Obwohl die Substitutionsbehandlung nachweislich den Gesundheitszustand opiatabhängiger Patienten verbessern und die Beschaffungskriminalität reduzieren kann, bestehen enge gesetzliche Regelungen, die die Therapiefreiheit der behandelnden Ärzte stark begrenzen: So werden durch das Betäubungsmittelgesetz und die zugehörigen Verordnungen nicht nur das Behandlungsziel (Abstinenz) sondern auch notwendige Therapiebausteine definiert, die darauf ausgerichtet sind, die Therapietreue des Patienten zu kontrollieren. Deutsche Ärzte, die die strengen Auflagen nicht strikt befolgten, wurden zu Gefängnisstrafen verurteilt. Wie der Artikel zeigt, fördern die bestehenden Gesetze eine „kontrollierende“ statt einer motivierenden (...) ärztlichen Behandlung, ohne wichtige Ziele, wie den Schutz der Allgemeinheit vor einer illegalen Verbreitung illegaler Opioide, vollständig zu erreichen. Zusammenfassend zeigt der Artikel, dass eine stärker am Wohl der Patienten ausgerichtete Substitutionsbehandlung (einschließlich notwendiger Kontrolluntersuchungen) mit hoher Wahrscheinlichkeit auch die Öffentlichkeit wirksamer vor den potenziellen Gefahren einer illegalen Verbreitung von gefährlichen Opioiden schützt als die Befolgung abstrakter, restriktiver gesetzlichen Normen. (shrink)

Disease-mongering, or the medicalisation of aspects of daily life in an attempt to generate commercial profit for a party other than the person whose complaint is medicalised, is a newly recognized and legitimate source of concern for both consumers and deliverers of health care. The interest brought to this area by the academy has the potential to acknowledge and address the consequences of the practice. However, before disease-mongering can establish itself firmly as an area of scholarly concern, researchers must understand (...) that the critique is not just about identifying commercial intent, but also about naming the mechanism through which discourses of health, cure and self-management are positioned. In this paper, I argue that a critical reflection on the construction of disease concepts and the mongering of their cure must include discussions of the foundations of health and the clinical encounter. I identify a number of pivotal issues within these themes that should be explored in order to ensure an unambiguous and productive discussion of disease-mongering and its correlates. (shrink)

Do Heidegger-teabags give philosophy a bad name? An essay about philosophy for the general public Among many academic philosophers, philosophy for the general public has a bad reputation. In this paper I give an overview of the main points of criticism, and use these to develop a positive account of what good philosophy for the general public could be. As a first step towards such an account, I outline different views on how philosophy for the general public can relate to (...) academic philosophy. Subsequently, I argue that what makes philosophy for the general public ‘good’, is just what makes philosophical work in general ‘good’: good philosophical work has a philosophical aim, employs philosophical methods and employs these methods in a sound way. Finally I argue that communicability of philosophical ideas should not be seen as a bonus feature but as the sine qua non of philosophical thinking: if academic philosophy paid more attention to communicability, we might not even need a distinct discipline of philosophy for the general public. I conclude with some concrete suggestions for improving such communicability. (shrink)

The recent discovery of a manuscript has allowed historians to understand the medical routine in a hospital known as the Schneidhaus in Augsburg between the sixteenth and nineteenth century. The context of the manuscript shows that at this institution, non-academic specialists, generally members of the guild of barber-surgeons and barbers, routinely performed surgical cures of intestinal hernia, scrotal swellings, and vesical calculus. The Schneidhaus exclusively admitted patients applying for such specialised treatments and offered no other services. Such a degree of (...) specialisation within medical establishments seems to have only existed in the Holy Roman Empire at this institution founded by the Fugger family in Augsburg. We propose that the Schneidhaus was either itself a model hospital or adopted a model from another site in Europe. In this paper, we investigate the connections of the Schneidhaus to the practice of surgeons in both Italy and Spain. In Italy, a momentous new technique for identifying and removing vesical calculi was first published in 1522. Although surgical treatment was established in Italian hospitals, they tended not to specialise in such surgical treatment exclusively. Moreover, at the time of the hospital’s foundation, the Fugger shifted their economic and social focus from Venice to the Iberian Peninsula. In Spain, research in the history of medicine is complicated by outdated notions about specialised surgery, not unlike those that were recently still current regarding the Holy Roman Empire. We attempt to disprove these notions and use the exemplary textbook of one academic physician, Francisco Díaz, to approach specialized surgical practice in sixteenth-century Spain. In his work, Díaz describes the new Italian surgical method in detail and recognizes the importance of craftsman surgeons to both its development and application. However, he also argues for an expanded role for academic physicians as supervisors of craftsman surgeons’ work. All this is suggestive of a greater network of surgical professionals within which both the methods of the craft and its organisational structures were transported. As such, the Schneidhaus can be seen as a node that embodied the institutionalization of surgical practice as a European phenomenon. Further research is necessary, and we propose how this might be carried out to reveal these historical phenomena in their full complexity. (shrink)

Children themselves place a high value on their own spiritual care when in hospital. However, the spiritual care of children in hospital is often overlooked. Hospitalisation and medical procedures can be traumatic and overwhelming for children, they often see hospitalisation as punishment for something they did wrong and they can even experience spiritual distress during illness and suffering. The spiritual care of hospitalised children should thus be a priority to help these children making sense of pain and suffering, and assisting (...) them to connect with a loving and forgiving God. Spirituality namely influences a diverse range of human concerns such as beliefs about illness and health, fears, relationships with family and friends and the experience of pain and suffering. Unfortunately, children often harbour misconceptions precisely in these areas. This article will draw directly on the given that children are concrete thinkers, yet able to have an understanding of holiness and God as the Holy One, if they receive the right guidance. The study will explore children’s spirituality and the way in which they experience holiness in the healthcare environment from a nursing science perspective. (shrink)

Centering Women of Color in Academic Counterspaces offers a rich multidimensional account of teaching, learning, and classroom dynamics among diverse students in a classroom counterspace centered on women of color. This book provides insights into learning outcomes, the process of transformational learning, and some of the challenges related to covering social justice topics like oppression, intersectionality, identity, beauty, body image, and inclusive leadership in a college classroom.

Much of the time, human beings seem to rely on habits. Habits are learned behaviours directly elicited by context cues, and insensitive to short-term changes in goals: therefore they are sometimes irrational. But even where habitual responses are rational, it can seem as if they are nevertheless not done for reasons. For, on a common understanding of habitual behaviour, agents’ intentions do not play any role in the coming about of such responses. This paper discusses under what conditions we can (...) say that habitual responses are, after all, done for reasons. We show how the idea that habitual behaviour cannot be understood as ‘acting for reasons’ stems from a widely but often implicitly held theoretical framework: the causal theory of action. We then propose an alternative, Anscombean understanding of intentional action, which can account for habitual responses being done for reasons. (shrink)

A well‐known typological observation is the dominance of subject‐initial word orders, SOV and SVO, across the world's languages. Recent findings from gestural language creation paradigms offer possible explanations for the prevalence of SOV. When asked to gesture transitive events with an animate agent and inanimate patient, gesturers tend to produce SOV order, regardless of their native language biases. Interestingly, when the patient is animate, gesturers shift away from SOV to use of other orders, like SVO and OSV. Two competing hypotheses (...) have been proposed for this switch: the noisy channel account (Gibson et al., 2013) and the role conflict account (Hall, Mayberry, & Ferreira, 2013). We set out to distinguish between these two hypotheses, disentangling event reversibility and patient animacy, by looking at gestural sequences for events with two inanimate participants (inanimate‐inanimate, reversible). We replicated the previous findings of a preference for SOV order when describing animate‐inanimate, irreversible events as well as a decrease in the use of SOV when presented with animate‐animate, reversible events. Accompanying the drop in SOV, in a novel condition we observed an increase in the use of SVO and OSV orders when describing events involving two animate entities. In sum, we find that the observed avoidance of SOV order in gestural language creation paradigms when the event includes an animate agent and patient is driven by the animacy of the participants rather than the reversibility of the event. We suggest that findings from gestural creation paradigms are not automatically linkable to spoken language typology. (shrink)

Recent studies of scientific interaction based on agent-based models suggest that a crucial factor conducive to efficient inquiry is what Zollman has dubbed ‘transient diversity’. It signifies a process in which a community engages in parallel exploration of rivaling theories lasting sufficiently long for the community to identify the best theory and to converge on it. But what exactly generates transient diversity? And is transient diversity a decisive factor when it comes to the efficiency of inquiry? In this paper we (...) examine the impact of different conditions on the efficiency of inquiry, as well as the relation between diversity and efficiency. This includes certain diversity-generating mechanisms previously proposed in the literature, as well as some factors that have so far been neglected. This study is obtained via an argumentation-based ABM. Our results suggest that cautious decision-making does not always have a significant impact on the efficiency of inquiry while different evaluations underlying theory-choice and different social networks do. Moreover, we find a correlation between diversity and a successful performance of agents only under specific conditions, which indicates that transient diversity is sometimes not the primary factor responsible for efficiency. Altogether, when comparing our results to those obtained by structurally different ABMs based on Zollman’s work, the impact of specific factors on efficiency of inquiry, as well as the role of transient diversity in achieving efficiency, appear to be highly dependent on the underlying model. (shrink)

Donald C. Ainslie's Hume's True Scepticism is a wonderful book—clearly written and forcefully argued—and was deservedly honored with Journal of the History of Philosophy's Book Prize for 2016. The focus of the book is part four of the first Book of Hume's Treatise, "Of the sceptical and other systems of philosophy." Ainslie develops an interpretation that takes seriously Hume's psychological claims, using them to solve puzzles in Hume scholarship, including the extent of Hume's scepticism, the nature of his sceptical crisis, (...) and the basis for his second thoughts on personal identity.I would encourage Ainslie to go further in tracing Hume's psychological explanations. In what follows, I will... (shrink)

It would be hard to imagine medical care without diagnosis, so pivotal is it to how Western medicine is practiced. Diagnosis is one of medicine’s principle tools, bringing with it as it does an explanation for what ails the sick person, an idea of what the treatment options might be, a prognosis, and much more. It assigns responsibility for illness, within medicine and outside. It will determine which specialty or sub-specialty can take care of which disorders. It also explains causation, (...) pointing the finger variably at the patient for what she ought to have done, or to the gene for what one can do little about. Diagnosis structures and explains relationships as it provides the impetus for the sick.. (shrink)

After the introduction of the fifth Diagnostic and Statistical Manual of Mental Disorders, familiar voices were raised in protest. The voices stem from ideas of which, among others, and in different ways, Michel Foucault and Thomas Szasz were influential proponents: The movement was referred to as 'antipsychiatry.' This movement reacted, among other things, to the system of categorization of mental disorders. Diagnoses, in a system of classification, were thought to be vague, arbitrary, labelling, stigmatizing, and scientifically and clinically poorly validated. (...) In contemporary debates on DSM-5, similar critiques can be heard, expressed by a movement now referred to as 'critical psychiatry'... (shrink)

Cognitive Science, Volume 46, Issue 2, February 2022.

Schellings Freiheitsschrift behandelt sowohl einen modernen, positiven Begriff von Freiheit, als auch die Nacht- und Schattenseiten der Freiheit, verbunden mit dem Begriff des Bosen und der Frage der Theodizee. Die Diskussion der Freiheitstheorie wird hier auf eine erst kurzlich wieder ins Blickfeld der Metaphysik geratene spekulative Weise vertieft. Die uberarbeitete Neuauflage erschliesst Schellings Text auf dem aktuellen Stand der Forschung.".

Even the simplest narratives combine multiple strands of information, integrating different characters and their actions by expressing multiple perspectives of events. We examined the emergence of referential shift devices, which indicate changes among these perspectives, in Nicaraguan Sign Language (NSL). Sign languages, like spoken languages, mark referential shift grammatically with a shift in deictic perspective. In addition, sign languages can mark the shift with a point or a movement of the body to a specified spatial location in the three-dimensional space (...) in front of the signer, capitalizing on the spatial affordances of the manual modality. We asked whether the use of space to mark referential shift emerges early in a new sign language by comparing the first two age cohorts of deaf signers of NSL. Eight first-cohort signers and 10 second-cohort signers watched video vignettes and described them in NSL. Narratives were coded for lexical (use of words) and spatial (use of signing space) devices. Although the cohorts did not differ significantly in the number of perspectives represented, second-cohort signers used referential shift devices to explicitly mark a shift in perspective in more of their narratives. Furthermore, while there was no significant difference between cohorts in the use of non-spatial, lexical devices, there was a difference in spatial devices, with second-cohort signers using them in significantly more of their narratives. This suggests that spatial devices have only recently increased as systematic markers of referential shift. Spatial referential shift devices may have emerged more slowly because they depend on the establishment of fundamental spatial conventions in the language. While the modality of sign languages can ultimately engender the syntactic use of three-dimensional space, we propose that a language must first develop systematic spatial distinctions before harnessing space for grammatical functions. (shrink)

In his 1963 response to an open letter from eight white religious leaders chastising his involvement in Birmingham, Martin Luther King, Jr. explained that civil rights activists’ blatant breaking of some laws while obeying others was the result of two types of laws: just laws and unjust laws. Civil rights activists believed they had a legal responsibility to obey just laws and a moral responsibility to disobey unjust laws. Today, new civil rights struggles continue to challenge unjust laws that shred (...) the fabric of democracy that America espouses. Drawing upon both the Civil Rights Movement and the contemporary Movement for Black Lives, this article argues that unjust laws and practices must be broken and challenged before a just society is established. It identifies four ethical strategies for social activism: collective work and responsibility, strategic timing and economic disconnection, political mobilization, and faithful perseverance. (shrink)

A large body of information and opinion related to COVID-19 is being shared via social media platforms. Recent reports have raised concerns about the reliability and verifiability of said information being disseminated and the way systems, processes and design of the platforms facilitates such spread. This, alongside other areas of concern, has resulted in several social media platforms taking steps towards tackling the spread of mis- and dis-information. Here we discuss approaches to online public health messaging from a range of (...) sources during COVID-19, with a focus on official and non-official sources in the United Kingdom. We highlight issues for ongoing public health decisions, and the potential impact for the future course of the pandemic. (shrink)

Why is the number seven lucky--even holy--in almost every culture? Why do we speak of the four corners of the earth? Why do cats have nine lives? From literature to folklore to private superstitions, numbers play a conspicuous role in our daily lives. But in this fascinating book, Annemarie Schimmel shows that numbers have been filled with mystery and meaning since the earliest times, and across every society. In The Mystery of Numbers Annemarie Schimmel conducts an illuminating tour (...) of the mysteries attributed to numbers over the centuries. She begins with an informative and often surprising introduction to the origins of number systems: pre-Roman Europeans, for example, may have had one based on twenty, not ten, while the Mayans had a system more sophisticated than our own. Schimmel also reveals how our fascination with numbers has led to a rich cross-fertilization of mathematical knowledge: "Arabic" numerals, for instance, were picked up by Europe from the Arabs, who had earlier adopted them from Indian sources. But the heart of the book is an engrossing guide to the symbolism of numbers. Number symbolism, she shows, has deep roots in Western culture, from the philosophy of the Pythagoreans and Platonists, to the religious mysticism of the Cabala and the Islamic Brethren of Purity, to Kepler's belief that the laws of planetary motion should be mathematically elegant, to the unlucky thirteen. After exploring the sources of number symbolism, Schimmel examines individual numbers ranging from one to ten thousand, discussing the meanings they have had for Judaic, Christian, and Islamic traditions, with examples from Indian, Chinese, and Native American cultures as well. Two, for instance, has widely been seen as a number of contradiction and polarity, a number of discord and antithesis. And six, according to ancient and neo-platonic thinking, is the most perfect number because it is both the sum and the product of its parts. Using examples ranging from the Bible to the Mayans to Shakespeare, she shows how numbers have been considered feminine and masculine, holy and evil, lucky and unlucky. A highly respected scholar of Islamic culture, Annemarie Schimmel draws on her vast knowledge to paint a rich, cross-cultural portrait of the many meanings of numbers. Engaging and accessible, her account uncovers the roots of a phenomenon we all feel every Friday the thirteenth. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)