BackgroundIn Saudi clinical settings, benevolent family care that reflects strongly held sociocultural values is commonly used to justify overriding respect for patient autonomy. Because the welfare of individuals is commonly regarded as inseparable from the welfare of their family as a whole, these values are widely believed to obligate the family to protect the welfare of its members by, for example, giving the family authority over what healthcare practitioners disclose to patients about their diagnoses and prognoses and preventing them from (...) making informed decisions about their healthcare.DiscussionFamily dominance over the healthcare decisions of competent patients is ethically problematic when the family prevent healthcare practitioners from disclosing diagnoses and prognoses to patients who have the capacity to consent and make decisions in their own best interests. Thus, the author holds that sociocultural values ought to be respected only when they do not prevent competent patients from knowing their diagnoses and prognoses or prevent them from making their own decisions.ConclusionHealthcare practitioners should not allow patients’ families to control what can or cannot be disclosed to competent patients. This is particularly important when patients are approaching death so that they may address their material and spiritual wishes—among other needs—as they prepare for death. Justification for this position is drawn from the Maqasid Al-Shariah-based Islamic bioethics approach, from which it is possible to argue that the harm of withholding diagnoses and prognoses from patients who are imminently dying outweighs the potential benefits. (shrink)

I distinguish between two conceptually different kinds of physical space: a space of ordinary material bodies, which is the space of points at which I could imaginably place the tip of my finger, or the center of a billiard-ball, and a space of elementary physical determinables, which is the smallest space of points such that stipulating what is happening at each one of those points, at every time, amounts to an exhaustive physical history of the universe. In all classical physical (...) theories, these two spaces happen to coincide – and what we mean by calling a theory “classical”, and all we mean by calling a theory “classical”, is precisely that these two spaces coincide. But once the distinction between these two spaces in on the table, it becomes clear that there is no logical or conceptual reason why they must coincide – and it turns out that a very simple way of pulling them apart from one another gives us quantum mechanics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 295 [Access article in PDF] Agency, Narrative, and Self:A Philosophical Case Conference John Z. Sadler and K. W. M. Fulford This issue of PPP features our second "philosophical case conference," which addresses three important and interrelated concepts in the philosophy of psychiatry. Our first philosophical case conference (Philosophy, Psychiatry, and Psychology Volume 5, Number 2, 1998) featured detailed case material concerning the manifold (...) issues involved in psychiatric euthanasia. For this issue, guest edited by J. Melvin Woody, the rich cases supplied by Lloyd Wells provide the foundation for a discussion of narrative accounts of the self and what it means to be an agent.Philosophical case conferences are an occasional feature of PPP, and develop topics to satisfy one or more criteria: to provide discussions that are important to clinical practice or research, to embed current or perennial philosophical debates in the nitty gritty of clinical practice and personal experience, and/or to provide a clinical testing ground for new conceptual developments relevant to the philosophy of psychiatry.The format for this issue involves four feature articles, the first by Wells, presenting detailed case material of several patients, followed by discussions (by Kennett & Matthews, Phillips, and Woody) inspired by, or addressing explicitly, the philosophical questions implied in such cases. Following these four feature articles, a panel of commentators (Glas, Hardcastle, Radden, Thornton, Weiner, Woodbridge) respond to the four feature articles as they wish, providing the variations on the agency, narrative, and self themes. We think you will find this issue of PPP to be a fine example of what the philosophy of psychiatry can do, and we give our abundant thanks to Mel Woody for putting this issue together.... (shrink)

The pigment melanin is found in all living kingdoms and in many different structures and forms. When its various functions are examined separately, its behaviors seem disparate and conflicting. It has a clear role in camouflage and sexual display. Other major roles are examined critically. It can act as a sun screen but is not a very effective one. It can also scavenge active chemical species, but this, too, is not done very effectively. It produces active radicals that can damage (...) DNA. It binds to drugs in ways that are either beneficial or deleterious. Aside from camouflage, its other roles can be brought together by a unifying hypothesis as first proposed by Proctor and McGinness nearly 20 years ago. Melanin is envisaged as an energy transducer with the properties of an amorphous semiconductor. It can absorb many different types of energy and dissipate them in the form of heat. However, if the energy input is too great, the output can be expressed in the form of activated chemical species that can damage cellular macromolecules resulting in cell death, mutations and cancer. The protective aspect of melanin in dark skin is seen as resulting from its high concentration and its confinement to ellipsoidal and densely packed organelles that can effectively shield the nucleus. In light skin, its radical nature is seen as potentially participating in the carcinogenic process, particularly when overwhelmed by intense episodes of sunburn. (shrink)

With age might come a decline in crucial driving skills. The effect of a collision warning system on older drivers' head movements behavior at intersections was examined.Methods: Twenty-six old-adults, between 55 and 64 years of age, and 16 Older drivers between 65 and 83 years of age, participated in the study. A CWS and a front-back in-vehicle camera were installed in each of the participants' own vehicles for 6 months. The CWS was utilized to identify unsafe events during naturalistic driving (...) situations, and the IVC was used to capture head direction at intersections. The experimental design was conducted in three phases, 2 months each. Unsafe events were recorded by the CWS during all phases of the study. In the second phase, the CWS feedback was activated to examine its effect on drivers' head movement' behavior at intersections.Results: Older drivers drove significantly more hours in total during the intervention phase than the baseline phase and the carryover phase. The study revealed no significant differences between the head movements of older and old-adult drivers at intersections. For intersection on the left direction, a significant improvement in drivers' head movements' behavior was found at T-junctions, turns and four-way intersections from phase 1 to phase 3, however, two intersection types presented a decrease along the study phases. The head movements' behavior at roundabouts and merges was better at phase 1 compared to phase 3. There was no significant reduction of the mean number of CWS unsafe events across the study phases.Conclusions: The immediate feedback provided by the CWS was effective in terms of participants' head movements at certain intersections but was harmful in others. However, older drivers drove many more hours during the active feedback phase, implying that they trusted the system. Therefore, in the light of this complex picture, using the technological feedback with older drivers should be followed with an additional mediation or follow-up to ensure safety. (shrink)

The idea that knowledge as an individual mental attitude with certain propositional content is not only true justified belief but a belief the truth of which does not result from any kind of luck, is widely spread in contemporary epistemology. This account is known as anti-luck epistemology. A very popular explanation of the inconsistency of that concept of knowledge with the luck-dependent nature of truth (so called veritic luck taking place when a subject’s belief could not be true if not (...) by mere coincidence) presumes that the status of propositional knowledge crucially depends on the qualities of actions that result in the corresponding belief, or processes backing them, which reflect the socalled intellectual virtues mainly responsible for subject’s relevant competences. This account known as Virtue Epistemology presumes that if a belief is true exclusively or mainly due to its dependence on intellectual virtues, it just cannot be true by luck, hence no place for lucky knowledge. But this thesis is hard to prove given the existence of true virtuous beliefs which could nevertheless be false if not for some lucky (for the knower) accident. This led to an appearance of virtue epistemological theories aimed specifically at an assimilation of such cases. Their authors try to represent the relevant situations as such where the contribution of luck is not crucial whereas the contribution of virtues is crucial. This article provides a critical analysis of the corresponding arguments as part of a more general study of the ability of Virtue Epistemology to provide justification for the thesis of incompatibility of propositional knowledge with veritic luck. It is shown that there are good reasons to doubt that Virtue Epistemology can do this. (shrink)

This chapter contains section titled: Organizing the Notes for On Certainty Groundlessness and Language‐games Searching for Primary Links Between Language and Reality Seeing Logic and Practice Pictures, Propositions and Reality Forms of Life Practices and Parallels Is the Title on Certainty a Happy One? Is on Certainty a Polemic against Moore? Is Wittgenstein's Main Interest in Moore's Propositions the Nature of Nonsense? Does Wittgenstein Say that the Propositions he is Interested in Form a Class, and Does he Say the Same (...) of all of Them? Are Wittgenstein's Propositions Context‐free? What is the Connection between Wittgenstein's Propositions and Logic? Is Wittgenstein Appealing to Primitive, Pre‐linguistic Reactions as the Basis of our Language‐games? What is Meant by the Sureness in Our Language‐games? How are Our Conclusions Related to the Notions of a Form of Life or World‐picture? How do Wittgenstein's Conclusions Differ from Some Classical and Contemporary Views of Our Relation to the World? Rhees's Development of Wittgenstein's Concerns. (shrink)

ABSTRACT Historically, maternal HIV research has focused on prevention of mother‐to‐child transmission and child outcomes, with little focus on the health outcomes of mothers. Over the course of the HIV epidemic, the approach to including pregnant women in research has shifted. The current landscape lends itself to reviewing the public health ethics of this research. This systematic review aims to identify ethical barriers and considerations for including pregnant and postpartum women living with HIV in treatment adherence and retention research. We (...) completed a systematic literature review following PRISMA guidelines with analysis using a relational ethics perspective. The included studies (n = 7) identified ethical barriers related to (a) women research participants as individuals, (b) partner and family dynamics, (c) community perspectives on research design and conduct, and (d) policy and regulatory implications. These broader contextual factors will yield research responsive to, and respectful of, the needs of pregnant and postpartum women living with HIV. While current regulatory and policy environments may be slow to change, actions can be taken now to foster enabling environments for research. We suggest that a relational approach to public health ethics can best support the needs of pregnant and postpartum women living with HIV; acknowledging this population as systematically disadvantaged and inseparable from their communities will best support the health of this population. (shrink)

Open peer commentary on the article “A Cybernetic Approach to Contextual Teaching and Learning” by Philip Baron. Upshot: Universities in South Africa and elsewhere are being challenged to prepare graduates for the world of work and to recognize the multitude of resources that students bring with them to the higher-education experience. A multimodal approach to pedagogy may assist in both of these regards.

Here at the Center, we had the privilege of seeing how Dan Callahan lived out his last days and weeks. True to his nature, Dan never stopped thinking or writing. Indeed, his wife Sidney told me that he finished his last essay one day before his death, on July 16th, insisting that she help him get to the computer so he could discuss it with a colleague. “It's my last one,” he told her with his characteristic self‐awareness. Dan also chose (...) the last topic he would focus on: climate change. At a December 2018 board meeting, Dan presented his desire to develop a workshop to explore the ways in which bioethics in general, and The Hastings Center in particular, might be able to make a valuable contribution to addressing the problem of global warming. (shrink)

In his Trauerspiel study, Benjamin analyses the role of the baroque allegorist in an age in which his word is the expression of the melancholic gaze of an abandoned subject handed over to an absolute immanence. But the allegorist makes a move through which he achieves to go from immanence to God, allegorizing the concept of evil that he himself has produced. Even when he meets the characteristics of those allegorists, Baltasar Gracian does not make, in our judgement, this kind (...) of betrayal to his own logos, surrendering completely to the consequences of natural history, the immanence and the allegorical saying. (shrink)

_A distinguished discussion of Weil's views on social philosophy, science, ethics, and religion._.