SummaryThe dichotomy between ‘scientific’ and ‘practical’ approaches to guideline development is false and divisive. Instead we should concentrate on developing mechanisms to develop and implement valid guidelines to improve patient care. The development of valid guidelines requires considerable expertise and is time consuming and expensive. It is most efficiently done at a regional or national level. The implementation of valid guidelines requires local action including the identification and modification of valid guidelines and a coordinated evidence-based implementation strategy (Grimshaw & Eccles (...) 1998). (shrink)

Mental health professionals working in hospitals or community clinics inevitably face the realisation that we possess imperfect conceptual means to understand mental disorders. In this paper the authors bring together ideas from the fields of Philosophy, Psychiatry, Cognitive Psychology and Linguistics to reflect on the ways we represent phenomena of high practical importance that we often take for granted, but are nevertheless difficult to define in ontological terms. The paper follows through the development of the concept of psychosis over the (...) last two centuries in the interplay of three different conceptual orientations: the categorical, dimensional and network approaches. Each of these represent the available knowledge and dominant thinking styles of the era in which they emerged and take markedly different stances regarding the nature of mental phenomena. Without particular commitment to any ontological positions or models described, the authors invite the reader into a thinking process about the strengths and weaknesses of these models, and how they can be reconciled in multidisciplinary settings to benefit the process of patient care. (shrink)

Postmodernism, its history and cultural context -- Postmodernism and philosophy / Stuart Sim -- Postmodernism and politics / Iain Hamilton Grant -- Postmodernism and feminism / Sue Thornham -- Postmodernism and lifestyles / Nigel Watson -- Postmodernism and religion / Pamela Sue Anderson -- Postmodernism and the postcolonial world / Eleanor Byrne -- Postmodernism and science and technology / Iain Hamilton Grant -- Postmodernism and architecture / Diane Morgan -- Postmodernism and art / Colin Trodd -- Postmodernism and (...) cinema / Val Hill -- Postmodernism and television / Marc O'Day -- Postmodernism and fiction / Barry Lewis -- Postmodernism and music / Derek B. Scott -- Postmodernism and popular culture / John Storey -- Postmodernism, modernity and the tradition of dissent / Lloyd Spencer -- Names and terms. (shrink)

The introduction of a generous stakeholding or capital grant scheme promises to secure the material conditions of freedom for all citizens. But if citizens “blow” their initial capital grants, as seems possible, they put this freedom in jeopardy. The paper argues that such “stakeblowing” is a genuine cause of concern with the proposal and defends two responses to it: an “educational response” that combines grants with training in asset management and a “paternalist response” that limits how grants can be used. (...) The latter response provides some support for the alternative basic income proposal, for the idea of a development grant, and, perhaps most plausibly, for a hybrid of the two. (shrink)

Mounting evidence suggests that endorsement of psychological continuity and the afterlife increases with age. This developmental change raises questions about the cognitive biases, social representations, and cultural input that may support afterlife beliefs. To what extent is there similarity versus diversity across cultures in how people reason about what happens after death? The objective of this study was to compare beliefs about the continuation of biological and psychological functions after death in Tanna, Vanuatu, and the United States. Children, adolescents, and (...) adults were primed with a story that contained either natural or supernatural cues. Participants were then asked whether or not different biological and psychological processes continue to function after death. We predicted that across cultures individuals would be more likely to endorse the continuation of psychological processes over biological processes and that a theistic prime would increase continuation responses regarding both types of process. Results largely supported predictions; U.S. participants provided more continuation responses for psychological than biological processes following both the theistic and non-theistic primes. Participants in Vanuatu, however, provided more continuation responses for biological than psychological processes following the theistic prime. The data provide evidence for both cultural similarity and variability in afterlife beliefs and demonstrate that individuals use both natural and supernatural explanations to interpret the same events. (shrink)

Clinical ethics literature typically presents ethics consultations as having clear beginnings and clear ends. Experience in actual clinical ethics practice, however, reflects a different characterization, particularly when the moral experiences of ethics consultants are included in the discussion. In response, this article emphasizes listening and learning about moral experience as core activities associated with clinical ethics consultation. This focus reveals that responsibility in actual clinical ethics practice is generated within the moral scope of an ethics consultant's activities as she or (...) he encounters the unique and specific features that emerge from interactions with a specific patient, or family, or practitioner within a given situation and over time. A long-form narrative about an ethics consultant's interactions is interwoven with a more didactic discussion to highlight the theme of responsibility and to probe questions that arise regarding follow-up within the practice of clinical ethics consultation. (shrink)

This article reexamines the classical distinction between professional and organizational work orientations for the case of engineers. Based on data from a survey questionnaire mailed to a sample of 800 engineers in the Rochester, New York, area in 1986, it argues that the two orientations are not opposites. Instead, it is possible to score high on measures of both orientations, or to score low on both. The result is a more complex, fourfold typology of engineers' work orientations. This fourfold typology (...) is then applied to the analysis of engineers' job satisfaction. The most important finding is that the content of engineers' work—that is, the level of challenge and the intrinsic interest of the work—is the central predictor of their satisfaction. The results thus support the conjecture that contemporary engineers have become highly focused—perhaps overly focused—on the gratifications derived from technical work as a process. (shrink)

Working within the tradition of continental philosophy, this article argues in favour of a phenomenological understanding of language as a crucial component of bioethical inquiry. The authors challenge the ‘commonsense’ view of language, in which thinking appears as prior to speaking, and speech the straightforward vehicle of pre-existing thoughts. Drawing on Maurice Merleau-Ponty's (1908–1961) phenomenology of language, the authors claim that thinking takes place in and through the spoken word, in and through embodied language. This view resituates bioethics as a (...) matter of bodies that speak. It also refigures the meaning of ethical self-reflexion, and in so doing offers an alternative view on reflexivity and critique. Referring to the Kantian critical tradition and its reception by Hannah Arendt and Michel Foucault, we advance a position we call ‘critical ethical reflexivity’. We contend that Merleau-Ponty's phenomenology of language offers valuable insight into ethical reflexivity and subject formation. Moreover, his understanding of language may foster new qualitative empirical research in bioethics, lead to more nuanced methods for interpreting personal narratives, and promote critical self-reflexion as necessary for bioethical inquiry. (shrink)

(No abstract is available for this citation).

A brief look at the philosophical thoughts of Bacon, Pascal, Hobbes, Galileo, Descartes, Spinoza, and Leibniz.

The Bohr-Heisenberg scheme, which forms the basis of any current version of the standard or Copenhagen interpretation of quantum mechanics, is shown to be internally inconsistent. Although the inconsistencies demonstrated here are directly relatable to Einstein's opinion that it is unsatisfactory to interpret physical theory solely in terms of the knowledge gained from experimental outcomes, it is nevertheless shown that Einstein's view requires important modification. The implications of the Bohr-Heisenberg schem's self-inconsistency are discussed in relation to Bell's theorem and Aspect's (...) experiments. (shrink)

British Journal for the History of Philosophy, Volume 19, Issue 3, Page 561-563, May 2011.

This article provides an overview of the key philosophical themes and debates in discussions of pornography. In particular, I consider the major positions on how pornography ought to be defined, when (and if ) it should be regulated, whether it is best understood as speech (or action), whether there is evidence that is it harmful. I argue in favor of what is known as the civil rights approach to pornography, as reflected in the work of Catharine MacKinnon.

Secondly, there is the approach of Augustine. Augustine focusses his original attention on the fact of understanding of immaterial substances, and thus can be said to begin his investigation of the soul with a conception of the soul as a substance separate in itself, apprehending universals in an immediate and direct act. Augustine, and the philosophers in this tradition, face the reverse of Aristotle's problem, for they must try to account for the fact of sensation with which he began, and (...) they must explain why the soul troubles to animate the body at all, why it operates at all through the medium of the body. (shrink)

Reginald Williams in (Think Autumn 2011) argued that the psychological need offers for endorsing atheism over theism. My article outlines six objections to his thesis, questioning how empirically verifiable the evidence he adduces is, and pointing out various logical fallacies such as illicit use of generalizations and begging the question. It concludes that atheism needs defending on stronger grounds.

This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the (...) practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives. (shrink)

This unique collection of readings provides a resource of primary source material, affording a survey of the history and systems of psychology from pre-Socratic thought to the present. Selected for accessibility, the 24 selections are organized to offer a representation of the historical sweep of psychological interpretations. After presenting approaches to the scholarly study of psychology's history, through an excerpt from Thomas Kuhn, the readings introduce the major themes of psychological inquiry in chronological fashion. The selections include the works of: (...) Plato, Aristotle, Augustine, Thomas Aquinas, Rene Descartes, Baruch Spinoza, John Locke, John Stuart Mill, Immanuel Kant, Wilhelm Wundt, Franz Brentano, William James, John Dewey, Sigmund Freud, Ivan Pavlov, John Broadus Watson, B.F. Skinner, Maurice Merleau-Ponty, and Carl Rogers. Features: Introductory essays for each group of readings provide important historical, social, and cultural background and context. Sample questions encourage critical reflection on the issues raised by the authors. Compatibility with most textbooks in the history and systems of psychology. (shrink)

BackgroundCentral to ethically justified clinical trial design is the need for an informed consent process responsive to how potential subjects actually comprehend study participation, especially study goals, risks, and potential benefits. This will be particularly challenging when studying deep brain stimulation and whether it impedes symptom progression in Parkinson’s disease, since potential subjects will be Parkinson’s patients for whom deep brain stimulation will likely have therapeutic value in the future as their disease progresses.MethodAs part of an expanded informed consent process (...) for a pilot Phase I study of deep brain stimulation in early stage Parkinson’s disease, an ethics questionnaire composed of 13 open-ended questions was distributed to potential subjects. The questionnaire was designed to guide potential subjects in thinking about their potential participation.ResultsWhile the purpose of the study (safety and tolerability) was extensively presented during the informed consent process, in returned responses 70 percent focused on effectiveness and 91 percent included personal benefit as potential benefit from enrolling. However, 91 percent also indicated helping other Parkinson’s patients as motivation when considering whether or not to enroll.ConclusionsThis combination of responses highlights two issues to which investigators need to pay close attention in future trial designs: (1) how, and in what ways, informed consent processes reinforce potential subjects’ preconceived understandings of benefit, and (2) that potential subjects see themselves as part of a community of Parkinson’s sufferers with responsibilities extending beyond self-interest. More importantly, it invites speculation that a different paradigm for informed consent may be needed. (shrink)

We have lived under the hegemony of the reductionistic scientific worldview since Galileo, Newton, and Laplace. In this view, the universe is meaningless, as Stephen Weinberg famously said, and organisms and a court of law are "nothing but" particles in morion. This scientific view is inadequate. Physicists are beginning to abandon reductionism in favor of emergence. Emergence, both epistemological and ontological, embraces the emergence of life and of agency. With agency comes meaning, value, and doing, beyond mere happenings. More organisms (...) are conscious. None of this violates any laws of physics, but it cannot be reduced to physics. Emergence is real, and the tiger chasing the gazelle are real parts of the real universe. We live, therefore, in an emergent universe. This emergence often is entirely unpredictable beforehand, from the evolution of novel functionalities in organisms to the evolution of the economy and human history. We are surrounded on all sides by a creativity that cannot even be prestated. Thus we have the first glimmerings of a new scientific worldview, beyond reductionism. In our universe emergence is real, and there is ceaseless, stunning creativity that has given rise to our biosphere, our humanity, and our history. We are partial co-creators of this emergent creativity. It is our choice whether we use the God word. I believe it is wise to do so. God can be our shared name for the true creativity in the natural universe. Such a view invites a new sense of the sacred, as those aspects of the creativity in the universe that we deem worthy of holding sacred. We are not logically forced to this view. Yet a global civilization, hopefully persistently diverse and creative, is emerging. I believe we need a shared view of God, a fully natural God, to orient our lives. We need a shared view of the sacred that is open to slow evolution, because rigidity in our view of the sacred violates how our most precious values evolve and invites ethical hegemony. We need a shared global ethic beyond our materialism. I believe a sense of God as the natural, awesome creativity in the universe can help us construct the sacred and a global ethic to help shape the global civilization toward what we choose with the best of our limited wisdom. (shrink)

Baby A1 was born prematurely with severe encephalopathy, injured brainstem, and a potentially injured spinal cord. He had no response to pain or other external stimuli. The neonatal team unanimousl...

Stuart Sim explores how Lyotard's brand of pragmatism can provide a focus for political theory and action in our cultural climate, especially in light of the dramatic resurgence of right-wing extremism.