The success of deep brain stimulation (DBS) for movement disorders and the improved understanding of the neurobiologic and neuroanatomic bases of psychiatric diseases have led to proposals to expand current DBS applications. Recent preclinical and clinical work with Alzheimer's disease and obsessive-compulsive disorder, for example, supports the safety of stimulating regions in the hypothalamus and nucleus accumbens in humans. These regions are known to be involved in addiction and overeating associated with obesity. However, the use of DBS targeting these areas (...) as a treatment modality raises common ethical considerations, which include informed consent, coercion, enhancement, threat to personhood, and manipulation of the reward center. Pilot studies for both of these conditions are currently investigational. If these studies show promise, then there is a need to address the ethical concerns related to the initiation of clinical trials including the reliability of preclinical evidence, patient selection, study design, compensation for participation and injury, cost-effectiveness, and the need for long-term follow-up. Multidisciplinary teams are necessary for the ethical execution of such studies. In addition to establishing safety and efficacy, the consideration of these ethical issues is vital to the adoption of DBS as a treatment for these conditions. We offer suggestions about the pursuit of future clinical trials of DBS for the treatment of addiction and overeating associated with obesity and provide a framework for addressing ethical concerns related to treatment. (shrink)

Dass "Wahrnehmung" sich historisch verändert, ist in den gegenwärtigen Debatten ebenso präsent wie die Einsicht, dass "Geschichte" selbst hochgradig wahrnehmungsabhängig ist. Die Autoren dieses Bandes erörtern die wechselseitigen Beziehungen von Wahrnehmung und Geschichte nicht allein theoretisch, sondern vorrangig materialbezogen - mit Blick auf konkrete Fallbeispiele. Das Spektrum der Beiträge reicht von der Erörterung der historischen Vermittlungsfunktion technischer Medien und verschiedener Künste bis zur Frage, welcher Logik Wahrnehmung und Vergessen der jüngsten und eigenen Geschichte unterliegen. Michel Foucault und Marshall McLuhan werden (...) als Vordenker einer solchen Aisthesis materialis, zu der hier "Markierungen" geliefert werden, begriffen. Beide kommen mit einem programmatischen Text auch selbst zu Wort. (shrink)

Can we sensibly attribute some of the happenings in our world to the agency of some of the things around us? We do this all the time, but there are conceptual challenges purporting to show that attributable agency, and specifically one of its most important subspecies, human free agency, is incoherent. We address these challenges in a novel way: rather than merely rebutting specific arguments, we discuss a concrete model that we claim positively illustrates attributable agency in an indeterministic setting. (...) The model, recently introduced by one of the authors in the context of artificial intelligence, shows that an agent with a sufficiently complex memory organization can employ indeterministic happenings in a meaningful way. We claim that these considerations successfully counter arguments against the coherence of libertarian free will. (shrink)

The First Conference of the International Society for the Study of Time was held at the Mathematisches Forschungsinstitut at Oberwolfach in the Black Forest, Federal Republic of Germany from Sunday, 31 August to Saturday, 6 September, 1969. The origin of this conference and the formation of the Society goes back to a proposal due to J. T. Fraser that was discussed at a conference on "Interdisciplinary Perspectives of Time" held by the New York Academy of Sciences in January, 1966. It (...) was unanimously agreed than that an international society should be formed on an interdisciplinary basis with the object of stimulating interest in all problems concerning 'time and that this object could best be attained by means of conferences held at regular intervals. J. T. Fraser was elected Secretary, S. Watanabe Treasurer, and I was elected President. It was agreed, at my suggestion, that the organization of the first conference of the newly formed Society be left to a committee of these three officers, on the understanding that they would invite authorities on the role of time in the various special sciences and humanities to form an Advisory Board to assist them. One of the main difficulties in seeking support for an interdisciplinary conference is that most foundations confine their interest exclusively either to the sciences or to the humanities. (shrink)

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

In 1956 Jacques Lacan proposed as interpretation of Edgar Allan Poe's "Purloined Letter" that at once challenged literary theorists and revealed a radically new conception of psychoanalysis. Lacan's far-reaching claims about language and truth provoked a vigorous critique by Jacques Derrida, whose essay in turn has spawned further responses from Barbara Johnson, Jane Gallop, Irene Harvey, Norman Holland, and others. The Purloined Poe brings Poe's story together with these readings to provide, in the words of the editors, "a structured exercuse (...) in the elaboration of textual interpretation. The Purloined Poe reprints the full text of Poe's story, followed by Lacan's "Seminar on 'The Purloined Letter,'" along with extensive commentary by the editors. Marie Bonaparte's and Shoshana Felman's discussions of traditional and contemporary approaches to "psychoanalysing" texts precede Alan Bass's new translation of Derrida's "Purveyor of Truth." The subsequent essays join the Lacan-Derrida debate and offer alternative readings by literary theorists, philosophers, psychologists, and psychoanalysts. The Purloined Poe convenes much of the most important current scholarship on "The Purloined Letter" and presents a rich sampling of poststructuralist discourse. (shrink)

Since the origins of the notion of emergence in attempts to recover the content of vitalistic anti-reductionism without its questionable metaphysics, emergence has been treated in terms of logical properties. This approach was doomed to failure, because logical properties are either sui generis or they are constructions from other logical properties. If the former, they do not explain on their own and are inevitably somewhat arbitrary (the problem with the related concept of supervenience, Collier, 1988a), but if the latter, reducibility (...) is assured because logical constructs are reducible, by definition, to their logical components. A satisfactory account of emergence must recognise that it is a dynamical, not a logical property of property of natural systems, and that its basis is dynamical rather than logical composition. Collier (1988a) introduced the concept of cohesion as the closure of the causal relations among the dynamical parts of a dynamical particular that determine its resistance to external and internal fluctuations that might disrupt its integrity. Cohesion is an equivalence relation that partitions a set of dynamical particulars into unified and distinct entities, providing the identity conditions for such particulars. Cohesion blocks reduction of dynamical particulars, and is necessary for dynamical emergence. We will give reasons for thinking that cohesion might be sufficient for emergence as well. (shrink)

The mind as a whole escapes objective studies because belief in mind- independent reality is self-contradictory and by definition excludes subjective experience (awareness, 'consciousness') from reality. The mind's center therefore vanishes in studies which imply exclusive objectivism or empiricism. This conceptual difficulty can be counteracted by acknowledging that all mental and world structures arise within an unstructured origin- and-matrix for knowledge-structures and beliefs. The mind's structure is thus at the center of reality. Use of such a zero-structure reference can also (...) help to clarify some related conceptual difficulties and to bridge the gap between the 'two cultures'. (shrink)

Something about the Western mind loves a dichotomy. Descartes’s distinction between res cogitans and res extensa shaped natural science and modern analytical philosophy. The existentialists could not escape this inclination, either. Sartre dichotomized the world, beginning his philosophical inquiry by distinguishing being from nothingness, the in-itself from the for-itself. It is, ultimately, the consequences of the Cartesian wounding of both thought and self that Erik Craig recognizes in his penetrating essay. He argues persuasively that, in working therapeutically with patients, we (...) need to go beyond the description of a pathological ontic state to its ontological structure. This.. (shrink)

A longitudinal, epidemiological study was carried out in a rural area of Kenya with a population of about 28,000 between 1974 and 1980. Population registration during this time showed that population growth was very high between 1974 and 1978 (4·4% per year) and much lower in 1979 and 1980 (1·1%). Natural increase was nearly as high as in Kenya as a whole (3·7%) in this period. Fertility was somewhat lower than in all Kenya (the crude birth rate was 46 per (...) 1000) while mortality was substantially lower (7 per 1000). Evidence is presented supporting the argument that these low mortality rates are genuine. Levels of temporary and permanent migration are high and probably characteristic for many parts of Kenya. The change in population growth in 1979 and 1980 is probably due to changes in economic conditions leading in particular to less in-migration and to more out-migration. (shrink)

In Alberts zweiten Kommentar zur Nikomachischen Ethik findet sich vor der Kommentierung des Aristoteles-Textes ein eigenständiger Traktat zum allgemeinen Begriff des Guten, der im Rahmen des Artikels erstmals in kritischer Edition zugänglich gemacht wird. In doktrinaler Sicht handelt es sich um einen Text von fundamentaler Bedeutung, insofern Albert verschiedene Definitionen und Bestimmungen des Guten in ihrer inhaltlichen Vereinbarkeit und Konvergenz aufweist. In nuce entwickelt Albert hier die für sein ganzes Werk maßgebliche Metaphysik des Guten, in welche sowohl die Transzendentalienlehre als (...) auch die Grundmotive einer teleologischen Strebensethik aristotelischen Zuschnitts integriert werden. Der ethisch relevante Begriff des Guten findet dadurch seine ontotheologische Fundierung im höchsten Guten, also in Gott. Der vorliegende Artikel rekonstruiert im Anschluss an die kritische Edition die zentralen Argumente des Traktats und verortet diese durch Abgleich mit anderen Schriften in Alberts gesamten Oeuvre und Denken.Albert‘s second commentary on Aristotle‘s Nicomachean Ethics is preceded by an independent treatise dealing with the general concept of the good, which is made accessible in a critical edition in this article for the first time. Regarding its doctrinal contents this treatise proves to be of fundamental importance because Albert demonstrates the compatibility and even the convergence of several different definitions and descriptions of the good, e.g. by Aristotle, Avicenna, Ps.-Dionysius and Boethius. Albert develops in a nutshell his metaphysics of goodness which is of overarching importance for his whole work and which integrates the theory of the transcendentals as well as the basic ideas of an ethical teleology in an Aristotelian vein. Thereby, the concept of the moral good finds its ultimate foundation in the highest good, i.e. in God. Drawing on the text of the presented critical edition the article retraces the central arguments of this treatise and compares them with other writings in order to show their place in Albert’s complete work and thought. (shrink)