The subject of this article are the definitional and regulatory aspects of experimental (or innovative) therapies, understood either as new and unproven treatment methods that can be tested – and for this purpose used – also in clinical trials, or as applications of these new and unproven procedures in medical practice. After a short introduction, recalling one of the important sources of the concept of experimental or innovative therapy, which was the Belmont Report, I first discuss the (...) problems related to the definition of experimental therapy (as a new and nonvalidated medical procedure used to improve the patient's health), and then the controversial issues related to its regulation (including in particular the required control to which each such therapeutic intervention should be subject). Finally, I point out the importance of the discussions on experimental therapy reported in this article, conducted in other countries or in international contacts, for the necessary revision or reinterpretation of Polish regulations regarding therapeutic experiments. (shrink)

The following text is a voice in the discussion around normative problems of innovative therapies. It particularly refers to problems related to the contribution of experimental therapies to the development of medical knowledge, also discussed in this issue in the article by Olga Dryla "Expanded access programs as a source of cognitive data.".

For a variety of reasons, the AIDS epidemic is forcing a thorough reassessment of many of the standards by which the terminally ill and other medical patients are treated by health-care systems throughout the world. This has generally been a good thing. It has provided needed motivation for public policy-makers to take seriously a range of health-care issues that have often been downplayed, ignored, or debated with vigour only within the relatively mute pages of the academic journals of health-care professionals, (...) philosophers, law professors and others. Issues such as euthanasia, testing for dangerous communicable diseases, palliative care, and even important general questions about the distribution and availability of health-care resources have been pushed toward the front of the public health-care agenda largely because of the impact of AIDS. And it is fair to say that these matters are often being addressed with an urgency and sensitivity that would be absent without the political impetus that was unleashed along with this disease. One of the most controversial issues that has arisen concerns access to experimental therapies by the terminally ill. As is the case in other areas, the political forces generated by the AIDS tragedy have created an opportunity for productive review of policies and practices that undoubtedly deserve scrutiny and reform. However, my aim in this paper is to urge caution on some of the advocates of reform. I will argue that many recent proposals to enhance access to experimental therapies by the terminally ill rest on philosophically unsupportable grounds and pose an unjustifiable threat to the public interest in finding safe and effective therapies for terminal illnesses. (shrink)

Cardiac xenotransplantation has an experimental status with great potential to become an alternative treatment for patients who are ineligible or waiting for a transplant. In this commentary, I discuss the first three multi-criteria approaches to patient selection presented by the authors to identify a primary target group of patients who could benefit from this therapy. The first criterion concerns adult patients with end-stage organ failure who have a high ‘medical need’ for xenotransplantation as an alternative treatment option. The (...) authors limit their argument to patients for whom ventricular assist devices and artificial hearts are contraindicated and who have no chance of being placed on the transplant list due to comorbidities, acute decompensation or complex congenital heart disease (CHD).1 These patients could be considered for xenotransplantation. However, given the high risk of failure of this experimental treatment and the excessive burden on the patient’s health, the procedure is permitted only in extremely rare situations such as those of Bennett (2022) or Faucette (2023)2 discussed …. (shrink)

Clinical ethics services are increasingly receiving case referrals regarding requests for access to experimental therapies. Sometimes, patients or families seek access to an experimental therapy that has not been subsidised by any government scheme, and for which no local clinical trial is underway. All else being equal, a patient may benefit from receiving an experimental therapy without making any other patient worse off. However, within public healthcare systems, treating only one patient with an experimental (...) therapy, when others might also benefit from it, evokes a troubling sense of inequity. In this paper, I examine the relevance of Pareto principles and the ‘levelling down’ objection to ethical deliberation about patient or family-initiated requests for experimental therapies. While facilitating access to an experimental therapy may benefit a patient without making any other patients worse off, this does not dispel ethically relevant considerations concerning equity. When deliberating about cases i... (shrink)

The article focuses on the issue of access to experimental therapy under the Convention for the Protection of Human Rights and Fundamental Freedoms, and more specifically in the case law of the European Court of Human Rights. To date, this issue has been the subject of three cases decided by the Court. In none of these cases the Court has recognized a right to experimental therapy. The article has two main research objectives. The first is to (...) reconstruct the arguments for the validity of the right to experimental therapy provided by the applicants in the cases considered by the Court. The second objective is to assess these arguments, as well as their criticism that might be found in Court’s decisions. (shrink)

An important strand of current experimental philosophy promotes a new kind of methodological naturalism. This chapter argues that this new ‘metaphilosophical naturalism’ is fundamentally consistent with key tenets of Wittgenstein’s metaphilosophy, and can provide empirical foundations for therapeutic conceptions of philosophy. Metaphilosophical naturalism invites us to contribute to the resolution of philosophical problems about X by turning to scientific findings about the way we think about X – in general or when doing philosophy. This new naturalism encourages us to (...) use resources from psychology that can empirically vindicate precisely some of the most controversial aspects of Wittgenstein’s conception of philosophy: They can establish the need, and provide key tools, for something worth calling ‘therapy’, in philosophy. As ‘pudding proof’ this chapter shows how methods and findings from psycholinguistics motivate and facilitate a therapeutic approach to a characteristically philosophical problem: ‘the problem of perception’. (shrink)

Self-experimentation is a valuable companion to self-management in the benefit of pharmaco-cognitive-behavior combination therapies. However, data on individuals participating as active therapeutic agents are sparse. Smoking cessation therapy is an example. Roberts' self-experimentation suggests trying more diversity in research to generate new ideas. This may inform current approaches to the cessation of smoking.

The prelims comprise: Introduction A (re)Defmition of what Human Gene Therapy is About Neurological Gene Therapy Ethics and Gene Therapy Acknowledgments Notes.

This is the first re-publication and first English translation of regulations concerning Human Experimentation which were binding law prior to and during the Third Reich, 1931 to 1945. The introduction briefly describes the duties of the Reichsgesundheitsamt, which formulated these regulations. It then outlines the basic concept of the Richtlinien for protecting subjects and patients on the one hand and for encouraging New Therapy and Human Experimentation on the other hand. Major issues, like personal responsibility of the physician or (...) researcher, teaching of ethics of research and therapy, and research and therapy on vulnerable populations, are compared with the regulations in the Nuremberg Code and subsequent regulations influenced by the Nuremberg Code. CiteULike Connotea Del.icio.us What's this? (shrink)

Advanced therapy medicinal products (ATMP) offer hope for health benefits in all situations where traditional methods of therapy fail or cannot be used for various reasons. The main purpose of this article is to analyze the concept of innovation as applied to the biotechnologies employed in ATMP. In the analysis of the concept, five main contexts of meaning that contribute to its understanding will be distinguished: a change in the way of thinking about the available spectrum of medical (...) procedures, the short time of recognition of technologies in the experimental and theoretical models, lack of clinical data in advance of used technologies, increase of technologies’ complexity and diversity of substrates used in them. The conducted analysis indicates the need to adopt an attitude of far-reaching caution in the evaluation of the safety of ATMP therapies in which innovative biotechnologies are used. (shrink)

Cet article interroge l’espace thérapeutique mouvant expérimenté dans une téléconsultation avec un couple. Il décrit les frontières polytopiques d’une séance online. Désormais, l’espace thérapeutique réunit trois lieux qui se superposent : chez le thérapeute, chez le patient et l’interface de rencontre, la plateforme numérique. L’auteure constate l’émergence d’une illusion partagée entre le thérapeute et son patient, favorisée par la superposition de deux mondes : virtuel et réel, dans l’écran et hors de l’écran. Le passage à une thérapie conjugale à distance (...) déplace les symptômes sur l’aspect territorial du cadre, tout en permettant de déployer un nouveau processus thérapeutique. Puisque les patients font entrer le regard du thérapeute dans leur habitat intérieur, la question du privé et de l’intime se pose : qu’est-ce qui est dévoilé? Le couple peut jouer avec la création de la mise en scène jusqu’à la « profanation rituelle », la transgression du cadre. L’article apporte une illustration clinique d’une « séance à l’envers ». (shrink)

The development of cancer therapies is a long and arduous process. Because it can take several years for a cancer agent to pass clinical testing and be approved for use, terminal cancer patients rarely have the time to see these experimental therapies become widely available. For most terminal cancer patients the only opportunity they have to access an experimental drug that could potentially improve their prognosis is by joining a clinical trial. Unfortunately, several aspects of clinical trial methodology (...) that are set in place in order to optimise drug development for the benefit of future generations of cancer patients, pose significant limitations to current patient participation. Therefore, several terminal cancer patients believe that they should have the right to access experimental agents that have passed initial safety testing without having to participate in clinical trials. However, granting off-trial access to patients could be detrimental to the scientific process of drug development, and thus could pose significant risks to the health of future patients relying on sound research. Examining this matter through two divergent ethical lenses, rights-based ethics and communitarian ethics, may provide new insight into the issues surrounding the balance between the autonomous rights of current terminal cancer patients, and the needs of future patients and the values of society. (shrink)

Occupational therapy often uses craft activities as therapeutic tools, but their therapeutic effectiveness has not yet been adequately demonstrated. The aim of this study was to examine changes in frontal midline theta rhythm (Fmθ) and autonomic nervous responses during craft activities, and to explore the physiological mechanisms underlying the therapeutic effectiveness of occupational therapy. To achieve this, we employed a simple craft activity as a task to induce Fmθ and performed simultaneous EEG and ECG recordings. For participants in (...) which Fmθ activities were provoked, parasympathetic and sympathetic activities were evaluated during the appearance of Fmθ and rest periods using the Lorenz plot analysis. Both parasympathetic and sympathetic indices increased with the appearance of Fmθ compared to during resting periods. This suggests that a relaxed-concentration state is achieved by concentrating on craft activities. Furthermore, the appearance of Fmθ positively correlated with parasympathetic activity, and theta band activity in the frontal area were associated with sympathetic activity. This suggests that there is a close relationship between cardiac autonomic function and Fmθ activity. (shrink)

Recently, spirituality-based interventions for modulating death anxiety in both unhealthy and healthy individuals have increased. However, the effectiveness of this treatment approach in reducing death anxiety remains controversial. Thus, this systematic review and meta-analysis aimed to clarify the impact of spiritual therapy interventions on death anxiety in Iran. We searched for all randomised and controlled trials related to the research topic in national and international databases, including Web of Science, PubMed, Scopus, Wiley, Taylor & Francis, ScienceDirect, SID, Civilica, IranDoc (...) and Noormags. Fifteen studies with 772 participants that were found relevant and fulfilled the defined exclusion and inclusion criteria were included in the analyses. Stata 17 software was used to analyse the data. The results showed a significant difference between the average death anxiety scores in the experimental and control groups after receiving spiritual therapy (standardised mean difference = –5.97, 95% confidence interval: –9.51, –2.44). In addition, the results of the Q and I2 tests indicated significant heterogeneity among the studies (p < 0.001; Q = 411.45; I2 = 99.50%). Thus, although the findings show that interventions based on spiritual therapy can reduce death anxiety, the high heterogeneity and publication bias of some trials limit the validity and generalisability of their effects. The findings of this meta-analysis will help in elucidating the effectiveness of spiritual therapy and open new horizons for this therapeutic approach for psychologists, counsellors and educational planners, thereby creating a relative consensus between advocates and critics of therapeutic spirituality. (shrink)

I read with great bewilderment the unconvincing arguments of Peter F. Omonzejele in his article “Ethical Challenges Posed by the Ebola Virus Epidemic in West Africa” published in the 11 issue of the Journal of Bioethical Inquiry. While the author glaringly mixed up anthropological issues concerning the hygiene of hand-washing and safe burials in an article with a title clearly focused on ethical challenges, he failed to establish how the current Ebola epidemic ravaging some West Africa countries made these human (...) practices ethical challenges. Anecdotal examples cited in the article fit entirely into the realm of anthropological and sociological issues fuelling the spread of Ebola but are not in any way related to ethical challenges. The title was either misleading or the author deliberately discussed anthropological/sociological issues tangentially in an article supposedly written on ethical issues.The author also contradicted himself, having categorized as a compelling need t .. (shrink)

Feeding and Being Fed. Supply Cycles and Nutrition Regimes at the Royal Prussian Institute for Experimental Therapy, 1900 to 1910. The article explores the everyday life and especially the feeding practices in the laboratories of the Institute for Experimental Therapy and the Georg Speyer House in Frankfurt, Germany, in the decade after 1900. The text focuses on the experimental animals and their entangled relationship to humans in the two institutes where life‐scientists tested the therapeutic effect (...) of chemicals and dyestuffs on pathogens and tumors. For this purpose countless animal experiments were conducted in the fields of chemotherapy and cancer research. The article focuses on the importance of animal feeding and feeding practices in the experimental processes and serum testing procedures. The behaviour of the animals, their health status, their appetite and weight were constantly monitored and deemed fundamental to the outcome of the experiment. Animal feeding was therefore an important factor within the epistemological process of knowledge production. Animal feeding was both orientated towards the needs of the experiments and governed by economic needs. Within their economic (life) cycles, the ontological status of the animals changed: they became vectors of pathogens and information, economic resources, objects of exchange, living resources and life stock for ongoing experiments, patients, and sometimes even food for other animals. Overall, feeding experimental animals played an important role in the research process. (shrink)

Spectacular treatment disasters in recent years have made it clear that informal "let's-try-it-and-see" methods of testing new proposals are more risky now than ever before, and have led many to call for a halt to experimentation in clinical medicine. In this easy-tp-read, philosophical guide to human experimentation, William Silverman pleads for wider use of randomized clinical trials, citing many examples that show how careful trials can overturn preconceived or ill-conceived notions of a therapy's effectiveness and lead to a clearer (...) understanding of clinical anomalies. Because it gives careful guidance on setting up trials and avoiding conceptual pitfalls, this book will be of great interest to all epidemiologists and clinical statisticians, and to a wide varitey of clinicians, pharmacologists, and nurses. Since it requires no medical or statistical knowledge, it will also appeal to ethicists, lawyers, and the general public. (shrink)

How can health plans make fair determinations about when “experimental” (and costly) treatments such as high dose chemotherapy with autologous bone marrow transplantation should be covered despite lack of clear clinical consensus about their benefits? Different models for managing “last chance” therapies evolving in some health plans offer promising examples of how issues of fairness and legitimacy in decisionmaking can be addressed.

The present work aims to efficiently carry out life-death education for college students, improve their psychological problems, and reduce suicide accidents by combining LDE with Dance Movement Therapy. DMT is a psychosomatic cross therapy that treats mental or physical diseases through dance or improvisation. Firstly, this paper introduces LDE and DMT and designs the activities of DMT intervention. Secondly, the relationship between DMT and LDE is analyzed. Finally, a questionnaire survey is conducted on the research objects. The research (...) objects are divided into the experimental group receiving DMT intervention, the control group participating in sports dance courses, and the benchmark group. The research data show no significant difference in interpersonal skills and emotional psychology among the three groups. The DMT intervention group has substantial changes in other factors except for the conflict control ability before and after the intervention. In addition, the questionnaire survey results after the intervention demonstrate that the DMT intervention group gets a significantly higher score in the interpersonal relationship, interpersonal relationship building ability, moderate rejection ability, self-disclosure ability, and emotional support ability. Therefore, DMT intervention positively impacts college students’ interpersonal relationships. After the sports dance course, there are differences in the total score of interpersonal ties and scores of interpersonal relationships building ability, self-disclosure ability, and emotional support ability in the control group, but with no significant difference in moderate rejection ability and conflict control ability. Therefore, compared with traditional psychotherapy methods, the DMT method reported here is conducive to releasing pressure and alleviating physical and mental anxiety. The research content provides new ideas for psychological education in colleges and universities and contributes to improving college students’ suicidal tendencies and helping college students grow up healthily. (shrink)

Long ago, I set out to solve a problem, but something happened along the way: I was diverted by an unexpected observation. Thereafter, the direction of my research was guided at each stage by increasing familiarity with the experimental material and what could be done with it. The result was the birth of therapy with cultured keratinocytes. Subsequent developments soon led to the formation of the company Biosurface Technology (later taken over by the Genzyme Corporation), which provided autologous (...) cultures for burn victims in many parts of the world. Further progress by others led to new therapeutic applications of cultured keratinocytes, such as treatment of an ocular disease and gene therapy. Unfortunately, there have developed serious regulatory problems that are a danger to future progress. As described in this brief history, the initial stages of development of cell therapy for the treatment of human disease were possible only because there was no restraint by committees or governmental regulations. BioEssays 30:897–903, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Gene therapy is the modification of the human genetic code to prevent disease or cure illness. This technology is in its infancy and remains confined to experimental clinical trials. Once the present barriers are overcome, gene therapy will confront humanity with a host of ethical challenges. Therapies targeted to the genes of germ-line cells will introduce permanent changes to the human gene pool. Furthermore, nonmedical gene modifications have the potential to introduce a new form of eugenics into (...) our society by which some members attempt to become inherently superior to others and humanity is re-engineered to man-made specifications. National Catholic Bioethics Quarterly 10.1 (Spring 2010): 45–50. (shrink)

To explore the effect of horticultural therapy on cultivating College Students’ positive psychological quality and to provide reference for college students’ mental health education, 176 college students were randomly divided into experimental group and control group. The experimental group was intervened by horticulture therapy, and the Chinese college students’ mental health evaluation system and Chinese college students’ positive psychological quality scale were used to test the experimental group and the control group. There was no difference (...) in the six dimensions of positive psychological quality between the experimental group and the control group in the pre-test. After 9 weeks of intervention, the differences between the experimental group and the control group in the “cognitive dimension” and “emotional dimension” were significant. The scores of emotional dimension and transcendental dimension in the experimental group were higher than those in the pre-test ; meanwhile, there is no difference in the other four dimensions. Horticultural therapy can promote the positive psychological quality of college students. (shrink)

In a recent study, Lantian and colleagues (2024) measured public attitudes toward the use of ‘love drugs’ as introduced through the work of Earp, Savulescu, and their collaborators. Use of a “revol...

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, (...) participants with a history of depression, currently in remission (N= 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N= 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse. (shrink)

The ArgumentPatients suffering from advanced, incurable cancer often receive from their doctors proposals to enroll in a clinical trial of an experimental therapy. Experimental therapies are increasingly perceived not as a highly problematic approach but as a near-standard way to deal with incurable cancer. There are, however, important differences in the diffusion of these therapies in Western countries. The large diffusion of experimental therapies for malignant disease in the United States contrasts with the much more restricted (...) diffusion of these therapies in the United Kingdom. The difference between the two reflects differences in the organization of health care in these countries and distinct patterns of the professionalization of medical oncology in America and in Britain. The high density and great autonomy of medical oncologists in the United States encourages there the diffusion of experimental therapies (regarded by some as expensive and inefficient); the lower density of these specialists in the United Kingdom and their task as consultants and not primary caregivers, favors the choice of more conservative (for some, too conservative) treatments. Theoretically, the decision as to whether patients suffering from advanced, incurable cancer will be steered toward an experimental therapy or toward palliative care depends on the values and beliefs of these patients and their physicians. In practice, however, such choice does not depend exclusively on the individual' cultural background and ethical values, but is also strongly affected by the — culturally conditioned — Professional and institutional structure of medicine. (shrink)

À partir d’une situation de couple dans lequel la communication semble bloquée par un trop plein de souffrance, due en partie à des traumatismes dans les liens de filiation de part et d’autre, l’auteure, grâce à un groupe de recherche, expérimente la nécessité d’un nouvel espace pour réguler un transfert massif. Le groupe de recherche prend en quelque sorte le relais de l’appareil psychique du thérapeute et met en scène les émotions et les représentations qui sont à l’œuvre au sein (...) du groupe thérapeutique. Il devient un lieu de dépôt et de mentalisation des émotions qui circulent dans le transfert, et se fait le porte-voix des souffrances traumatiques enfermées dans les incorporats, ces ratés de l’introjection. (shrink)

The case of Andrew Gobea, the first child to receive experimental gene therapy for SCID, and a reflection on the associated ethical implications of gene therapy research.

In a recent study, Lantian and colleagues (2024) measured public attitudes toward the use of ‘love drugs’ as introduced through the work of Earp, Savulescu, and their collaborators. Use of a “revol...

The ethics of experimentation on human subjects has become the subject of much debate among medical scientists and philosophers. Ethical problems and conflicts of interest become especially serious when research subjects are recruited from the class of patients. Are patients who are ill and suffering in a position to give voluntary and informed consent? Are there inevitable conflicts of interest and moral obligation when a personal physician recruits his own patients for an experiment designed partly to advance scientific knowledge and (...) only partly as therapy for those patients? The views of the eminent American ethicist Hans Jonas on these issues are briefly summarised and criticised, and some moral guidelines are then proposed to regulate experimentation on human subjects. (shrink)

Obsessive–compulsive disorder is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion (...) for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD, and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances, by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bernard Mandeville and the Therapy of “The Clever Politician”Harold J. CookAs the institutional authority of the learned physicians of Augustan London waned, new threats to the classical foundations of medical practice appeared. 1 Patients had more freedom to chose from a variety of practitioners and practices, giving both consumer demand and the advertising skills of suppliers an even more powerful hand in medical affairs. While the burgeoning medical (...) marketplace developed mostly because of the profound socio-economic and political changes of the late Stuart period, intellectual transformations were at play, too. The new science appeared to encourage empiricism and the development of new remedies based on experimentation, devaluing university education in medical classics, but conversely the new science could strengthen physicians’ claims to superiority over mere patients and practitioners. Medical materialists, for instance, could turn the classical advisor/client relationship into that of an expert contolling a passive recipient (patient) for his or her own good.One contemporary debate that shows the implications of materialism for medical relationships is the theory of the passions. The passions linked mind and body. According to most classical accounts, one could (or should) control the passions by applying reason, resulting in both a virtuous and a healthy life. But according to a strong version of materialism, the mind could not hope to control the passions. A doctor therefore could no longer appeal to patients’ reason; rather, he had to manipulate the patient’s passions for his or her own good. Hence for a materialist, the doctor was not an adviser to the patient but an expert therapist, not a teacher of health and virtue but a “clever politician” who ordered bodily passions. Some versions of the new science, then, favored [End Page 101] the expertise of physicians while undermining older views about learned authority. Such an outlook is clear in the work of Dr. Bernard Mandeville, whose famous Fable of the Bees shows how the “clever politician” played on passions to make the body politic run smoothly. Mandeville held coherent views on politics, economics, moral philosophy, and medicine. Like many doctors of his time, he fought to establish his expertise in the new science. His views are expressed most clearly in the theory of the passions. By examining his discussion of the passions in both his social commentary and his medical dialogues, we can note similarities among his various writings and glimpse one of his fundamental positions on medicine and humanity.The Fable and its CriticsTo many English minds of the early eighteenth century, no one exemplified materialism’s threat better than Dr. Bernard Mandeville. Mandeville’s famous slogan, the subtitle of his Fable of the Bees—“private vices, public benefits”—seemed to epitomize materialism’s inherent immorality. The book seemed to argue that what most people recognized as human vices were the main engines of the collective good. Mandeville’s famous book pictured human nature as animalistic, in which the passions held sway over reason. In Mandeville’s world, it appeared, reason became little more than the ability to rationalize, the instrument of hypocrisy, merely letting people cover their true motives (grounded as they were in the passions) with empty words pretending to more exalted ends.His Fable had begun as a little, anonymous, satirical poem in 1705, titled “The Grumbling Hive: or, Knaves Turn’d Honest.” It began by speaking of “A Spacious Hive well stockt with Bees, / That liv’d in Luxury and Ease.” Many of the bees were knaves, with no calling free of deceit, but while “every Part was full of Vice, / Yet [was] the whole Mass a Paradise; /... Such were the Blessings of that State; / Their Crimes conspir’d to make them Great.” Avarice, prodigality, luxury, pride, envy, vanity, folly, fickleness, and inconstancy employed millions, encouraging ingenuity and industry and creating pleasures and comforts “To such a Height, the very Poor / Liv’d better than the Rich before.” But many of the thriving bees complained, shouting for honesty and virtue. When Jove “rid / The bawling Hive of Fraud,” economic collapse followed, with the consequent end of arts and sciences as well; population declined; the hive’s territory decreased; and the remaining bees toiled long and... (shrink)

The moral case for experimentation on animals rests both on the goods to be realized, the evils to be avoided thereby, and on the duty to respect persons and to secure them in the enjoyment of their natural moral rights. Some experimentation on animals presents no problems of justification as it involves no harm at all to the animals which are the subject of experiments and is such as to seek to achieve an advance in knowledge. Experiments on non-sentient animals, (...) like those on plant life, may harm the subjects but in ways that in themselves need raise no morally significant issues. Moral issues may arise if the subjects of experiments are members of an endangered species and for like reasons but not simply on account of the harm caused by the experiment to the subjects. Other experimentation on animals is to be justified solely in terms of its benefit to animals, even though it involves harm to the animals upon which experiments are performed. There are many poisons and diseases to which animals and not human beings are exposed which give rise to the need for experiments to determine effective therapies, treatments, or other remedies. Examples include annual rye grass toxicity, foot-and-mouth disease, the many fowl diseases, and so on. Human beings commonly have an interest in successfully experimenting to find effective remedies, either a financial interest as with farm animals, race horses and the like, amusement interest as with pets, or a concern not to have a species or variety become extinct. The moral case for such experiments may be strengthened by reference to such interests if they in turn have a moral basis, but generally it does not depend for its validity on this. Other experimentation that harms the animals involved is to be justified in terms of the benefits to be realized and evils lessened for persons by the knowledge and the use of the knowledge gained, where the knowledge is used to secure the enjoyment of their moral rights by persons. Much experimentation benefits both persons, contributing to the securing of their enjoyment of their moral rights, and animals which do not possess moral rights, and is to be morally justified on both counts. Obviously a great amount of experimentation occurs today which does not admit of justification along any of these lines, and hence, is such that it must be condemned as being morally wrong. (shrink)

The aim of the present paper is to offer a critical examination of the episte- mological foundations of rational emotive behavior therapy (REBT). Taking the tension between the basic presupposition between REBT and the ABC cognitive model constituting its core as its cue, the paper focuses on the causal relation between cognition and emotion and tries to argue that, at closer inspection, neither the theoretical, nor the experimental reasons ad- duced in favor of the idea of a determining (...) role of cognition in the appear- ance of mental disturbance actually hold. (shrink)

Stem cell research has entered the public consciousness through the media. Proponents and opponents of all such research, or of human embryonic stem cell research specifically, engage in heated exchanges in the modern public forum where stakeholders negotiate, the agora. One common claim that emerges from the fray is that a particular type of stem cell research should be pursued as the most promising path toward the reduction of suffering and untimely death for all of humanity. Upon evaluation, experimental (...) data regarding the potential role of stem cells in regenerative therapies for three conditions—spinal cord injury, type 1 diabetes, and cardiovascular disease—tell distinct, complex, and inconclusive stories. Further analyses in this article incorporate realistic considerations of a broad range of relevant factors--limited funding for biomedical research, media motives, the discordance hypothesis of evolutionary medicine, the relationship between religion and science, medical care in developing nations, and culture wars over abortion. Holistic investigation inspired by the current agora conversation supports the need to drastically change interactions regarding stem cell research so that its potential to benefit humanity may be more fully realized. (shrink)

Obsessive-compulsive disorder (OCD) is a deeply enigmatic psychiatric condition associated with immense suffering worldwide. Efficacious therapies for OCD, like exposure and response prevention (ERP) are sometimes poorly tolerated by patients. As many as 25 percent of patients refuse to initiate ERP mainly because they are too anxious to follow exposure procedures. Accordingly, we proposed a simple and tolerable (immersive yet indirect) low-cost technique for treating OCD that we call “multisensory stimulation therapy.” This method involves contaminating a rubber hand during (...) the so-called “rubber hand illusion” (RHI) in which tactile sensations may be perceived as arising from a fake hand. Notably, Jalal and Ramachandran (2015), showed that such fake hand contamination during the RHI provokes powerful disgust reactions in healthy volunteers. In the current study, we explored the therapeutic potential of this novel approach. OCD patients (n = 29) watched as their hidden real hand was being stroked together with a visible fake hand; either synchronously (inducing the RHI) (i.e., the experimental condition; n = 16) or asynchronously (i.e., the control condition; n = 13). After 5 minutes of tactile stimulation, the rubber hand was contaminated with fake feces, simulating conventional exposure therapy. Intriguingly, results suggested sensory assimilation of contamination sensations into the body image via the RHI: patients undergoing synchronous stimulation did not report greater contamination sensations when the fake hand was initially contaminated relative to asynchronous stroking. But contrary to expectations, they did so after the rubber hand had been contaminated for 5 minutes; as assessed via disgust facial expressions (a secondary outcome) and in vivo exposure (upon discontinuing the illusion). Further to our surprise, synchronous and asynchronous stroking induced an equally vivid and fast emerging illusion, which helps explain why both conditions initially (5 minutes after initiating tactile stimulation) provoked contamination reactions of equal magnitude. This study is the first to suggest heightened malleability of body image in OCD. Importantly, it may pave the way for a tolerable technique for the treatment of OCD—highly suitable for poorly resourced and emergency settings, including low-income and developing countries with minimal access to high-tech solutions like virtual reality. (shrink)

Bioethics, Volume 36, Issue 1, Page 25-41, January 2022.

Homosexual aversion therapy enjoyed two brief but intense periods of clinical experimentation: between 1950 and 1962 in Czechoslovakia, and between 1962 and 1975 in the British Commonwealth. The specific context of its emergence was the geopolitical polarization of the Cold War and a parallel polarization within psychological medicine between Pavlovian and Freudian paradigms. In 1949, the Pavlovian paradigm became the guiding doctrine in the Communist bloc, characterized by a psychophysiological or materialist understanding of mental illness. It was taken up (...) by therapists in Western countries who were critical of psychoanalysis and sought more ‘scientific’ diagnostic and therapeutic methods that focused on empirical evidence and treating actual symptoms. However, their attitude towards homosexuality often played a decisive role in how they used aversion therapy. Whereas Czechoslovakian researchers cautioned readers about low success rates and agitated for homosexual law reform in 1961, most of their anglophone counterparts selectively ignored or misrepresented the results of ‘the Prague experiment’, instead celebrating single-case ‘success’ stories in their effort to correct ‘abnormal’ sexual orientation. In histories of queer sexuality and its pathologization, the behaviourist paradigm remains almost entirely unmapped. This article provides the most detailed study to date of aversion therapy literature from both sides of the East/West border. In doing so, it contributes to the project not only of ‘decentring Western sexualities’, but of decentring Western sexological knowledge. Given its Pavlovian origins, the history of homosexual aversion therapy can be fully understood only in the context of Cold War transnational sexological knowledge exchange. (shrink)

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social domains. The vignettes (...) described a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)

Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture.Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first (...) time to practice placement education.Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga and Castilla-La Mancha. Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale. All these instruments were also completed 1 week after the end of the clinical practice.Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women and men, when the internship area was not considered.Conclusions: The results show that resilient students are more optimistic and work to improve a situation beyond doing simply what is expected of them, knowing how to control their feelings. This is beneficial for students in practice education, since, during these, they face difficult situations that require a resilient pattern, which helps reduce stress and the burnout syndrome. (shrink)

Difficulties in various cognitive functions are common observations in people experiencing anxiety. However, limited research has investigated the effects of psychotherapy on abnormal cognitive functioning. This study assessed whether psychotherapy-related reductions of anxiety result in improvements of cognitive functioning as well. Fifty-four participants with high self-reported anxiety, divided into two experimental groups (N = 28 and N = 26), and 27 non-anxious control participants (N = 27) completed a battery of memory tasks and anxiety questionnaires in three consecutive time (...) points. In experimental group 1, participants started systemic family therapy immediately after the first time point, while, in experimental group 2, participants begun the same type of therapy three months later at the second time point. The results showed that, compared to control participants, at the beginning of the experiment, participants in the experimental groups had significantly lower memory performance, along with higher anxiety. Psychotherapy had a beneficial effect on anxiety symptoms and cognitive performance, with significant changes occurring only after intervals of treatments. These results show that psychotherapy is effective not only in reducing anxiety symptoms but on cognitive functioning as well. This improvement might be linked to the release of cognitive resources previously absorbed by worrisome thoughts, facilitated by a heightened protection from interference. (shrink)

Tackling impaired bioenergetics in multiple sclerosis has been recently recognized as an innovative approach with therapeutic potential. Guanidinoacetic acid is an experimental nutrient that plays a significant role in high-energy phosphate metabolism. The preliminary trials suggest beneficial effects of supplemental GAA in MS, with GAA augments biomarkers of brain energy metabolism and improves patient-reported features of the disease. GAA can also impact other metabolic footprints of MS, including demyelination, oxidative stress, and GABA-glutamate imbalance. In this mini-review article, we summarize (...) studies evaluating GAA effectiveness in MS, explore mechanisms of GAA action, and discuss the challenges of using dietary GAA as an element of MS therapy. (shrink)

Trehalose is a natural disaccharide with a remarkable ability to stabilize biomolecules. In recent years, trehalose has received growing attention as a neuroprotective molecule and has been tested in experimental models for different neurodegenerative diseases. Although the underlying neuroprotective mechanism of trehalose's action is unclear, one of the most important hypotheses is autophagy induction. The chaperone‐like activity of trehalose and the ability to modulate inflammatory responses has also been reported. There is compelling evidence that the dysfunction of autophagy and (...) aggregation of misfolded proteins contribute to the pathogenesis of Alzheimer's disease (AD) and other neurodegenerative disorders. Therefore, given the linking between trehalose and autophagy induction, it appears to be a promising therapy for AD. Herein, the published studies concerning the use of trehalose as a potential therapy for AD are summarized, providing a rationale for applying trehalose to reduce Alzheimer's pathology. (shrink)

New technologies regularly bring about profound changes in our daily lives. Romantic relationships are no exception to these transformations. Some philosophers expect the emergence in the near future of love drugs: a theoretically achievable biotechnological intervention that could be designed to strengthen and maintain love in romantic relationships. We investigated laypeople’s resistance to the use of such technologies and its sources. Across two studies (Study 1, French and Peruvian university students, N after exclusion = 186; Study 2, Amazon Mechanical Turk (...) sample, N after exclusion = 693, pre-registered), we found that the use of love drugs designed to strengthen and maintain love in romantic relationships are considered as more morally problematic than psychological therapy with the same aim. In Study 2, we show that this last effect is partially due to the fact that the love resulting from the use of love drugs is perceived as less authentic, intense, and durable. We discuss the specific role of authenticity in the relative moral disapproval of love drugs. (shrink)