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)

SummarySon preference has been considered as a determinant of women's risk of intimate partner violence experience in India, although quantitative evidence from large nationally representative studies testing this relationship is limited. This study examines the association between husband's son preference, sex composition of children and risk of physical and sexual IPV victimization among wives. Information was collected for 26,284 couples in the nationally representative 2005–2006 National Family Health Survey of India. The exposures were husband's son preference measured as husband's desire (...) for one or more sons greater than the number of daughters and sex composition of the household: only sons, only daughters and mixed. Outcome included past year physical and/or sexual IPV. The results showed that husband's reported son preference and sex composition of children were not associated with risk for IPV victimization in the models adjusted for socio-demographic factors. The findings from this first population-based study of socio-cultural norms around son preference and married Indian women's risk for IPV victimization indicate that cultural preference for sons does not influence women's risk for IPV victimization. (shrink)

English summary: It seems that reason is less a universal principle than something inherently bound to the contexts in which it appears. These contributions to a conference held on the occasion of Christoph Schwobel's 60th birthday explore the character of reason's manifold contexts: the grounding of reason in the inner word of God 's Trinitarian life as well as the disclosure of reason and and its limits in human conversation. German description: Vernunft scheint in der Gegenwart weniger ein allgemeines Prinzip (...) als eine in Kontexte eingebundene Grosse zu sein. Die Beitrage einer Tagung anlasslich von Christoph Schwobels 60. Geburtstag, gehen der Frage nach dem Charakter dieser Kontextbindung nach: der Begrundung der Vernunft im trinitarischen Gesprach wie der Erschliessung und Problematisierung der Vernunft im menschlichen Gesprach. Mit Beitragen von V. Brummer, G. van den Brink, C. Drobe, H. J. Eckstein, D.-M. Grube, J. Halfwassen, S. Heine, F. Hermanni, E. Herms, W. Harle, W. Homolka, W. Jeanrond, R. W. Jenson, D. Kelsey, A. F. Koch, A. Kupsch, V. Leppin, P.-C. Lai, P. Lo, A. Min, J. Moltmann, M. Muhling, P. Peterson, M. Sarot, F. Schweitzer, A. Torrance, J. Webster, M. Welker, M. Wendte, M. Wisse, H. Wisskirchen und L. Zak. (shrink)

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of (...) knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

This 1990 collection explores one recurrent theme connecting philosophy and politics: the relation between the nature of man and the structure of society. It does so by concentrating on the topical issue of the market economy as an attempt to resolve the clash between individual autonomy and collective action. Beginning with a historical and personal recollection by Enoch Powell and a response by Robert Skidelsky, the volume then provides a forum for political theorists and philosophers to take issue on the (...) fundamental topics of markets and morals; liberal man; and equality and libertarianism. It succeeds equally as a stimulating textbook and a book for the general reader who wishes to understand the philosophical issues arising in a market economy. (shrink)

The functioning of a subject in a changing environment is most effective from the point of view of survival if the subject can form, maintain and use internal representations of the external world for decision-making. These representations are also called reflection in a broad sense. Using it, one can win in reflexive games since an internal representation of the enemy allows predicting their future moves. The goal is to assess the reflexive potential of heuristic model objects – artificial neural networks (...) – in the reflexive games “Even-Odd” (or “Matching pennies”) and “Rock-Paper-Scissors”. We used homogeneous fully connected neural networks of small sizes (from 8 to 45 neurons). Games were played between neural networks with different configurations and parameters (size, step size for modifying weight coefficients). A set of reflexivity criteria is presented, corresponding to different levels of consideration: neuronal, behavioral, formal. The transitivity of formal success in the game is shown. The most successful configurations, however, may not meet other criteria of reflexivity. We hypothesize that the best compliance with the criteria and, as a consequence, universal success in reflection tasks is achievable for heterogeneous configurations with a structure in which the formation of hierarchical systems of attractors is possible. (shrink)

O texto busca refletir criticamente sobre alguns fenômenos sociais contemporâneos, fortemente imbricados, notadamente as tendências contemporâneas de entrincheiramento e achatamento do eu; o reforço da iconomania e da compulsiva produção de avatares de si, em meio a bolhas narcísicas digitais, franqueadas pelas recentes tecnologias de informação e comunicação; e a virtual destruição da intimidade e da privacidade, diante da emergência de panópticos digitais e da vigilância algorítmica. Para tanto, toma-se como ponto de partida proposições apresentadas por Christopher Lasch em sua (...) obra _The Minimal Self: Psychic Survival in Troubled Times_, publicada originalmente em 1984, em particular a própria noção de mínimo eu, as quais são, então, entretecidas com argumentos de Christophe Dejours, Günther Anders, Theodor Adorno, Hebert Marcuse, Jonathan Crary, entre outros. Em acréscimo, busca-se salientar a ancoragem desses processos à hodierna dinâmica de acumulação de capital, a partir da crítica da economia política, perspectiva que atravessa todo o texto, bem como assinalar a atualidade do pensamento de Lasch. (shrink)

The question of how to handle incidental findings has sparked a heated debate among neuroimaging researchers and medical ethicists, a debate whose urgency stems largely from the recent explosion in the number of imaging studies being conducted and in the sheer volume of scans being acquired. Perhaps the point of greatest controversy within this debate is whether the magnetic resonance imaging scans of all research participants should be reviewed in an active search for pathology and, moreover, whether this search should (...) be performed by a radiologist. Resistance to routine readings performed by radiologists, as opposed to selective review of those scans on which investigators have spotted a possible IF, has been fueled in part by the obvious and enormous cost — financial and logistical — of engaging radiologists to read massive numbers of scans. This cost would be especially burdensome, even prohibitive, to investigators who are not affiliated with a medical center, because of their limited access to radiologists and other medical expertise. (shrink)

We weigh the presumed benefts of routinely searching all research scans for incidental fndings against its substantial risks, including false-positive and false-negative fndings, and the possibility of triggering unnecessary, costly evaluations and perhaps harmful treatments. We argue that routinely searching for IFs may not maximize benefts and minimize risks to participants.

Ecologists are challenged by the need to bridge and synthesize different approaches and theories to obtain a coherent understanding of ecosystems in a changing world. Both food web theory and regime shift theory shine light on mechanisms that confer stability to ecosystems, but from different angles. Empirical food web models are developed to analyze how equilibria in real multi-trophic ecosystems are shaped by species interactions, and often include linear functional response terms for simple estimation of interaction strengths from observations. Models (...) of regime shifts focus on qualitative changes of equilibrium points in a slowly changing environment, and typically include non-linear functional response terms. Currently, it is unclear how the stability of an empirical food web model, expressed as the rate of system recovery after a small perturbation, relates to the vulnerability of the ecosystem to collapse. Here, we conduct structural sensitivity analyses of classical consumer-resource models in equilibrium along an environmental gradient. Specifically, we change non-proportional interaction terms into proportional ones, while maintaining the equilibrium biomass densities and material flux rates, to analyze how alternative model formulations shape the stability properties of the equilibria. The results reveal no consistent relationship between the stability of the original models and the proportionalized versions, even though they describe the same biomass values and material flows. We use these findings to critically discuss whether stability analysis of observed equilibria by empirical food web models can provide insight into regime shift dynamics, and highlight the challenge of bridging alternative modelling approaches in ecology and beyond. (shrink)

Critics of Hannah Arendt's Lectures on Kant's Political Philosophy argue that Arendt fails to address the most important problem of political judgment, namely, validity. This essay shows that Arendt does indeed have an answer to the problem that preoccupies her critics, with one important caveat: she does not think that validity is the all-important problem of political judgment--the affirmation of human freedom is.

Aristotle argued that you need some wealth to live well. The Stoics argued that you could live well with or without wealth. But the Cynics argued that wealth is a hinderance. For the Cynics, a good life consists in self-sufficiency, or being able to rule and help yourself. You accomplish this by living simply and naturally, and by subjecting yourself to rigorous philosophical exercises. Cynics confronted people to get them to abandon extraneous possessions and positions of power to live better. (...) And while the Cynics were experts in living in this way, their ascetic lifestyles made their message curious to some audiences. This paper reflects on Cynic ascetic practices and the ways others perceived them. (shrink)

This essay examines the significantly different approaches of John Rawls and Hannah Arendt to the problem of judgment in democratic theory and practice.

Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in recommending a principled (...) version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors. (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

In _Violence and Civility_, Étienne Balibar boldly confronts the insidious causes of violence, racism, nationalism, and ethnic cleansing worldwide, as well as mass poverty and dispossession. Through a novel synthesis of theory and empirical studies of contemporary violence, the acclaimed thinker pushes past the limits of political philosophy to reconceive war, revolution, sovereignty, and class. Through the pathbreaking thought of Derrida, Balibar builds a topography of cruelty converted into extremism by ideology, juxtaposing its subjective forms and its objective manifestations. Engaging (...) with Marx, Hegel, Hobbes, Clausewitz, Schmitt, and Luxemburg, Balibar introduces a new, productive understanding of politics as antiviolence and a fresh approach to achieving and sustaining civility. Rooted in the principles of transformation and empowerment, this theory brings hope to a world increasingly divided even as it draws closer together. (shrink)

Research ethics committees are charged with providing an opinion on whether research proposals are ethical. These committees are overseen by a central office that acts for the Department of Health and hence the State. An advisory group has recently reported back to the Department of Health, recommending that it should deal with inconsistency in the decisions made by different RECs. This article questions the desirability and feasibility of questing for consistent ethical decisions.

Individual and Society in Buddhism. W. G. Weeraratne. Metro Printers Ltd., Colombo. 101pp £2.