Although a number of microfinance initiatives have improved financial inclusion in various regions of developing countries, the transferability of their foundations from one context to another is still a challenge. This study proposes an innovative process-based model targeting the initial stages of the transfer process that links three interconnected categories: local contextual conditions, transferring practices, and initial developmental consequences. The results were produced through a longitudinal study of the implementation of three community development banks on the periphery of Sao Paulo (...) based on a highly successful Brazilian model known as Banco Palmas. In addition to the process-based model, our findings contribute to the microfinance and bottom of the pyramid literatures, showing a cross-fertilization that has been insufficiently explored. (shrink)

The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics (...) that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probablyin lieuof robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS. (shrink)

Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights (...) from patients’ subjective perceptions of postoperative self-change provides a potent explanation of potential DBS-induced self-estrangement. (shrink)

The goal of this article is to shed light on Deep Brain Stimulation (DBS) postoperative suicidality risk factors within Treatment Resistant Depression (TRD) patients, in particular by focusing on the ethical concern of enrolling patient with history of self-estrangement, suicide attempts and impulsive–aggressive inclinations. In order to illustrate these ethical issues we report and review a clinical case associated with postoperative feelings of self-estrangement, self-harm behaviours and suicide attempt leading to the removal of DBS devices. Could prospectively identifying and excluding (...) patients with suicidality risk factors from DBS experimental trials—such as history of self-estrangement, suicide attempts and impulsive–aggressive inclinations—lead to minimizing the risk of suicidality harm? (shrink)

Although being generally safe, the use of Deep Brain Stimulation has been associated with a significant number of patients experiencing postoperative psychological and neurological harm within experimental trials. A proportion of these postoperative severe adverse effects have lead to the decision to medically prescribe device deactivation or removal. However, there is little debate in the literature as to what is in the patient’s best interest when device removal has been prescribed; in particular, what should be the conceptual approach to ethically (...) guide the decision to remove or maintain implants. The purpose of this article is to examine the ethical issues raised when patients refuse brain device explantation despite medical prescription. In order to illustrate these issues, we report and discuss a clinical case involving a patient suffering from treatment resistant depression who experienced forms of postoperative self-estrangement, as well as suicidal attempts, but who resists giving consent to device explantation. (shrink)

Optogenetics is being optimistically presented in contemporary media for its unprecedented capacity to control cell behavior through the application of light to genetically modified target cells. As such, optogenetics holds obvious potential for application in a new generation of invasive medical devices by which to potentially provide treatment for neurological and psychiatric conditions such as Parkinson's disease, addiction, schizophrenia, autism and depression. Design of a first-in-human optogenetics experimental trial has already begun for the treatment of blindness. Optogenetics trials involve a (...) combination of highly invasive genetic and electronic interventions that results in irreversible and permanent modifications of an individual's nervous system. Given its novelty, its uncertain benefit to patients, and its unique risk profile of irreversible physiological alteration, optogenetics requires a reassessment of the ethical challenges for protecting human participants in clinical trials, particularly at formative stages of clinical evaluation. This study explores the evolving ethical issues surrounding optogenetics’ potential harm to participants within trial design, especially focusing on whether Phase 1 trials should incorporate efficacy as well as safety endpoints in ways that are fair and respectful to research trial participants. (shrink)

To conclude that there is enough or not enough evidence demonstrating that deep brain stimulation causes unintended postoperative personality changes is an epistemic problem that should be answered on the basis of established, replicable, and valid data. If prospective DBS recipients delay or refuse to be implanted because they are afraid of suffering from personality changes following DBS, and their fears are based on unsubstantiated claims made in the neuroethics literature, then researchers making these claims bear great responsibility for prospective (...) recipients' medical decisions and subsequent well-being. Our article “Deflating the ‘DBS causes personality’ bubble” reported an increase in theoretical neuroethics publications suggesting putative DBS-induced changes to personality, identity, agency, autonomy, authenticity and/or self and a critical lack of supporting primary empirical studies. This special issue of Neuroethics brings together responses to our initial publication, with our own counter-responses organized according to common themes. We provide a brief summary for each commentary and its main criticisms as well as a discussion of the way in which these responses can: 1) help clarify the meaning of PIAAAS, suggesting supplementary frameworks for understanding the impact of DBS on PIAAAS; 2) provide further empirical evidence of PIAAAS by presenting results from the researchers’ own work; and/or 3) offer a critique of our research approach and/or findings. Unintended postoperative putative changes to PIAAAS remain a critical ethical concern. It is beyond dispute that we need to develop reliable empirical and conceptual instruments able to measure complex cognitive, affective, and behavioural changes in order to investigate whether they are attributable to DBS alone. (shrink)

. Computational chemistry grew in a new era of “desktop modeling,” which coincided with a growing demand for modeling software, especially from the pharmaceutical industry. Parameterization of models in computational chemistry is an arduous enterprise, and we argue that this activity leads, in this specific context, to tensions among scientists regarding the epistemic opacity transparency of parameterized methods and the software implementing them. We relate one flame war from the Computational Chemistry mailing List in order to assess in detail the (...) relationships between modeling methods, parameterization, software and the various forms of their enclosure or disclosure. Our claim is that parameterization issues are an important and often neglected source of epistemic opacity and that this opacity is entangled in methods and software alike. Models and software must be addressed together to understand the epistemological tensions at stake. (shrink)

A system of natural deduction rules is proposed for an idealized form of English. The rules presuppose a sharp distinction between proper names and such expressions as the c, a (an) c, some c, any c, and every c, where c represents a common noun. These latter expressions are called quantifiers, and other expressions of the form that c or that c itself, are called quantified terms. Introduction and elimination rules are presented for any, every, some, a (an), and the, (...) and also for any which, every which, and so on, as well as rules for some other concepts. One outcome of these rules is that Every man loves some woman is implied by, but does not imply, Some woman is loved by every man, since the latter is taken to mean the same as Some woman is loved by all men. Also, Jack knows which woman came is implied by Some woman is known by Jack to have come, but not by Jack knows that some woman came. (shrink)

Les recherches de Natalie Depraz sur l’intersubjectivité rejoignent ici celles de Frédéric Mauriac, particulièrement dans les cas dits « d’urgence psychiatrique ». La question est ainsi de savoir comment poser et penser le rapport fulgurant de la force vitale à ce désir tout humain de vouloir en finir. En ces cas, quelles paroles faut-il oser et quel mode de relation convient-il d’instaurer? La contribution entend offrir des perspectives théoriques et pratiques, essentiellement thérapeutiques, en mettant d’abord en évidence, d’une part, (...) la situation de la phénoménologie henryenne devant la phénoménologie historique et, d’autre part, sa situation devant une praxis fondée sur la singularité de l’approche en deuxième personne. (shrink)

In her article, Pascale Hess raises the issue of whether her proposed model may be extrapolated and applied to clinical research fields other than stem cell-based interventions in the brain (SCBI-B) (Hess 2012). Broadly summarized, Hess’s model suggests prioritizing efficacy over safety in phase 1 trials involving irreversible interventions in the brain, when clinical criteria meet the appropriate population suffering from “degenerative brain diseases” (Hess 2012). Although there is a need to reconsider the traditional phase 1 model, especially with respect (...) to first-in-human clinical trials involving novel technologies, the question arises as to whether it is appropriate to advocate for a new model that prioritizes efficacy over safety across all phase 1 clinical research trials involving irreversible interventions in the brain. -/- . (shrink)

Postmortem research on the brains of American tackle football players has revealed the presence of chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repeated head trauma. Repeated concussion is a risk factor for CTE, raising ethical concerns about the long-term effects of concussion on athletes at risk for football-related concussion. Of equal concern is that youth athletes are at increased risk for lasting neurocognitive and developmental deficits that can result in behavioral disturbances and diminished academic performance. In this (...) article, we consider evidence of the effects of concussion in youth athletes, and discuss ethical duties to youth athletes and how these duties might be satisfied, given the intrinsic risks of football. Finally, we evaluate potential strategies for reducing concussions in junior football, and recommend the optimal strategy for reducing brain injury to an acceptable level while still making available the benefits of football participation for youth athletes. (shrink)

Background: Informed consent for genetic tests is a well-established practice. It should be based on good quality information and in keeping with the patient’s values. Existing informed consent assessment tools assess knowledge and values. Nevertheless, there is no consensus on what specific elements need to be discussed or considered in the consent process for genetic tests.Methods: We performed a systematic review to identify all factors involved in the decision-making and consent process about genetic testing, from the perspective of patients. Through (...) public databases, we identified studies reporting factors that influence the decision to accept or decline genetic testing. Studies were included if they reported the perspective of patients or at-risk individuals. All articles were thematically coded.Results: 1989 articles were reviewed: 70 met inclusion criteria and 12 additional articles were identified through the references of included studies. Coding of the 82 articles led to the identification of 45 factors involved in decision-making and consent, which were initially divided into three domains: in favor of, against or with an undetermined influence on genetic testing. Each factor was also divided into three subdomains relating to the informed choice concept: knowledge, values or other. The factors in the “other” subdomain were all related to the context of testing (e.g. timing, cost, influence of family members, etc), and were present in all three domains.Conclusions: We describe the network of factors contributing to decision-making and consent process and identify the context of genetic testing as a third component to influence this process. Future studies should consider the evaluation of contextual factors as an important and relevant component of the consent and decision-making process about genetic tests. Based on these results, we plan to develop and test a more comprehensive tool to assess informed consent for genetic testing. (shrink)

There has been a surge in mass media reports extolling the potential for using three-dimensional printing of biomaterials to treat a wide range of clinical conditions. Given that mass media is recognized as one of the most important sources of health and medical information for the general public, especially prospective patients, we report and discuss the ethical consequences of coverage of 3D bioprinting in the media. First, we illustrate how positive mass media narratives of a similar biofabricated technology, namely the (...) Macchiarini scaffold tracheas, which was involved in lethal experimental human trials, influenced potential patient perceptions. Second, we report and analyze the positively biased and enthusiastic portrayal of 3D bioprinting in mass media. Third, we examine the lack of regulation and absence of discussion about risks associated with bioprinting technology. Fourth, we explore how media misunderstanding is dangerously misleading the narrative about the technology. (shrink)

For John Wyclif, the fundamental belief that Scripture is true de virtute sermonis is grounded in the fact that the meanings of the words therein are equivocal. A word can have several different meanings depending on whether it is outside or inside Scripture as well as on its location in Scripture. This principle allows each and every word in Scripture to be endowed with its own meaning — however figurative, i.e., metaphorical, allegorical etc. it may be —, tailored for the (...) very context in which it is used. Scripture cannot then fail to be true in virtue of the syntactic-semantic properties of language, which are precisely set up in accordance with the message to be delivered. All in all, Scripture as the matrix of all logics and semantics is a holistic system that may serve as master key for deciphering any possible meaning of a word. (shrink)

Le but de cet article est de montrer comment la lecture de Kant par Bergson, loin de se ramener à un mot d’ordre sommaire, comporte une reprise partielle, une critique précise, un refus ultime enfin, qui conduisent au cœur d’une relation profonde entre deux philosophies irréductibles. La reprise partielle de la distinction entre intelligence et intuition, et même entre matière et forme de l’intuition, doit être comprise autrement que comme un hommage ironique. Elle seule permet de comprendre l’unité que Bergson (...) revendique contre Kant, d’abord entre matière et forme de l’intuition, dans le cas du temps, puis entre intelligence et intuition même, à partir de L’évolution créatrice. À son tour, cette unité permet aussi de comprendre pourquoi l’intelligence reste à l’écart de l’intuition pratique dans le dernier grand livre de Bergson. « Gagnée » par l’intuition, l’intelligence ou l’entendement le sont donc bien en un double sens : non seulement surmontés, mais envahis par elle, jusqu’à une limite qui révèle au cœur d’un problème commun, une singulière différence.The purpose of this paper is to show how Bergson’s reading of Kant, far from any expeditive fightword, implies at the same time some reappropriation, a precise critique, and a final objection that together lead to the heart of a profound relationship between two irreducible doctrines. The partial endorsing of Kant’s distinction between intelligence and intuition, and even between matter and form of intuition itself, must not be understood only as a ironical hommage. On the contrary, it helps understanding the unity Bergson advocates against Kant, first between the matter and form of intuition, in the case of time, then between intuition and intelligence itself, after Creative Evolution. In its own turn, that unity helps understanding why intelligence is put aside of practical intuition in Bergson’s last great book. Intelligence or understanding are thus « won » in a double way : not only as surpassed, but also as penetrated by intuition, up to a last limit, which reveals a peculiar difference, at the heart of a common problem. (shrink)

(2005). Between Critique And Metaphysics. Angelaki: Vol. 10, continental philosophy and the sciences the french tradition issue editor: andrew aitken, pp. 39-57.

Some writers have noted that valuation is often focused on foreseen changes. They say that we often don't value situations in terms of what we would have in them only but also in terms of the gains or losses that they offer us — that we then focus on departures from our status quo. They argue that such thinking conflicts with basic economic analysis, and also that it violates logic: they say that it is irrational. I agree that it seems (...) to be common. But is such a way of setting one's values a challenge to economics? And does it conflict with being rational? (shrink)

The study by Levy et al. (2024) offers new insights into clinical trial participant experience when assessing a novel visual cortical prosthesis (VCP) during an early feasibility study (EFS). We ap...

À travers quels langages, outils et pratiques pouvons-nous comprendre la destruction écologique et la violence racialisée en tant que processus unifié à l’œuvre dans la production du monde? Comment pouvons-nous, à la fois, habiter et interrompre cette conjoncture catastrophique? Qui sommes-nous pour cela, d’ailleurs? Je m’inspire de la provocation de Christina Sharpe (2016) en faveur du « travail de sillage » pour étudier ces questions dans le contexte du monde océanique. En travaillant à travers différents genres et en puisant dans (...) diverses sources, j’expérimente des thèmes de perte, de sensation, d’échelle, d’incertitude, de persistance et de temps, pour chercher un récit qui pourrait suggérer un avenir différent au milieu d’une catastrophe en cours. (shrink)

La bibliographie Platon 1990-1995 prend concretement la suite du travail bibliographique (couvrant la periode 1950-1990) deja paru dans la revue Lustrum publiee a Gottingen et qui preserve, pour l'essentiel, la presentation materielle. Pour la periode ici consideree (1990-1995), on denombre plus de 70 entreprises d'edition et de traduction, et surtout pres de 1800 travaux d'interpretation, livres ou articles eux-memes publies dans des periodiques, actes de congres, melanges ou recueils. Ces travaux, ecrits en une dizaine de langues differentes, sont ici accompagnes (...) pour la plupart d'une notice et analyses dans un index tres detaille. Le chercheur dispose ainsi d'une sorte de carte geographique lui permettant de s'orienter facilement dans cet immense territoire de litterature secondaire et d'aller rapidement d'un point a un autre en evitant les detours fastidieux et les impasses. (shrink)

According to several recent studies, a big chunk of college students in North America and Europe uses so called ‘smart drugs' to enhance their cognitive capacities aiming at improving their academic performance. With these practices, there comes a certain moral unease. This unease is shared by many, yet it is difficult to pinpoint and in need of justification. Other than simply pointing to the medical risks coming along with using non-prescribed medication, the salient moral question is whether these practices are (...) troubling in and of themselves. In due consideration of empirical insights into the concrete effects of smart drugs on brain and behavior, our attempt is to articulate wherein this moral unease consists and to argue for why the authors believe cognitive enhancement to be morally objectionable. The authors will contend that the moral problem with these practices lies less in the end it seeks, than in the underlying human disposition it expresses and promotes. Some might ask, what is wrong with molding our cognitive capacities to achieve excellence, get a competitive edge, or, as the whim takes us? In all of these occasions, the usage of smart drugs serves a certain goal, a telos. The goal is, broadly speaking, this: outsmarting opponents in an arms race for limited resources and thereby yielding a competitive edge. In plain words: competition is valued higher than cooperation or solidarity. What is wrong with striving for this goal? The authors submit that the question whether people really want to live in a society that promotes the mentality ‘individual competition over societal cooperation' deserves serious consideration. In developing their answer, the authors draw on an ‘Ethics of Constraint' framework, arguing that widespread off-label use of smart drugs bears the risk of negative neural/behavioral consequences for the individual that might, in the long run, be accompanied by changing social value orientations for the worse. (shrink)

This article aims at defending the old theory of iconological dualism that opposes ‘handmade’ pictures to photographic pictures. I defend a new version of that theory, according to which photographs always enable viewers to have singular thoughts on the things photographed, while handmade pictures by themselves never enable viewers to have singular thoughts but only enable them to have what I call ‘thoughts by depiction’. To this end, I defend the old theory according to which singular thoughts require a special (...) relation—called ‘acquaintance’—between the thinker and the object thought about. I put this traditional view forward thanks to a new version of the classic spy argument for the acquaintance constraint on singular thoughts. (shrink)

A Correction to this paper has been published: https://doi.org/10.1007/s11841-021-00853-5.