BackgroundDuring the course of a previous study, our laboratory made a serendipitous finding that just thinking about genital stimulation resulted in brain activations that overlapped with, and differed from, those generated by physical genital stimulation.ObjectiveThis study extends our previous findings by further characterizing how the brain differentially processes physical ‘touch’ stimulation and ‘imagined’ stimulation.DesignEleven healthy women participated in an fMRI study of the brain response to imagined or actual tactile stimulation of the nipple and clitoris. Two additional conditions – imagined (...) dildo self-stimulation and imagined speculum stimulation – were included to characterize the effects of erotic versus non-erotic imagery.ResultsImagined and tactile self-stimulation of the nipple and clitoris each activated the paracentral lobule and the secondary somatosensory cortex. Imagined self-stimulation of the clitoris and nipp... (shrink)

Medicine is still largely a pre-Darwin, pre-Newton enterprise…. We do not yet understand the underlying mechanisms of the major illnesses which plague humanity, and therefore much of what is done in the treatment of illness must still be empirical, trial and error therapy. We are compelled by our limitations to resort to shoring things up, applying halfway technology, trying to fix things after the fact.

The purpose of the paper is to explore the similarity between care ethics and process theology’s views of the world and God’s nature, especially as it relates to the process concepts of the consequent and superject natures of God. The ethic of care concept of the one who cares-for corresponds in interesting ways to process theology’s notion of the consequent and superject natures of God. The author hopes to encourage conversation between these two disciplines which appear to have such striking (...) similarities. (shrink)

We are often told that we are morally obligated to produce equal opportunity for all. Therefore, it seems we should examine what power we have to produce that desirable state. For it would be nonsense to say we are required to provide what is beyond our power to provide. When we examine this question, we find our power limited by two sets of constraints. One set comprises formal constraints upon the idea itself of equal opportunity. We cannot do the logically (...) impossible. The other set comprises limits upon our ability to produce the directed socio-economic change, getting known outputs for known inputs. I illustrate the formal constraints by outlining the work of Douglas Rae. The constraints upon our abilities I illustrate with evidence from sociology and politics. At the end, we shall discover that our power to make opportunities equal is sharply though not unbearably limited. A critical but unbaised survey will reveal that in the past fifty years we have gone remarkably far towards doing all that we are presently capable of doing to equalize opportunities. Perhaps we shall go even farther when we learn how. The word ‘real’ in the title is opposed to ‘ideal’ or even ‘chimerical'. It may seem an interesting question what equality of opportunity should consist in were we able to produce directed socio-economic change at will. But we are not. Therefore, a more interesting and more important question is what equality of opportunity consists in given the very large number of constraints within which we must work to achieve it. (shrink)

We live in an anxious world, riddled with unpredictable threats to our safety and unexpected hatreds directed toward us. It is easy to obsess on the terrors around us, about which we can do little, and lose perspective on the real and sometimes devastating risks that we encounter in our daily lives. These everyday risks need to be regularly revisited — to remind ourselves that they can be reduced with the application of sharp minds, careful scholarship, and political will.Medical errors (...) in the American health-care system are just such a problem. The risk of death or serious injury at the hands of the American health-care system is not trivial, as we have learned over the past few years as the health-care establishment has acknowledged the level of iatrogenic injury in the system. If, as the Institute of Medicine reported in To Err Is Human, as many as 100,000 people every year are dying in hospitals, clinics, and doctors’ offices as the result of actions or omissions that could have been avoided, then this is a social problem of great magnitude and one that the law must try to correct. (shrink)

This article proposes ethical — and legal — accountability for lawyers representing clients such as private equity (PE) firms who create ownership structures for nursing home systems. Using PE ownership as a case study, I will show that nursing home residents are often harmed and Medicaid costs inflated. I propose private law provides tools to compel such accountability, through (1) aiding and abetting doctrines and (2) fiduciary doctrines that require that the fiduciary be responsible for its vulnerable beneficiaries, not just (...) ethically but for damages and equitable relief. I further propose that the teaching of Professional Responsibility needs to be changed to force law students to consider the effect of legal practice on third parties in situations like health care financing. (shrink)

theories. What was Freud thinking, when, and why and what were the major influences which shaped his ideas? We follow the inner movement of his theory construction, its meaning and coherence, as well as his conceptual logic and personal directions concerning his evolving views of the reciprocal interactions between mind and body, the motivational force of instinctual drives, and the dominant role of sexuality rooted in evolutionary biology in human development, behaviour, and the creation of neurotic disturbances. We follow Freud's (...) construction and sequential reconstructions of his theoretical models concerning the nature, dynamics, and principles of unconscious mental functioning, including his changing concepts on the nature and purpose of dreams. We trace his changing views on the role of deferred action of early childhood experiences and the determining role of unconscious fantasy, psychic reality, in the formation of adult character structure and neuroses. Through such historical analysis this book provides grounding for a meaningful understanding of Freud's familiar concepts: id, ego, superego, and the Oedipus complex. We explore what these concepts meant to Freud, why he conceived them, and what functions they served in his theory of mind. This is the perfect book for students and trainees wanting to learn more about the development of Freud's ideas, as well as for established psychoanalysts and psychotherapists interested in expanding their knowledge of Freud's theories. (shrink)

The use of effective field theory, in situations wherein the energy-momentum of light particles is much lower than the rest mass of heavy degrees of freedom, has become an important one in contemporary physics. Herein we examine various means by which this effective action can be evaluated, using the effective photon–photon interaction—the Euler–Heisenberg Lagrangian—as a pedagogical example.

Pain is undertreated in the American health-care system at all levels: physician offices, hospitals, long-term care facilities. The result is needless suffering for patients, complications that cause further injury or death, and added costs in treatment overall. The health-care system's failure to respond to patient pain needs corrective action. Excuses for such shortcomings are simply not acceptable any longer.Physicians have long been accused of poor pain management for their patient. The term “opiophobia” has been coined to describe this remarkable clinical (...) aversion to the proper use of opioids to control pain. If the professional mandate of the health-care professional is to relieve suffering, then physicians are falling far short of their obligations by accepting myths about the use of opioids in the face of evidence to the contrary. (shrink)

Physicians and institutional providers face expanding liability exposure today, in spite of state tort reform legislation and public awareness of the costs of malpractice for providers. Standards of practice are evolving rapidly; new medical technologies are being introduced at a rapid rate; information is proliferating as to treatment efficacy, patient risk, and diseases generally. Tort standards mirror this change. As medical standards of care evolve, they provide a benchmark against which to measure provider failure. The liability exposure of physicians is (...) affected by the generation of data, including outcomes data usable to profile physician practice, and statistical data that allows for predictions as to treatment efficacy, and patient prognosis; obligations to inform patients and third parties of risk created by contagious disease and other sources of harm; obligations of physicians to disclose risks that the provider creates for the patient; obligations to disclose conflicts of interest arising out of the practice setting; and duties arising from new epidemiological knowledge. (shrink)

Scientific discovery and scientific progress are made by scientists, not philosophers. Philosophers sometimes overlook this fact. It appears to be completely ignored by those who call themselves feminist philosophers of science. A favored claim among them is that the production of a feminist epistemology, or of a feminist society, or of both together, will produce something called ‘feminist science’. Feminist science will be different, they say, from the science we now have. One leading proponent of this view, Sandra Harding, writes: (...) “[t]he sciences that gain world ascendancy in the future are unlikely to be so distinctively Western and androcentric as are the dominant tendencies today.” But just how will they differ? Like all utopians these feminists are short on specifics and we are never told what such a science as science would look like, even in outline, much less in detail, nor how it is likely to differ as science from swnh. (shrink)

Health-care provider liability has again taken center stage in American political debate, but with an ironic twist. In the seventies, physicians wanted tort reform, but they measured such reform solely by a reduction in both the risk of being sued and the size of any judgment a plaintiff could win. Malpractice reforms in many states in the seventies therefore capped damages, reduced contingency awards to lawyers, and restricted other tort rules to limit plaintiff success. Today physicians are conflicted. They want (...) an increase in liability exposure — not for themselves, but for managed care plans. We have therefore ended up with a series of overlapping debates, with the same debaters taking contradictory positions. Should managed care organizations—until now protected by ERISA preemption from liability—be liable? Physicians say yes. But should physicians be protected from the threat of suit, which they argue acts as an in terrorem device that drives disclosure of medical errors into hiding? (shrink)

The birth of political thought has long been associated with the development of either the polis as a new form of political organization in Greece, or of democracy as a new form of government in Athens. This article suggests that this view ought to be expanded. Between the late 6th and 4th centuries bc, the Greek polis of Athens established large, participatory democratic institutions. But the transformation that the polis underwent did not merely affect political structures: in this period, Athens (...) transitioned from an undeveloped, limited access, ‘natural state’ toward a developed open access society – a society characterized by impersonal, perpetual, and inclusive political, economic, legal and, social institutions. Those who witnessed this transformation first-hand attempted to grapple, often critically, with its implications. We show that Thucydides, Plato, and other Greek political thinkers devoted a considerable part of their work to analyzing the polis’ tendency toward not only political, but also economic, social, and legal inclusion. Without understanding this larger picture, we cannot adequately explain the development of Greek political thought. (shrink)