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)

Several facts about organ donation and transplantation are not in dispute: (1) there is a shortage of available organs; (2) many potential organ donors die after authorized withdrawal of life-susta...

Are humans too generous and too punitive? Many researchers have concluded that classic theories of social evolution (e.g., direct reciprocity, reputation) are not sufficient to explain human cooperation; instead, group selection theories are needed. We think such a move is premature. The leap to these models has been made by moving directly from thinking about selection pressures to predicting patterns of behavior and ignoring the intervening layer of evolved psychology that must mediate this connection. In real world environments, information processing (...) is a non-trivial problem and details of the ecology can dramatically constrain potential solutions, often enabling particular heuristics to be efficient and effective. We argue that making the intervening layer of psychology explicit resolves decades-old mysteries in the evolution of cooperation and punishment. (shrink)

Positive changes or transformations have been the subject of study within spiritual traditions as well as humanistic and transpersonal psychology. The aim of the current study is to understand the process of transformation among Moslems in Indonesia, who follow spiritual practices, to achieve the nafs al-muṭma ínnah [tranquil self]. Ten participants in Yogyakarta province were involved in this study. They were recruited using nafs al-muṭmaʾinnah scale developed by the authors. In-depth interviews of both the participants and their significant others were (...) conducted. To analyse the data, an interpretative phenomenological analysis was employed. Five themes emerged from the data, including deviation from the basis of religious environment, spiritual discipline, transformative experiences, new characters and a continuous process. We conclude that participants experience spiritual-religious transformation and achieve the state of nafs al-muṭma ínnah [tranquil self]. The process of transformation occurs gradually after a sudden experience, and it continuously happens throughout the course of life. Three factors contribute to the transformation, including the role of predisposition, the role of a spiritual guide and the role of spiritual experiences.Contribution: As the study of spiritual-religious transformation is mainly conducted within a Judea-Christian tradition, this study significantly contributes to the literature by providing spiritual-religious transformation from an Islamic-Sufi perspective. (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)

This book argues that the ability to integrate biological and psychological levels of understanding is inhibited by two important issues. Ideas about the autonomic nervous system are integrated with those from the author's previous text A Basic Theory of Neuropsychoanalysis.

PrécisDespite significant scholarship, research, and funding dedicated to implementing criminal diversion programs over the past two decades, persons with serious mental illness and substance use disorders remain substantially overrepresented in United States jails and prisons. Why are so many U.S. adults with behavioral health problems incarcerated instead of receiving treatment and other support to recover in the community? In this paper, we explore this persistent problem within the context of “relentless unmet need” in U.S. behavioral health (Alegría et al., 2021).

PurposeThe purpose of this study is to describe the implementation and outcomes of an Eye Movement and Desensitization Reprocessing treatment-program for women with posttraumatic stress disorder after childbirth.MethodsA prospective cohort-study with pre- and post-measurements was carried out in the setting of an academic hospital in the Netherland. Included were women who gave birth to a living child at least 4 weeks ago, with a diagnosis of PTSD, or severe symptoms of PTSD combined with another psychiatric diagnosis. All received up to (...) 8 sessions of EMDR-therapy. The posttraumatic stress disorder Checklist for DSM-5 was administered before and after treatment. Trauma history was assessed before treatment with the Life Events Checklist for the DSM-5, the Childhood Trauma Questionnaire and the Childbirth Perception Scale. Descriptive statistics were used.ResultsForty-four women were referred, 26 met the inclusion criteria. After treatment, none of the women met the criteria for diagnosis of PTSD after on average 5 weekly sessions of EMDR- therapy. These outcomes are promising, as they were achieved in women with relatively high levels of psychiatric comorbidity and high rates of previous mental health treatment.ConclusionImplementing an EMDR-treatment program for women with PTSD after childbirth in the setting of an academic hospital is feasible and effective. Key factors for success include a close collaboration between the relevant hospital departments and a thorough case conceptualization addressing the etiology of the PTSD. (shrink)

Philosophy of science is the organized expression of a growing intent among philosophers and scientists to clarify, perhaps unify, the programs, methods and results of the disciplines of philosophy and of science. The examination of fundamental concepts and presuppositions in the light of the positive results of science, systematic doubt of the positive results, and a thorough-going analysis and critique of logic and of language, are typical projects for this joint effort. It is not necessary to be committed to a (...) belief that science and philosophy are or should be one, or else that “never the twain shall meet.” If anything, there is to be expected a wholesome regard for the value of established science in furnishing a foil for philosophy and a check on its old extravagances. This does not mean that even the best-established science may not be subject to most devastating criticism by analysis of its foundations. In fact, despairing of the philosophy of the schools, science has done it largely for itself. The theories of gravitation, atomicity, electro-magnetism, evolution, relativity and quanta have all arisen through drastic revisions of complacent fundamental “truths.”. (shrink)

The dead donor rule (DDR) has facilitated the saving of hundreds of thousands of lives. Recent advances in heart donation, however, have exposed how DDR has limited donation of all organs. We propose advancing the moment in the dying process at which death can be determined to increase substantially the supply of organs for transplantation. We justify this approach by identifying certain flaws in the Uniform Determination of Death Act and proposing a modification of that law that permits earlier procurement (...) of healthier organs in greater numbers. (shrink)

Cognitive Science, Volume 46, Issue 6, June 2022.

The application of recycled aggregate as a sustainable material in construction projects is considered a promising approach to decrease the carbon footprint of concrete structures. Prediction of compressive strength of environmentally friendly concrete containing recycled aggregate is important for understanding sustainable structures’ concrete behaviour. In this research, the capability of the deep learning neural network approach is examined on the simulation of CS of EF concrete. The developed approach is compared to the well-known artificial intelligence approaches named multivariate adaptive regression (...) spline, extreme learning machines, and random forests. The dataset was divided into three scenarios 70%-30%, 80%-20%, and 90%-10% for training/testing to explore the impact of data division percentage on the capacity of the developed AI model. Extreme gradient boosting was integrated with the developed AI models to select the influencing variables on the CS prediction. Several statistical measures and graphical methods were generated to evaluate the efficiency of the presented models. In this regard, the results confirmed that the DLNN model attained the highest value of prediction performance with minimal root mean squared error. The study revealed that the highest prediction performance could be attained by increasing the number of variables in the prediction problem and using 90%-10% data division. The results demonstrated the robustness of the DLNN model over the other AI models in handling the complex behaviour of concrete. Due to the high accuracy of the DLNN model, the developed method can be used as a practical approach for future use of CS prediction of EF concrete. (shrink)

The United States Court of Appeals for the Seventh Circuit held, in Murrey v. United States ), that claims for a physician's failure to obtain a patient's informed consent are not barred by the Federal Tort Claims Act as a species of misrepresentation. The court further held that the claim was not barred by the failure to include the issue of informed consent in the administrative claim. This decision reduces the burden on plaintiffs to state every cognizable claim consistent with (...) the facts in an administrative proceeding; the failure to do so would prevent them from raising the claim in court.The patient, Thomas Murrey, a sixty-eight-year-old U.S. veteran, sought treatment at a Veteran's Administration hospital in North Chicago, Illinois. VA doctors diagnosed him with prostate cancer, and advised him to undergo surgery to remove his entire prostate. (shrink)

Cognitive Science, Volume 46, Issue 5, May 2022.

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole‐genome sequencing and micro‐array based analysis enable genome‐wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre‐test information and achieving autonomous decision‐making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so‐called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set‐up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set‐up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct‐to‐consumer applications of the new genetics. (shrink)

Does the desirability of social institutions for public goods provision depend on the extent to which they include mechanisms for endogenous enforcement of cooperative behavior? We consider alternative institutions that vary the use of direct punishments to promote social cooperation. In one institution, subjects participate in a public goods experiment in which an initial stage of voluntary contribution is followed by a second stage of voluntary, costly sanctioning. Another institution consists of the voluntary contribution stage only, with no subsequent opportunity (...) to sanction. In a third stage subjects vote for which institution they prefer for future interactions: do they prefer one that does allow sanctions or one that does not allow sanctions? Our results show that even though sanctions are frequently used when available, the clear majority of individuals vote for the institution that does not allow sanctions. Thus, a distinction is required between the principles that guide the choice of institutions and the principles that apply to actions guided by institutions. Our results indicate that it is the wealth generated by the institution that determines its desirability. (shrink)