When mental health service users are detained under a Section of the Mental Health Act (MHA), they must remain in hospital for a specific time period. This is often against their will, as they are considered a danger to themselves and/or others. By virtue of being detained, service users are assumed to have lost control of an element of their behaviour and as a result their dignity could be compromised. Caring for detained service users has particular challenges for healthcare professionals. (...) Respecting the dignity of others is a key element of the code of conduct for health professionals. Often from the service user perspective this is ignored. (shrink)

BackgroundHospitals face a disclosure dilemma when large-scale adverse events affect multiple patients and the chance of harm is extremely low. Understanding the perspectives of patients who have received disclosures following such events could help institutions develop communication plans that are commensurate with the perceived or real harm and scale of the event.MethodsA mailed survey was conducted in 2008 of 266 University of Washington Medical Center (UWMC) patients who received written disclosure in 2004 about a large-scale, low-harm/low-risk adverse event involving an (...) incomplete endoscope cleaning process. The survey measured patients’ satisfaction with this disclosure, their concerns about healthcare outcomes, and their recommendations for future communication, given similar circumstances.ResultsSurveys were received from 127 of 266 (48 percent) of eligible respondents; 98 percent thought that UWMC was right to inform them about this event, and mean satisfaction with the disclosure was 7.7 on a 0 to 10 scale. Of the 127 respondents, 64 percent were somewhat or very concerned that the endoscope cleaning problem might cause them health problems; 60 percent reported their impressions of UWMC’s honesty and integrity had increased; 31 percent said their perceptions of the quality of care had increased; 94 percent agreed that institutions should tell patients about any error in their care, even when the risk of harm was low, although 28 percent agreed that such notifications would make them anxious. Respondents who reported concern that the event could cause them health problems were less likely to be satisfied with the institution’s disclosure. Patients cited their right to know information material to their own health and healthcare as an important reason for disclosure.ConclusionRecipients of disclosure of a large-scale, low-harm/low-risk event overwhelmingly supported being told of the event and endorsed notification of patients for similar events in the future. Although informing patients may cause concern for some, institutions should ensure their disclosure policies and procedures reflect their patients’ preferences. (shrink)

Family Medicine Groups (FMGs) are the most recently developed primary care organizations in Quebec (Canada). Nurses within FMGs play a central role for patients with chronic diseases (CD). However, this complex role and the nursing activities related to this role vary across FMGs. Inadequate knowledge of nursing activities limits the implementation of exemplary nursing practices. This study aimed to describe FMG nursing activities with patients with CD and to describe the facilitators and barriers to these activities. A multiple‐case study was (...) performed with ten nurses practicing among patients with CD in FMGs. Five data sources were used to provide an in‐depth description of nursing activities and the facilitators and barriers to the development of these activities. After qualitative data analysis, findings show that nursing activities are clustered into five domains: Global assessment of the patient, Care management, Health promotion, Nurse–physician collaboration, and Planning services for patients with CD. Activities vary depending on contextual factors identified in each case. This multiple‐case study provides a clear description of nursing activities with patients with CD. There is a need for improved nursing activities and expertise in domains of activities that are less present in FMGs, such as case management and interprofessional collaboration. (shrink)

Caribbeanists working on the Francophone Caribbean within the Anglophone academy are perhaps particularly well placed to bring into focus the linguistic and cultural losses of the dislocations and relocations of High Capitalism. Although our object of study should facilitate critical insights into the fundamental linguistic and cultural indifference and irresponsibility of capitalist extraction models and into what is at stake politically and ethically in contemporary versions of those profiteering models, the commercialist reductionism currently formatting not just our own pulverized academic (...) universe, but the entire globe over which it has by now comprehensively spread, surely works against any such truly critical positioning. (shrink)

This article presents a commentary by James Steuart on David Hume’s History of the Tudors, written in the early 1760s. In doing so, the article sketches new aspects of Steuart’s political and historical thought at a time when he was hopeful about returning to Scotland from his long continental exile, following his leading role in the 1745 Jacobite rising. After providing a short biographical context, it establishes that the text was written whilst Steuart was working on his Political Oeconomy, and (...) when the ‘Marian controversy’ dominated Scottish historical debate. It goes on to explore the influence of Steuart’s friend Mary Wortley Montagu on his criticism of Hume’s misogynistic representation of Mary, Queen of Scots. It then reconstructs Steuart’s central argument about the failures of monarchs to adapt from feudal to commercial society, resulting in untrammelled liberties that harmed the lower classes. Concerned with the history of industry and commerce, political judgment, and the spirit of the people, Steuart’s hitherto unpublished commentary is a key source for understanding the ‘late Jacobite’ system of thought which influenced the reign of George III and inspired radicals later in the century. (shrink)

This paper introduces the concept of gothic violence in order to better theorize how domination operates in Mary Wollstonecraft’s unfinished novel, The Wrongs of Woman, or Maria. The fictive companion to A Vindication of the Rights of Woman, Maria is an account of the titular character’s struggle for self-determination in all aspects of her life, including her desire for a companionate partnership. I argue that Maria’s ultimate lack of freedom is directly attributable to coverture, the patriarchal legal fiction whereby (...) wives are subsumed under the legal persona of their fathers or husbands. Building on scholarship that positions Wollstonecraft as a republican feminist, I show how Maria articulates what I call gothic violence, a form of psychic domination that places the other in a condition of unfreedom by denying their status as an autonomous being and holding them in subordination through a variety of techniques, such as denial of legal and social status and testimonial quieting. I show how gothic violence results in the unfreedom of women through its reliance on domestic settings and intimate relationships, and with the support of law and custom, of which coverture is a central example. I conclude by suggesting that attending to gothic violence in Wollstonecraft’s thought allows us to further see the continuity between her political and fictional writings. (shrink)

In the contemporary life sciences more and more researchers emphasize the “limits of reductionism” (e.g. Ahn et al. 2006a, 709; Mazzocchi 2008, 10) or they call for a move “beyond reductionism” (Gallagher/Appenzeller 1999, 79). However, it is far from clear what exactly they argue for and what the envisioned limits of reductionism are. In this paper I claim that the current discussions about reductionism in the life sciences, which focus on methodological and explanatory issues, leave the concepts of a (...) reductive method and a reductive explanation too unspecified. In order to fill this gap and to clarify what the limits of reductionism are I identify three reductive methods that are crucial in the current practice of the life sciences: decomposition, focusing on internal factors, and studying parts in isolation. Furthermore, I argue that reductive explanations in the life sciences exhibit three characteristics: first, they refer only to factors at a lower level than the phenomenon at issue, second, they focus on internal factors and thus ignore or simplify the environment of a system, and, third, they cite only the parts of a system in isolation. (shrink)

This paper examines potential ethical and legal issues arising during the research, develop- ment and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of individ- ual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological samples; data; health; vulnerable (...) populations; neural organoids; and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detri- mental to best personalizing treatment decisions in the clinic. (shrink)

We hypothesize that effective collaboration is facilitated when individuals and environmental components form a synergy where they work together and regulate one another to produce stable patterns of behavior, or regularity, as well as adaptively reorganize to form new behaviors, or irregularity. We tested this hypothesis in a study with 32 triads who collaboratively solved a challenging visual computer programming task for 20 min following an introductory warm‐up phase. Multidimensional recurrence quantification analysis was used to examine fine‐grained (i.e., every 10 (...) s) collective patterns of regularity across team members' speech rate, body movement, and team interaction with the shared user interface. We found that teams exhibited significant patterns of regularity as compared to shuffled baselines, but there were no systematic trends in regularity across time. We also found that periods of regularity were associated with a reduction in overall behavior. Notably, the production of irregular behavior predicted expert‐coded metrics of collaborative activity, such as teams' ability to construct shared knowledge and effectively negotiate and coordinate execution of solutions, net of overall behavioral production and behavioral self‐similarity. Our findings support the theory that groups can interact to form interpersonal synergies and indicate that information about system‐level dynamics is a viable way to understand and predict effective collaborative processes. (shrink)

This book takes a fresh look at Socrates as he appeared to three ancient writers: Aristophanes, who attacked him for his theoretical studies; Plato, who immortalized him in his dialogues; and Aristotle, who criticized his political views. It addresses the questions of the interrelation of politics and philosophy by looking at Aristophanes' Clouds, Plato's Republic, and Book II of Aristotle's Politics--three sides of a debate on the value of Socrates' philosophic life. Mary Nichols first discusses the relation between Aristophanes (...) and Plato, showing that the city as Socrates' place of activity in the Republic resembles the philosophic thinktank mocked in Aristophanes' Clouds. By representing the extremes of the Republic's city, Plato shows that the dangers attributed by Aristophanes to the city are actually inherent in political life itself. They were to be moderated by Socratic political philosophy rather than Aristophanean comedy. Nichols concludes by showing how Aristotle addressed the question at issue between Plato and Aristophanes when he founded his political science. Judging Plato's and Aristophanes' positions as partial, Nichols argues that Aristotle based his political science on the necessity to philosophy of political involvement and the necessity to politics of philosophical thought. (shrink)

Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery’s effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery’s effectiveness in response to actual competition. This study examined (a), whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery intervention, (...) and (b), the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images. (shrink)

When deciding what disorders to screen newborns for, we should be guided by evidence of real effectiveness, take opportunity cost into account, distribute costs and benefits fairly, and respect human rights. Current newborn screening policy does not meet these requirements.

The phenomenology of inner temporalizing developed by Edmund Husserl provides a helpful framework for understanding a type of experiencing that can be part of the Post-Traumatic Stress Disorder (PTSD). My paper extrapolates hints from Husserl's work in order to describe those memories — flashbacks — that come so strongly to consciousness as to overtake the experiencer. Husserl's work offers several clues: his view of inner temporalization by which conscious experiences flow in both a serial and a nonserial manner; a characterization (...) of process memory as distinct from representational memory; and the notion of telos, which takes human subjectivity as intrinsically changeable, for example, by means of a retroactive cancellation that would allow the PTSD experiencer to re-process the original meaning of the traumatic experience into a meaning that fits the current situation and thus allows a recovery. (shrink)

Der Körper hat Konjunktur. Als ausgestellter, verfüg- und verführbarer begegnet er uns täglichim Übermaß. Es war nur eine Frage der Zeit, bis im Spiel der sich in den Wissenschafteneinander ablösenden turns auch ein corporeal (oder body) turn ausgerufen würde. Dabeibleibt im genannten turn der Gegenstand der Untersuchung nicht selten reduziert auf das, wasman im deutschen Sprachgebrauch »Körper« nennt: ein physisches Substrat, das wie ein Dingunter Dingen beschreibbar ist. Gegen diese Verkürzung stellt der Begri des »Leibes«,spätestens seit Edmund Husserl, eine präzise (...) theoretische Intervention in die wissenschaftlicheund philosophische Diskussion um Körper und Körperlichkeit dar: Dem objektiv beobachtbaren Körper, den wir haben, wird der lebendige Leib, der wir sind, gegenübergestellt. Diesem »Leib«, seiner Geschichte, seinen Varianten und seinem Versprechen gehen dieAutoren der vorliegenden Beiträge nach. Inhaltsübersicht Emmanuel Alloa/Thomas Bedorf/Christian Grüny/Tobias Nikolaus Klass: Einleitung I. Der Leibbegriff in der Phänomenologie Emmanuel Alloa / Natalie Depraz: Edmund Husserl – „Ein merkwürdig unvollkommenkonstituiertes Ding“ – Stefan Kristensen: Maurice Merleau-Ponty I – Körperschema undleibliche Subjektivität – Emmanuel Alloa: Maurice Merleau-Ponty II – Fleisch und Dierenz – David Espinet: Martin Heidegger – Der leibliche Sinn von Sein – Thomas Bedorf: EmmanuelLevinas – Der Leib des Anderen – Karel Novotný: Körper, Leib, Aektivität in Jan Pato č kasPhänomenologie der natürlichen Welt – Julia Scheidegger: Michel Henry – TranszendentaleLeiblichkeit – Jörg Sternagel: Bernhard Waldenfels – Responsivität des Leibes – Kerstin Andermann: Hermann Schmitz – Leiblichkeit als kommunikatives Selbst- und Weltverhältnis II. Zur Geschichte des Leibbegris Emmanuel Alloa: Archaische Leiblichkeit. Die griechische Antike und die Entdeckung desKörpers – Theresia Heimerl: Der Leib Christi und der Körper des Christen: Körper und Leib alszentrale Problemzonen des Christentums – Marc Rölli: Philosophische Anthropologie im 19. Jahrhundert – Zwischen Leib und Körper – Tobias Nikolaus Klass: Friedrich Nietzsche – Denkenam „Leitfaden des Leibes“ – Andreas Cremonini: Sigmund Freud – Der gelebte vs. derphantasmatische Leib – Uta Noppeney: Kurt Goldstein und Frederik Buytendijk – Der Leib-Begri in der organismischen Biologie – Volker Schürmann: Max Scheler und Helmuth Plessner– Leiblichkeit in der Philosophischen Anthropologie – Marion Lauschke: Ernst Cassirer und AbyWarburg – Kulturanthropologie III. Grenzen und Kritik des Leibbegris Christian Grüny: Theodor W. Adorno – Soma und Sensorium – Ulrich Johannes Schneider: Michel Foucault – Der Körper und die Körper – Burkhard Liebsch: Paul Ricoeur – Das leiblicheSelbst begegnet dem Widerstand des Anderen – Mirjam Schaub: Gilles Deleuze – Was weiß ein„Körper ohne Organe“ vom Leib? – Kathrin Busch: Jean-Luc Nancy – Exposition und Berührung– Shaun Gallagher: Embodiment: Leiblichkeit in den Kognitionswissenschaften – Marie-Luise Angerer: Gender und Performance – Ist leibliche Identität ein Konstrukt? – Thomas Bedorf/Selin Gerlek: Praxistheorien – Leibkörperliche Praktiken im Vollzug. (shrink)

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were (...) conducted with a diverse group of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mary Margaret Mackenzie THE TEARS OF CHRYSES: RETALIATION IN THE ILIAD1 ATHEORY of punishment is a systematic justification of the practice of punishment. Before the emergence of true penology in classical Greece—in Plato's Laws for example—penal transactions are associated only with pre-philosophic rationalizations. But such rationalizations must, nevertheless, be regarded as the antecedents of a formalized theory of punishment. In order to understand the classical approach to punishment, (...) therefore, we should look to the early literature for evidence, descriptive or evaluative, of the penological antecedents. To begin at the beginning, this article will consider the Iliad. Yet this procedure begs questions. First of all, a critic might deny the propriety of the use of literary evidence in a study of a philosophical problem. The objection is twofold—both against the treatment of literature as philosophy and against the assumption of continuity in the transition from non-philosophical to explicitly philosophical sources. To this the answer lies partly in the nature of Greek culture. Until the sophistic age there existed no moral philosophy as such—and yet the Greeks were capable of considering and solving moral problems, such as the questions surrounding the practice of punishment. Thus while we should distinguish between this unphilosophical approach and the systematic analyses of the philosopher, the problems with which they deal remain the same. Second, Homer depicts a fictional society: it is a common contention that we therefore have no grounds for attributing consistency or historical reality to any of the institutions described in the poems. Thus the proposition is that, not content with inventing a story to tell, Homer imagined all the trappings of the fiction as well—the conventions and the sentiments bear no relation to conventions or values of his own or any other time. The same argument might be applied to other literary works which make no claim to historicity. But its plausibility depends upon an inflated notion of fiction in which nothing of the 4 Philosophy and Literature story approaches the familiar experiences of its hearers. It is, of course, more reasonable to suppose that fiction generally derives its impact from familiarity, and that Homer's popularity was founded in his appeal to the audience's imagination in the context of their own lives. Thus while the story itself is fiction, it is associated with fact in its detail—the commonplaces of social life and human reaction among which the heroes move. Our task is to look to the commonplaces, for here will be found the social practices and the assumptions which Homer's audience would take for granted. Finally, we may generally suppose that the context of a particular source is determined chiefly by its antecedents. If, however, we are to treat the Homeric poems as the earliest Greek literary sources available to us, there is a major difficulty in this establishment of context: the absence of antecedent. The discussion of Homeric society has been severely hampered by the lack of contemporary referents and by the consequent temptation to import our own values as yardsticks for the measuring of the idiosyncracies of Homeric thought. To a large extent this is a useful enterprise; it is possible, for instance, to point out the differences between Homeric military structure and our own, or between the kingship system and the political structures of later Greek societies. On the other hand, as soon as the discussion turns to values, the issue becomes complicated; to compare two values, in our own society and in the Homeric poems, tends to presuppose some common ground where there need be none, to assume that the way we might translate a word reflects significantly upon its original use. This third difficulty gives rise to an eristic dilemma, common in the history of ideas: how do we know that a transaction is a punishment unless we already know that it is a punishment? Or if we are uncertain whether punishment occurs (and if we have no common language to help in the identification), where should we look for it? Further, having established the area in which punishment should occur, what criteria are to be employed to determine whether in fact it does? The first... (shrink)

Psychology is dead. The self is a fiction invented by the brain. Brain plasticity isn?t all it?s cracked up to be. Our conscious learning is an observation post factum, a recollection of something already accomplished by the brain. We don?t learn to speak; speech is generated when the brain is ready to say something. False memories are more prevalent than one might think, and they aren?t all that bad. We think we?re in charge of our lives, but actually we are (...) not. On top of all this, the common belief that reading to a young child will make her brain more attuned to reading is simply untrue. (shrink)

Newman’s dramatic poem, “The Dream of Gerontius”, was set to music by Edward Elgar in 1900. This essay brings out the sympathy of mind and heart between poet and composer, and perhaps between them both and the listener of today, as well as the universality and depth of the human stake in some kind of personal and peopled life after death.

The Body in Adolescence: Psychic Isolation and Physical Symptoms examines the affective experience of psychic isolation as an important and painful element of adolescent development. Mary Brady begins by discussing how psychic isolation, combined with the intensity of adolescent processes, can leave adolescents unable to articulate their experience. She then shows how the therapist can understand and help adolescents whose difficulty with articulation and symbolization can leave them vulnerable to breakdown into physical bodily symptoms. This book introduces fresh ideas (...) about adolescent development in the first chapter. Subsequent chapters include clinical essays involving adolescent patients presenting with bodily expressions such as anorexia, bulimia, cutting, substance abuse, and suicide attempts. Attention is also paid to adolescents’ use of social media in relation to these bodily symptoms – such as their use of on-line ‘pro-ana’ or cutting sites. Clinicians can feel challenged or even stymied when presented with their adolescent patient’s fresh cut or recent episode of binge drinking. Brady uses Bion’s conceptualization of containment and the balance of psychotic versus integrative parts of the personality to examine the emergence of concrete bodily symptoms in adolescence. Throughout, Mary Brady offers ways of understanding and empathically engaging with adolescents. This book is essential reading for psychoanalysts and psychotherapists who treat adolescents and other patients with physical symptoms, as well as other readers with an interest in the psychoanalytic understanding of these issues. (shrink)

In “Constitutivism without Normative Thresholds,” Kathryn Lindeman raises two objections to what she aptly calls Threshold Constitutivism. My aim in this short discussion is to respond to her first objection. Although I will argue that this objection fails, I will also argue that thinking through how to respond to it reminds us of something important, namely, that many of the Norm-Governed Kinds that are directly related to intentional action are social kinds, that is, kinds whose existence conditions we ourselves collectively (...) write. Everyone, whether constitutivist or not, needs to think seriously about what those existence conditions should be. [1] Journal of Ethics and Social Policy 12 (3): 231-258 (2017). [2] Lindeman’s second objection depends on her view, which I do not share, that “Normative Constitutivism has ambitions to be an explanatory strategy for norms in general” (238, my emphasis). (shrink)

How contemporary Chinese art is creating “a philosophy of life, a philosophy of politics, and a natural philosophy,” as artist Qiu Zhijie says it must, is explored in this collection of essays by philosophers and art historians from America and China.