Mozambique has seen remarkable growth in biomedical research over the last decade. To meet a growing need, the National Committee for Bioethics in Health of Mozambique encouraged the development of ethical review processes at institutions that regularly conduct medical and social science research. In 2012, the Faculty of Medicine of University Eduardo Mondlane and the Maputo Central Hospital established a joint Institutional Committee on Bioethics for Health. This study examines the experience of the first 4 years of the CIBS FM (...) & MCH. This study provides a descriptive, retrospective analysis of research protocols submitted to and approved by the CIBS FM & MCH between March 1, 2013 and December 31, 2016, together with an analysis of the Committee’s respective reviews and actions. A total of 356 protocols were submitted for review during the period under analysis, with 309 protocols approved. Sixty-four percent were submitted by students, faculty, and researchers from UEM, mainly related to Master’s degree research. Descriptive cross-sectional studies were the most frequently reviewed research. The majority were prospective and used quantitative methodologies. The Departments of Internal Medicine at MCH and Community Health at the FM submitted the most protocols from their respective institutions, with 38 and 53% respectively. The CIBS’s average time to final approval for all protocols was 56 days, rising to 161 for the 40 protocols that required subsequent national-level review by the CNBS. Our results show that over its first 4 years, the CIBS FM & MCH has been successful in managing a constant demand for protocol review and that several broad quality improvement initiatives, such as investigator mentoring and an electronic protocol submission platform have improved efficiency in the review process and the overall quality of the protocols submitted. Beyond Maputo, long-term investments in training and ethical capacity building for CIBS across the country continue to be needed, as Mozambique develops greater capacity for research and makes progress toward improving the health of all its citizens. (shrink)

This paper explores the ethical and conceptual implications of the findings from an empirical study (reported elsewhere) of decision-making capacity in anorexia nervosa. In the study, ten female patients aged thirteen to twenty-one years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semistructured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient-participants were also tested using the (...) MacArthur Competence Assessment Tool—Treatment test of competence. This is a formalized, structured, interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief, self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches. (shrink)

Indigenous knowledge is often dismissed as ‘traditional and outdated’, and hence irrelevant to modern ecological assessment. This theoretical paper critically examines the arguments advanced to elevate modern western ecological knowledge over indigenous ecological knowledge, as well as the sources and uses of indigenous ecological knowledge. The central argument of the paper is that although the two systems are conceptually different, it would be fallacious to regard one as superior to the other merely because they are premised on different worldviews.

In lieu of an abstract, here is a brief excerpt of the content:Decision-Making as a Broader ConceptJacinta O. A. Tan (bio), Anne Stewart (bio), and Tony Hope (bio)KeywordsCompetence, decision-making, capacity, anorexia nervosa, autonomy, values, identityWe thank Demian Whiting for the thoughtful critique of aspects of our paper (Tan et al. 2006a). A primary aim of our research was to provide empirical grounds on which to stimulate discussion about the nature of decision-making capacity (DMC). Whiting criticizes in particular the concept of (...) 'pathological values' that we suggested might be relevant in the assessment of DMC and in the related issue of deciding when a patient's refusal of beneficial treatment should be overridden.Whiting's central concern is with DMC. Whiting argues that the absence of pathological values should not be a criterion for DMC. We are unclear whether he is also arguing that pathological values do not provide a reason of any kind for overriding treatment refusal. At the end of the paper he writes: "we cannot justify compulsory treatment of patients who have pathological values... on the grounds that these patients lack DMC" (2009, XX). This seems to leave open the possibility that we may be able to justify compulsory treatment of patients who have pathological values on grounds other than that they lack DMC. As we wrote in our response to the discussants of our original paper, "The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests" (Tan et al. 2006b, 300).In deciding on whether to use compulsory treatment, there are other relevant factors that may need to be considered, such as the seriousness of the decision, which determines the threshold for competence. However, in this response we consider three issues. First, we argue that the current concept of DMC is by no means so clear cut or generally agreed upon as Whiting implies, and that some of the lack of clarity relates to pathological values. Second, that the concept of DMC is itself dependent on accounts of autonomy, and that it is plausible that pathological values can affect autonomy. Third, we directly consider the question of whether a coherent account of pathological values might be given based on a concept of authenticity.The Current Criteria for DMCWhiting argues that the current criteria for DMC are correct and that an additional criterion along the lines of absence of pathological values should not be added. This argument assumes that there is a clear and agreed understanding of the current criteria. We believe this is not the case for three reasons.(i) Whiting begins his account of DMC by saying that it is normally taken to include: "(1) [End Page 345] understanding (and appreciation)" (2009, 341). Already there is an area of dispute, and the use of parentheses reflects this. The concept of 'appreciation' was developed by Grisso and Applebaum (Grisso, Appelbaum, and Hill-Fotouhi 1997). It is not included in either English common law development, for example (ReC), nor in the criteria specified in the Mental Capacity Act 2005. More important, Grisso and Appelbaum in their comment on our original paper (2006) argue that our work advances thinking about 'appreciation' rather than requiring that we add new elements. The implication is that they believe that what we have called pathological values are relevant to the assessment of capacity and are already included in an account of capacity that incorporates the criterion of 'appreciation.' In our response, we argued that pathological values are not entirely captured within the account of appreciation that Grisso and Appelbaum had previously given. We do not want to revisit that issue here, but the point of relevance is that on one view (that of Grisso and Appelbaum) pathological values are already included in the current criteria for DMC as part of the concept of appreciation, whereas on Whiting's view they are not.(ii) Even if there were agreement over the wording and concepts relevant to DMC there is a further important issue: how are those concepts... (shrink)

Este artículo presenta una lectura crítica de un trabajo central de Axel Honneth desde la teoría de la sujeción de Judith Butler. Intenta mostrar que, por la ausencia en su escrito de una consideración sobre el poder, el pensador alemán no logra cumplir satisfactoriamente su objetivo propuesto de enfrentar las posturas que cuestionan el potencial crítico del reconocimiento. La hipótesis que aquí se maneja es que esa ausencia está ligada a su definición del reconocimiento como lo contrario de las prácticas (...) de dominio o sometimiento. Ahora bien, Honneth afirma que el escepticismo de esas posturas respecto del reconocimiento se basa en la idea de que toda praxis recognoscente reproduce de alguna manera el orden social dominante. El presente trabajo se propone entonces, cuestionar esta aseveración del autor advirtiendo que un análisis sobre el modo en que el poder actúa en las prácticas cotidianas de reconocimiento no necesariamente conlleva una renuncia de la función crítica del concepto para la teoría social. Más bien, como sugiere la noción butleriana (y foucaultiana) de crítica, sólo enmarcando al reconocimiento en el horizonte normativo que lo delimita puede convertirse en la base de la indagación social. (shrink)

The aim of this study was to ascertain nurses' and doctors' perspectives on the practice of slow codes, which are cardiopulmonary resuscitative efforts that are intentionally performed too slowly for resuscitation to occur. A Heideggerian phenomenological study was conducted in 2005, during which data were gathered in the Republic of Ireland from three nurses and two doctors (via unstructured interviews) and analysed using Colaizzi's reductive procedure. Slow codes do occur in Ireland and are intended as beneficent acts. However, slow codes (...) were identified as pointless and undignified when intrusive measures were employed. There is a need for discussion on the topic of slow codes in Ireland, and for aids to cardiopulmonary resuscitation decision making to be developed, such as advance directives, communication training, clinical guidelines and an explanatory leaflet for patients and families. (shrink)

This paper is a critical examination of Odera Oruka’s theory of punishment in his Punishment and Terrorism in Africa. It argues that although Oruka clearly highlights the weaknesses of the Retributionist and Utilitarian accounts of punishment and therefore calls for the Reformist view of ‘treating both the criminal and society’, he is mistaken in calling for the abolition of punishment simply because it cannot reform the criminal. The paper contends that the reform of the criminal is only one major function (...) of punishment and not the only one, and so we cannot call for its abolition on the basis of this single consideration. The paper further urges that Oruka’s theory of punishment is rather deterministic: according to him, the criminal commits the crime because of the criminal forces which he or she has very little control over, so that he or she cannot be held morally responsible for his or her actions. (shrink)

The main argument of this theoretical paper is that the pursuit of honest profits in a voluntary market exchange is not only moral but also ingrained in human nature, in that human beings pursue activities that benefit them and avoid those that cause them loss. Through an examination of the Kenyan business venture called Iko Toilet (which is a mix of the Kiswahili word ‘iko’ meaning ‘there is’ and the English word ‘toilet’ to literally mean ‘there is a Toilet’), the (...) paper contends that there is no inherent contradiction between doing well (engaging in honest voluntary business transactions) in order to do good (maximize legitimate profits). (shrink)

This second volume in the Come Along: We Are Truth-Bound series is a cross-examination of the concepts derived in Volume One, conducted by means of a dialogue with a representative thinker from each of the related bodies of knowledge. The study reveals reality to be an intricate, harmoniously-integrated whole.

El artículo tiene la intención de defender una alternativa a la forma en que los intelectuales han reaccionado a la sensación de insuficiencia cultural sobre América Latina. Este sentimiento se deriva de la percepción de que la vida latinoamericana está constituida como una relación de yuxtaposición entre diferentes elementos culturales. Este modo de existencia no comparte el mismo estatuto de la historia europea moderna. Sin embargo, las evaluaciones tradicionales acerca de la historia de América Latina se llevan a cabo a (...) través de criterios históricos europeos. La propuesta consiste en cambiar las perspectivas de criterios más cerca de nuestro modo de vida. Así que si usted puede conseguir una filosofía más adecuada para el entorno cultural de América Latina o una filosofía latinoamericana que tenga en cuenta nuestra forma de ser. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Studying Penguins to Understand BirdsJacinta O. A. Tan (bio), Anne Stewart (bio), Ray Fitzpatrick (bio), and Tony Hope (bio)Keywordsanorexia nervosa, treatment decision-making, competence, valuesWe are grateful to Grisso, Appelbaum, Charland, and Vollmann for their thoughtful commentaries on our paper. We would like to respond by picking up on some of the points they make, although we do not address all the issues raised.Our general aims in the paper are (...) less immediately pragmatic than are the central concerns of Grisso and Appelbaum. Our interest is primarily in a number of ethical, and related conceptual, issues that arise from empirical data. In the long run, of course, we believe that these ethical and conceptual issues are important to the care of people with mental disorders, but our focus is philosophical.Our central interest is what justifies overriding treatment refusal. We are unhappy with a "status" approach according to which, for example, the mere fact that a person suffers a mental disorder provides grounds for overriding her wishes. Such an approach, it seems to us, fails to identify reasons, and discriminates against those with mental disorder, a view shared by the Law Commission (The Law Commission 1995). We are, on the other hand, attracted by the approach that grounds any overriding of treatment refusal on lack of capacity (or competence) to make treatment decisions. The concept of capacity has been well developed through legal cases and conceptual analysis, not least by Grisso and Appelbaum themselves. We were struck, however, first through clinical experience, and subsequently from the pilot study reported in our paper, that many patients with anorexia nervosa who refuse treatment do not necessarily lack capacity, using the current criteria, and yet show features or give reasons that raise serious doubts as to whether it is right to respect their refusal of treatment.To avoid reliance on a "status" approach, the issue with which we are grappling is whether the concept of capacity (and therefore lack of capacity) can be developed to encompass some of our findings, and whether it is ethically right to do so. Charland makes the important point that the concept of competence, or capacity, has both a descriptive and a prescriptive component. It is for this reason that the question of whether, for example, we should extend the criteria for capacity is part of the question of when it is morally right to override treatment refusal.Grisso and Appelbaum suggest that our work advances "our thinking about appreciation, rather than requiring that we add new elements" (2006, 297). From our perspective, and at this stage, it is a secondary issue whether we are suggesting a development of appreciation, or a new element (e.g., "pathological values"). The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in [End Page 299] such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests.We chose to study anorexia nervosa for various reasons, but we expect that the issues raised have a more general relevance (such as to substance abuse and impulse control disorders as Grisso and Appelbaum and Charland suggest). We do not expect the results to be relevant to all, or even most, mental disorders. Our main interest is not the specific management of people with anorexia, but how the data challenge, and help to develop, the concept of capacity, and the ethical analysis of overriding patient refusal of treatment. Our paper aims to address what we understand Charland to be referring to by the "pretheoretical desiderata" (2006, 283) of the concept of capacity. One reason why we chose anorexia as the focus of this work is because it is different from many mental disorders in the issues that it raises. In this it is, perhaps, rather like studying penguins to better understand the concept of bird just because penguins, although clearly birds, have unusual features.We agree, therefore, with Grisso and Appelbaum's caution that it would be unwise to jump in and change the MacCAT-T on the basis of the results... (shrink)

Capacity and competence in the field of child and adolescent psychiatry are complex issues, because of the many different influences that are involved in how children and adolescents make treatment decisions within the setting of mental health. This article will examine some of the influences which must be considered, namely: developmental aspects, the paradoxical relationship between the need for autonomy and participation and the capacity of children, family psychiatry, and the duty of care towards children and adolescents. The legal frameworks (...) relevant to consideration of consent and competence will be briefly considered, as well as some studies of children's consent, participation and competence. A case vignette will be used as a focus to consider the complexity of the issue of competence in child and adolescent psychiatry, in the particular mental disorder of anorexia nervosa. (shrink)

In this text we explore and present some elements that allow us to consider the elaboration of a feminist theory of the State. In principle, it is about starting from a materialistic philosophical perspective that provides us with a broad and rigorous framework for inquiry, which includes a consideration of the complex social topic in which our practices are inscribed and a special attention to the dynamics of affects that guide us in them. Based on this perspective, we propose the (...) concept of State of care. The logic of care to which we refer here is not limited to the problem of social reproduction but crosses the set of instances and practices, and simultaneously involves a way of knowing, a way of being and a way of constituting oneself. (shrink)

This article presents a conceptual analysis of the contemporary understanding of NURSING in Australia and proposes strategies for decolonisation. Through historical reflection and the lens of cultural safety and critical race theory, it examines some conditions which make up this concept, including “Florence Nightingale‐influenced practices,” “intellectual practitioners,” and “whiteness in nursing.” This analysis aims to identify conditions which we take to be necessary for the folk concept of NURSING to be satisfied and which result in negative outcomes. The article explores (...) why these conditions are plausibly included in this concept and possible objections to their inclusion. These conditions, and subsequently the concept of NURSING, are then critiqued. In this conceptual analysis of NURSING in Australia, we explore three conditions. By critically examining these conditions through the lens of cultural safety and employing decolonising methodologies, the article sheds light on the complex interplay of historical legacies, contemporary practices and potential negative outcomes within the nursing profession. The conclusions drawn propose a shift toward decolonisation, advocating for a cultural safety framework to address historical injustices and highlights possible ways in which one might amend the concept of nursing to be more inclusive of Aboriginal and Torres Strait Islander people. The need for this change is emphasised by the acknowledgement of historical conditions that perpetuated racism and hindered equitable healthcare. Ultimately, the article advocates for a comprehensive decolonisation of the concept of NURSING in Australia, urging the nursing profession to implement cultural safety for the overall well‐being of Aboriginal and Torres Strait Islander people. The authors of this article would like to acknowledge the people of the Dharawal and Dharug language group, who are the custodians of the unceded land we have worked on throughout this project. We would also like to acknowledge Aboriginal and Torres Strait Island people nationwide and warn them that some traumatic aspects of Aboriginal and Torres Strait Islander history are mentioned throughout this article. Always was, always will be, Aboriginal land. Two authors on this article identify as Aboriginal, while three do not. Two authors are registered nurses, one is an anthropologist, one is a philosopher and one is a historian. (shrink)

A última década da Guerra Fria foi turbulenta. Seu início apresentou tensão comparável àquela existente nos anos 1950 e princípio dos 1960. A partir de meados dos anos 1980, entretanto, houve distensão, o fim da Guerra Fria e a desintegração do próprio sistema internacional bipolar de poder. O cinema, como outras formas de produção cultural, foi instrumento de propaganda e mobilização durante toda a Guerra Fria. O objetivo deste artigo é analisar como a Guerra Fria se apresentou nos filmes de (...) maior bilheteria nos EEUU na década de 1980. O inimigo comunista é examinado nesses longas-metragens tendo como base a retórica reaganista do período.The Cold War and the Communist Enemy on the US Movie Theater Screens in the 1980s The last decade of the Cold War was a turbulent one. Its beginning showed tension comparable to that of the 1950s and early 1960s. As of the mid-1980s, however, there was a détente, the end of the Cold War and the collapse of the bipolar international power system. Movies, like other forms of cultural production, were tools for propaganda and mobilization throughout the Cold War. The purpose of this paper is to analyze how the Cold War was shown in the 1980s movies with the highest box-office sales in the US. The Communist enemy is examined in these feature films according to the Reaganist rhetoric of the period. Resumen La Guerra Fría y el enemigo comunista en los cines norteamericanos de los años 1980 La última década de la Guerra Fría fue turbulenta. Su inicio presentó una tensión comparable a la existente en los años 1950 y principios de los años 1960. Sin embargo, a partir de mediados de los años 1980, hubo distensión, el fin de la Guerra Fría y la desintegración del propio sistema internacional bipolar de poder. El cine, como otras formas de producción cultural, fue instrumento de propaganda y movilización durante toda la Guerra Fría. El objetivo de este artículo es analizar cómo la Guerra Fría se presentó en las películas de mayor taquilla en EEUU en la década de los 80'. El enemigo comunista es examinado en esos largometrajes, teniendo como base la retórica reaganista del período. (shrink)

The difficulties faced by Descartes to think about the body/soul substancial union, since he started from the real distinction of both the substances. An attempt to consider this conflicting union by means of a complementarity oposition.As dificuldades enfrentadas por Descartes para pensar a união substancial corpo/alma, já que partiu da distinção real das duas substâncias. Uma tentativa de pensar essa união conflitante em termos de uma oposição por complementaridade.

A tese principal deste artigo é que emoções são parcialmente constituídas por estados corporais. No centro da discussão está a tradição James-Lange e serão estabelecidas duas premissas para identificar as abordagens mais relevantes acerca desse ponto: a Premissa de James, que será investigada a partir do trabalho do próprio autor; e a Premissa de Lange, que será investigada a partir do trabalho de Prinz. Embora se inscreva na mesma tradição, a perspectiva apresentada neste artigo diverge de ambas posições ao defender (...) uma visão sistêmica, na qual as emoções são constituídas tanto por estados periféricos corporificados quanto por estados cerebrais. A visão sistêmica parece vulnerável a duas críticas principais: de que as emoções, ao contrário de estados corporais, possuem intencionalidade; e as neurociências mapearam as bases neurais das emoções, então não há motivo para colocar fora do cérebro os componentes que as constituem. Em relação à primeira crítica, argumenta-se que as emoções não possuem intencionalidade direta, uma vez que não influenciam os comportamentos de modo específico, como objetos ou conteúdos representacionais o fazem. No tocante à segunda crítica, as conclusões das neurociências dizem menos do que aparentam acerca dos constituintes das emoções. A confusão na literatura empírica resulta da falha em distinguir corretamente emoções de desejos. Isso será realizado mediante a análise do debate entre as teorias de James-Lange para, posteriormente, mostrar como a Premissa de Lange desconstrói teorias relevantes desta posição, inclusive a sua própria. (shrink)

Possuímos sentimentos divergentes com relação a aspectos do presente: somos otimistas com relação à expansão da democracia e cautelosos com relação à aplicação intensa da técnica. Indago se é possível manter esses dois sentimentos divergentes a partir de uma análise da situação cultural que produziu as noções atuais de natureza e sujeito – os respectivos fundamentos da técnica e da democracia contemporâneas. Constato que o sistema técnico-democrático, do qual essas noções emergiram, impõe uma conexão específica entre a natureza e o (...) sujeito, de tal forma que o movimento produzido em uma delas afeta necessariamente a outra. Portanto, democracia e técnica se constituem como as duas faces de uma mesma moeda e não devem ser tratadas de maneira abstrata, como dois elementos distintos. As tentativas de identificação de problemas e de proposição de soluções sobre a técnica e a democracia tenderão a produzir resultados inócuos se partirem dessa perspectiva abstrata que os representa como dois elementos separados da vida contemporânea.: We have different feelings about aspects of the actual world: we are optimistic about the expansion of democracy and cautious about the technique’s intense application. I ask if it’s possible to keep these two conflicting feelings from an analysis of the cultural situation that produced the current notions of nature and subject – the respective foundations of contemporaries technique and democracy. I note the technical democratic system, which these notions have emerged, imposes a specific connection between nature and subject, such that the movement produced in one necessarily affects another. Therefore, democracy and technique constitute as two sides of the same coin and should not be treated abstractly as two distinct elements. Attempts to identify problems and propose solutions about the technique and democracy will tend to produce innocuous results if they start from this abstract point of view that represent them as two separate elements of contemporary life. Keywords: Technique; Democracy; Nature; Subjectivity; Technical Democratic System. (shrink)

A pesquisa analisou os possíveis impactos da aplicação de uma sequência didática envolvendo o aplicativo (app) Telegram à prática pedagógica sob a perspectiva da aprendizagem significativa. Este estudo foi desenvolvido no Mestrado Profissional em Educação Profissional e Tecnológica (ProfEPT) em sua linha de pesquisa “Práticas Educativas em Educação Profissional e Tecnológica (EPT). Nesse estudo aplicado de abordagem qualitativa aplicaram-se dois questionários semiestruturados: um aos estudantes da disciplina de empreendedorismo e outro aos docentes do Curso Técnico em Administração no CEDUP Guaramirim. (...) Complementarmente, optou-se para análise dos dados a análise textual discursiva (ATD), categorizando-os pelos conteúdos, procedimentos e atitudes relevantes à prática pedagógica. Ao consolidar os dados, questionou-se: Como o app Telegram pode ser envolvido à prática pedagógica de forma que contribua para uma aprendizagem significativa? Em resposta a indagação, elaborou-se um produto educacional no formato de uma sequência didática, como instrumento que integrou os conhecimentos prévios aos interesses pedagógicos dos discentes, com os desafios e competências docentes envolvendo a TDIC. Os resultados obtidos demonstraram que a participação discente ao incorporar o app Telegram no processo de planejamento e aplicação da prática pedagógica contribuiu para uma aprendizagem democrática, autônoma, criativa e significativa. (shrink)

It feels like there’s two of you inside—like there’s another half of you, which is my anorexia, and then there’s the real K [own name], the real me, the logic part of me, and it’s a constant battle between the two. The anorexia almost does become part of you, and so in order to get it out of you I think you do have to kind of hurt you in the process. I think it’s almost inevitable. We came to the (...) concept of authenticity belatedly, one might say. We had been talking to people who had a diagnosis of anorexia nervosa about their experiences of living with their condition, and though we had not raised issues of authenticity or identity ourselves, they often did. They struggled with questions of .. (shrink)

Ugar and Malele 1 critique the use of ‘generic’ technologies like artificial intelligence (AI) and machine learning (ML) for mental health diagnoses, particularly in sub-Saharan African countries. They highlight how these AI medical tools often overlook traditional perspectives and local contexts. The article has the merit of working on ethical issues regarding the particularities and risks of using AI and ML for health diagnosis in the Global South, an urgent and neglected topic. According to the authors, the use of these (...) AI technologies leads to overgeneralisation in diagnosing mental disorders, which could be especially problematic in the mental health field because of value-laden judgements intrinsic to the definition of mental health disorders. This argument is theoretically grounded in the hybrid conceptualisation of mental disorders proposed by Wakefield. 2 This author’s perspective incorporates both factual and value components in defining mental disorders, framing them as context-dependent ‘harmful dysfunctions’... (shrink)

Resumo: Os monstros ocupam um lugar de destaque no ambiente da cultura contemporânea, especialmente no cinema. O objetivo desse artigo é compreender os motivos dessa presença marcante. Em primeiro lugar, podemos observar que os monstros indicam os limites morais e epistemológicos da modernidade. Entretanto, os monstros contemporâneos têm se tornado mais sutis, interiorizando-se ou espiritualizando-se. Podemos notar, então, que eles passaram a representar a potência humana para assumir qualquer vida efetiva – ou a liberdade, entendida como pura indeterminação. Por meio (...) da figura dos monstros, o homem constata sempre que pode ser muito mais do que é. Dessa forma, os monstros nos permitem apreender um dos dilemas centrais da cultura contemporânea: como nós conseguiremos resolver a diferença entre o que somos, aqui e agora, e todas as possíveis vidas humanas que podemos vir a adotar em um processo de autoaperfeiçoamento? (shrink)

Deep Brain Stimulation is currently being investigated as an experimental treatment for patients suffering from treatment-refractory AN, with an increasing number of case reports and small-scale trials published. Although still at an exploratory and experimental stage, initial results have been promising. Despite the risks associated with an invasive neurosurgical procedure and the long-term implantation of a foreign body, DBS has a number of advantageous features for patients with SE-AN. Stimulation can be fine-tuned to the specific needs of the particular patient, (...) is relatively reversible, and the technique also allows for the crucial issue of investigating and comparing the effects of different neural targets. However, at a time when DBS is emerging as a promising investigational treatment modality for AN, lesioning procedures in psychiatry are having a renaissance. Of concern it has been argued that the two kinds of interventions should instead be understood as rivaling, yet “mutually enriching paradigms” despite the fact that lesioning the brain is irreversible and there is no evidence base for an effective target in AN. We argue that lesioning procedures in AN are unethical at this stage of knowledge and seriously problematic for this patient group, for whom self-control is particularly central to wellbeing. They pose a greater risk of major harms that cannot justify ethical equipoise, despite the apparent superiority in reduced short term surgical harms and lower cost. (shrink)

L'auteur part de la définition la plus intuitive du concept de neutralité pour présenter quatre thèses qui se sont révélées comme des acquis du débat. Ces thèses affirment : 1) que la neutralité est un concept politique et non pas moral ; 2) qu'elle vise les justifications de l'action de l'État et non pas ses conséquences ; 3) qu'elle n'oblige pas nécessairement l'État à s'abstenir d'agir ; et 4) qu'elle est avant tout neutralité envers les individus et seulement de manière (...) dérivée neutralité envers les conceptions du bien. Ensuite, l'auteur discute deux affirmations qui jouissent d'une popularité aussi forte que les précédentes mais qui sont beaucoup moins évidentes. La première est qu'il y a des liens profonds entre l'idée de neutralité et l'idée d'égalité. La deuxième est qu'il y a un rapport d'équivalence entre le concept de neutralité et celui d'anti-perfectionnisme. Mettre en question cette dernière affirmation implique une prise de distance par rapport à quelques argumentations bien connues en faveur de la neutralité, mais cette opération s'impose si on veut répondre aux critiques de ceux qui proposent l'abandon de cette exigence normative.The article presents four theses that can be seen as firm outcomes of the contemporary debate on the principle of neutrality. These theses affirm that 1) neutrality is a political concept, not a moral one ; 2) neutrality involves the justifications of the State's action, not its consequences ; 3) neutrality does not imply State's inactivity ; and 4) State's neutrality is before anything neutrality between individuals and it is only afterwards between conceptions of the good. The second part of the article discusses two widely accepted but far more controversial statements. The first one says that there are deep links between neutrality and equality. The second one ajfirms that neutrality and anti-perfectionism are equivalent. To challenge the latter implies to reject some of the most popular cases for neutrality. However, this is needed if one wants to react to the great criticism coming from enemies of this principle. (shrink)

As ideias estão em Deus e são compreendidas por seus limites em relação à sua essência ilimitada. A originalidade do ser de Tomás de Aquino pode ser testada se comparada com as múltiplas teorias a respeito da ideia que se desenvolveram ao longo dos séculos na investigação filosófica. Das ideias subsistentes de Platão à ideia como subsistência em Hegel, os percursos aristotélico e tomista revelam-se opções intelectuais moderadas no âmbito gnosiológico, em razão de suas conquistas metafísicas. Deixando de lado os (...) problemas gnosiológicos em favor de uma abordagem metafísica do problema da ideia, pode-se perceber que, para Tomás, tanto o valor do conceito na ordem gnosiológica, quanto a subsistência da ideia na ordem metafísica, se resolvem apenas em ordem ao ser. A terceira das Quaestiones Disputatae De Veritate aborda diretamente o problema e traz sua formulação definitiva no pensamento de Tomás. Todas as perfeições das ideias estão em Deus formaliter, pertencem à sua essência, mas a ideia da essência divina somente Deus a conhece, pois identifica-se com seu ser, o Ipsum Esse Subsistens. (shrink)