims to expand the scope and enrich the foundations of decision theory. By addressing such issues as ambivalence, inner conflict, and the constraints (...) imposed upon us by our attachments to others, Frederic Schick reveals that our thinking is often more subtle than standard theories of rationality allow. Only a theory that respects that subtlety can illumine what is otherwise puzzling. The book contains many examples drawn from history and literature dealing with subjects such as love, war, friendship, and crime. (shrink)