Two issues are raised. (1) What is the nature of the drug effect Heyman thinks confers value to drugs? (2) What is the evidence that drug use decreases the value of drugs and of conventional incentives over the long-term? There is considerable evidence for the opposite; a persistent increase in the sensitivity of neural systems that mediate drug value.

Physicians, nurses, and other clinicians readily acknowledge being troubled by encounters with patients who trigger moral judgments. For decades social scientists have noted that moral judgment of patients is pervasive, occurring not only in egregious and criminal cases but also in everyday situations in which appraisals of patients' social worth and culpability are routine. There is scant literature, however, on the actual prevalence and dynamics of moral judgment in healthcare. The indirect evidence available suggests that moral appraisals function via a (...) complex calculus that reflects variation in patient characteristics, clinician characteristics, task, and organizational factors. The full impact of moral judgment on healthcare relationships, patient outcomes, and clinicians' own well-being is yet unknown. The paucity of attention to moral judgment, despite its significance for patient-centered care, communication, empathy, professionalism, healthcare education, stereotyping, and outcome disparities, represents a blind spot that merits explanation and repair. New methodologies in social psychology and neuroscience have yielded models for how moral judgment operates in healthcare and how research in this area should proceed. Clinicians, educators, and researchers would do well to recognize both the legitimate and illegitimate moral appraisals that are apt to occur in healthcare settings. (shrink)

Heyman explains useful ways to bring addictive drug use under environmental control. We doubt that relapse is explained by drug features such as immediate reinforcement, clouding of judgment, and so forth. Relapse may require explanation in terms of enduring sensitization of incentive neural substrates, but even if its causal assumptions are wrong, Heyman's model makes useful predictions for behavioral control.

Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease can lead to the development of neuropsychiatric symptoms. These can include harmful changes in mood and behaviour that alienate family members and raise ethical questions about personal responsibility for actions committed under stimulation-dependent mental states. Qualitative interviews were conducted with twenty participants following subthalamic DBS at a movement disorders centre, in order to explore the meaning and significance of stimulation-related neuropsychiatric symptoms amongst a purposive sample of persons (...) with PD and their spousal caregivers. Interview transcripts underwent inductive thematic analysis. Clinical and experiential aspects of post-DBS neuropsychiatric symptoms were identified. Caregivers were highly burdened by these symptoms and both patients and caregivers felt unprepared for their consequences, despite having received information prior to DBS, desiring greater family and peer engagement prior to neurosurgery. Participants held conflicting opinions as to whether emergent symptoms were attributable to neurostimulation. Many felt that they reflected aspects of the person’s “real” or “younger” personality. Those participants who perceived a close relationship between stimulation changes and changes in mental state were more likely to view these symptoms as inauthentic and uncontrollable. Unexpected and troublesome neuropsychiatric symptoms occurred despite a pre-operative education programme that was delivered to all participants. This suggests that such symptoms are difficult to predict and manage even if best practice guidelines are followed by experienced centres. Further research aimed at predicting these complications may improve the capacity of clinicians to tailor the consent process. (shrink)

Theorists at the interface of medicine and the humanities have recently suggested that interpretation as a literary activity can be applied to the practice of clinical medicine. This article reviews such theories and their literary metaphors and methods. In pushing these ideas further, it is proposed that a number of guidelines can be applied to interpretation as a practical activity for clinical medicine.

Accumulating evidence indicates that simulated natural settings can engage mechanisms that promote health. Simulations offer alternatives to actual natural settings for populations unable to travel outdoors safely; however, few studies have contrasted the effects of simulations of natural settings to their actual outdoor counterparts. We compared the impacts of simulated and actual natural settings on positive and negative affect (mood) levels using a pooled sample of participants enrolled in extant experimental studies. Relevant articles were identified from a review of research (...) published/in press by March 2020 and updated during the peer review of the current study. Of 16 articles identified, 6 met the inclusion criteria and administered a single cross-cutting, standardized instrument [the Positive and Negative Affect Schedule (PANAS)] before and after exposure. Random effects meta-analysis of pooled effects showed that positive affect increased in the actual settings but not in their simulated counterparts (Hedge's g = 0.87; 95% CI, 0.54, 1.20). We observed little difference in effects on negative affect change scores ( g = −0.28; 95% CI, −0.62, 0.06), with studies generally showing reductions in negative affect in both settings. Further research with additional populations, settings, antecedent conditions, and durations would provide a more robust understanding of differences in effects between these two ways to enhance mood by viewing nature. (shrink)

Bird kill rate and disruption of habitat has been reported when industrial wind turbines are introduced into migratory bird paths or other environments. While the literature could be more complete regarding the documentation of negative effects on birds and bird habitats during the planning, construction, and operation of wind power projects, there is sufficient evidence to raise concerns. Authoritative and mandatory vigilance monitoring and long-term surveillance over the life of the industrial wind facility are lacking. By the time the documentation (...) of the rate of bird kills, including that of endangered species is available in an environs of an industrial wind turbine facility, the damage may be irreversible. This article briefly explores the negative environmental impacts of the siting of industrial wind turbines and associated infrastructure, including transformer stations and transmission lines, in proximity to migratory bird corridors, wetlands, and nesting grounds. Research is required prior to proceeding with further industrial wind development in these environs. The authors propose that there is sufficient scientific evidence to require invoking the precautionary principle and halting further development until these risks are resolved. (shrink)

Upon entering the examination room, Caitlyn encounters a woman sitting alone and in distress. Caitlyn introduces herself as the hospital ethicist and tells the woman, Mrs. Dennis, that her aim is to help her reach a decision about whether to perform an autopsy on her recently deceased husband. Mrs. Dennis begins the encounter by telling the ethicist that she has to decide quickly, but that she is very torn about what to do. Mrs. Dennis adds, “My sons disagree about the (...) autopsy.” As a standardized patient, a specialized actor, the woman playing Mrs. Dennis has already delivered the same opening lines several times to different learners practicing their clinical ethics consultation skills. An SP encounter is a simulated patient encounter used for educational purposes that requires the standardization of verbal and behavioral responses. In the encounter, the simulator, or “patient,” uses a scripted medical history to enable the learner to employ a certain skill, say, the ability to perform a neurological exam. The use of standardized patients in the evaluation of clinical skills has become a staple in medical education. To tackle the challenge of teaching clinical ethics consultation skills, we have incorporated SP encounters into the curriculum of the Bioethics Program of The Union Graduate College and the Icahn School of Medicine at Mount Sinai. SP encounters are incorporated into one of our onsite classes, the Onsite Clinical Ethics Practicum, and they are part of the capstone examination, which all of our graduates must complete successfully. The inclusion of simulated encounters into the curriculum is one way in which we equip our students with the core competencies specified by the American Society for Bioethics and Humanities Task Force for clinical ethicists. (shrink)

Discrete choice experiments—selecting the best and/or worst from a set of options—are increasingly used to provide more efficient and valid measurement of attitudes or preferences than conventional methods such as Likert scales. Discrete choice data have traditionally been analyzed with random utility models that have good measurement properties but provide limited insight into cognitive processes. We extend a well-established cognitive model, which has successfully explained both choices and response times for simple decision tasks, to complex, multi-attribute discrete choice data. The (...) fits, and parameters, of the extended model for two sets of choice data (involving patient preferences for dermatology appointments, and consumer attitudes toward mobile phones) agree with those of standard choice models. The extended model also accounts for choice and response time data in a perceptual judgment task designed in a manner analogous to best–worst discrete choice experiments. We conclude that several research fields might benefit from discrete choice experiments, and that the particular accumulator-based models of decision making used in response time research can also provide process-level instantiations for random utility models. (shrink)

The COVID‐19 pandemic exposes underlying inequalities in our socio‐economic and health systems, such as gender‐based violence (GBV). In emergencies, particularly ones that involve quarantine, GBV often increases. Policymakers must utilize community expertise, technology and existing global guidelines to disrupt these trends in the early stages of the COVID‐19 epidemic. Gender norms and roles relegating women to the realm of care work puts them on the frontlines in an epidemic, while often excluding them from developing the response. It is critical to (...) value women’s roles in society and include their voices in the decision‐making process to avoid unintended consequences and ensure a comprehensive response that caters to the needs of the most vulnerable groups. (shrink)

Association between sister chromatids is essential for their attachment and segregation to opposite poles of the spindle in mitosis and meiosis II. Sister‐chromatid cohesion is also likely to be involved in linking homologous chromosomes together in meiosis I. Cytological observations provide evidence that attachment between sister chromatids is different in meiosis and mitosis and suggest that cohesion between the chromatid arms may differ mechanistically from that at the centromere. The physical nature of cohesion is addressed, and proteins that are candidates (...) for holding sister chromatids together are discussed. Dissolution of sister‐chromatid cohesion must be regulated precisely, and potential mechanisms to release cohesion are presented. (shrink)

This article presents evidence over which we stumbled while investigating a completely different part of the Platonic Corpus. While examining the ordinary working vocabulary of the doubtful dialogues and of those undisputed dialogues most readily compared with them, it seemed essential to have a representative sample of Plato's allegedly 'middle' and 'late' dialogues also. The real surprise came when the Critias was included, showing some frequencies not previously observed in Platonic dialogues. This prompted treatment of the Timaeus also, some of (...) which showed comparable peculiarities. The most distinctive feature was the increase in the rate of the definite article from around 8% of total vocabulary in dialogues assumed to be early, or around 10% in Laws, to some 14% in sizeable parts of the Timaeus-Critias, where Plato seemed no less interested in the literary credentials of his creations than elsewhere. Tests intended for application to our original set of problems were yielding results that appeared to bear on a number of problems central to the interpretation of the Timaeus-Critias. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

In lieu of an abstract, here is a brief excerpt of the content:The Idealization of Contingency in Traditional Japanese AestheticsRobert Wicks (bio)In many popular writings that date from the initial decades of the twentieth century, and also in recent scholarly studies, "Japanese aesthetics"—insofar as we can speak sweepingly of a complicated, multidimensional, and dynamic historical phenomenon—is characterized with a set of adjectives whose present linguistic entrenchment is clearly evident. Specifically we read that traditional Japanese aesthetics is an aesthetics of imperfection, (...) insufficiency, incompleteness, asymmetry, and irregularity, not to mention perishability, suggestiveness, and simplicity.1 Given this collection of qualities, we are presented with a matching set of paradigmatic Japanese aesthetic experiences and objects, both as illustrations and as legitimations of this close-to-standard portrait. Examples include the suggestive moon covered by drifting clouds, the irregularly formed ceramics of ceremonial teacups, the simple and asymmetrical arrangement of unpolished rocks in the dry landscape garden, the bold and dashing monochromatic strokes typical of Zen calligraphy, transient cherry blossoms, serene and cloud-capped mountain summits, lonely thatched huts, sunsets in the foggy twilight, the call of a crane that breaks through the silence, and the light autumn rain that drizzles upon a secluded pond.Upon further reflection, it becomes noticeable that some familiar Japanese aesthetic objects do not easily conform to this standard picture, and this raises doubts about the typical characterization of Japanese aesthetics. The quintessentially Japanese shōji screens and tatami mats, for instance, are uniformly rectangular rather than irregular in form. They are, moreover, neither asymmetrical, nor imperfect, nor incomplete, nor insufficient. How then, can these perfectly regular screens and mats—items crucial to the aesthetics of Japanese domestic architecture—fit neatly into the usually encountered portrait of traditional Japanese aesthetics, if it is said to be fundamentally "the worship of imperfection"?2 Or similarly if "imperfection" is [End Page 88] the keynote of this aesthetics, how does one explain the meticulously raked surfaces of the dry landscape garden or the impeccably perfected movements requisite for performing the Japanese tea ceremony?3Since such examples do not obviously fit into an "aesthetics of imperfection and insufficiency," some reconsideration of the prevailing characterization of Japanese aesthetics is needed to accommodate these, along with other examples of "perfected" items and arrangements. In short, the main difficulty is that the concept of "perfection" has been underthematized.4 To develop a revaluation of the presently submerged status of "perfection" in most scholarly discussions of Japanese aesthetics, I will highlight the familiar principle of aesthetic complementarity but contextualize the experiential foundations of this principle in a specifically Japanese-philosophic manner, namely, in reference to a fundamental feature of time-consciousness, as described by Dōgen (1200-53). This historical grounding will align the principle of complementarity with some of the acknowledged Zen Buddhist sources of traditional Japanese aesthetics.5 The upshot will be that the above-cited collection of adjectives typically used to describe the prevailing atmosphere of Japanese aesthetics—imperfection, asymmetry, incompleteness, suggestibility, etc.—presents only half of the aesthetic and philosophic story and, moreover, tends to pass over what can be appreciated as a more consequential underlying concept, namely, the idea of "contingency."In what follows, basic reflections on the phenomenology of time-consciousness will lead to the claim that, in many paradigmatic instances of traditional Japanese aesthetics, we have before us a situation that is aptly describable as "the idealization of contingency." This involves the assertion of a philosophic proposition through an aesthetic presentation (i.e., the proposition is expressed using metaphor, symbolism, or analogy). In the case of traditional Japanese aesthetics, the main proposition is the Buddhist-associated one that the foundation of things is contingent, conditional, and nonabsolute (i.e., there are no absolute foundations). The aesthetic presentation of this proposition will, as we shall see, make ample room for "perfection" in understanding Japanese aesthetics: By means of juxtaposing contingent, perishable individuals (which usually have an "imperfect" appearance) against a perfected, polished, and idealized background, the contingency of the individuals is thereby aesthetically highlighted and made more readily appreciable.The resulting criticism of the standard characterization is thus a simple one: The typical group of concepts used to describe traditional Japanese aesthetics has neglected to give due... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.1 (2003) 80-97 [Access article in PDF] Literary Truth as Dreamlike Expression in Foucault's and Borges's "Chinese Encyclopedia" Robert Wicks ALTHOUGH THE TOPIC REMAINS MOSTLY unexplored, Michel Foucault had an aesthetic and intellectual attraction towards writers and artists in the Spanish-speaking tradition. For example, at the conclusion of his Histoire de la folie (Madness and Civilization, 1961)—a book which brought him extensive intellectual recognition in France—Foucault (...) drew his readers' attention to José de Goya y Lucientes's (1746-1828) well-known etching, El Sueño de la Razón Produce Monstruos (The Sleep of Reason Brings Forth Monsters, Plate 43 of Los Caprichos, 1797). In Foucault's estimation, by revealing a "night which is doubtless that of classical unreason," Goya's work represented a socially removed condition within which people encounter "what is most solitary" and experience what is "deepest" within themselves. With his reference to Goya's imagery, Foucault illustrated a major theme of his history of madness, namely, how people referred to as "mentally ill" experienced a gradual, physical exclusion from participation in public society, and how they were eventually isolated in a more frightening way: within their physical confinement, they were subject to techniques of psychological and spiritual alienation that reduced them to a condition of utter solitude.In a comparable, if not more central manner, Foucault used as thematic motifs for the preface, first and second chapters of a book for which he is widely known, Les Mots et les choses (The Order of Things, 1966), the work of three major writers and artists from the Spanish-speaking world: Jorges Luis Borges (1899-1986), Diego Velázquez (1599-1660), and Miguel de Cervantes (1547-1616). Among these references, the most popular is probably Foucault's discussion of [End Page 80] Velázquez's Las Meninas—a painting which captured Foucault's interest as a perfect exemplar of its time period—and which inspired him to devote the entire first chapter of his book to decoding the mechanics of its perspectival arrangement. And within the community of those who read, write and discuss the interrelationship between Foucault's thought, literary theory and the contemporary emphasis upon the multivocal quality of textual meaning, Foucault's citation of an excerpt from a short story by Borges—the subject of this essay—is also familiar. Foucault introduced his 1966 book, The Order of Things, with the following words: This book first arose out of a passage in Borges, out of the laughter that shattered, as I read the passage, all the familiar landmarks of my thought—our thought, the thought that bears the stamp of our age and our geography—breaking up all the ordered surfaces and all the planes with which we are accustomed to tame the wild profusion of existing things, and continuing long afterwards to disturb and threaten with collapse our age-old distinction between the Same and the Other. This passage quotes a "certain Chinese encyclopedia" in which it is written that "animals are divided into: (a) belonging to the Emperor, (b) embalmed, (c) tame, (d) suckling pigs, (e) sirens, (f) fabulous, (g) stray dogs, (h) included in the present classification, (i) frenzied, (j) innumerable, (k) drawn with a very fine camelhair brush, (l) et cetera, (m) having just broken the water pitcher, (n) that from a long way off look like flies." In the wonderment of this taxonomy, the thing we apprehend in one great leap, the thing that, by means of the fable, is demonstrated as the exotic charm of another system of thought, is the limitation of our own, the stark impossibility of thinking that. 1The short story from which Foucault extracted the above, quasi-cubistic, excerpt was published in Borges's 1952 collection, Otras Inquisiciones (Other Inquisitions), and is entitled, "The Analytical Language of John Wilkins." Although this story's entirety is rarely surveyed in discussions of Foucault, appreciating its broader contents helps illuminate why Foucault began The Order of Things with this entertaining and bizarre segment. Borges's original... (shrink)

In his presentation at the 1993 Society of Business Ethics conference, Ed Freeman offered a provocative explanation for why the normative core of business and society (B&S) research is perceived as fundamentally at odds with the pervasive wisdom on business and the academic literature on management (e.g., "business ethics is an oxymoron"). He termed this explanation the separation thesis. This article explores the possibility that the separation thesis captures a pervasively held view about corporations, even among B &S researchers. To (...) support this claim, the author looks at whether three value dichotomies, which provide the conceptual underpinnings of the separation thesis, are prevalent in the literature. The article provides evidence from the literatures in ethics, corporate social responsibility/ performance, and wider management issues to support its claims, and then looks at alternative possibilities for developing inquiry to avoid the pitfalls of these value dichotomies and, therefore, the separation thesis. (shrink)

The Tao of Ordinariness is an invitation to come home to your authentic self in a world now clearly mesmerized by "spin," narcissism, fantasy, and exhibitionism. The book offers an alternative to pressures to measure your self-worth by numbers of likes and followers- i.e., living with a constant fear of "missing out" and seeking external validation for who you think you should be-instead of being comfortable with who you truly are.

This book celebrates the work of Patricia Werhane, an iconic figure in business ethics. This festschrift is a collection of articles that build on Werhane’s contributions to business ethics in such areas as Employee Rights, the Legacy of Adam Smith, Moral Imagination, Women in Business, the development of the field of business ethics, and her contributions to such fields as Health Care, Education, Teaching, and Philosophy. All papers are new contributions to the management literature written by well-known business ethicists, such (...) as Norman Bowie, Richard De George, Ronald Duska, Edwin Hartman, Michael Hoffman, Mollie Painter-Morland, Mark Schwartz, Andrew Wicks, and others. The volume is comprised of articles that reflect on Werhane’s work as well as build on it as a way to advance further research. At the end of the festschrift, Pat Werhane provides responses to each chapter. The first chapter of the book also includes the overview of Patricia Werhane’s work and her academic career. The book is written to appeal to management scholars and graduate students interested in the areas of Business Ethics, Modern Capitalism, and Human Rights. Patricia Werhane is one of the most distinguished figures in the field of business ethics. She was a founder of the field, she is one of its leading scholars, and she has had a profound impact on the world of business practice. Among her many accomplishments, Pat is known for her original work on moral imagination, she is an acclaimed authority on employee rights in the workplace, and she is one of the leading scholars on Adam Smith. Having been active in Academia for over 50 years, Werhane is a prolific author of over a hundred articles and book chapters, and the author or editor of twenty-seven books, including Adam Smith and his Legacy for Modern Capitalism, Moral Imagination and Management Decision-Making, and co-authored books Organization Ethics in Health Care, Alleviating Poverty Through Profitable Partnerships, Obstacles to Ethical Decision-Making, Corporate Responsibility: The American Experience, and Research Approaches to Business Ethics and Corporate Responsibility. (shrink)

I raise skeptical doubts about the prospects of Bayesian formal epistemology for providing an adequate general normative model of epistemic rationality. The notion of credence, I argue, embodies a very dubious psychological myth, viz., that for virtually any proposition p that one can entertain and understand, one has some quantitatively precise, 0-to-1 ratio-scale, doxastic attitude toward p. The concept of credence faces further serious problems as well—different ones depending on whether credence 1 is construed as full belief (the limit case (...) of so-called partial belief) or instead is construed as absolute certainty. I argue that the notion of an “ideal Bayesian reasoner” cannot serve as a normative ideal that actual human agents should seek to emulate as closely as they can, because different such reasoners who all have the same evidence as oneself—no single one them being uniquely psychologically most similar to oneself—will differ from one another in their credences (e.g., because they commence from different prior credences). I argue that epistemic probability, properly understood, is quantitative degree of evidential support relative to one’s evidence, and that principled epistemic probabilities arise only under quite special evidential circumstances—which means that epistemic probability is ill suited to figure centrally within general norms of human epistemic rationality. (shrink)

Causal compatibilism claims that even though physics is causally closed, and even though mental properties are multiply realizable and are not identical to physical causal properties, mental properties are causal properties nonetheless. This position asserts that there is genuine causation at multiple descriptive/ontological levels; physics-level causal claims are not really incompatible with mentalistic causal claims. I articulate and defend a version of causal compatibilism that incorporates three key contentions. First, causation crucially involves robust patterns of counterfactual dependence among properties.Second, often (...) several distinct such patterns, all subsuming a single phenomenon, exist at different descriptive/ontological levels (e.g., microphysical, neurobiological, macrobiological, and psychological). Third, the concept of causation is governed by an implicit contextual parameter that normally determines a specific descriptive/ontological level as the contextually relevant level, for the context-sensitive semantic evaluation of causal statements. (shrink)

Metaethics, understood as a distinct branch of ethics, is often traced to G. E. Moore's 1903 classic, Principia Ethica. Whereas normative ethics is concerned to answer first order moral questions about what is good and bad, right and wrong, metaethics is concerned to answer second order non-moral questions about the semantics, metaphysics, and epistemology of moral thought and discourse. Moore has continued to exert a powerful influence, and the sixteen essays here represent the most up-to-date work in metaethics after, and (...) in some cases directly inspired by, the work of Moore. (shrink)

Este trabajo ejemplifica brevemente los rasgos del nihilismo mediante la escena del loco descrita por Nietzsche en La Gaya Ciencia. Analiza la crisis de la personalidad histórica de los pueblos derivada del proceso de globalización, apoyándose en los tres niveles de la civilización distinguidos por Ricoeur en Tareas del Educador Político. Pone de manifiesto la interacción de innovación y tradición en la identidad de los individuos, las instituciones y los pueblos a partir de los conceptos ricoeurianos de identidad ídem e (...) ipse, desarrollados en Soi Meme comme en Autre. Procede, finalmente, al análisis de la identidad de la Universidad de Chile, e inspirándose en los conceptos antes expuestos y en procesos hermenéuticos presentes en la obra de filósofos tales como Kant y Habermas, aborda la posibilidad de una hermenéutica de los valores que han definido históricamente esa identidad, como contribución a la celebración del bicentenario de la instauración originaria de nuestra institucionalidad democrática. This work briefly exemplifies the characteristics of nihilism with the scene of the madman described by Nietzsche in The Gay Science. Supported by the three levels within civilization distinguished by Ricoeur in Tareas del Educador Político, analyzes the crisis of the historic personality of nations, derived from the globalization process. Starting from the concepts of idem and ipse identities, developed by Ricoeur in Soi Meme comme un Autre, the work shows the interaction of innovation and tradition in the identity of individuals, institutions and nations. Finally it examines the identity of the University of Chile and inspired by the concepts before mentioned and by the hermeneutic processes present in the work of philosophers such as Kant and Habermas, examines de possibility of a hermeneutic of the values that have historically defined that identity. (shrink)

OBJECTIVE: This paper addresses the question of the circumstances which lead clinicians to use legal coercion in the management of patients with severe anorexia nervosa, and explores similarities and differences between such formal coercion and other forms of 'strong persuasion' in patient management. METHOD: Logistic regression and other statistical analysis was undertaken on 75 first admissions for anorexia nervosa from a sample of 117 successive admissions to an eating disorder facility in New South Wales, Australia, where an eating disorder was (...) the primary diagnosis. Admissions with other primary diagnoses, such as bulimia nervosa (25 episodes), and entries with a co morbid diagnosis (e.g. depression or opiate overdose), were discarded, leaving 96 admissions by 75 individuals. RESULTS: Resort to measures of legal coercion into treatment was found to be associated with three main indicators: the patient's past history (number of previous admissions); the complexity of their condition (the number of other psychiatric co morbidities); and their current health risk (measured either by Body Mass Index or the risk of re-feeding syndrome). CONCLUSIONS: Our study is consistent with the few earlier studies about indicators for legal coercion in anorexia nervosa management, and suggests that clinicians use legal coercion very sparingly, distinguishing legal coercion from other forms of close clinical management of patients. (shrink)

Morphological content is information that is implicitly embodied in the standing structure of a cognitive system and is automatically accommodated during cognitive processing without first becoming explicit in consciousness. We maintain that much belief-formation in human cognition is essentially morphological : i.e., it draws heavily on large amounts of morphological content, and must do so in order to tractably accommodate the holistic evidential relevance of background information possessed by the cognitive agent. We also advocate a form of experiential evidentialism concerning (...) epistemic justification—roughly, the view that the justification-status of an agent’s beliefs is fully determined by the character of the agent’s conscious experience. We have previously defended both the thesis that much belief-formation is essentially morphological, and also a version of evidentialism. Here we explain how experiential evidentialism can be smoothly and plausibly combined with the thesis that much of the cognitive processing that generates justified beliefs is essentially morphological. The leading idea is this: even though epistemically relevant morphological content does not become explicit in consciousness during the process of belief-generation, nevertheless such content does affect the overall character of conscious experience in an epistemically significant way: it is implicit in conscious experience, and is implicitly appreciated by the experiencing agent. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 23 (2003) 181-183 [Access article in PDF] Keeping the Faith: Thai Buddhism at the Crossroads. By Sanitsuda Ekachai. Edited by Nick Wilgus. Bangkok: Post Books, 2001. 192 pp. Sanitsuda Ekachai, editorial columnist and features section editor of the Bangkok Post, writes this book in the Menckanian tradition of muckraking journalism. A collection of columns from the past decade, the book has an angry goal—the reform of a (...) corrupt Thai Buddhist sangha. Somehow, however, the author manages to accomplish the task without an angry or bitter tone. One suspects that this is because she has the goods. In thirty-six short features and twenty-one even shorter editorials, Ekachai paints a damning picture of a corrupt Theravada Buddhist sangha that has lost touch with both its religious tradition and its lay constituency.She presents overwhelming evidence of the corruption. She tells several well-publicized stories of sexual scandals involving bhikkhus and mentions a dozen more. She carefully tallies the possessions of rich bhikkhus and richer temples. She makes clear the unrepentant patriarchy of the authoritarian Buddhist hierarchy and reminds us of the un-Buddhist character of a sangha that will not allow the ordination of bhikkhunis. And she argues that the root cause of much of this drifting from Buddhist ideals is a buying into the consumerism that has gripped much of modern Thai culture.This last point—consumerism—is important. If the book has a theme—always a tall order for a collection of articles—it is the economic enslavement of Thai culture and the sangha to capitalistic values. Of course, the West is the culprit here. Since Thailand, strictly speaking, has never been colonialized, the West managed to corrupt Thailand (or Siam as some prefer) simply by being in the area. As one of Ekachai's key informants, Sulak Sivaraksha succinctly put it, "Siam is culturally and intellectually colonized because the country identifies itself closely with the West" (161). [End Page 181]A close second as a theme, however, is patriarchy. Patriarchy, not Buddhism, is the root of the gender imbalance in the sangha. The Buddha embraced (a bit reluctantly to be sure) the order of bhikkhunis and made it clear his reluctance was an upayic or strategic matter, not a question of the spiritual status of women. Women are as able as men when Enlightenment is the question. Patriarchy is also at the root of Thailand's shameful sex industry—one in thirty women in Thailand is a prostitute. The culture is at fault here, a culture that sees women as objects rather than persons.Sivaraksha ties consumerism and patriarchy together when he says, "In a consumer society, the seeking for endless sensory pleasures and possessions has become the ultimate quest while Buddhism teaches about letting go" (75). The combination of testosterone-blocking celibacy and baht- driven greed has been too much for the modern bhikkhus of Thailand.Not all bhikkhus, however. Ekachai's book rises above the level of pure muckraking through the simple expedient of offering hope. She tells a dozen or more stories of enlightened (small "e") bhikkhus who are taking steps at reform. By "ordaining" (and thereby protecting) endangered trees in a forest. By teaching the dhamma instead of occultism. By showing economic restraint in the face of runaway rapaciousness. These are inspiring stories of bhikkhus named Buddhadasa, Dhammapitika, Udompatanakorn, Kutajitto, Supajarawat,Visalo, and Kabilsingh. Hope is personalized in these reformers.Reading between the lines, one can imagine a response to Ekachai's overwhelming case: the traditional Thai sangha is organized to serve rural village folk. Although the traditional village still exists in Thailand, it is becoming an endangered species in the face of the urbanized juggernaut. The sangha simply hasn't discovered the keys to reaching a changed constituency. Reading between the lines, one suspects that the author would wholeheartedly agree with this defense. Only she wouldn't consider it a defense but a reason, and a well-known reason at that. Her rejoinder would be that the current leadership must know it is out of touch, but still refuses any move... (shrink)

Laws, codes, and rules are essential for any community, public or private, to operate in an orderly and productive fashion. Without laws and codes, anarchy and chaos abound and the purpose and role of the organization is lost. However, danger is significant, and damage serious and far-reaching when individuals or organizations become so focused on rules, laws, and specifications that basic principles are ignored. This paper discusses the purpose of laws, rules, and codes, to help understand basic principles. With such (...) an understanding an increase in the level of ethical and moral behavior can be obtained without imposing detailed rules. (shrink)

A recently developed model of general collective intelligence defines a method for organizing humans or artificially intelligent agents that is believed to create the potential to exponentially increase the general problem-solving ability of groups of such entities over that of any individual entity. An analysis based on this model suggests that many and perhaps all “wicked problems” are collective optimization problems that cannot reliably be addressed without a system of collective optimization, but that might be reliably addressed through such a (...) system. This paper briefly introduces the concept of GCI as well as why it is a system of collective optimization, and explores why “wicked problems” from the perspective of GCI are collective optimization problems, and therefore why such problems might require GCI to be reliably solvable. (shrink)

What is real? Less than you might think. We advocate austere metaphysical realism---a form of metaphysical realism claiming that a correct ontological theory will repudiate numerous putative entities and properties that are posited in everyday thought and discourse, and also will even repudiate numerous putative objects and properties that are posited by well confirmed scientific theories. We have lately defended a specific version of austere metaphysical realism which asserts that there is really only one concrete particular, viz., the entire cosmos (...) (see Horgan and Potr (2000, 2002), Potr (2003)). But there are various potential versions of the generic position we are here calling austere metaphysical realism; and it is the generic view that constitutes the ontological part of the overall approach to realism and truth that we will describe here. What is true? More than you might think, given our austere metaphysical realism. We maintain that truth is semantically correct affirmability, under contextually operative semantic standards. We also maintain that most of the time, the contextually operative semantic standards work in such a way that semantic correctness (i.e., truth) is a matter of indirect correspondence rather than direct correspondence between thought or language on the one hand, and the world on the other.1 When correspondence is indirect rather than direct, a given statement (or thought) can be true even if the correct ontology does not include items answering to all the referential commitments (as we will here call them) of the statement. 2 This means that even if a putative object is repudiated by a correct ontological theory, ordinary statements that are putatively about that object may still be true. For instance, the statement “The University of St. Andrews is in Scotland” can be semantically correct (i.e., true) even if the right ontology does not include any entity answering to the referring term ‘The University of St. Andrews’, or any entity... (shrink)

Moral judgments are typically experienced as being categorically authoritative – i.e. as having a prescriptive force that is motivationally gripping independently of both conventional norms and one's pre-existing desires, and justificationally trumps both conventional norms and one's pre-existing desires. We argue that this key feature is best accommodated by the meta-ethical position we call ‘cognitivist expressivism’, which construes moral judgments as sui generis psychological states whose distinctive phenomenological character includes categorical authoritativeness. Traditional versions of expressivism cannot easily accommodate the justificationally (...) trumping aspect of categorical authoritativeness, because they construe moral judgments as fundamentally desire-like. Moral realism cannot easily accommodate the aspect of inherent motivational grip, because realism construes moral judgments as a species of factual belief. (shrink)

Within cognitive science, mental processing is often construed as computation over mental representations—i.e., as the manipulation and transformation of mental representations in accordance with rules of the kind expressible in the form of a computer program. This foundational approach has encountered a long-standing, persistently recalcitrant, problem often called the frame problem; it is sometimes called the relevance problem. In this paper we describe the frame problem and certain of its apparent morals concerning human cognition, and we argue that these morals (...) have significant import regarding both the nature of moral normativity and the human capacity for mastering moral normativity. The morals of the frame problem bode well, we argue, for the claim that moral normativity is not fully systematizable by exceptionless general principles, and for the correlative claim that such systematizability is not required in order for humans to master moral normativity. (shrink)