ObjectiveThe novel coronavirus is linked to increases in emotional distress and may be particularly problematic for those with pre-existing mental and physical conditions, such as chronic pain and posttraumatic stress disorder. However, little empirical research has been published on resilience factors in these individuals. The present study aims to examine authenticity as a resilience factor among those with chronic pain and/or PTSD.MethodsPrior to the national response to the pandemic, participants were screened for pain-related disability and PTSD symptoms, and on the (...) basis of those responses were categorized into one of four groups: healthy, chronic pain only, PTSD only, or comorbid chronic pain and PTSD. During the CV-19 pandemic, participants responded again to the ODI and PCL-5, in addition to the Wood Authenticity Scale, Brief Pain Inventory, and items related to the CV-19 pandemic.ResultsA total of 110 participants, aged 42.19, completed the survey during the pandemic. The comorbid group endorsed higher levels of CV-19 Threat and Impact compared to all other groups. Authenticity moderated this relationship relevant to CV-19 Threat among those in the chronic pain only group, and not in any other group.ConclusionThe comorbid group endorsed higher levels of CV-19 Threat and Impact compared to all other groups. Importantly, greater authenticity was associated with less CV-19 Threat in the chronic pain only group, and not in any other group. The present study also highlights the importance of engaging authentically for those with chronic pain during the pandemic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ought We to Require Emotional Capacity as Part of Decisional Competence?Paul S. Appelbaum* (bio)AbstractThe preceding commentary by Louis Charland suggests that traditional cognitive views of decision-making competence err in not taking into account patients’ emotional capacities. Examined closely, however, Charland’s argument fails to escape the cognitive bias that he condemns. However, there may be stronger arguments for broadening the focus of competence assessment to include emotional capacities, centering (...) on the ways in which emotions aid humans in processing information. Before emotional capacities are added to the list of functions essential for decisional competence, though, the feasibility and utility of such a reorientation must be demonstrated.To what extent ought persons’ capacities to experience emotion be taken into account when determining whether they should be deemed competent to make their own decisions? In the previous article, Louis Charland (1998) argues that traditional models of decision-making competence—of which the MacArthur Competence Treatment Study is a typical example—are mistaken in focusing narrowly on persons’ cognitive abilities to the neglect of emotional factors. In contrast, he suggests, constructs of competence ought explicitly to require a capacity to experience emotions, which he believes is central to meaningful decision making, before deeming persons competent.Charland, as he acknowledges, is not the first to suggest that the presence of some degree of emotional capacity is a necessary element of competence, but his argument is among the most elaborate to date and is certainly worth closer examination. Looked at carefully, however, Charland’s argument does not make quite the case for the determination of emotional capacity in competence assessment that he claims for it. Indeed, as I demonstrate below, Charland may share the same “pernicious [End Page 377] cognitive bias” that he ascribes to more traditional approaches. However, despite what I identify as the problems in Charland’s argument, others have raised more disturbing questions about the lack of attention to emotional issues in competence assessment. Thus, I am not ready to reject entirely the possibility that determinations of decisional competence ought to consider emotional factors. I conclude by outlining the questions that remain to be answered to identify more clearly the potential benefits of such an approach.The Construct of Decision-Making CompetenceSome preliminary comments about the nature of the dominant construct of decision-making competence may provide a useful frame for my response to Charland’s paper. Contemporary ideas of competence are tied inextricably to the ideal of self-determination in modern Western societies. Such societies are committed to respect for individual choice, both as a good in its own right and on the grounds that each person knows best what choices will maximize his or her own welfare. In general, therefore, states will not intervene to prevent persons from acting on their decisions, even when the choices they make—like the decision to smoke or to refuse potentially life-saving medical care—may objectively be thought to be detrimental to them.In some cases, however, the presumption that people will act in their own interests, as well as the notion that there is something intrinsically valuable in respecting their choices, fails (Buchanan and Brock 1989). When people’s minds are so disordered that they cannot be said to be making meaningful choices, other values come into play. Such people are called “incompetent.” When persons reach that point, the state’s interest in protecting its citizens becomes primary and someone else must make decisions on their behalf. Note that the size of this group must be sharply limited, lest a liberal society’s commitment to self-determination be undermined: There is no more profound infringement of the rights of citizens than the determination that they are incompetent. Thus, the criteria for incompetence must be selected in a deliberately narrow fashion—alternately, one might say that the standards for competence are made intentionally broad—so that all but a tiny percentage of citizens will be permitted to make decisions on their own.In the Anglo-American world, the process of formulating criteria of competence by and large has been left to the common law courts. Over the course of centuries they have identified the capacities that are, in... (shrink)

There is a long and successful scholarly tradition of commenting on Nietzsche’s deep affinity for the philosophy of Heraclitus. But scholars remain puzzled as to why he suggested at the end of his career, in Ecce Homo, that the doctrine he valued most, the eternal recurrence of the same, might also have been taught by Heraclitus. This essay aims to answer this question through a close examination of Nietzsche’s allusions to Heraclitus in his first published mention of eternal recurrence in (...) The Joyful Science and in a related set of notes from the period when he was formulating and defending his doctrine of eternal recurrence while writing Thus Spoke Zarathustra. The key to answering this question, it is argued, is that Nietzsche came to believe that the doctrine of eternal recurrence, when properly understood as requiring identical repetition, has to presuppose a Heraclitean reality of eternal, absolute, and universal flux. (shrink)

Ideas of love within religion are usually driven by one of two mythologies – either a personal God who commands love or a mystical God of ineffable love – but both are inadequate for motivating love of neighbour. The first tends towards legalism and the second offers no cognitive guidance. The situation is further complicated by there being different understandings of love of neighbour in the various Abrahamic religions, as exemplified in the approaches of two philosophers, Søren Kierkegaard and Emmanuel (...) Levinas. A better approach is therefore to explore actual practices of love in everyday life, and to discover how love might be performed openly and creatively. One such practice is recognition of vulnerability, and this too is often driven by a mythology, in this case one marked by fear, and by a violence either imposed or avoided. One paradigmatic example is the vulnerability felt by speakers, especially women, in front of an audience. A turning from wilful ignorance of vulnerability and a turning to reliance on collective work, modelled on an awareness of mutual vulnerability and openness to the unknown, will help to change our philosophical and social imaginary. The dark myth of vulnerability can be transformed into finding opportunities in vulnerability for openness to affection and so to an enhancement of life. It is only from the perspective of this new imaginary, and from everyday practices of it, that the double love-command – love of God and love of neighbour – will function as any kind of common ground between religions. (shrink)

: Responding to the paper by Miller and Joffe, we review the development of the concept of therapeutic misconception (TM). Our concerns about TM's impact on informed consent do not derive from the belief that research subjects have poorer outcomes than persons receiving ordinary clinical care. Rather, we believe that subjects with TM cannot give an adequate informed consent to research participation, which harms their dignitary interests and their abilities to make meaningful decisions. Ironically, Miller and Joffe's approach ends up (...) largely embracing the very position that they inaccurately attribute to us: the belief that, with some exceptions, it is only the prospect of poorer outcomes that should motivate efforts to dispel TM. In the absence of empirical studies on the steps required to dispel TM and the impact of such procedures on subject recruitment, it is premature to surrender to the belief that TM must be widely tolerated in clinical research. (shrink)

This article shows that Nietzsche’s published presentations endorse the cosmological truth of eternal recurrence and that they indicate how belief in this truth can be supported with direct mnemonic evidence as well as a priori scientific proof. It also introduces a refutation of any attempt to construe Nietzsche’s doctrine as a thought experiment that would help to test or promote the affirmation of nonrecurring life.

The ‘universal cell reaction’ (UCR), a coordinated biphasic response to external (noxious and other) stimuli observed in all living cells, was described by Nasonov and his colleagues in the mid‐20th century. This work has received no attention from cell biologists in the West, but the UCR merits serious consideration. Although it is non‐specific, it is likely to be underpinned by precise mechanisms and, if these mechanisms were characterized and their relationship to the UCR elucidated, then our understanding of the integration (...) of cellular function could be improved. As a step towards identifying such mechanisms, I review some recent advances in understanding cell mechanics and the stress response and I suggest potentially testable hypotheses. There is a particular need for time‐course studies of cellular responses to different stimulus doses or intensities. I also suggest a correspondence with hormesis; re‐investigation of the UCR using modern biophysical and molecular‐biological techniques might throw light on this much‐discussed phenomenon. BioEssays 29:324–333, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

In this article, I examine the linguistic features in Nietzsche's presentations that have led readers to assume that “the same” means numerical identity. I also evaluate the following argument about personal identity that has been used to support this assumption: if we are not numerically identical to our recurring counterparts, then we have no reason to be concerned about the prospect of reliving our lives and Nietzsche's theory cannot have any of the existential significance he ascribes to it. My conclusion (...) is that Nietzsche actually has in mind a complete qualitative identity that includes all spatiotemporal properties. Thus, the supporting argument fails because the problem of persistence through change over time is not relevant to a theory in which persons are neither recurring at a later time nor undergoing any change when they recur. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Examining the Ethics of Human Subjects ResearchPaul S. Appelbaum (bio)The work of the Advisory Committee on Human Radiation Experiments confirms once again the value of combining empirical and normative approaches to problems in clinical and research ethics. The Committee, like its predecessor, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, spent relatively modest sums of money gathering targeted data to inform (...) its deliberations. The results of the Committee’s research, which are discussed by Nancy Kass and Jeremy Sugarman in this issue of the Kennedy Institute of Ethics Journal, enhance our understanding of the current ethical status of human subjects research, helping to focus attention on areas of particular concern, and lay the basis for future research and policy development.My comments here focus on the two major empirical studies conducted by the Committee—the Research Proposal Review Project and the Subject Interview Study. I will underscore just a few of the primary findings from these studies, consider their limitations, and explore their implications. Readers interested in the details of the studies should consult the Committee’s Final Report (ACHRE 1995), on which I rely in part and which provides additional information on the methodology and findings of the studies.Research Proposal Review ProjectWhat can be learned from the Committee’s review of 125 federally-funded human research studies? In answering that question, one cannot ignore the irony inherent in the Committee’s decision to review documents related to institutional review board (IRB) consideration of the selected protocols. The single most frequent complaint about the current system for protecting human subjects is that IRBs focus almost exclusively on review of consent forms and other research documents, as if they bore some close relationship to what actually transpires between investigators and potential research subjects. Only a small number of studies examine the research consent process. Nevertheless, existing data strongly [End Page 283] suggest that subject recruitment often involves an extended process of courtship, during which the information contained in consent forms is only a small part of the information passed between investigators and subjects (Benson, Roth, and Winslade 1985; Lidz et al. 1984).Indeed, the second of the Committee’s studies—the Subject Interview Study, which is discussed below—appears to confirm these findings. In-depth interviews with 99 individuals who reported that they were former or current research subjects suggest that “[f]or many, the decision to participate seemed to have been made before the consent form was given to them, and they signed it almost as a formality” (ACHRE 1995 [GPO, p. 742; Oxford, p. 471]). 1 Why, then, did the Committee focus its attention on documents that in many cases seem to play only a tangential role in the consent process? As is the case with IRBs around the country, the answer appears to be that consent forms and related documents are the only easily available window on consent transactions. In addition, under the current system, consent forms constitute the part of the process that IRBs can influence most easily. Consequently, it suits almost everyone’s needs—except perhaps those of the research subjects—to pretend that they reflect what actually transpires in the recruitment process. To the Committee’s credit, it was well aware of this dilemma. Nonetheless, it struggled to wring valid lessons from these limited data in its Final Report.Perhaps the most interesting finding from the Research Proposal Review Project is just how poor so many consent forms are. Given the disproportionate emphasis that many IRBs place on the content of the forms, one would expect that investigators by now would have learned to design documents that meet objective standards of adequacy, such as those applied by the Committee. Indeed, except in the most unusual circumstances, doing so would virtually guarantee that the IRB will ask no further questions about subject recruitment procedures. Although the data justify the inference that many investigators do not yet understand which information is essential to communicate to potential subjects, nor have learned how to do so effectively, they also force us to a still more radical conclusion. If the IRBs were doing their jobs, the Committee... (shrink)

Comparative studies demonstrate that homologous neural structures differ in function and that neural mechanisms underlying behavior evolved independently. A neural structure does not serve a particular function so much as it executes an algorithm on its inputs though its dynamics. Neural dynamics are altered by a neuromodulation, and species-differences in neuromodulation can account for behavioral differences.

Voluntariness of consent to research has not been sufficiently explored through empirical research. The aims of this study were to develop a more comprehensive approach to assessing voluntariness and to generate preliminary data on the extent and correlates of limitations on voluntariness. We developed a questionnaire to evaluate subjects’ reported motivations and constraints on voluntariness. 88 subjects in five different areas of clinical research—substance abuse, cancer, HIV, interventional cardiology, and depression—were assessed. Subjects reported a variety of motivations for participation. Offers (...) of financial incentives were common but not influential, pressures from others were rare, and no threats were reported. However, certain financial incentives and—paradoxically—altruistic motivations led some subjects to feel more constrained. Consistent with previous studies, no one pattern of motivation was common to all research subjects. There was little evidence of constrained voluntariness, but some suggestion of areas of concern. Voluntariness appears to be susceptible to systematic empirical investigation. (shrink)

Despite much misunderstanding among modern readers and preachers, Jesus' saying in Matthew 5:13 (“You are the salt of the earth”) concerns sacrificing one's life to follow Christ. Moreover, this high cost of discipleship has cosmic significance.

Volume 20, Issue 2, February 2020, Page 49-50.

The target article does not address the neural mediation of complex social behavior. I review evidence that such mediation may be compatible with proposed Bayesian information-processing principles. Notably, however, such mediation occurs subcortically as well as cortically, concerns reward uncertainty and information uncertainty, and impacts culture via group-level payoff structures that define individualism and collectivism.

Presents the first book-length study of the profound influence of Descartes' philosophy on Husserl's project for phenomenology.

This article examines some of the phenomenological features in Lev Vygotsky’s mature psychological theory, especially in Thinking and Speech and The Current Crisis in Psychology. It traces the complex literary and philosophical influences in 1920s Moscow on Vygotsky’s thought, through Gustav Shpet’s seminars on Husserl and the inner form of the word, Chelpanov’s seminars on phenomenology, Bakhtin’s theory of the production of inner speech, and the theoretical insights of the early Gestalt psychologists. It begins with an exposition of two central (...) Husserlian schemas: part-whole theory and the thesis of the naïve standpoint, both of which Vygotsky was clearly familiar with. This is followed by an account of the reception of phenomenology in early Soviet Russia. The article’s central sections are concerned with a careful unpacking and critique of Vygotsky’s employment of Husserlian method and analysis in his later doctrine of the ‘inner plane of speech’, his use of part-whole theory, and his identification of Husserl’s position with an untenable version of idealism. The article closes with the contention that Vygotsky misrepresents the phenomenological analysis of meaning formation and appropriates basic Husserlian conceptual terms in his elaboration of the ‘inner form of the word’; but Vygotsky does so in such a way that he enriches our descriptive access to the individual development of humans’ dynamic use of language. (shrink)

Reading the Fourth Gospel in search for its first audience can lead to a fresh awareness of the way in which the contemporary disciple is its audience.

This essay is one of ten contributions to a special editorial feature in The Journal of Nietzsche Studies 49.2, in which authors were invited to address the following questions: What is the future of Nietzsche studies? What are the most pressing questions its scholars should address? What texts and issues demand our urgent attention? And as we turn to these issues, what methodological and interpretive principles should guide us? The editorship hopes this collection will provide a starting point for discussions (...) about the most fruitful directions for Nietzsche scholarship to take and the most promising avenues for building on the best recent work. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 17-18, August 2011.