There is general acknowledgement that both the anterior cingulate and orbitofrontal cortex are implicated in reinforcement-guided decision making, and emotion and social behaviour. Despite the interest that these areas generate in both the cognitive neuroscience laboratory and the psychiatric clinic, ideas about the distinctive contributions made by each have only recently begun to emerge. This reflects an increasing understanding of the component processes that underlie reinforcement- guided decision making, such as the representation of reinforcement expectations, the exploration, updating and representation (...) of action values, and the appreciation that choices are guided not just by the prospect of reward but also by the costs that action entails. Evidence is emerging to suggest that the anterior cingulate and orbitofrontal cortex make distinct contributions to each of these aspects of decision making. (shrink)

In this paper we focus on what is referred to as the ‘mineness’ of experience, that is, the intimate familiarity we have with our own thoughts, perceptions, and emotions. Most accounts characterize mineness in terms of an experiential dimension, the first-person givenness of experience, that is subsumed under the notion of minimal self-consciousness or a ‘minimal self’. We argue that this account faces problems and develop an alternative account of mineness in terms of the coherence of experiences with what we (...) label an ‘embodied biography’. Building on a near consensus among consciousness researchers over the function of consciousness as integrating infor- mation, we argue that the phenomenology of mineness consists in the absence of any further thought on top of the experience itself. Finally we argue that this non-phenomenological account of mineness fits well with existing data on pathologies of mineness such as delusions of thought insertion. (shrink)

Background:Surveillance technology such as tag and tracking systems and video surveillance could increase the freedom of movement and consequently autonomy of clients in long-term residential care settings, but is also perceived as an intrusion on autonomy including privacy.Objective:To explore how clients in residential care experience surveillance technology in order to assess how surveillance technology might influence autonomy.Setting:Two long-term residential care facilities: a nursing home for people with dementia and a care facility for people with intellectual disabilities.Methods:Ethnographic field study.Ethical considerations:The boards (...) representing clients and relatives/proxies of the clients were informed of the study and gave their written consent. The clients’ assent was sought through a special information leaflet. At any time clients and/or proxy were given the option to withdraw from the study. The research protocol was also reviewed by a medical ethics committee.Findings:Our findings show a pattern of two themes: (1) coping with new spaces which entailed clients: wandering around, getting lost, being triggered, and retreating to new spaces and (2) resisting the surveillance technology measure because clients feel stigmatized, missed the company, and do not like being “watched.”Conclusion:Client experiences of surveillance technology appear to entail a certain ambivalence. This is in part due to the variety in surveillance technology devices, with each device bringing its own connotations and experiences. But it also lies in the devices’ presupposition of an ideal user, which is at odds with the actual user who is inherently vulnerable. Surveillance technology can contribute to the autonomy of clients in long-term care, but only if it is set in a truly person-centered approach. (shrink)

To stimulate research and innovation (R&I), to contribute to the solution of societal challenges and to align R&I with societal values, the European Commission has launched the governance framework of Responsible Research and Innovation (RRI). RRI figures in many high-level EU policies as a means to promote smart growth, and a growing community of R&I practitioners from both the public and private sectors appears committed to it. Although debates on what RRI precisely entails have not reached closure yet, RRI provides (...) an interesting avenue to explore ways of making R&I more societally germane. While recognizing the usefulness of keeping critical reflection on RRI’s meaning alive, we suggest that to make the step from theorizing to implementation, RRI could benefit from a clearer conceptualization. This chapter presents the iterative trajectory in conceptualizing RRI followed as part of RRI Tools, one of a number of EC-funded research projects and support acts aimed at fleshing out what RRI can and should be, and the conceptualization of RRI that this led to. It suggests that RRI is best captured if in R&I governance attention is paid to the five p’s of Purpose, Products, Processes, Preconditions and People, and that further elaborations on the meaning of RRI should happen in dialogue with attempts at practicing RRI. (shrink)

The mathematical framework of Relativistic Schrödinger Theory (RST) is generalized in order to include the self-interactions of the particles as an integral part of the theory (i.e. in a non-perturbative way). The extended theory admits a Lagrangean formulation where the Noether theorems confirm the existence of the conservation laws for charge and energy–momentum which were originally deduced directly from the dynamical equations. The generalized RST dynamics is applied to the case of some heavy helium-like ions, ranging from germanium (Z=32) to (...) bismuth (Z=83), in order to compute the interaction energy of the two electrons in their ground-state. The present inclusion of the electron self-energies into RST yields a better agreement of the theoretical predictions with the experimental data. (shrink)

In our reflections upon the view of Leibniz on the many religions and their relations we elaborate three points. In the first place, Leibniz appears to be a faithful Christian, nominally a Lutheran, but not exactly bound to just one confession. He tried to be a real ecumenist. During all his career he made efforts to come to one, universal church , on a dogmatic as well as a practical level. For this aim he corresponded on these topics with many (...) influential catholics of his time, e.g. with Arnauld, Bossuet and Pellisson . Leibniz saw the other forms of monotheism as preliminary stages of Christianity. For him the remaining religions were paganism and therefore they should be suppressed. But Christianity would be enriched by an exchange with the three other forms of monotheism. In the second place, we may conclude that Leibniz understood toleration as a recognition of the other and as an expectation for exchange. But in the third place, we have to take into account his final religious perspective: natural religion . This is an almost philosophical religion with Christian features, usually called deism. With the help of his natural religion Leibniz wanted to combat what he called the atheism and materialism of the philosophy of his time, i.e. the ideas of Hobbes, Descartes and Spinoza. But his own position is rather close to them. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

Background As our society is ageing, nursing homes are finding it increasingly difficult to deal with an expanding population of patients with dementia and a decreasing workforce. A potential answer to this problem might lie in the use of technology. However, the use and application of surveillance technology in dementia care has led to considerable ethical debate among healthcare professionals and ethicists, with no clear consensus to date. Aim To explore how surveillance technology is viewed by care professionals and ethicists (...) working in the field, by investigating the ideal application of surveillance technology in the residential care of people with dementia. Methods Use was made of the concept mapping method, a computer-assisted procedure consisting of five steps: brainstorming, prioritising, clustering, processing by the computer and analysis. Various participants (ranging from ethicists to physicians and nurses) were invited on the basis of their professional background. Results The views generated are grouped into six categories ranging from the need for a right balance between freedom and security, to be beneficial and tailored to the resident, and clearly defined procedures to competent and caring personnel, active monitoring and clear normative guidance. The results are presented in the form of a graphic chart. Conclusions There appears to be an inherent duality in the views on using surveillance technology which is rooted in the moral conflict between safety and freedom. Elaboration of this ethical issue has proved to be very difficult. (shrink)

The chronic worldwide lack of organs for transplantation and the continuing improvement of strategies for in situ organ preservation have led to renewed interest in elective non-therapeutic ventilation of potential organ donors. Two types of situation may be eligible for elective intensive care: patients definitely evolving towards brain death and patients suitable as controlled non-heart beating organ donors after life-supporting therapies have been assessed as futile and withdrawn. Assessment of the ethical acceptability and the risks of these strategies is essential. (...) We here offer such an ethical assessment using the four principles of medical ethics of Beauchamp and Childress applying them in their broadest sense so as to include patients and their families, their caregivers, other potential recipients of intensive care, and indeed society as a whole. The main ethical problems emerging are the definition of beneficence for the potential organ donor, the dilemma between the duty to respect a dying patient's autonomy and the duty not to harm him/her, and the possible psychological and social harm for families, caregivers other potential recipients of therapeutic intensive care, and society more generally. Caution is expressed about the ethical acceptability of elective non-therapeutic ventilation, along with some proposals for precautionary measures to be taken if it is to be implemented. (shrink)

New class of therapies, including bipolar therapies (BPT) and paradoxical unipolar therapies (PUT) were firstly proposed in relation to a clinical insight and to some results of biological investigations, then they gave rise to mathematical modeling which brought a justification of these therapies, at least from a theoretical point of view. After recalling the mathematical model for the regulation of agonistic antagonistic couples, and reporting the fundamental types of control simulation by means of it, we point out the validity of (...) therapeutical applications inferred from this model. These therapy modalities, including BPT and PUT, now concern the following diseases: astrocytomas, epilepsia and trials on multiple sclerosis. Even if such attempts are in their early stage, noticeably for the last case where biological changes have mainly been studied, it seems that a large span of treatments is open to BPT and PUT. Improvement of these techniques in the future depends, in our opinion, on a parallel working on the dynamics of the mathematical model and the dynamics, perceived by clinical insight and confirmed by biological investigations, of the body reactions to such strategies. Justification of BPT and PUT was given, by resorting to the notion of pathological homeostasis which, too often, intervenes in order to nullify the effects of unilateral (not paradoxical) therapies. This research has elicited some therapies which use two agents with antagonistic effects or only an agent with effects similar to the agent already in excess in the body - in both cases at nearly physiological doses. (shrink)

The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide. This study aimed to explore the content of this pressure as experienced by general practitioners. We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: emotional blackmail, control and direction by others, doubts about fulfilling the (...) criteria, counterpressure by patient’s relatives, time pressure around referred patients and organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative, the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account. (shrink)