In developing nations, the implementation of Foundational Identity Systems (FIDS) has optimised service delivery and inclusive economic growth. Cross-border e-government will gain traction as developing countries increasingly look to identity federation and trustworthy interoperability through FIDS for the identification and authentication of identity holders. Despite this potential, the interoperability of FIDS in the African identity ecosystem has not been well-studied. Among the difficulties in this situation are the intricate internal political dynamics that have led to weak institutions, suggesting that FIDS (...) could be used for political purposes; additionally, citizens’ or identity holders’ habitual low trust in the government raises concerns about data security and privacy protection. Similarly, vendor lock-in, cross-system compatibility, and ambiguous legislative rules for data exchange are other concerns. Interoperability is fundamentally necessary as a precondition for e-government services and serves as the foundation for the best possible service delivery in the areas of social security, education, and finance, as well as gender equality as demonstrated by the European Union (EU). Moreover, the integration of cross-border FIDS and an ecosystem of effective data governance will be created by unified data sharing via an interoperable identity system. Thus, in this study, we point to the challenges, opportunities, and requirements for cross-border interoperability in an African setting. Furthermore, we investigated current interoperability solutions such as the EU’s eIDAS and Estonian X-Road and proposed an approach for scoping requirements to achieve a fully functional interoperable identity ecosystem in the African setting. Our findings show that interoperability in the African identity ecosystem is essential for expanding the scope of e-government throughout the continent and for bolstering the smooth authentication and verification of identity holders for inclusive economic growth. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Creativity Belongs to the Person, not to DiseaseJuan J. López-Ibor Jr. (bio) and María-Inés López-Ibor (bio)Keywordscreativity, patho-biography, Saint Teresa, visionsIn the paper, “From the Visions of Saint Teresa of Jesus to the Voices of Schizophrenia,” Cangas, Sass, and Pérez-Álvarez (2008) take an original approach to patho-biography that is very welcome.The temptation to designate historical individuals or characters of fiction as suffering from mental disease has always produced (...) disagreeable feelings in me. This sort of abuse of psychiatry and of the people in question is parallel to the abuse by the media or lay citizens when they describe, say, an especially violent murderer as a schizophrenic—forgetting that the vast majority of people with schizophrenia are not in the least violent. Having read Santa Teresa’s writings during my adolescence, well before I even considered entering medicine, I reacted to comments about her alleged psychiatric illnesses with uneasiness, to put it mildly. The Santa Teresa of La Vida de la Santa Madre Teresa de Jesús (her autobiography), of the Camino de Perfección, and of the El Castillo Interior was surely not a mental patient, it seemed to me. The same would apply to San Juan de La Cruz, Jean D’Arc, Don Quijote, Sancho Panza, Edipus, and Clitemnestra, to mention a few. Even van Gogh’s paintings did not seem to me the productions of a patient with schizophrenia or epilepsy. Of course all of them may have suffered, at certain periods of life, symptoms attributable to a mental disorder, but their creativity rested elsewhere, and was often manifest during healthy periods of their lives. After years spent fighting the stigma of mental diseases, and after organizing several exhibitions of works of art of people with mental diseases, we came to the conclusion that creativity and singularity belong to the person, not to the illness. Some of the diseases of these individuals may have being accidents (van Gogh’s hallucinations and psychotic symptoms, for example, were most probably due to intoxications with absinthe, then rich in hallucinogenic alkaloids such as tujone), or, together with other life circumstances, may have had unspecific influences on the person’s condition. In contrast with many other psychiatric disorders that are represented in ancient Greek and Roman literature, there are no descriptions of individuals with schizophrenia in the Greek and Roman literature dating from the fifth century bc to the beginning of the second century Ad (Evans et al. 2003), and several authors have speculated that schizophrenia did not exist before the eighteenth century (Ellard 1987).Caution is important when dealing with mental health and religious issues in contrast with creativity. The creativity of people suffering from bipolar disorders is well recognized (Jamison 1993) and [End Page 277] the same applies to alcohol and drug intoxication. Tellenbach (1986) has also written on the creativity of depressed persons, although he refers more to the disposition of mood (Schwermut) than to clinical depression as such. The link between melancholia and genius put forward by Aristotle has often been misinterpreted. The philosopher was considering the melancholic temperament and not the melancholic illness as we would understand it today. Of the four temperaments, it is in his view only the melancholic that is gifted with creativity. The sanguine person seeks the immediate pleasures of life, the choleric one considers himself powerful and dedicates himself to manifesting this power, and the phlegmatic individual is disconnected from life and seeks to live without effort or pleasure. The melancholic temperament leads to creativity because of the predominance of doubt, reflection, and dissatisfaction with the miseries of life.Freud’s notion of religiosity as a collective obsessive neurosis is totally mistaken, in my view. The three main themes of obsessions are cleanliness, order, and guilt. In none of these cases is the theme the goal of the action; rather, it is a strategy to contain anxiety. As a consequence, patients with obsessions and compulsions about dirt and cleanliness tend to be dirty themselves, because the real purpose of their compulsions is not in fact to be clean but rather to satisfy a ritual. When order... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Anthropological Perspectives in Psychiatric NosologyJuan J. López-Ibor Jr. (bio) and María-Inés López-Ibor (bio)KeywordsDSM, etiology, Aristotelian causes, social dramasPsychiatry and clinical psychology, as we learn in this paper, are disciplines in need of an ontological perspective. Very few branches of contemporary learning share this characteristic. Probably only theoretical physic and theology—as the rest have long ago given up trying to define and understand the essence of their object, (...) for example, life in the case of biology or mind in psychology. Consequently, the paper by Pérez-Álvarez, Sass and García-Montes, “The Ontology of Mental Disorders in Constructivist Perspective,” (2008) should be welcomed and indeed included in the reading lists for trainees in psychiatry and clinical psychology.The authors propose an approach to the understanding of mental disorders that is extremely attractive and well articulated, and which also has practical implications for clinicians. It is not just another “philosophical divertimento” devoid of scientific and practical importance. Let us analyze the article in an orderly way.Less DsmThe authors of the target paper disapprove of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III/IV approach to defining illnesses by starting from the symptoms that are present—on the grounds that this may lead clinicians to assume that their sole role is to identify, fight, and suppress the symptoms by whichever procedure. They propose an alternative that is dear to myself because it follows the path of the so-called “anthropological” psychiatry of Binswanger, von Gebsattel, Erwin Strauss, Zutt, López-Ibor, Sr., and others. In essence, this is a phenomenological approach to the meaning of mental diseases, one that emphasizes how the illness is revealed to the patient him- or herself.The target article’s criticism of DSM should be considered in the context of the abuses committed on its behalf. The DSM is not a textbook of psychiatric disorders, nor does it contain a definition of the diseases. The DSM does not tell what a disease is (Klerman et al. 1984)—something that is impossible with a classification system based on the manifestations of the diseases, the signs and symptoms. The DSM, as its title states, is just a diagnostic and statistical manual, which does not contain anything about the origin of [End Page 259] any disease nor an explanation of why it exists or what it means. The DSM is, in fact, just a tool to determine whether a disease is present, and therefore to facilitate communication between professionals and with other individuals, without saying anything about the disease’s aitia—a key term (associated with notions of essence as well as cause) to be discussed below. In theory, most clinicians should understand these limitations; it may be, however, that this is not really the case for many who read or use the DSM. In the world there are around 200,000 psychiatrists; since 1980 the number of DSM copies sold is in the order of several hundred thousand.The misuse of a classification system is even more noticeable in the International Classification of Diseases (ICD)-10 Research Version. The instructions for the use of this version recommend that the first step is to make an inventory of all the symptoms present, and then to construct a diagnosis based on them. This how all computer-assisted systems work. This procedure can, however, only be valid if the clinician has already reached a diagnostic conclusion by other means—a diagnosis then to be confirmed for research purposes. It may be that this is one of the reasons why the ICD-10 Research Version has almost never actually been used for research.Furthermore, the concept of symptoms in psychiatry applies only to organic mental disorders (Schneider 1959), conditions in which the patient’s attitude and way of experiencing the symptoms do not play the kind of role that they play in schizophrenia and other mental disorders. The quotation from the important paper by Sass and Parnas in this context is most appropriate. It is indeed that case that “subjective experience can play an important causal role in the progressive experiential transformations of a developing schizophrenic illness... (shrink)

Being and value, by J. Zaragüeta y Bengoechea.--The origin of man, by X. Zubiri.--Negation, by J. Gaos.--The juridical notion of the human person and the rights of man, by L. Legaz y Lacambra.--History and truth, E. Nicol.--Vital anxiety, by J. J. López Ibor.--The moralization of power through its self--imitation, by J. L. Aranguren.--The doctor-patient relationship in the general framework of interhuman relationships, by P. Laín Entralgo.--On the singular character of the historical destiny of Europe, by L. Díez del Corral.--On (...) taking things for granted, by J. Ferrater Mora.--The idea of metaphysics, by J. Marías. (shrink)