In The Conditions for Ethical Chemical Restraint, Crutchfield and Redinger (2024) propose ethical standards for the use of chemical restraints, which they consider normatively distinct from physica...

Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term “social bioethics.” Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors (...) use social bioethics to reframe common ethical issues in psychiatric services and discuss potential implications. Lastly, the authors discuss how social bioethics illuminates the ways healthcare ethics consultants in both policy and clinical decision-making participate in and shape broader social, political, and economic systems, which then cyclically informs the design and delivery of healthcare. (shrink)

Bioethical consensus promotes a shared decision making model, which requires healthcare professionals to partner their knowledge with that of their patients—who, at a minimum, contribute their valu...

This article examines neuroleptics in relation to the histories of biopsychiatry and neoliberalism in the United States. Drawing from Foucault's concept of biopower, I contend that neuroleptics are socially constructed as a mechanism to address underlying biological illnesses in order to achieve neoliberal subjectivity for mad/disabled people. I then argue this biopsychiatric and neoliberal construct dominates services with the expressed goal of creating people who self‐govern their own drug consumption. This, however, contrasts with accounts that depict intersubjective balancing acts between (...) treatment providers and mad/disabled people, who must incorporate the various effects of psychoactive drugs beyond measures of rehabilitation. In doing so, I advocate for new lines of psychological inquiry that critically examine the structural determinants of poverty and the underlying constructions of citizenship and wellness. (shrink)

Volume 24, Issue 10, October 2024, Page 48-50.

In the wake of injustices in healthcare, the field of clinical ethics consultation would benefit from new methods that support ethicists in addressing the role of intersecting systems of oppression in healthcare decision-making.1 We argue for an expanded view of Delany and colleagues’ critical dialogue method to accomplish this by integrating a constructivist lens.2 By doing so, critical dialogue holds the potential to not only encourage a deeper examination of operating moral assumptions but also offers an important framework for examining (...) how underlying social structures shape ethical reasoning in clinical cases.3 As a first step in consultation methods, ethicists are often encouraged to solicit the viewpoints of treatment teams. Taking a constructivist viewpoint, these encounters can reveal to ethicists the narratives that teams share, which are iteratively developed through patient and treatment team interactions, and play a central role in how teams interpret cases. Further, consider that concepts in clinical ethics cases can directly contribute to the characterisation of patients by treatment teams, such as decisional capacity or agreeableness to care. In this regard, how treatment teams frame ethical concerns is not necessarily a direct reflection of the core issues; rather, their interpretations are partially rooted in narratives about patients and the interpersonal dynamics through …. (shrink)

Dougherty, R., Critical points in an algebra of elementary embeddings, Annals of Pure and Applied Logic 65 211-241.Given two elementary embeddings from the collection of sets of rank less than λ to itself, one can combine them to obtain another such embedding in two ways: by composition, and by applying one to the other. Hence, a single such nontrivial embedding j generates an algebra of embeddings via these two operations, which satisfies certain laws . Laver has shown, among other things, (...) that this algebra is free on one generator with respect to these laws.The set of critical points of members of this algebra is the subject of this paper. This set contains the critical point κ0 of j, as well as all of the other ordinals κn in the critical sequence of j ). But the set includes many other ordinals as well. The main result of this paper is that the number of critical points below κn grows so quickly with n that it dominates any primitive recursive function. In fact, it grows faster than the Ackermann function, and even faster than a slow iterate of the Ackermann function. Further results show that, even just below κ4, one can find so many critical points that the number is only expressible using fast-growing hierarchies of iterated functions. (shrink)

A famous result of Hausdorff states that a sphere with countably many points removed can be partitioned into three pieces A, B, C such that A is congruent to B, B is congruent to C, and A is congruent to B ∪ C; this result was the precursor of the Banach–Tarski paradox. Later, R. Robinson characterized the systems of congruences like this which could be realized by partitions of the sphere with rotations witnessing the congruences. The pieces involved were nonmeasurable. (...) In the present paper, we consider the problem of which systems of congruences can be satisfied using open subsets of the sphere ; of course, these open sets cannot form a partition of the sphere, but they can be required to cover "most of" the sphere in the sense that their union is dense. Various versions of the problem arise, depending on whether one uses all isometries of the sphere or restricts oneself to a free group of rotations, or whether one omits the requirement that the open sets have dense union, and so on. While some cases of these problems are solved by simple geometrical dissections, others involve complicated iterative constructions and/or results from the theory of free groups. Many interesting questions remain open. (shrink)

Hausdorff's paradoxical decomposition of a sphere with countably many points removed actually produced a partition of this set into three pieces A,B,C such that A is congruent to B, B is congruent to C, and A is congruent to B ∪ C. While refining the Banach–Tarski paradox, R. Robinson characterized the systems of congruences like this which could be realized by partitions of the sphere with rotations witnessing the congruences: the only nontrivial restriction is that the system should not require (...) any set to be congruent to its complement. Later, J. F. Adams showed that this restriction can be removed if one allows arbitrary isometries of the sphere to witness the congruences. The purpose of this paper is to characterize those systems of congruences which can be satisfied by partitions of the sphere or related spaces into sets with the property of Baire. A paper of Dougherty and Foreman gives a proof that the Banach–Tarski paradox can be achieved using such sets, and gives versions of this result using open sets and related results about partitions of spaces into congruent sets. The same method is used here; it turns out that only one additional restriction on a system of congruences is needed to make it solvable using subsets of the sphere with the property of Baire with free rotations witnessing the congruences. Actually, the result applies to any complete metric space acted on in a sufficiently free way by a free group of homeomorphisms. We also characterize the systems solvable on the sphere using sets with the property of Baire but allowing all isometries. (shrink)

This paper consists of three parts supplementing the papers of K. Hauser 2002 and D. Mumford 2000: There exist regular open sets of points in with paradoxical properties, which are constructed without using the axiom of choice or the continuum hypothesis. There exist canonical universes of sets in which one can define essentially all objects of mathematical analysis and in which all our intuitions about probabilities are true. Models satisfying the full axiom of choice cannot satisfy all those intuitions and (...) they violate them in a very similar way as those models which satisfy also the continuum hypothesis. (shrink)

In mental health policy, a central ethical dilemma concerns involuntary outpatient commitment (OPC), which aims to treat vulnerable individuals with serious mental illness who decline services. The first concern regards whether coercive services undermine the quality of clinical interactions within treatment, particularly as it relates to psychiatric medication use. The second concern is the unexamined role that OPC, and coercive psychiatric programs more broadly, play in the broader landscape of social welfare policy. To examine these concerns, the purpose of this (...) dissertation is to analyze how the management of psychiatric medications in involuntary outpatient services is undergirded by (a) provider and client interpretations of psychiatric medication effects and (b) moral discourses related to coercion and client autonomy. To achieve this aim, I examined data from a team-based ethnography that consisted of 1000 hours of participant observations and 56 semi-structured interviews with 20 clients, 21 providers, and 12 client family members with diverse backgrounds. I analyzed how medication compliance was discussed, monitored, and enforced in an involuntary outpatient program. My analysis demonstrates that medications were interpreted as a technology to control clinical symptoms (clinical control) though, particularly among clients, were also viewed as a method to control client mental experiences, behavioral expression, and autonomy (social control). Providers believed that medications were a necessary component of services (compulsory compliance) and could reduce client vulnerability to violence victimization and perpetration related to clinical symptoms (medicating vulnerability). To address client noncompliance, providers employed several strategies that I categorized as client manipulation. These strategies included providers, family members, and court officials strategizing ways to undermine client autonomy without clients’ knowledge (concealed collusion), deceiving clients into believing that medications were mandated when they were not (performing coercion), and minimizing the role of client consent and preferences in decision-making processes (circumventing consent). These findings demonstrate the pervasive role of manipulation to gain client medication compliance in OPC, which I named institutional coercion. They also highlight that the broader moral justifications for manipulating clients relate to their status as structurally vulnerable in their community settings and a growing relationship between the erosion of the welfare state and psychiatric coercion. (shrink)

Results of Sierpiski and others have shown that certain finite-dimensional product sets can be written as unions of subsets, each of which is ‘narrow’ in a corresponding direction; that is, each line in that direction intersects the subset in a small set. For example, if the set ω × ω is partitioned into two pieces along the diagonal, then one piece meets every horizontal line in a finite set, and the other piece meets each vertical line in a finite set. (...) Such partitions or coverings can exist only when the sets forming the product are of limited size.This paper considers such coverings for products of infinitely many sets . In this case, a covering of the product by narrow sets, one for each coordinate direction, will exist no matter how large the factor sets are. But if one restricts the sets used in the covering , then the existence of narrow coverings is related to a number of large cardinal properties: partition cardinals, the free subset problem, nonregular ultrafilters, and so on.One result given here is a relative consistency proof for a hypothesis used by S. Mrówka to produce a counterexample in the dimension theory of metric spaces. (shrink)

The series of Cambridge Texts in the History of Political Thought is in the process of putting into the hands of students useful, inexpensive editions of the most important works of Western political thought, especially suitable for classroom use. Here we have another welcome addition to the series, the minor texts of Marsiglio of Padua previously unavailable in the English language.

Reiman's project is to turn Rawls's A Theory of Justice into the theory of justice, by remedying a defect in Rawls's theory--a defect which has left the theory open to serious objections. The book, at heart, is an attempt to provide a moral grounding for Rawls's assumptions concerning the justice of the social contract. Reiman wants to provide the rational defense of Rawls that Rawls himself failed to produce; Rawls's tendency to rely on "intuition" in defending his principles of justice (...) leaves him short of the rational justification Reiman seeks to furnish. The path to this end is a fulsome one, demanding the development of theories of natural and social justice. (shrink)