Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in (...) relation to best practice. Inpatient staff need to be aware of their practice values, be able to access education and supervision and negotiate apparent contradictions. Further patient/clinician focused enquiry is necessary to mitigate the negative and stigmatising effects of locked mental health units. (shrink)
This article responds directly to an article published in Research Ethics in 2011 where Schrag argued against ethics review for social science and humanities research. He argued that review committees offer solutions in search of a problem, impose silly restrictions and apply inappropriate principles. He suggests that review committees typically lack appropriate expertise and argued that the process harms the innocent. This article refutes these claims and offers a case study of the ethical review process at Queen Mary University of (...) London (QMUL) to offer counter claims. The discussion highlights the way in which the QMUL process is sensitized to the challenges posed by social science and humanities research and is a process that, rather than focusing upon avoiding harm, emphasizes notions of care to both participants and researchers. (shrink)
Distributed acoustic sensing can revolutionize the seismic industry by using fiber-optic cables installed permanently to acquire on-demand vertical seismic profile data at fine spatial sampling. With this, DAS can solve some of the issues associated with conventional seismic sensors. Studies have successfully demonstrated the use of DAS on cemented fibers for monitoring applications; however, such applications on tubing-deployed fibers are relatively uncommon. Application of tubing-deployed fibers is especially useful for preexisting wells, where there is no opportunity to install a fiber (...) behind the casing. In the CO2CRC Otway Project, we acquired a 3D DAS VSP using a standard fiber-optic cable installed on the production tubing of the injector well. We aim to analyze the quality of the 3D DAS VSP on tubing, as well as discuss lessons learned from the current DAS deployment. We find the limitations associated with the DAS on tubing, as well as ways to improve the quality of the data sets for future surveys at Otway. Due to the reduced coupling and the long fiber length, the raw DAS records indicate a high level of noise relative to the signal. Despite the limitations, the migrated 3D DAS VSP data recorded by cable installed on tubing are able to image interfaces beyond the injection depth. Furthermore, we determine that the signal-to-noise ratio might be improved by reducing the fiber length. (shrink)
Justifying involuntary psychiatric treatment on the basis of a judgment that a person lacks capacity is usually expressed in terms of a person’s ability to make a decision about his or her health and treatment. Typically, this relates to the ability to refuse treatment. Exactly what “capacity” means, however, and how one determines when another individual lacks capacity, or lacks sufficient capacity, in this context is particularly controversial, with the United Nations Committee on the Rights of Persons with Disabilities insisting (...) that involuntary treatment be abandoned altogether and capacity tests avoided.Capacity is a concept that has multiple meanings and applications across different disciplines and... (shrink)
When clinical services aspire to quality improvement, creative and innovative approaches to old problems are needed to drive such change. Whilst new ef orts should be applauded, information on this topic can be somewhat grey from an ethical and research point of view. Within the mental health profession there is currently an expectation to routinely evaluate care and disseminate i ndings. The notion of service enhancements under the guise of routine practice is an interesting and untested ethical issue. Should clinical (...) innovation continue to enjoy such impunity as patient autonomy is often compromised as they are often compelled to accept treatment under the coercion of mental health legislation? We believe that it should not. All involvement in any form of research is voluntary, thus patients should also have the right to decline participation in quality projects if they wish to do so. (shrink)
This paper examines the puruṣa concept in the Caraka Saṃhitā, an early text of Ayurveda, and its relation to Indic thinking about phenomenal worldhood. It argues that, contrary to the usual interpretation, early Ayurveda does not consider the person to be a microcosmic replication of the macrocosmos. Instead, early Ayurveda asserts that personhood is worldhood, and thus the person is non-different from the phenomenal totality of his existence. This is confirmed by the CS’s several definitions of puruṣa, which are alternately (...) posed in terms familiar to Vaiśeṣika, early Sāṃkhya, early Buddhism, and Upaniṣadic monism. It is likewise confirmed by the Ayurvedic logic of sāmānya, which governs the meaning of the list of person-to-world correspondences in CS 4.5 and its often misinterpreted claim, puruṣo’yam lokasaṃmitaḥ. Finally it is confirmed in the program of Ayurvedic therapeutics, which aims at establishing various kinds of “appropriateness” for the sake of effecting samayoga—the “harmonious joining” of person and world. (shrink)
Neuroethics is a relatively novel field of investigation. Applied to mental health practice and research, neuroethics would seem to enlighten many traditional ethical connundra. This editorial introduces this symposium on neuroethics in the Journal of Bioethical Inquiry.
It is generally assumed, without argument, that legal theory, legal philosophy, philosophy of law, and jurisprudence all mean the same thing. This paper rejects that assumption, and in particular the assumption that jurisprudence is the same thing as legal philosophy. This assumption has recently been challenged by Roger Cotterrell in his article “Why Jurisprudence Is Not Legal Philosophy,” and I seek to build on his arguments by adding insights found in the work of Stanley Fish.
Since 2010 the People’s Republic of China has been engaged in an effort to reform its system of organ transplantation by developing a voluntary organ donation and allocation infrastructure. This has required a shift in the procurement of organs sourced from China’s prison and security apparatus to hospital-based voluntary donors declared dead by neurological and/or circulatory criteria. Chinese officials announced that from January 1, 2015, hospital-based donors would be the sole source of organs. This paper examines the availability, transparency, integrity, (...) and consistency of China’s official transplant data. Forensic statistical methods were used to examine key deceased organ donation datasets from 2010 to 2018. Two central-level datasets — published by the China Organ Transplant Response System and the Red Cross Society of China — are tested for evidence of manipulation, including conformance to simple mathematical formulae, arbitrary internal ratios, the presence of anomalous data artefacts, and cross-consistency. Provincial-level data in five regions are tested for coherence, consistency, and plausibility, and individual hospital data in those provinces are examined for consistency with provincial-level data. COTRS data conforms almost precisely to a mathematical formula while Central Red Cross data mirrors it, albeit imperfectly. The analysis of both datasets suggests human-directed data manufacture and manipulation. Contradictory, implausible, or anomalous data artefacts were found in five provincial datasets, suggesting that these data may have been manipulated to enforce conformity with central quotas. A number of the distinctive features of China’s current organ procurement and allocation system are discussed, including apparent misclassification of nonvoluntary donors as voluntary. A variety of evidence points to what the authors believe can only be plausibly explained by systematic falsification and manipulation of official organ transplant datasets in China. Some apparently nonvoluntary donors also appear to be misclassified as voluntary. This takes place alongside genuine voluntary organ transplant activity, which is often incentivized by large cash payments. These findings are relevant for international interactions with China’s organ transplantation system. (shrink)
In Ox. Pap. xxxii i ff., no. 2617, Mr. Lobel published fragments which he shows reason to believe are from Stesichorus’ Geryoneis. Further work has been done on them by Professor D. L. Page and Mr. W. S. Barrett, and the more substantial fragments are included in an Appendix to Page's Lyrica Graeca Selecta . Fr. 4, the most considerable piece, describes how, in Lobel's words: ‘a person, who I do not think there is much room to doubt is Heracles, (...) delivers a secret attack on somebody which consists in shooting him through the head. Though only one “forehead”, one “crown”, and one “neck” are mentioned and the Geryones of Stesichorus had six hands and six feet and therefore presumably three heads, as elsewhere , the possibility that Geryones is here in question does not seem to be ruled out.’. (shrink)