Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each (...) from the staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics. (shrink)

ArgumentWhile science and economy are undoubtedly interwoven, the nature of their relationship is often reduced to a positive correlation between economic and scientific prosperity. It seems that the modern scholarship focusing on “success stories” tends to neglect counterintuitive examples such as the impact of economic crises on research. We argue that economic difficulties, under certain circumstances, may also lead to the prosperous development of scientific institutions. This paper focuses on a particular organism, the Pine Institute in Bordeaux in France. (...) Not only was it a key actor in the process of defining the discipline of resin chemistry, but also it remained for years at the heart of the local resin producing industry. Interestingly, there is an actual inverse correlation between the Institute's budgets and the prices and production of resinous products. The Pine Institute's existence seemed to have been driven by the crisis of the resin industry. (shrink)

Addiction is a phenomenon that usually offers challenges to theories of action. If we consider the standard causal theory of addiction, explaining addicts’ action in terms of their addictive desires leaves them without agency. If the compulsive desires bring about the action, despite the addicts’ views and attitudes toward their addiction, the desire just seems to force the addict to act accordingly. In light of philosophical studies, this is not a plausible way of understanding addicts’ action, as they are agents (...) in the sense that they are basically able to control their action and refrain from acting according to their addiction. Still it seems more difficult for addicts to act against the addictive desire. There has been empirical research that heroin addicts, for instance, have strong attentional bias to heroin-related cues and this feeds the strong desire they have for heroin. In the presentation, I will consider two ways in which the addictive desire may be understood as a source of difficulty that the agent may experience in their action. (shrink)

Breastfeeding advocates have criticised the phrase ‘breast is best’ as mistakenly representing breastfeeding as a departure from the norm rather than the default for infant feeding. Breastfeeding mothers have an interest in representing breastfeeding as the default, for example, to counteract criticism of breastfeeding outside the home. This connects to an increasing trend to frame feeding babies formula as harmful, which can be seen in research papers, public policy and information presented to parents and prospective parents. Whether we (...) frame infant-feeding decisions in terms of harming or benefit, protection or risk matters because these distinctions are generally morally significant and thus holding that those who decide to use formula ‘harm’, ‘risk harm’ to their babies or describing formula feeding as ‘dangerous’ is likely to contribute to guilt associated with formula feeding and thus to undermine the well-being of vulnerable women. It may undermine attempts to improve breastfeeding rates by leading women to reject information about health outcomes surrounding infant-feeding decisions. However, these distinctions do not apply easily to infant-feeding decisions, in part because of difficulties in determining whether we should treat breastfeeding as the normative baseline for infant feeding. I show that neither the descriptive ‘facts of the matter’ nor moral or pragmatic considerations provide an easy answer before discussing how to respond to these considerations. (shrink)

Background: Psychological abuse of older people is difficult to recognise; specifically, nursing home residents have been documented to be at higher risk of psychological abuse during daily care, such as during feeding. Healthcare professionals adopt positive and negative verbal prompts to maintain residents’ eating independence; however, negative prompts’ purposes and implications have never been discussed to date. Research aims: To critically analyse negative verbal prompts given during mealtimes as forms of abuse of older individuals and violation of ethical principles. (...) Research design: This is a secondary analysis of three cases of negative prompts that emerged in a large descriptive study based upon focus group methodology and involving 13 nursing homes and 54 healthcare professionals. Participants and research context: This study included 3 out of 13 nursing homes caring for residents with moderate/severe functional dependence in self-feeding mainly due to dementia; in these nursing homes, we conducted three focus groups and 13 healthcare professionals participated. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after being approved by the Review Board of the Trust. Findings: With the intent of maintaining self-feeding independence, negative verbal prompts have been reported as being used by nursing home teams. By critically analysing these negative prompts, it turned out they could trigger intimidation, depression and anxiety and thus could be considered as forms of abuse; moreover, negative prompts can threaten the ethical principles of (1) autonomy using a paternalist approach, (2) beneficence and non-maleficence as with the intent to act in the best interests of residents (to maintain self-feeding independence) they are harmed in their dignity and (3) justice, given that residents who received negative prompts are treated differently from those who received positive prompts. Discussion: Eating should be a pleasant experience with a positive impact on physiological, psychological and social well-being. However, negative prompting can lead to abuse and violation of basic ethical principles, destroying the healthcare professional resident and relative relationships strongly dependent on trust. Conclusion: Negative verbal prompting must be avoided. (shrink)

Food security is one of the major concerns in the Philippines. Although livestock and poultry production accounts for a significant proportion of the country’s agricultural output, smallholder households are still vulnerable to food insecurity. The current study aims to examine how livestock production and selling difficulties affect smallholder households’ food-insecure conditions. For this objective, Bayesian Mindsponge Framework (BMF) analytics was employed on a dataset of the Food and Agriculture Organization’s Data in Emergencies Monitoring (DIEM) system. We found that production (...) and selling difficulties significantly adversely affect food insecurity in the Philippines. However, their effects vary according to the severity of food insecurity. In particular, production and selling difficulties affect the households’ likelihood of eating less healthy and nutritious food equally. However, the production difficulties have more negligible impacts on the possibility of skipping meals and even ambiguous impacts on the likelihood of not eating for a whole day compared to the effects of selling difficulties. Moreover, we also found that the market plays a crucial role in facilitating not only livestock trading but also livestock production (e.g., purchase of feed and medicines). Based on these findings, we suggest that the livestock market needs to be expanded and regulated to maintain the balancing prices between livestock products and products and services used for livestock production, and facilitate the product-exchanging mechanism. (shrink)

The sensitivity of focus to context has often been analyzed in terms of focus-based anaphoric relations between sentences and surrounding discourse. The literature, however, has also noted empirical difficulties for the anaphoric approach, and my goal in the present paper is to investigate what happens if we abandon the anaphoric view altogether. Instead of anaphoric felicity conditions, I propose that focus leads to infelicity only indirectly, when the semantic processes that it feeds—in particular, exhaustification and question formation—make an inappropriate (...) contribution to discourse. I outline such an account, in line with Roberts (In Papers in semantics, Vol. 49 of Working papers in linguistics, 91–136, The Ohio State University, 1996 ) and incorporating recent insights from Büring (In Questions in discourse, Vol. 36 of Current research in the semantics/pragmatics interface, 6–44, Leiden: Brill, 2019 ) and Fox (In Proceedings of Sinn und Bedeutung 22, 403–434, 2019 ). This account, which I motivate on conceptual grounds, has no anaphoric conditions on focus placement and has only an economy condition as a potential felicity condition on focus. However, there are cases where the fine control offered by anaphoricity seems needed, either to block deaccenting that would be licensed by a question or to allow local deaccenting that is not warranted by a question. Such cases challenge non-anaphoric accounts such as the present one and appear to support recent anaphoric proposals such as Schwarzschild (In Making worlds accessible. Essays in honor of Angelika Kratzer, 167–192, 2020 ), Wagner (In The Wiley Blackwell companion to semantics, Oxford: Wiley-Blackwell, 2020 ), and Goodhue (Journal of Semantics 39: 117–158, 2022 ). I argue that this potential motivation for anaphoricity is only apparent and that to the extent that anaphoric conditions on focus from the literature are not inert, they are in fact harmful. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Listening In: Music, Mind, and the Modernist NarrativeRandall Everett AllsupEric Prieto, Listening In: Music, Mind, and the Modernist Narrative ( Lincoln NE: University of Nebraska Press, 2002)Modernism. The Interpretation of Dreams, the assembly line, The Rite of Spring, the Panama Canal. The modernist sensibility is characterized above all by the "willful big idea"—history as text, a manifesto in conflict with itself and its past. Hopeful and revolutionary like (...) the writings of Karl Marx or progressive and corrupt like the Manhattan Project, such events-as-manifesto had a way of feeding off each other. Through collaboration, conflict, and competition, modernists from Robert Moses to Elliott Carter raced to explain and exemplify, often deliberately creating conflict as if crisis were its own rationale, its own sine qua non. One could hypothesize that this arms race of complexity collapsed—exhausted—about the same time that Communism did. Its failure to sustain its ideas (rather than outpace them one after another) may be one reason we live in an anti-dialectical world, an unmodern place of fundamentalisms and easy freedoms.Author Eric Prieto is at home in the modern world more so than the present; his heroes are French intellectuals after all, those lovers of complexity. In Listening In: Music, Mind, and the Modernist Narrative, he investigates late modernist authors who looked to music as a way to exemplify the inward nature of mind [End Page 93] and the outward nature of place. To understand this book, we must revisit some formal aesthetic theories, namely that music's value resides in its ability to name without signifying, that musical properties like intervallic distance, dynamic contrast, and the space-time component that is rhythm put us in touch with the Kantian a priori—the-thing-in-itself, the Schopenhauerian will. Music as sound-in-itself (to riff on Kant and Schopenhauer) becomes a metaphor for the noumenal world or is mimetic at the very least of the abstract and non-linear nature of thought. Prieto argues that "wherever a music model is present [among his examples] it always serves to further this inwardly directed mode of mimesis I call 'listening in,' where the primary object of representation is not the outside world but the subtly modulating interactions between consciousness and world."1Prieto's book is highly consistent. He masterfully captures the spirit of cooperation from modernist writer to musician to thinker and back. Concentrating on three authors, Robert Pinget, Michel Leiris, and Samuel Beckett, Prieto cites the influences of composers like Bach and Beethoven, as well as philosophers like Wittgenstein and Schopenhauer on their literary works. He brings in thinking from Nelson Goodman and Ferdinand de Saussure. The result is literary criticism as manifesto. Reader beware, this is a book for an elevated audience, those rare folk who are comfortable with structural linguistics, nineteenth-century music aesthetics, specialized academic scholarship, and word puzzles. To explain for example why an author like Beckett is inspired by music to create abstract or associative narratives rather than traditional stories of cause and effect, Prieto writes:In music, this progression necessarily takes place on the level of audible resemblances, but in literature, by virtue of the properties of the two-tiered linguistic sign, analogical progression may take place either on the level of the signifier (via the principle of paronomasia), on the level of the signified (via metaphorical substitutions, as in the association of ideas), or between the two levels (punning, "imitative harmony").2This density of language and concept speak well of Prieto's intellect and one is likewise impressed by his broad understanding of music and letters, yet it is the musical scholar who gets the short end of the deal. Paronomasia? "Audible resemblance" is not a musical term I have heard used. In Listening In: Music, Mind, and the Modernist Narrative, music serves as starting point, an inspiration, not as an equal partner. This holds true for Beckett and Pinget as well as for Prieto. The result can be disconcerting, even to readers like me for whom the cross-disciplinary study of music and literature is a fascinating endeavor.Difficulty, nonetheless, has its rewards and this is one lesson of... (shrink)

An elderly patient in his early eighties is hospitalized in a long-term facility, with advanced Alzheimer disease. He is otherwise relatively strong and free from other life-threatening conditions, except for the fact that he has difficulties swallowing. After several episodes of acute aspiration pneumonia doctors prescribe “strict fast”: only hydration through an IV catheter should be administered during the night, in order to relieve the feeling of hunger, provide comfort, and stave off death. The patient is surrounded by a (...) warm and extremely close-knit Mediterranean family. His wife and six adult children take turns feeding him properly mixed food twice a day and prefer to take the risk of causing another... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Martha Nussbaum and the Moral Life of MiddlemarchRohan MaitzenWe are all of us born in moral stupidity, taking the world as an udder to feed our supreme selves.George Eliot, MiddlemarchIAs is well known to readers of this journal, Martha Nussbaum emphasizes in her essays on fiction as moral philosophy that the philosophical significance of novels is found, not in whatever theories or principles they might overtly discuss or dramatize, (...) but in their literary form and their prose style. In particular, she finds in the late novels of Henry James an alternative to the reductive, pseudoscientific prose of contemporary analytic philosophy, which she argues inhibits the range of possible answers to the basic ethical question "How should one live?"1 James's prose shows "attention to particulars, a respect for the emotions, and a tentative and non-dogmatic attitude to the bewildering multiplicities of life" (LK, p. 27), and thus it exemplifies the Aristotelian ethical conception she advocates.In this essay I want to disentangle Nussbaum's theory of the ethical significance of fictional form—which I endorse—from her preoccupation [End Page 190] with James—which I do not. Far from being, as she believes, egalitarian, humane, and morally responsible, the Jamesian consciousness Nussbaum would have us emulate is elitist, exclusionary, and morally inert; further, in its commitment to indeterminacy, mystery, and obscurity, the Jamesian model is in fact profoundly anti-philosophical.2 I propose instead George Eliot's Middlemarch as exemplary of fiction's potential contribution to "the job of moral philosophy" (LK, p. 138). Nussbaum may admire the subtlety and density of The Golden Bowl, but I will argue that in its narrative strategies and its integration of novelistic perception and philosophic reflection, Middlemarch proves a better ethical guide and a better example of literature that is also philosophy.In making this argument, I will rely on the terms set by Nussbaum herself for the ethical evaluation of fiction. Unlike other philosophers who invoke literature only as a "rich source of examples awaiting illumination by philosophy," Nussbaum insists that analysis of a text's literary properties is the essential methodology of ethical criticism.3 Every aspect of form and style "expresses a sense of life and of value, a sense of what matters and what does not" (LK, p.5). We discover this "sense of life" through close reading; "our engaged experience line by line," as Wayne Booth says, reveals the character of the implied author, the would-be friend urging on us a particular "pattern of desires."4On Nussbaum's reading, James's prose is ethically exemplary because it is "the prose of Aristotelian perception":It depicts in its cadences the moral effort of straining to see correctly and to come up with the appropriate picture or description; its tensions, obliquities, and circumnavigations express the sheer difficulty of finding the right description or picture for what is there before one. If, as James says, to "put" is to "do," showing this is showing moral activity of a valuable kind.(LK, p. 88)But Nussbaum ends up at James because her alternative moral theory begins there, not because moral philosophy that is literary inevitably sounds like James or supports Aristotle.5 As Nussbaum's gestures towards a more general theory of the role of "the novel" in philosophy indicate, novels may share generic features which complement or correct conventional philosophical discourse, but investigating other novels in this way may also lead us to other, non-Aristotelian, non-Jamesian ethical conceptions. My commentary on Middlemarch presents one such alternative. First, however, I will consider our "engaged experience" of The [End Page 191] Golden Bowl, a key example for Nussbaum, to show more particularly why we ought to be cautious about accepting James's late style as exemplary for moral philosophy, despite Nussbaum's passionate advocacy. What kind of friend do we meet there, in that world full of indeterminacy, obliquity, and circumnavigation? What kind of guidance in practical reasoning do we get from this implied author—what "ought" emerges from the Jamesian "is"?Perhaps because, as Nussbaum admits, her work on fiction as moral philosophy emerged "out of a longstanding love" for The... (shrink)

BackgroundDecision-making in end-stage dementia is a complex process involving medical, social, legal and ethical issues. In ESD, the person suffers from severe cognitive problems leading to a loss of capacity to decide matters regarding health and end-of-life issues. The decisional responsibility is usually passed to clinicians and relatives who can face significant difficulty in making moral decisions, particularly in the presence of life-threatening swallowing problems.AimThis study aimed to understand the decision-making processes of clinical teams and relatives in addressing life-threatening swallowing (...) difficulties in ESD in long-term care in Malta.MethodThe study followed a qualitative approach where six case studies, involving six different teams and relatives of six different patients, were interviewed retrospectively to understand their decision-making in connection with the management of swallowing difficulties in ESD. Data were collected through semistructured interviews with each stakeholder. All data were transcribed and subjected to thematic analysis.ResultsFour themes were identified: the vulnerability of patients in dementia decision-making; the difficult role of relatives in decision-making; the decisional conflict between aggressive care through tube feeding versus oral comfort feeding; a consensus-building decision-making process as ideal to facilitate agreement and respect for patient’s dignity.ConclusionDecision-making to manage swallowing difficulties in ESD is a challenging process, which involves an interpretation of personal values, beliefs, patient preferences, care needs and clinical practice. Better communication between clinicians and relatives in dementia helps promote agreement between stakeholders leading to a care plan that respects the dignity of patients at their end of life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Circumcision:Ordinary and Universal in My CommunityAllan J. JacobsMy1 circumcision experiences are remarkable mostly for their ordinariness. My wife Danaë gave birth to our son Perseus2 while I was a resident in obstetrics and gynecology in a city where we had no family. Perseus was circumcised in a Jewish brit milah3 ceremony on the eighth day of his life, as were my wife's and my male ancestors back into ancient (...) times. We were relieved because Perseus had just recovered from a potentially serious condition. After a difficult forceps delivery, his blood bilirubin rose almost to the point where he might have developed the dreaded kernicterus syndrome. Kernicterus can cause permanent severe motor, intellectual and visual impairment. It was unclear whether he would be discharged from the hospital in time. He had to spend a week in restraints under a bright light whose frequency degraded bilirubin. Happily, he came home the day before the scheduled brit.Our four parents attended the brit. Danaë's father was the sandek,4 being granted the honor of holding our son on his lap during the circumcision ceremony. The mohel, or circumciser, was the local Conservative rabbi. We were mildly anxious because he didn't do many circumcisions in this city with few Jews. Perseus cried briefly after he was circumcised. The circumcision undoubtedly was far less stressful than treatment of elevated bilirubin. The circumcision certainly was less painful than the prodding and sticks for the many blood tests he had to undergo in the hospital, not to mention the pain of his difficult forceps delivery. Perseus did not seem to have much discomfort in his penis afterward, and had no circumcision complications.After the brit, our parents and my resident colleagues ate refreshments and chatted for an hour or so. A brit milah is a happy occasion, but not an elaborate one. It marks the end of the joy, anxiety, and excitement of the child's birth and its aftermath and is followed by the less exalted rhythm of feedings, diaper changes, and sleep deprivation.At the brit, our boys are assigned Hebrew names and confirmed in the Biblical covenant between God and the Hebrew people established between God and Abraham, and reaffirmed between God and Moses. Regardless of the historical truth of the formation of the covenant, it is accepted as a myth tantamount to [End Page 71] truth. In other words, regardless of its literal truth, such a myth is to be regarded as true because it concretizes God's demands or a moral truth. The covenant is real for me whether or not there was a historical Abraham. As with other religious commitments, the obligation to circumcise our sons is unprovable, but binding. On this basis, Perseus's ancestors on both sides were circumcised in brit milah ceremonies for many centuries into the past.My two grandsons were circumcised as well. Achilles was circumcised among friends and relatives. The mohel was an experienced obstetrician who was certified to officiate at a brit milah following the practices of Conservative Judaism. He administered adequate analgesia with topical local anesthetic cream followed by an injected regional block. Achilles slept through his circumcision, suffered no complications, and had little discomfort afterward. My other grandson had a circumcision performed as an infant outside the context of Judaism and is not being raised as a Jew.The two brit milah in my family were beautiful, dignified ceremonies, welcoming the infants into the Jewish fold, and bestowing their Hebrew names.5 Some of my relatives, including Perseus's son, had circumcisions performed in a medical setting without a ceremony. None of the many boys in my family had obvious short- or long-term problems with their circumcisions. My social circle has many Reform and Conservative Jews. I have never heard any Jewish man in my circle of acquaintances complain about his circumcision. Circumcision is a given. Problems are rare, and an exposed glans is the norm. Our men typically enjoy sex and have no difficulty in fathering children. Circumcision is part of the comforting cocoon of custom and tribe that helps to protect us as a group. It also reinforces Jewish endogamy... (shrink)

It’s widely agreed that animal pain matters morally – that we shouldn’t, for instance, starve our animal companions, and that we should provide medical care to sick or injured agricultural animals, and not only because it benefits us to do so. But do we have the same moral responsibilities towards wild animals? Should we feed them if they are starving, and intervene to prevent them from undergoing other forms of suffering, for instance from predation? Using an example that includes both (...) wild and domesticated animals, I outline two contrasting ways of thinking about our moral responsibilities with respect to assisting animals that are apparently in need. One approach is based entirely around animals’ capacities; the other takes context and historical relations into account as well. While not attempting to adjudicate between these views, I’ll point out the advantages and difficulties of both. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Care of the terminal patient:Are we on the same page?Lauren WancataIn surgical training a “service” or care team consists of sick patients admitted to the hospital and the medical team caring for the patient. Each service consists of an attending physician, a chief resident, a senior resident and junior residents structured as a hierarchy. The chief was gone for the week. As a senior trainee I would be the (...) acting chief—a role I had assumed many times before this month. To prepare for the week of his absence, I read through each patient’s chart, and the chief and I discussed each patient—diagnosis, procedures, and plans.One was a 41–year–old male with cancer—he was young, but a patient like him was not uncommon at my institution. He originally came in through the emergency department with abdominal pain and difficulty with urination. His admitting medical team started the work–up for his symptoms—blood tests, a CAT scan, and consults to other physician services with specialized knowledge. He eventually underwent endoscopy with biopsies of his stomach and placement of stents into his ureter and kidney for his urinary issues. With return of the biopsies, he had a diagnosis—cancer. He required additional procedures, including the placement of stents into his bile ducts, as they, like his ureter, had become affected by the cancer. The next step was staging the cancer to determine his treatment options. Our surgical service was consulted for a diagnostic laparoscopy with washing—we would take a look inside his abdomen with a camera and obtain a fluid sample to be sent to the pathologist for review, the standard of care for this type of cancer. When the camera was placed nodules were seen—a sample of the nodules and the fluid were sent to a pathologist and determined to be positive for cancer: metastatic disease, stage IV. A special feeding tube was placed into his small intestine to aid in nutritional support, as he had already lost a significant amount of weight, and improving his nutrition would be imperative for any further treatments. Following this operation, oversight of his day–to–day care was taken on by our surgical service, and he had been under our care for a period of time before I rotated onto the service for the month.What was the plan for his care in the hospital, and what was his–long–term plan? His cancer could not be surgically removed due to the extent of its spread within his body. He had recently undergone another CAT scan due to an elevation in his white blood cell count (this elevation was a sign of possible infection) and a thoracentesis, a procedure to remove some of the fluid that was collecting around his lungs. Nephrologists (kidney specialist) had been consulted due to his declining kidney function. Throughout the days, his tube feeds, his source of nutrition, would often be turned off due to bloating and feeling full.Each morning, I rounded with our team, and we would see how he was doing. We would discuss how his night went, and make a plan for the day. He was a man of few words, but his wife was always at his bedside, to support him, listen to updates and keep tract of his progress. She had worked at the hospital and had seen a wide range of patients. She would ask about his kidney function, his tube feeds, and his labs. But, she never asked about his prognosis. I would leave his room each day with the unnerving feeling that the patient, family members and care team were not on the same page. Yes, we all wanted him to get better and to leave the hospital. [End Page 28] But, was he really going to get better? What defined better? Did the patient and his family really know the extent of his disease and his prognosis?Towards the end of my week as chief, I started to ask if they had any other questions. It had been a few weeks since his operation. Was there anything that they wanted to discuss or ask me about? At the... (shrink)

As David White explains in the Introduction to Tantra in Practice, Tantra is an Asian body of beliefs and practices that seeks to channel the divine energy that grounds the universe, in creative and liberating ways. The subsequent chapters reflect the wide geographical and temporal scope of Tantra by examining thirty-six texts from China, India, Japan, Nepal, and Tibet, ranging from the seventh century to the present day, and representing the full range of Tantric experience--Buddhist, Hindu, Jain, and even Islamic. (...) Each text has been chosen and translated, often for the first time, by an international expert in the field who also provides detailed background material. Students of Asian religions and general readers alike will find the book rich and informative. The book includes plays, transcribed interviews, poetry, parodies, inscriptions, instructional texts, scriptures, philosophical conjectures, dreams, and astronomical speculations, each text illustrating one of the diverse traditions and practices of Tantra. Thus, the nineteenth-century Indian Buddhist Garland of Gems, a series of songs, warns against the illusion of appearance by referring to bees, yogurt, and the fire of Malaya Mountain; while fourteenth-century Chinese Buddhist manuscripts detail how to prosper through the Seven Stars of the Northern Dipper by burning incense, making offerings to scriptures, and chanting incantations. In a transcribed conversation, a modern Hindu priest in Bengal candidly explains how he serves the black Goddess Kali and feeds temple skulls lentils, wine, or rice; a seventeenth-century Nepalese Hindu praise-poem hammered into the golden doors to the temple of the Goddess Taleju lists a king's faults and begs her forgiveness and grace. An introduction accompanies each text, identifying its period and genre, discussing the history and influence of the work, and identifying points of particular interest or difficulty. The first book to bring together texts from the entire range of Tantric phenomena, Tantra in Practice continues the Princeton Readings in Religions series. The breadth of work included, geographic areas spanned, and expert scholarship highlighting each piece serve to expand our understanding of what it means to practice Tantra. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:diacritics 35.1 (2005) 136-146MuseSearchJournalsThis JournalContents[Access article in PDF]The Christian Bain de Diane, or the Stakes of an Ambiguous ParatextPatrick AmstutzTranslated by Gerald MooreUpon its publication, Le bain de Diane elicited few reactions on the part of criticism. Klossowski's name was still a secret and, despite its note among writers such as Bataille, Beauvoir, Camus, Parain, and Sartre and their public following, the number of readers to have read this (...) fifth work remained confined to those already familiar with Klossow-ski the essayist (Sade mon prochain, Méditations bibliques de Hamann), or the novelist (La vocation suspendue, Roberte, ce soir). The discreet silence that characterized the first reception of Le bain de Diane would last until the end of the seventies, despite a reedition in 1972 by the same publisher. During this time three important moments made Le bain de Diane resurface at the heart of the literary world: first, in fictional form, thanks to a subtle but explicit homage paid by Henri Thomas [Le promontoire]; second, in the form of a penetrating commentary article by Michel Foucault ["La prose d'Actéon"], and finally, at the hands of René Micha and Catherine Backès-Clément, key contributors to the issue that the review L'Arc dedicated to the writer. The reedition of Le bain de Diane by Gallimard1 would significantly relaunch interest in this work which, one comes increasingly to realize, is a major text in the Klossowskian oeuvre: offering a reflection on the image and writing, it was Gilles Quinsat who would open this new period of critical reception.An Uncertain IdentityQuinsat emphasizes the "series of 'tableaux' that glazes Le Bain de Diane" in accordance with a "circular" descriptive movement, he says, "from vision to commentary, attributed to the deferral without end of signs, and which feeds the entire work of Pierre Klossowski" [95]. And if he borrows the term "exegesis" from Foucault to describe the genre of the work, he immediately associates it with that of "narrative." A quarter of a century earlier, a commentary in the new Nouvelle revue française had already underlined the "disconcerting" character of Klossowski's book, by accentuating not only the strangeness of its thematic, but also the difficulties posed by the uncertainty of its generic belonging (which is echoed by the absent mention of a paratext): the critic, hesitating, suggested somewhat confusedly a typological kinship with philosophical commentary, theological scholasticism, prose poetry, series of paintings, historical narrative and even the analysis of myths [Amer 144]. In fact, this mythological "reverie," neither an essay nor a narrative, is, from this point of view, a typically Klossowskian [End Page 136] book, as Ian James has more recently reminded us [143]. Le bain de Diane mixes erudite commentary and narrative discourse so well that it entices its commentators into the traps of scholarly, historical, and philological annotation. Yet this would be to forget, as Maurice Blanchot has observed [92–94], that the written oeuvre of Klossowski belongs fully to the field of literature, even more so than to those of philosophy, theology, or psychoanalysis.When it comes to discerning the literariness of this literary object, which the different paratextual and intertextual stakes and levels underline, the principal difficulty consists in not losing oneself in a mythological labyrinth and innumerable variants of the cult of Artemis, which was one of the most significant, oldest, and popular cults of the Greco-Roman era and which plunges into a world on whose complexity historians and philologists have insisted on many occasions. The study of Klossowski's sources could lead one through multiple disciplines (philology, mythography, psychoanalysis, the history of religions, history of art, French literature—all centuries cobbled together, and so on) to overly vast inquiries: the goddess "of a thousand names" assumes a properly vertiginous semiotic richness, and the cult of Artemis, before being linked to that of Apollo, stretches back to time immemorial where, behind Artemis, can be glimpsed the Asiatic figure of a Great Mother Goddess, whose... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Response to Susan Laird, “Musical Hunger: A Philosophical Testimonial of Miseducation”Heidi WesterlundCan hunger and satisfaction, which according to John Dewey form “the arsis and thesis of a child’s life,”1 create the rhythm and heartbeat of music education? Susan Laird shows us through her autobiographical experiences how this heartbeat was missed in her case, while the undertone of her narrative and testimonial begs a wider self-reflection upon the culture (...) of music education. Indeed, Laird’s testimonial assumes that musical hunger has something to do with professional music educators; that musical hunger and satisfaction while setting the beat for a person’s musical life are not simply biological functions—something that exists and stays no matter how and what the person is fed or where and with whom the person eats. As Dewey wrote,[t]he very tendency of the child, while hungry, to recall his previous satisfaction, and to anticipate the coming one, is the beginning of the recognition of time. It grows more definite and accurate just in the degree in which all experiences are related to each other as members of one whole.2The imaginative musical dinner table that Laird’s testimonial lays out calls for music educators to reflect upon what kind of meal is served, not only from their own perspective but also from that of their students. Yet, reconstructing the menu is demanding in a profession that struggles with the pros and cons of a tradition in which teachers have learnt to teach in the same way that they themselves have been taught, also teaching using the same order in which they have learned—only hoping to do it more effectively.Quite recently, when visiting the recording studio at the Sibelius Academy department of music education to listen to one of my student’s work with her own rock band, I was reminded by my own remembrances of the difficulty, as well as the necessity, of reconstructing traditions in music teacher education. My thoughts led me fleetingly back to the ‘70s when making arrangements, improvisations, or working in recording studios were part of my musical life, until they were overwhelmed by the then-prevalent diet of professional music studies. Although my experiences of general music education were similar to those of Laird, teachers in the specialized music school fed me with goal-directed instruction in more than one instrument, in music theory, solfege, and the history of Western [End Page 81] art music. Looking back, however, I was lucky in more ways than one: my adolescent leisure time was blessed with numerous choirs, orchestras, and gigging bands—bringing a self-organized satisfaction and motivation to all kinds of music and musical activities. Multiple diets were feeding my musical life: I obtained the strengthening vitamin drops and enjoyed my self-made smorgasbord with family and friends, none of which had been enough by themselves to lead me into the profession. Yet, when entering the university to pursue my professional music studies, I experienced events in reverse order to that which Lucy Green describes in How Popular Musicians Learn.3 As I then did not have a piano of my own, I only had the opportunity to practice what was necessary for exams and so I practically stopped playing for fun. I also realized that not all flute teachers were able to accompany their students as did my first teacher, and so I had to play my flute repertoire for most of the year only imagining how the pieces would sound as a whole with no community with whom to share the joy of music making. While watching my student working in front of the studio desk searching for the right bass sound for her own song—a song that she was performing with friends and fellow students—to give the song the final touch for her work for the pedagogy of African-American music (popular music) course, to my own surprise I suddenly felt a long-forgotten hunger and desire. I was reminded of the challenges facing teacher education in exemplifying by its own practices a music education that does not take for granted that particular subject content or official... (shrink)

Although inclusion in formal value chains extends the prospect of improving the livelihoods of rural small-scale producers, such a step is often contingent on compliance with internationally-promoted food safety standards. Limited research has addressed the challenges this represents for small rural producers who, grounded in culturally-embedded food safety conceptions, face difficulties in complying. We address this gap here through a multiple case study involving four public school feeding programs that source meals from local rural providers in the Bolivian (...) Altiplan. Institutional logics theory is used to describe public food safety regulations and to compare them to food safety conceptions in the local indigenous Aymara rural setting. We identify a value-based conflict that leads to non-compliance of formal food safety rules that jeopardizes the participation of small farmers in the market. These include: partial adoption of formal rules; selective adoption of convenient rules; and ceremonial adoption to avoid compliance. Decoupling strategies allow local actors to largely disregard the formal food safety regulations while accommodating traditional cultural practices and continuing to access the market. However, these practices put the long-term sustainability of the farmers’ participation in potentially favorable opportunities at risk. (shrink)

Withdrawing Artificial Nutrition and Hydration in the neonatal intensive care units has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders’ experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 (...) different clinical neonatology departments. We interviewed both the parents and some of the HCP who cared for the baby, at least 6 months after this latter deceased. We proceeded through in-depth individual qualitative interviews. Content was analyzed for themes and patterns that emerged from the data. Some parents expressed that WANH offered an opportunity to the family to spend a few demedicalized days with the baby before she dies, without any tubes and machines, and to be well supported by the HCP during this palliative stage. But others evaluated the practice in retrospect as a terrible ordeal. All said that, at least, the time of waiting for death to ensue should not last too long. After a few days, it becomes unbearable because of the transformation of the baby’s appearance and because they, as parents, began to wonder if she was not dying from starvation rather than from her initial disease. An important proportion of HCP also expressed some kind of ethical unease. This was due to the psychological violence involved in the decision for a human being to stop feeding a little one, and also to the difficulty to deal with the fundamental intention behind the decision of WANH: indeed, could it be claim that it does not presuppose the intention of provoking the infant’s death? The discussion focuses on the point to know if WANH can be considered as a source of progress from an ethical point of view, particularly in comparison with earlier practices—that in France could involve active euthanasia by lethal injection. We argue that when HCP are merely focused on avoiding that WAHN could be construed as a way of intending to hasten the baby’s death, the practice is at risk to be implemented in a way that becomes ethically counterproductive. Focusing on this intention easily distract the clinical teams from what should be their ultimate concern, namely the baby’s comfort during the dying process, as well as the support owned to her parents. To conclude, we suggest that the ethical priorities, when WANH is decided, should be the support due to the patient and her family on the one hand, and, on the other hand to implement it in such a way that at least the baby seems to have died of her initial disease and never of starvation. This means that HCP have a duty to control the timing of death, even though this might be incompatible with the worry to avoid the intention of hastening the baby’s death. (shrink)

Informed consent may be unobtainable in online contexts. This article examines the difficulties of obtaining informed consent online through a Facebook case study. It is proposed that there are at least two ways informed consent could be waived in research: first, if the data are public, and second, if the data are textual. Accordingly, the publicness of the Facebook News Feed is considered. Taking account of the wide availability of Facebook users’ data, and reflecting on how public those users (...) perceive their information to be, this paper argues that some Facebook data are properly viewed as public to semi-public in nature. A second issue is whether the Facebook News Feed data collection ought to be classified as document-based or human subjects research. Since the Facebook News Feed involves social interaction that may elicit ‘ethically important moments’, this paper proposes that observing it may constitute human subjects research. While informed consent is desirable for human subjects research, it is suggested that Facebook News Feed observations are comparable to observational research in a public space, and thus waiving informed consent in this online setting could be justifiable. (shrink)

In this essay I consider the question that divides quetism from existentialism and to defend a particular line on that question. The essay is in three main sections. In the first I set out a view of philosophy under which it grows out of reflection on the views that shape ordinary practice. In the second section I outline a theory as to how exactly practice commits us to such views. And then in the third section I argue on the basis (...) of that account that, notwithstanding serious difficulties, philosophy can feed back onto the views that inform practice and recast them in various ways. I reject the existentialist vision according to which there is no limit to how far philosophy may lead us to reconstruct ourselves. But I also reject the quietist view that philosophy must leave everything as it was. Under the picture adopted, philosophy can be expected to have a threefold impact--meditative, methodological, and moral--on people's habits of experience and behaviour. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Birth of the Psychoanalytic Hero:Freud's Platonic LeonardoJohn FarrellThough the intellectual force of Freudian psychoanalysis grows weaker and weaker with time, its importance for the understanding of twentieth-century intellectual culture only increases. Freud made psychology a key ingredient in the century's conception of its own uniqueness and modernity. He claimed to initiate a decisive break with the past, but he also claimed to recover the past, indeed all of (...) human behavior, on new, scientific grounds. What Freud proposed was not just a new way of thinking about psychology but a new psychology, one that would permit unprecedentedly intrepid investigation of the past and the unconscious sources of its ways of thinking. But whereas Freud hoped to give us a new psychology of knowledge, what he did was to reintroduce one of the oldest psychologies of knowledge in a moderately disguised form. I will attempt to show this and assess the implications through a close examination of Freud's treatment of Leonardo da Vinci, a man he considered one of the great forerunners of the modern intellect.Psychoanalysis is both a theory of the psyche and a scientific movement. Its dual nature makes it almost a unique element in the culture of modern science. Freud and his followers repudiated the separation between institutional affiliation and intellectual commitment that had been carried down from seventeenth-century England. The original form of the psychoanalytic movement was a throwback to that of the ancient philosophical academies.1 Almost from the beginning of psychoanalysis its founders had recourse to a canon of dogma with the primacy of the libido at its center. Adherence to this canon, and the rituals of initiation and training surrounding it, became the basis for [End Page 233] an exclusive intellectual and professional commitment that separated initiates from the professional community at large.It is well known that the founders of psychoanalysis made use of psychoanalytic theory to explain the movement's adversarial relationship with the outside world. The doctrine of resistance to the libido allowed Freudians to interpret the hidden motives of anyone who might disagree with them. The ire of critics could be cited as proof of the intensity of unconscious repression applied to sexuality, the incredulity of unbelievers as evidence of an unwillingness to endure the wounds to human narcissism exacted by the Freudian system, and even slips of the tongue could be turned against unwitting opponents. The fact that psychoanalysis was greeted with hostility in some quarters was taken to prove that the universal tendency of humankind was to resist its teachings, and the lapsing away of prominent disciples illustrated the difficulty of living with these hard truths. Heretics were pitied as weaklings unable to face up to the power of the unconscious, unable to keep themselves from disguising it with it some pale reflection of the ego. And so the embattled history of psychoanalysis became part of the empirical evidence of its validity in a way that could never have occurred with a theory generated in the normal research environment. The doctrine of resistance seemed to have been designed as much for polemical as for analytic purposes. Like the monster in Forbidden Planet, the fifties Freudian fairy tale, the more psychoanalysis was resisted, the more it grew. The self-confirming value that could be derived from the history of the movement as a cultural scandal even led Freud to exaggerate the hostility of his early reception and the intensity of his early isolation. With the doctrine of resistance, Freud had imported into science the style of the avant-garde, which feeds upon rejection, outrage, and the breach of bourgeois manners. The concept of "resistance to psychoanalysis" is still in use among psychoanalysts today.The argument from resistance, however useful it may have been as a defense mechanism of psychoanalytic rhetoric, leads to a troubling theoretical question: If the truths of psychoanalysis are naturally repugnant to humankind, so much so that we have a powerful constitutional tendency to hide them from ourselves, what could have liberated Freud and his followers to unearth these unwelcome secrets from the depths of their own psyches? If we take the "resistance to psychoanalysis" as a... (shrink)

The purpose of this study is to examine how financial stress affects academic performance among university students in South East Nigeria. By using descriptive statistics and the Chi-Square model, we examined the relationship between financial stress and academic outcomes among 250 participants from five South Eastern universities. Several key factors contributing to financial stress were examined such as students’ monthly income, medical bills cost, ability to save, academic materials cost, student borrowing levels, and cost of feeding. The findings indicate (...) that students’ monthly income and the cost of medical bills are the key determinants of financial stress among students. Based on the second objective, the study revealed that inability to pay bills as student, the inability to purchase required academic materials (books, course packs, supplies) due to their high costs, difficulties in paying school fees, and work schedules are the most significant factors that contribute to financial stress which negatively affect academic performance for students. Therefore, we recommend that government should enhance its financial assistance programs to alleviate financial stress among university students as this will improve their academic performance. Also, Collaboration with external stakeholders, can further enhance the resources available to students in need. Finally, this study illustrates the detrimental effects of financial stress on academic performance among university students in southeast Nigeria and should be interpreted with caution as its limited to South-East Nigeria. (shrink)

Recent research on the metaethical beliefs of ordinary people appears to show that they are metaethical pluralists that adopt different metaethical standards for different moral judgments. Yet the methods used to evaluate folk metaethical belief rely on the assumption that participants interpret what they are asked in metaethical terms. We argue that most participants do not interpret questions designed to elicit metaethical beliefs in metaethical terms, or at least not in the way researchers intend. As a result, existing methods are (...) not reliable measures of metaethical belief. We end by discussing the implications of our account for the philosophical and practical implications of research on the psychology of metaethics. (shrink)

In this article, we examine the emergence of a concept of medical feeding that emphasizes artificiality and medical technology. We discuss how this concept has been created in specific contrast to the daily provision of food and water; medical definitions retain clear disjunctures with cultural and religious beliefs surrounding food, gendered aspects of eating and feeding, and the everyday practices of social and family life in the United States. We begin with an examination of the historical processes involved (...) in creating artificial nutrition and hydration as a medical concept, including the evolution of terminology and practices in relation to technology advancement, legal cases, and public discourse. We.. (shrink)

In Free Will, Agency, and Meaning in Life, Derk Pereboom proposes an optimistic model of life that follows on the rejection of both libertarian and compatibilist beliefs in free will, moral responsibility, and desert. I criticize his views, focusing on punishment. Pereboom responds to my earlier argument that hard determinism must seek to revise the practice of punishment in the direction of funishment, whereby the incarcerated are very generously compensated for the deprivations of incarceration. I claimed that funishment is a (...) practical reductio: of hard determinism. Pereboom replies, but I claim that he misses a key component of my reductio, the idea that moving in the direction of funishment will considerably weaken the deterrence of potential criminals so that hard determinism becomes self-defeating in practice. Beyond the challenge of funishment, I raise various other difficulties with Pereboom’s model, concerning its deeply unintuitive implications, the harm it does to the motivation of potential criminals, its weakness in resisting utilitarian-like dangers, and more. Our conclusions should lead to a re-evaluation of the compatibilist interpretation of moral life, as a richer, more plausible, and safer interpretation than hard determinism. This needs to be combined with a true hard determinist acknowledgment of the deep injustice and tragedy involved in punishment in light of the absence of libertarian free will. Such a complex view will come closer to doing justice to notions of justice, morality, and decency. (shrink)

Mental time travel and language enable us to go back and forth in time and to organize and express our personal experiences through time reference. People with Alzheimer’s disease have both mental time travel and time reference impairments, which can greatly impact their daily communication. Currently, little is known about the potential relationship between time conceptualization (i.e., mental time travel) and time reference difficulties in this disease. A systematic review of the literature was performed to determine if this link (...) had already been investigated. Only three articles integrated both time conceptualization and time reference measures. However, the link between the two was not systematically analyzed and interpreted. This review highlights the lack of research addressing the question of the influence of time conceptualization impairments in Alzheimer’s disease on other cognitive domains, and especially language. (shrink)

The current study aimed to investigate the extent to which familial history of reading and math difficulties have an impact on children’s academic outcomes within a 3-year longitudinal study, which evaluated their core reading and math skills after first and second grades, as well as performance on complex academic tasks after second and third grades. At baseline, parents were asked to complete the Adult Reading History Questionnaire and its adaption, Adult Math History Questionnaire, to index familial history of reading (...) and math difficulties, respectively. Preliminary findings established the psychometric properties of the AMHQ, suggesting that it is a reliable and valid scale. Correlation analyses indicated that the ARHQ was negatively associated with children’s reading skills, whereas the AMHQ was negatively related to math outcomes. Path results revealed that the ARHQ predicted children’s performance on complex reading tasks indirectly via their core reading skills, and the AMHQ was linked to complex math outcomes indirectly via core math abilities. The ARHQ was also found to be negatively correlated with measures of children’s math performance, with path findings suggesting that these relations were indirectly explained by differences in their core reading skills. These results suggest that assessing familial risk for academic difficulties may be crucial to understanding comorbid etiological and developmental associations between reading and math differences. (shrink)

Both Hegel and the later Wittgenstein were concerned with the problem of how to begin speculation, or the problem of beginning. I argue that despite many differences, there are surprising similarities between their thinking about the beginning. They both consider different kinds of beginnings and combine them into complex analogies. The beginning has a subjective and an objective moment. The philosophizing subject has to begin with something, with an object. For Hegel, the objective moment is pure being. For Wittgenstein, the (...) objective moment is something that cannot be doubted. As regards the subjective moment, the philosophizing subject has to decide, without any reason, to conclude her quest for the presuppositionless beginning and finally begin at the beginning. The arational moment of this decision is echoed throughout any rational thought. Any application of a (rational) rule is, ultimately, a blind decision to apply this rule. (shrink)

Growing literature has linked attention bias variability to the experience and treatment of posttraumatic stress disorder. Unlike assessments of attention bias in only one direction, A...

In modern zoos, enrichment programs have become a standard part of animal care routines. Although 'higher' primates usually receive complex enrichment programs, encompassing many types of enrichment, these are less common for prosimians. These animals often largely receive food-based enrichment, as was previously the case at Auckland Zoo, where the ring-tailed lemur enrichment schedule contained only three different items, all food-related. Lemurs tend to be considered less curious and quick to learn than other primates, as well as being less manually (...) dextrous, and for these reasons can be overlooked for complex enrichment. However, they have strong sensory abilities, in particular an acute sense of smell (Sauther et al 1999). This paper describes an enrichment program designed for the lemurs at Auckland Zoo with the aim of stimulating all senses. (shrink)

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more (...) generally in other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities. (shrink)

It is shown in this article in how far one has to have a clear picture of Gödel’s philosophy and scientific thinking at hand (and also the philosophical positions of other philosophers in the history of Western Philosophy) in order to interpret one single Philosophical Remark by Gödel. As a single remark by Gödel (very often) mirrors his whole philosophical thinking, Gödel’s Philosophical Remarks can be seen as a philosophical monadology. This is so for two reasons mainly: Firstly, because it (...) pictures a monadology already via its form. And secondly, because Gödel wanted to establish in his Philosophical Remarks a modern monadology in adapting the philosophical principles of Leibniz’s monadology to modern science. This article will only deal with the first aspect that has been mentioned namely that a single remark by Gödel (very often) mirrors his whole philosophy (at the time) for example: set theory, perception and intuition of mathematical objects and axioms, the nature of the human mind, the concept and existence of God, and so on. This renders it extremely difficult to interpret Gödel’s philosophical remarks but interpreting it provides also a deep insight in Gödel’s philosophical thoughts. (shrink)

Feed-forward Pavlovian conditioning can serve as a proximate mechanism for the evolution of social behavior. Feed-forward can provide the impetus for animals to associate other individuals' presence, and cooperation with them, with the acquisition of resources, whether or not the animals are genetically related. Other social behaviors such as play and grooming may develop as conditioned stimuli in feed-forward social systems.

This paper focuses on 3 features of Freyenhagen's Aristotelian version of Adorno. (a) It challenges the strict negativism Freyenhagen finds in Adorno. If we have morally relevant interests in ourselves, it is implicit that we have a standard by which to understand what is both good and bad for us (our interests). Because strict negativism operates without reference to what is good, it seems to be detached from real interests too. Torture, it is argued, is, among other things, a violation (...) of those interests. (b) Freyenhagen identifies the “impulse” in Adorno as an untutored yet moral reaction to morally demanding situations. The plausibility of this primitivism and its compatibility with Adorno's general worries about immediacy are considered. (c) The disruptive character of Adorno's version of the categorical imperative, its willingness to complicate action through wholesale reflection on the norms of what we are committing ourselves to, is set in contrast with Freyenhagen's Aristotelian claim that certain notions, such as “humanity,” cannot be intelligibly questioned. (shrink)

Whilst it is generally accepted that breast-feeding lowers the likelihood of conception, this relationship is not straightforward and there appears to be a wide variation in the effectiveness of the association between individual mother-infant pairs. Up to about 6 months post-partum breast-feeding probably can be used as a family planning method, with up to 98% effectiveness if behavioural guidelines are adhered to . But beyond this time significant variations appear between different countries, and even different communities within countries, (...) which make any overall recommendation impossible. To understand the reasons for variation in the duration of lactational infecundity it is necessary to understand the mechanisms involved, but knowledge of these processes is still far from complete. There are, nevertheless, enough data to indicate that suckling and maternal milk output are intimately linked with the return of fecundity. (shrink)

The use of Nasogastric (NG) feeding in the provision of artificial nutrition and hydration at the end of life has, for the most part, been regarded as futile by the medical community. This position has been led chiefly by prevailing medical data. In Singapore, however, there has been an increase in its utilization supported primarily by social, religious and cultural factors expressly to prolong life of the terminally ill patient. Here this article will seek to review the ethical and (...) clinical impact of this treatment and provide some understanding for such decisions in the light of the Duty of Palliative Care [DoPC]. Complemented by virtue ethics theory, the DoPC highlights and seeks to realize the individual case specific goals of care that maximize comfort and quality of life of the patient in the face of rapid attenuation of treatment options and the eminence of the final outcome by considering each of these factors individually in order to provide the best outcome for the patient and the family. (shrink)