There are differences in caregivers’ literacy and health literacy levels that may affect their ability to consent to children participating in clinical research trials. This study aimed to explore the effectiveness, and caregivers’ understandings, of the process of informed consent that accompanied their child’s participation in a dental randomized control trial (RCT). Telephone interviews were conducted with a convenience sample of ten caregivers who each had a child participating in the RCT. Pre-tested closed and open-ended questions were used, and the (...) findings were produced from an inductive analysis of the latter and a descriptive analysis of the former. Participants had limited understanding of the purpose of the RCT and rated the readability of the consent form more highly than they rated their understanding of the research. All felt that informed consent was vital, but some caregivers had not read the consent documents. Some caregivers enrolled their child in the RCT because they trusted the researchers, and the majority wanted to improve dental care for children. The informed consent process was not always effective despite high readability of the informed consent documents. Researchers must consider the health literacy of the study group, and actively engaging with caregivers to achieve meaningful informed consent may be challenging. Future research could explore participants’ perspectives of informed consent in populations with low health literacy and assess whether an underlying expectation not to comprehend health-related information may be a barrier to informed consent. (shrink)

The influence of John Locke's thought in Europe and America rests largely on his articulation and defence of a liberal political philosophy, and in his formulation of a theory of knowledge where experience and environment provide the exclusive starting points in the educational process. Generally he continues to be associated with the eighteenth-century 'Age of Reason' or Enlightenment, where the malleability of human nature, together with the inherent dignity and freedom of the individual, were placed at the forefront of reform (...) efforts on both sides of the Atlantic. This book argues that while Locke's concern for the enhancement of individual autonomy, religious toleration, and constitutional government was indeed fundamental to later generations, Locke himself viewed the improvement of the human condition in terms of its relationship to the ancient Christian story. In particular, Locke's larger integration 'project' was to assist his contemporaries in their efforts both to recognise and to secure the greatest happiness. Locke, in other words, was chiefly interested in life beyond the grave, in salvation, and his recommendations for the reform of politics, education and religion were all viewed by the author as instrumental to the chief business of humankind. Locke's universe was a God-directed one, where human's were set specific tasks and where reward was contingent upon behaviour in this life. Locke viewed himself as a defender of the historical faith, and his work was devoted to broadening the opportunities for individual salvation. (shrink)

We introduce the Relational Blockworld (RBW) as a paradigm for deflating the mysteries associated with quantum non-separability/non-locality and the measurement problem. We begin by describing how the relativity of simultaneity implies the blockworld, which has an explanatory potential subsuming both dynamical and relational explanations. It is then shown how the canonical commutation relations fundamental to non-relativistic quantum mechanics follow from the relativity of simultaneity. Therefore, quantum mechanics has at its disposal the full explanatory power of the blockworld. Quantum mechanics exploits (...) this expanded explanatory capability since event distributions among detectors per the density matrix follow from spacetime relations (symmetry group) alone. Thus, the event distributions of non-relativistic quantum mechanics follow from a blockworld wherein spacetime relations are fundamental. Per RBW "quantum mysteries" are deflated and the implications for consciousness and the perception of temporal flow and absolute becoming are explored. We conclude that given RBW, consciousness is no less fundamental than any "physical" feature of the world such as brain states. Further, active consciousness is needed to explain the illusion that it is a dynamical world and consciousness in its most fundamental state is relational and non-local. (shrink)

The ethical nature of transformational leadership has been hotly debated. This debate is demonstrated in the range of descriptors that have been used to label transformational leaders including narcissistic, manipulative, and self-centred, but also ethical, just and effective. Therefore, the purpose of the present research was to address this issue directly by assessing the statistical relationship between perceived leader integrity and transformational leadership using the Perceived Leader Integrity Scale (PLIS) and the Multi-Factor Leadership Questionnaire (MLQ). In a national sample of (...) 1354 managers a moderate to strong positive relationship was found between perceived integrity and the demonstration of transformational leadership behaviours. A similar relationship was found between perceived integrity and developmental exchange leadership. A systematic leniency bias was identified when respondents rated subordinates vis-à-vis peer ratings. In support of previous findings, perceived integrity was also found to correlate positively with leader and organisational effectiveness measures. (shrink)

Philosophy has much to offer psychiatry, not least regarding ethical issues, but also issues regarding the mind, identity, values, and volition. This has become only more important as we have witnessed the growth and power of the pharmaceutical industry, accompanied by developments in the neurosciences. However, too few practising psychiatrists are familiar with the literature in this area. -/- The Oxford Handbook of Philosophy and Psychiatry offers the most comprehensive reference resource for this area ever published. It assembles challenging and (...) insightful contributions from key philosophers and others to the interactive fields of philosophy and psychiatry. Each contributions is original, stimulating, thorough, and clearly and engagingly written - with no potentially significant philosophical stone left unturned. Broad in scope, the book includes coverage of several areas of philosophy, including philosophy of mind, science, and ethics. For philosophers and psychiatrists, The Oxford Handbook of Philosophy and Psychiatry is a landmark publication in the field - one that will be of value to both students and researchers in this rapidly growing area. (shrink)

Contributors: Steven M. Cahn, James W. Nickel, J. L. Cowan, Paul W. Taylor, Michael D. Bayles, William A. Nunn III, Alan H. Goldman, Paul Woodruff, Robert A. Shiver, Judith Jarvis Thomson, Robert Simon, George Sher, Robert Amdur, Robert K. Fullinwider, Bernard R. Boxhill, Lisa H. Newton, Anita L. Allen, Celia Wolf-Devine, Sidney Hook, Richaed Waaserstrom, Thomas E. Hill, Jr., John Kekes.

William of Malmesbury's Regesta Regum Anglorum is one of the great histories of England, and one of the most important historical works of the European Middle Ages. Although its focus is national, its scope encompasses most of Western Europe and beyond, providing a full-scale account of the First Crusade. Apart from its formidable learning, it is characterized by narrative skill and entertainment value - with topics including unpowered flight and Henry I's zoo. This edition in the Oxford Medieval Texts series (...) is the first modern translation and edition. A full historical introduction is supplied in Volume II. (shrink)

William of Malmesbury's Regesta Regum Anglorum is one of the great histories of England, and one of the most important historical works of the European Middle Ages. Although its focus is national, its scope encompasses most of Western Europe and beyond, providing a full-scale account of the First Crusade. Apart from its formidable learning, it is characterized by narrative skill and entertainment value - with topics including unpowered flight and Henry I's zoo. This edition in the Oxford Medieval Texts series (...) is the first modern translation and edition. A full historical introduction is supplied in Volume II. (shrink)

THE PROBLEM OF THE INTERPRETATION OF HAMANN Johann Georg Hamann is an intriguing but poorly known figure in the contemporary intellectual world. Yet this is the man whom Kierkegaard saluted as "Emperor!", whose writings were to have been arranged for publication by none other than Goethe himself, and whom Dilthey numbered among the primordial figures in the rise of modern historical consciousness. There are reasons for the persistence of this general ignorance. Hamann is deep. And, in addition, there is his (...) forbidding style. The readers of Kierkegaard and Dilthey, two other giants who them selves achieved late recognition, have not had to face this kind of imposing obstacle. Not only does Hamann expect his readers to handle themselves in deep water, but to intuit their way between his ideas which bob up like islands with no visible connection between them. Like Kierkegaard too, Hamann has had his troubles with the public. He himself referred to the hope that he would be understood by a "better posterity". In fact only the last few years have seen the printing of some of his more controversial writings, in particular his theories on the nature of human sexuality. (shrink)

This chapter outlines the origins in ordinary language philosophy of a new skills-based approach to working with complex and conflicting values in medicine called values-based practice. Ordinary language philosophy focuses on our use of words as a useful first step in coming to a more complete understanding of their meanings. The theory of values-based practice was developed by applying ideas from ordinary language philosophy to the long-running debate about the "boundary problem" presented by the concept of mental disorder. Ordinary language (...) philosophy turns this debate topsy-turvy: it shows, that the concept of mental disorder instead of being the target problem is a resource for coming to a more complete understanding of the meanings of concepts of disorder as a whole including the concept of bodily disorder; and correspondingly, that the value-laden nature of mental disorder far from being part of the problem points to an evaluative element of meaning in concepts of disorder as a whole, again including concepts of bodily disorder. It is these topsy-turvy results that underpin the development of values-based practice. In a brief concluding section we indicate the potential for further development of values-based practice supported by ordinary language and other philosophies particularly through engagement with non-Western language groups representing diverse traditions of thought and practice in mental health. (shrink)

This section concerns the question of how best to understand the scientific status of mental health care in general and psychiatry in particular. On the assumption that psychiatry is based, in part at least, on natural science, what is the nature or the general shape of that science? Some of the chapters aim at shedding light on component parts of a scientific world view: causation, explanation, natural kinds, models of medicine, etc. Others concern potentially fruitful scientific approaches to mental health (...) care, drawing on brain imaging results, phenomenology, enactivism and what can be learnt from debate of the status of psychoanalysis. One overall lesson is that twenty-first-century psychiatry needs twenty-first-century philosophy of science. (shrink)

This Section examines several moral dilemmas and epistemological aporias in clinical practice and shows how clinicians can benefit from the introduction of philosophical methods and discourse. The authors develop these issues having in mind emblematic mental disorders and typical clinical situations. One important claim shared by the Authors is that a great effort has been made to ground psychiatry on evidence-based science, and to tie it to our growing understanding of the human brain. This is obviously an exceedingly important project, (...) but it would be a mistake to assume that the central questions of psychiatry can be completely resolved through scientific inquiry. Science offers guidance for clinical practice only in light of our concepts and normative judgments. (shrink)

In the editorial introduction the stage is set for the chapters in the section by a brief discussion of the relationship between the disciplines of philosophy and psychiatry. Then each chapter briefly is summarized or highlighted.

In this introduction to the Section II, the thrust of the component chapters is described. An important strand in the philosophy of psychiatry since its beginnings has been sociopolitical critiques: criticism which aims to improve and humanize psychiatric practice and mental health systems. From this standpoint, the introduction provides an overview of this tradition, including considerations of "postpsychiatry," value commitments in psychiatry, the recovery movement, racism and sexism in the field, and technology.

A cross-disciplinary discussion of the basis of interpersonal relating is of interest to philosophers and psychiatrists for several reasons. The development of successful clinical practice may depend, at least partly, on having an accurate understanding of the basic character of unimpaired interpersonal relating because such understanding can shed light on the nature and source of its disturbed forms. How we think about the basis of "mind-minding" competencies influences how we think about the prognosis and possible treatment of dysfunctional interpersonal relating. (...) Another reason is that philosophical frameworks influence the way we think about and evaluate possible psychiatric disorders and philosophical discussions may be of direct practical importance to psychiatry given that different theories suggest different potential ways of devising therapies. (shrink)

The editorial introduction sets the stage for the chapter by identifying the roles that concepts and categories play not just in the field of mental health medicine but in the human mind itself. Then, each chapter is summarized or highlighted.

Following on from Section IV on summoning concepts, this section of the Handbook presents theoretically informed descriptions of psychopathologies. The topics of the chapters range from anxiety, depression, and body image disorders, through emotion and affective disorders, to delusion, thought insertion, and the fragmentation of consciousness. These phenomena call, not only for assessment and diagnosis, but also for understanding on the part of both the engaged clinician and the philosophical commentator. They also provide case studies for general philosophical questions about (...) different levels of description and conceptualisation and the relationships between them, and about the contributions to psychological understanding that are made by phenomenology, clinical expert knowledge, and the sciences of the mind. (shrink)

In this introduction to Section VI, the thrust of the component chapters is described. The classification and diagnosis of mental disorders collects a number of philosophical challenges to the field that call for responses from a variety of philosophical resources: hermeneutics, phenomenology, philosophy of mind, narrative theory, philosophy of science, epistemology-to name a few. The authors in this section address the general challenges in the classification of psychopathology, as well as address particular kinds of mental disorders, including autism, dementia, mania, (...) psychotic disorders, and personality disorders. (shrink)

This chapter introduces the edited volume, The Oxford Handbook of Philosophy and Psychiatry. Published in 2013, the centenary of Karl Jaspers' General Psychopathology, the chapter draws lessons from the last hundred years for the coming century. No predictions are made. Instead, five 'conditions for flourishing' are set out: 1) Particular Problems - the importance of focussing on well-defined particular problems rather than general theory building, 2) Product- orientation - remaining always responsibly product oriented in the specific sense that both sides (...) put in the work necessary to 'go deep' with each other's fields, 3) Partnership - working in partnerships of one kind or another, 4) Process - constant reflection on process based on peer review but leaving scope for the occasional rogue voice to cut innovatively against the grain, and 5) Q - a condition of a different kind, Q is an empirically derived measure of the balance between in-group cohesion and out-group openness required to support creativity. Illustrations are given of how these five conditions for flourishing have underpinned the rapid expansion of philosophy and psychiatry in the closing decades of the twentieth century, and, correspondingly, are also reflected in the Handbook as a whole. Overviews and commentaries on individual contributions to the Handbook are given in extended editorial introductions to each of its eight sections. (shrink)

Sartre rationalizes sexuality much like Plato. Rationalization here refers to the way Sartre tries to facilitate explanation by changing the terms of the discussion from sexual to nonsexual concepts. As a philosophy which, above all, highlights those features of human existence which seem most resistant to explanation, one would expect existentialism to highlight sexuality as a category that is crucial for considering human existence. Descartes comes immediately to mind when one focuses on Sartre's major categories. In Sartre's case however, it (...) is not mind and matter but consciousness and its opposite: "nothingness" and "being." This irreducible dualism is the key to the trouble human beings have with existence. Humans try to deal with the tensions implied by this dualism by trying to pretend people are not subjects but objects. Sartre calls this "bad faith." He begins by attempting to take human sexuality seriously as a fundamental category, but ends by abandoning the effort in favor of other substitutes. (shrink)

Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...) ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)