In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

I explore some new directions—suggested by feminism—for medical ethics and for philosophical ethics generally. Moral philosophers need to confront two issues. The first is deciding which moral issues merit attention. Questions which incorporate the perspectives of women need to be posed—e. g., about the unequal treatment of women in health care, about the roles of physician and nurse, and about relationship issues other than power struggles. “Crisis issues” currently dominate medical ethics, to the neglect of what I call “housekeeping issues.” (...) The second issue is how philosophical moral debates are conducted, especially how ulterior motives influence our beliefs and arguments. Both what we select—and neglect—to study as well as the “games” we play may be sending a message as loud as the words we do speak on ethics. (shrink)

Some of the authors of the essays on Chinese philosophers prefer the pin yin system of romanization for Chinese names and words, while others prefer the Wade‐Giles system. Given that both systems are in wide use today, important names and words are given in both their pin yin and Wade‐Giles formulations. The author's preference is printed first, followed by the alternative romanization within brackets.

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

ABSTRACT BACKGROUND: The objective of this study was to identify factors motivating women to take part in endometriosis research and to determine if these factors differ for women participating in clinical versus basic science studies. METHODS: A consecutive series of 24 women volunteering for participation in endometriosis‐related research were asked to indicate, in their own words, why they chose to volunteer. In addition, the women were asked to rate, on a scale of 0 to 10, sixteen potentially motivating factors. The (...) information was gathered in the form of an anonymous self‐administered questionnaire. RESULTS: Strong motivating factors (mean score >8) included potential benefit to other women's health, improvement to one's own condition, and participation in scientific advancement. Weak motivating factors (mean score <3) included financial compensation, making one's doctor happy, and use of ‘natural’ products. No difference was detected between clinical and basic science study participants. CONCLUSION: This study is the first study to specifically investigate the factors that motivate women to take part in endometriosis research. Understanding why women choose to take part in such research is important to the integrity of the informed consent process. The factors most strongly motivating women to participate in endometriosis research related to improving personal or public health; the weakest, to financial compensation and pleasing the doctor. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

This book engages with the writings of W.G. Sebald, mediated by perspectives drawn from curriculum and architecture, to explore the theme of unsettling complacency and confront difficult knowledge around trauma, discrimination and destruction. Moving beyond overly instrumentalist and reductive approaches, the authors combine disciplines in a scholarly fashion to encourage readers to stretch their understandings of currere. The chapters exemplify important, timely and complicated conversations centred on ethical response and responsibility, in order to imagine a more just and aesthetically experienced (...) world. In the analysis of bildung as human formation, the book illuminates the pertinent lessons to be learned from the works of Sebald and provokes further investigations into the questions of memory, grief, and limits of language. Through its juxtaposition of curriculum and architecture, and using the prose of Sebald as a prism, the book revitalizes questions about education and ethics, probes the unsettling of complacency, and enables conversation around difficult knowledge and ethical responsibility, as well as offering hope and resolve. An important intervention in standard approaches to understanding currere, this book provides essential context for scholars and educators with interests in the history of education, curriculum studies, cultural studies, memory studies, narrative research, Sebaldian studies, and educational philosophy. (shrink)

The Executive Council pro tem of the HSA, organized during a business session of the Wofford Symposium at Spartanburg, S. C. last November, met et Vanderbilt University the following March and drafted a constitution for the Society. The members of this Council were Darrel E. Christensen of Wofford College, Robert L. Perkins of the University of South Alabama, Frederick G. Weiss, George L. Kline, Warren E. Steinkraus, Donald P. Verene, and Otho M. Adkins. Shortly thereafter the constitution was adopted (...) and an election was held. Professors Christensen, Steinkraus, Perkins, and Verene were elected President, Vice-President, Secretary, and Treasurer of the Society. * * * PURPOSE * * * The purpose of the HSA, as specified by Article II of the constitution, is "to promote the study of the philosophy of Hegel, its place within the history of thought, its relation to social, political, and cultural movements since his time, and its relevance to contemporary issues and fields of knowledge. In addition to the study of the thought and significance of Hegel, the Society has as its purpose the furtherance of original philosophical thought which has its basis in the philosophy of Hegel or which treats issues in the style, manner, or method of Hegel.". (shrink)

Negotiation is a complex and dynamic decision process during which parties perceptions, preferences, and roles may change. Modelling such a process requires flexible and powerful tools. The use of rule-based formalism is therefore expanded from its traditional expert system type technique, to structuring and restructuring non-trivial processes like negotiation. Using rules we build a model of a negotiation problem. Some rules are used to infer positions and reactions of the parties, other rules are used to modify problem representation when such (...) a modification is necessary. We illustrate the approach with a contract negotiation case between two large companies. We also show how this approach could help one party to realize that negotiations are being carried on against their assumptions and expectations. (shrink)

In CQ n.s. 26 . 62–84 I argued that the defeat of Sparta in 371 B.C. was not due to the pursuit of unwise policies towards the other Greek states. Unwise policies there had been. Sparta being by no means superior to Athens in the formulation of foreign policy, but these did not affect the position on the eve of Leuctra when, with Thebes politically isolated, and with some of the Boeotians disaffected, Cieombrotus at the head of a numerically superior (...) Spartan and allied army was poised for the, destruction of Theban power; a triumph of policy it must have seemed. Sparta failed for military reasons. Her army was unequal to the military genius of Epaminondas. (shrink)

In 404 Sparta stood supreme, militarily and politically master of Greece, in concord with Persia. By 362, the year at which Xenophon terminated his history on the sad note of ‘even greater confusion and uncertainty’, she was eclipsed militarily, never to win a great battle again; and so far from being master even of the Peloponnese that she would spend the rest of time struggling to recover her own ancestral domain of Messenia, no longer a world power, merely a local (...) wrangler. The reasons for all this which are to seek are of absorbing interest and prime importance for the history of Greece, but it is hard to resist the temptation to connect the change with the policies of Agesilaus whose reign virtually coincided with the period in question. He was king for forty-one years and over thirty of them well before the battle of Leuctra and he had influence in the state unequalled as far as we can tell by any other king. (shrink)

Celebrated and castigated as the “Hobbes of the twentieth century” and even a modern Machiavelli. Carl Schmitt (1888–1984) is undoubtedly the most controversial legal and political theorist of the twentieth century. He greatly influenced the thinking of such political scientists and political philosophers as Hans J. Morgenthau, Franz Neumann, Otto Kirchheimer, Leo Strauss, and Julien Freund. But Schmitt always spoke and wrote as a jurist. He grounded his thinking in jurisprudence and was the teacher in the wider sense of such (...) jurists as Ernst‐Wolfgang Böckenförde and Ernst‐Rudolf Huber. (shrink)

The reader of Demosthenes can hardly avoid the impression that there was something sadly awry with the Athenian naval system in the two decades prior to Chaeronea. The war in the north Aegean was essentially a naval war, and Demosthenes frequently enough blamedAthen's failure on her lack of preparation. ‘Why do you think, Athenians,… that all our expeditionary forces are too late for the critical moments?…In the business of the war and the preparation for it everything is in disorder, unreformed, (...) undefined. So it is that some news arrives, we appoint trierarchs, we give them the opportunity legally to get others to act in their stead, we consider provision of money, then it is decided that the metics and those “living out” should go on the ships, then again you yourselves, then to allow substitutes, and during these delays^the cause for which we would have been sailing is lost before we have sailed] For we spend the time for action on preparations, but the critical moments for action do not last as long as our dilatoriness and cautious procedures’ . This was spoken in 351 and it is much the same a decade later. (shrink)

In 346 the Athenians were sadly deceived by Philip. The long war for Amphipolis had taken its toll and the people wanted relief, but the real motive of those who wanted peace in 346, both Philocrates with his principal abettor Demosthenes, and Eubulus and Aeschines, was to try to keep Philip out of Greece itself.2 In Elaphebolion the only debate was about means, whether, as Aeschines wanted, to try to get Phocis included in a Common Peace, or, as Demosthenes with (...) a clearer view of what Philip would accept urged, to make a separate peace and alliance and leave the salvation of Phocis to the future: he probably thought that, if Philip should afterwards attack Phocis, Athens could choose between her allies and, as in 352, rush to the aid of Phocis. (shrink)

Furthermore, adults with decision-making capacity, including pregnant women, can currently accept interventions with moderate net risks for themselves in other settings (e.g., open f...

The history of economic thought has always attracted some of the brightest minds in the discipline. These chroniclers of development have helped form our current views, and it is no surprise that many among them have been at the forefront of new movements in the history of ideas. This notable collection summarizes the work of these key historians of economics and attempts to quantify their impact. Some of the writers covered, such as Friedrich Hayek and Joan Robinson, are already assured (...) of their place among the greatest economists of the twentieth century, but the collection also stresses the influence of those still active in shaping our perceptions - including Mark Blaug, Samuel Hollander and Donald Winch. Written by an impressive roster of contributors, many of whom are themselves well-known in the history of economic thought, this key book features writings from John Creedy, Roger Blackhouse and Neil De Marchi, as well as the editors of the collection as a whole, Warren J. Samuels and Steven Medema. (shrink)

The contributors to this volume seek to answer this question by exploring how analytic and holistic processes contribute to our perception of faces, objects, ...

A function is recursive (in given operations) if its values are computed explicitly and uniformly in terms of other "previously computed" values of itself and (perhaps) other "simultaneously computed" recursive functions. Here, "explicitly" includes definition by cases. We investigate those recursive functions on the structure $\mathbf{N} = \langle \omega, 0, \operatorname{succ,pred}\rangle$ that are computed in terms of themselves only, without other simultaneously computed recursive functions.

ObjectivesThis paper aims to identify potential areas for refinement in existing theoretical models of suicide, and introduce a new integrative theoretical framework for understanding suicide, that could inform such refinements.MethodsLiterature on existing theoretical models of suicide and how they contribute to understanding psychological processes involved in suicide was evaluated in a narrative review. This involved identifying psychological processes associated with suicide. Current understanding of these processes is discussed, and suggestions for integration of the existing literature are offered.ResultsExisting approaches to understanding (...) suicide have advanced the current knowledge of suicide in various ways. They have guided valuable research in the following areas: motivations for suicide and the psychological distress which influences suicide attempts; ambivalence about suicide; suicidal individuals’ focus of attention; and ways in which individuals who contemplate suicide differ from individuals who attempt suicide. We outline a new theoretical framework as a means to integrating all of these concepts into the three principles of control, conflict, and awareness. Within this framework, suicide is regarded as occurring due to a long standing conflict between an individual’s personal goals, culminating in an episode of acute loss of control. The new framework posits that the individual then strives to regain control through the means of suicide because of a narrowed awareness of consequences of their actions on other valued goals. This psychological mechanism of limited awareness is posited to be the common pathway by which individuals make a suicide attempt, regardless of which risk factors are present.ConclusionThis article introduces a theoretical framework that generates several hypotheses for future research, and focuses on psychological processes occurring during immediate crisis. One of the key hypotheses resulting from our predictions on how individuals progress from contemplating to attempting suicide will be tested in an ongoing program of research: Individuals who attempt suicide have a significantly reduced awareness of consequences of suicide, which would negatively impact on their important life goals, values, principles, or ideals, compared to individuals who contemplate suicide. Therapy guided by the new framework may be more flexible, immediate, and client-focused than other therapies for suicidal individuals. (shrink)

Against the background assumptions that knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service. These evaluations were collected through (...) a quality assessment effort at our institution. Drawing from the qualitative elements of our survey instrument, we describe unexpected variations among the requests for ethics consultation and the retrospective reports from those colleagues making the requests. Focusing on just one aspect – the reason for request – raised several core questions about how we should evaluate those retrospective reports, what could be learned from the differences that we were now encountering, and what we could learn about the process of evaluating our practices. Working through these questions, we suggest several issues to consider in ongoing efforts to describe and evaluate clinical ethics consultation: the role of time and memory in evaluating retrospective evaluations, the importance of attending to the language of moral shift or disruption with which our colleagues describe their experiences, and how to understand the role of ethics consultation in creating ‘moral space’ for colleagues to process their moral experiences. (shrink)