Background: The Directive 2001/20/EC was an important first step towards consistency in the requirements and processes for clinical trials across Europe. However, by applying the same rules to all types of drug trials and transposing the Directive’s principles into pre-existing national legislations, the Directive somewhat failed to meet its facilitation and harmonisation targets. In the field of ethics, the Directive 2001/20/EC conditioned the way of understanding and transposing the “single opinion” process in each country. This led to a situation in (...) which two models of research ethics committees organisation systems exist, being the model in which the “single opinion” is considered to be the decision made by a single ethics committee more effective and simpler in terms of administrative and logistic workload. Method: A survey was conducted in 10 European countries. Members of the European Clinical Research Infrastructures Network working party number 1, with expertise in the field of ethics, responded. Results: There is a major heterogeneity in the composition of ethics committees among the surveyed countries based on the number of members, proportion of experts versus lay members and expertise of the scientific members. A harmonised education of the ethics committees’ membership based in common curricula is recommended by the majority of countries. Conclusions: Despite the efforts for harmonisation of the European Clinical Trial Directive, from an ethical point of view, there remains a plurality of ethics committees' systems in Europe. It is important to comprehend the individual national systems to understand the problems they are facing. (shrink)

Professionalism requires that physicians uphold the best interests of patients while simultaneously insuring just use of health care resources. Current articulations of these obligations like the American Board of Internal Medicine Foundation's Physician Charter do not reconcile how these obligations fit together when they conflict. This is the problem of dual agency. The most common ways of dealing with dual agency: “bunkering”—physicians act as though societal cost issues are not their problem; “bailing”—physicians assume that they are merely agents of society (...) and deliver care typically based on a strongly consequentialist public health ethic; or “balancing”—a vaguely specified attempt to uphold both patient welfare and societal need for judicious resource use simultaneously—all fail. Here I propose how the problem of dual agency might begin to be addressed with rigor and consistency. Without dealing with the dual agency problem and getting more specific about how to reconcile its norms when they conflict, the expectations of professionalism risk being written off as cute, nonbinding aphorisms from the medical profession. (shrink)

The duality of attention is explored by turning our focus to the political and cultural conceptions of automatic attention and deliberate attention, with the former being associated with animality and “uncivilized” behavior and the latter with intelligence and self-mastery. In this article, I trace this ongoing dualism of the mind from early race psychology in the late nineteenth century to twentieth century psychological models including those found in psychoanalysis, behaviorism, neo-behaviorism, and behavioral economics. These earlier studies explicitly or implicitly maintained (...) a deficiency model of controlled attention and other mental processes that were thought to differ between racial groups. Such early models of attention included assumptions that Black and Indigenous peoples were less in control of their attention compared to whites. This racialized model of attention, as seen in the law of economy in the nineteenth century, with similar manifestations in psychoanalysis and neo-behaviorism in the twentieth century, can now be seen in present-day dual-process models as used in current psychological research and behavioral policy. These historical connections show that attention is not a value-neutral term and that attention studies do not stand outside of race and structural racism. (shrink)

Background Reasonable disagreement about the role awarded to gamete donors in decision-making on the use of embryos created by gamete donation for research purposes emphasises the importance of considering the implementation of participatory, adaptive, and trustworthy policies and guidelines for consent procedures. However, the perspectives of gamete donors and recipients about decision-making regarding research with EGDs are still under-researched, which precludes the development of policies and guidelines informed by evidence. This study seeks to explore the views of donors and recipients (...) about who should take part in consent processes for the use of EGDs in research. Methods From July 2017 to June 2018, 72 gamete donors and 175 recipients completed a self-report structured questionnaire at the Portuguese Public Bank of Gametes. Agreement with dual consent was defined as the belief that the use of EGDs in research should be consented by both donors and recipients. Results The majority of participants were willing to donate embryos for research. Almost half of the donors and half of the recipients considered that a dual consent procedure is desirable. This view was more frequent among employed recipients than among non-employed. Donors were less likely to believe that only recipients should be involved in giving consent for the use of EGDs in research and were more frequently favourable to the idea of exclusive donors’ consent. Conclusions Divergent views on dual consent among donors and recipients indicate the need to develop evidence-based and ethically sustainable policies and guidelines to protect well-being, autonomy and reproductive rights of both stakeholder groups. More empirical research and further theoretical normative analyses are needed to inform people-centred policy and guidelines for shared decision-making concerning the use of EGDs for research. (shrink)

Dual Process Theory is currently a popular theory for explaining why we show bounded rationality in reasoning and decision-making tasks. This theory proposes there must be a sharp distinction in thinking to explain two clusters of correlational features. One cluster describes a fast and intuitive process, while the other describes a slow and reflective one. A problem for this theory is identifying a common principle that binds these features together, explaining why they form a unity, the unity problem. To solve (...) it, a hypothesis is developed combining embodied predictive processing with symbolic classical approaches. The hypothesis, simplified, states that Type 1 processes are bound together because they rely on embodied predictive processing whereas Type 2 processes form a unity because they are accomplished by symbolic classical cognition. To show that this is likely the case, the features of Dual Process Theory are discussed in relation to these frameworks. (shrink)

Alzheimer's disease (AD) is a neurodegenerative disease exhibiting amyloid beta (Aβ) peptide accumulation as a key characteristic. Autophagy, which is dysregulated in AD, participates in the metabolism of Aβ. Unexpectedly, we recently found that autophagy, in addition to its degradative function, also mediates the secretion of Aβ. This finding adds Aβ to an increasing number of biomolecules, the secretion of which is mediated by autophagy. We also showed that inhibition of Aβ secretion through genetic deletion of autophagy leads to intracellular (...) Aβ accumulation, which enhanced neurodegeneration induced by autophagy deficiency. Hence, autophagy may play a central role in two pathological hallmarks of AD: Aβ amyloidosis and neurodegeneration. Herein, we summarize the role of autophagy in AD with focus on Aβ metabolism in light of the recently established role of autophagy in protein secretion. We discuss potential routes for autophagy‐mediated Aβ secretion and suggest experimental approaches to further elucidate its mechanisms. (shrink)

What role does language play during attention allocation in perceiving and remembering events? We recorded adults‟ eye movements as they studied animated motion events for a later recognition task. We compared native speakers of two languages that use different means of expressing motion (Greek and English). In Experiment 1, eye movements revealed that, when event encoding was made difficult by requiring a concurrent task that did not involve language (tapping), participants spent extra time studying what their language treats as the (...) details of the event. This „linguistic encoding‟ effect was eliminated both when event encoding was made easier (no concurrent task) and when the concurrent task required the use of language (counting aloud). In Experiment 2, under conditions of a delayed concurrent task of counting aloud, participants used language covertly just prior to engaging in the additional task. Together, the results indicate that language can be optionally recruited for encoding events, especially under conditions of high cognitive load. Yet, these effects are malleable and flexible and do not appear to shape core biases in event perception and memory. (shrink)

Dual process theory proposes clusters of features that form two dichotomous groups in cognition. One standing internal issue is defining what the reference of these two dichotomous groups could be in the mind or brain. Does dual process theory speak of two systems, types, minds, modes, kinds or just metaphors? A particular common answer is that differences in clusters of features are evidence of different underlying systems, often called system 1 and system 2. However, the suggestion to abandon the ‘system’ (...) terminology is now common in the literature, but the consequences of doing so need to be addressed. This work reviews and critically discusses previous suggestions. (shrink)

Let (L; f) be a finite simple Ockham algebra and let (X;g) be its dual space. We first prove that every connected component of X is either a singleton or a generalised crown (i.e. an ordered set that is connected, has length 1, and all vertices of which have the same degree). The representation of a generalised crown by a square (0,1)-matrix in which all line sums are equal is used throughout, and a complete description of X, including the number (...) of connected components and the degree of the vertices, is given. We then examine the converse problem of when a generalised crown can be made into a connected component of (X; g). We also determine the number of non-isomorphic finite simple Ockham algebras that belong properly to a given subvariety P 2n,0. Finally, we show that the number of fixed points of (L; f) is 0,1, or 2 according to the nature of X. (shrink)

To call attention to and motivate action on ethical issues in business or society, messengers often criticize groups for wrongdoing and ask these groups to change their behavior. When criticizing target groups, messengers frequently identify and express concern about harm caused to a victim group, and in the process address a target group by criticizing them for causing this harm and imploring them to change. However, we find that when messengers criticize a target group for causing harm to a victim (...) group in this way—expressing _singular concern_ for the victim group—members of the target group infer, often incorrectly, that the messenger views the target group as less moral and unworthy of concern. This inferred lack of moral concern reduces criticism acceptance and prompts backlash from the target group. To address this problem, we introduce _dual concern_ messaging—messages that simultaneously communicate that a target group causes harm to a victim group and express concern for the target group. A series of several experiments demonstrate that dual concern messages reduce inferences that a critical messenger lacks moral concern for the criticized target group, increase the persuasiveness of the criticism among members of the target group, and reduce backlash from consumers against a corporate messenger. When pursuing justice for victims of a target group, dual concern messages that communicate concern for the victim group _as well as_ the target group are more effective in fostering openness toward criticism, rather than defensiveness, in a target group, thus setting the stage for change. (shrink)

The self‐teaching hypothesis describes how children progress toward skilled sight‐word reading. It proposes that children do this via phonological recoding with assistance from contextual cues, to identify the target pronunciation for a novel letter string, and in so doing create an opportunity to self‐teach new orthographic knowledge. We present a new computational implementation of self‐teaching within the dual‐route cascaded (DRC) model of reading aloud, and we explore how decoding and contextual cues can work together to enable accurate self‐teaching under a (...) variety of circumstances. The new model (ST‐DRC) uses DRC’s sublexical route and the interactivity between the lexical and sublexical routes to simulate phonological recoding. Known spoken words are activated in response to novel printed words, triggering an opportunity for orthographic learning, which is the basis for skilled sight‐word reading. ST‐DRC also includes new computational mechanisms for simulating how contextual information aids word identification, and it demonstrates how partial decoding and ambiguous context interact to achieve irregular‐word learning. Beyond modeling orthographic learning and self‐teaching, ST‐DRC’s performance suggests new avenues for empirical research on how difficult word classes such as homographs and potentiophones are learned. (shrink)

Rawlsians argue for principles of justice that apply exclusively to the basic structure of society, but it can seem strange that those who accept these principles should not also regulate their choices by them. Valid moral principles should seemingly identify ideals for both institutions and individuals. What justifies this nonintuitive distinction between institutional and individual principles is not a moral division of labor but Rawls’s dual commitments to conventionalism and constructivism. Conventionalism distinguishes the relevant ideals for evaluating institutions from those (...) for evaluating actions, while constructivism explains why this distinction is morally fundamental. (shrink)

Hoerl and McCormack demonstrate that although animals possess a sophisticated temporal updating system, there is no evidence that they also possess a temporal reasoning system. This important case study is directly related to the broader claim that although animals are manifestly capable of first-order relational reasoning, they lack the capacity for higher-order, role-based relational reasoning. We argue this distinction applies to all domains of cognition.

The role of interaction in learning is essential and profound: it must provide the means to solve open problems (those only vaguely specified in advance), but cannot be captured using our familiar formal cognitive tools. This presents an impasse to those confined to present formalisms; but interaction is fundamentally dynamical, not formal, and with its importance thus underlined it invites the development of a distinctively interactivist account of life and mind. This account is provided, from its roots in the interactivist (...) biological constitution of life, through the evolution of the dual internal regulatory capacities expressed as intentionality and intelligence, to its expression in self-directed anticipative learning in persons and in science. (shrink)

Multitasking is a critical feature of our daily lives. Using a dual-task paradigm, this experiment explored adults’ abilities to simultaneously engage in everyday motor and cognitive activities, counting while walking, under conditions varying the difficulty of each of these tasks. Motor difficulty was manipulated by having participants walk forward versus backward, and cognitive difficulty was manipulated by having participants count forward versus backward, employing either a serial 2 s or serial 3 s task. All of these manipulations were performed in (...) single-task conditions and dual-task conditions. Both motor performance variables and cognitive variables were assessed in these conditions. Analyses of single-task conditions revealed that both motor and cognitive manipulations predictably influenced performance. Analyses of dual-task performance revealed influences of motor and cognitive factors on both motor and cognitive performance. Most centrally, dual-task costs for motor variables revealed that such costs occurred primarily for temporal or spatiotemporal gait parameters and were driven by cognitive manipulations. Dual-task cost analyses for cognitive measures revealed negative dual-task costs, or dual-task benefits, for cognitive performance. Finally, the effects of dual-task manipulations were correlated for motor and cognitive measures, indicating dual-task performance as a significant individual difference variable. These findings are discussed with reference to theories of attentional allocation, as well as the possible role of auditory–motor entrainment in dual-task conditions. (shrink)

We explore the developmental paradox of false belief understanding. This paradox follows from the claim that young infants already have an understanding of false belief, despite the fact that they consistently fail the elicited-response false belief task. First, we argue that recent proposals to solve this paradox are unsatisfactory because they (i) try to give a full explanation of false belief understanding in terms of a single system, (ii) fail to provide psychological concepts that are sufficiently fine-grained to capture the (...) cognitive requirements for the various manifestations of false belief understanding, and (iii) ignore questions about system interaction. Second, we present a dual-system solution to the developmental paradox of false belief understanding that combines a layered model of perspective taking with an inhibition-selection-representation mechanism that operates on different levels. We discuss recent experimental findings that shed light on the interaction between these two systems, and suggest a number of directions for future research. (shrink)

The science of evolution acutely raises the perennial question of humankind’s place in the world. How does the theological anthropology of humans as imago Dei relate to an evolutionary anthropology with human beings derived from ancestral hominid species? Evolutionary biologists disclose ever greater similarities and continuity between animals and humans. Is human distinctiveness simply continuous with other ancestral forms of life or is there any kind of discontinuity? The answers to these questions depend not only on zoological considerations but also (...) on one’s philosophy of nature. The standard anthropology within the Catholic Church is the dual-origin model: the human body originates through evolution, but the human soul is directly created by God. This formulation, however, is not without difficulties, primarily for its seeming Cartesian dualism of a body and soul as distinct substances. This paper develops the anthropology of David Braine who, drawing upon Aristotle, Thomas Aquinas, and Ludwig Wittgenstein, clearly situates humans as animals in great continuity with them. However, as linguistic animals who think in a medium of words, humans have a form of life—a soul—that transcends bodily processes. Braine’s anthropology provides a more coherent anthropology to understand the continuity and discontinuity of the human person in phylogenetic relationship to other species within an evolutionary perspective. (shrink)

Organ procurement organization (OPO) staff play an essential role in the facilitation of organ donation as they guide family members and loved ones of dying patients through the donation process. Throughout the donation process, OPO staff must assume the role of a dual advocate, considering both the interests of the donor (which often include the wishes of the donor’s family) and the interests of potential recipient(s). The benefits of this role are well established; however, minimal literature exists on the ways (...) this role can cause moral distress in OPO staff, who frequently face scenarios in which adhering to the wishes of a donor family may compromise donation potential but failing to honor donor family requests may result in further emotional burden for the family. Given the frequency with which these ethically complex situations exist during donation, OPO staff are at heightened risk for experiencing moral distress and burnout, yet they are seldom acknowledged in the existing moral distress literature. As a result, it is unclear whether the current practices available to mitigate moral distress are beneficial for this population. (shrink)

Recent research suggests that the subjective feeling of conscious recollection is uniquely characterized by joint memory for several context features while merely familiar memories lack this property . In the present research we took the novel approach of extending the dual task paradigm to the simultaneous study of subjective retrieval experience and joint memory for two orthogonal context features. While dual task load during encoding lead to reductions in the frequency of the subjective experience of conscious recollection and reductions in (...) overall context memory, joint context memory was not affected. Furthermore, the relation of higher overall context memory for consciously recollected items than for familiar items was preserved even under dual task load. These results have import implications for theories of long-term feature binding and the processes involved in producing the experience of conscious recollection. (shrink)

A sketchy subquantum theory deeply influenced by Wheeler’s ideas (Am. J. Phys. 51:398–404, 1983) and by the de Broglie-Bohm interpretation (Goldstein in Stanford Encyclopedia of Philosophy, 2006) of quantum mechanics is further analyzed. In this theory a fundamental system is defined as a dual entity formed by bare matter and a methodological probabilistic classical Turing machine. The evolution of the system would be determined by three Darwinian informational regulating principles. Some progress in the derivation of the postulates of quantum mechanics (...) from these regulating principles is reported. The entanglement in a bipartite system is preliminarily considered. (shrink)

A dual-audience signaling problem framework provides a deeper understanding of the perpetuation of group-based inequality. We describe a model of underachievement among minority youth that posits a necessary trade-off between academic success and peer social support that creates a dilemma not typically encountered by nonminorities. Preliminary evidence consistent with the approach is discussed. Such strategic agent perspectives complement the psychological approach put forth by Dixon et al., but with minimal ancillary assumptions.

A coordinate-free formulation is established for (semi) classical particle-field interactions. The exterior language of spacetime chains and De-Rham currents enables the description to include extended strings and membranes besides point particles. Treating physical fields in terms of sections of particular bundles, a unified account of interactions is presented in terms of an intrinsic action principle on a bundle of jets over spacetime. The theory is illustrated by considering the specific model of point particles with intrinsic spin covariantly coupled to theU(1) (...) andSL(2, C) connections describing the electromagnetic and gravitational fields, respectively. The notion of dual spin is examined in this context and coupled equations for this particle-field system are explicitly derived in a local chart. Attention is drawn to the global implications of the theory. (shrink)

It is a theorem of Prikry [7] that ifκcarries a uniformη-descendingly complete ultrafilter then the stationary reflection propertyfails. In this paper we will derive similar results, but here from properties of filters rather than ultrafilters.Throughoutκandηwill denote regular cardinals withη<κ, andIwill denote an ideal onκ, by which we mean a setI⊆P such that Iis closed under taking subsets and finite unions and αЄIfor eachα<κ, butκ∉I.Iis said to beμ-complete if it is closed under taking unions of size <μ,I* = {X⊆κ∣κ−XЄI} is the (...) filter dual toIand ifAЄI+ −I), thenI∣Ais the ideal onκgiven byI∣A= {X⊆κ∣X∩AЄI}. Ifh: A→κthenhis said to be unbounded modIif for eachα<κ,h−1 = {ξЄA∣h<α} ЄIand a least function forIifhis unbounded modIand wheneverg: A→κis a function, unbounded modI, then {ξЄA∣g{ξ) shrink)

The concept of selecting for a disability, and deafness in particular, has triggered a controversial and sometimes acrimonious debate between key stakeholders. Previous studies have concentrated on the views of the deaf and hard of hearing, health professionals and ethicists towards reproductive selection for deafness. This study, however, is the first of its kind examining the views of hearing children of deaf adults towards preimplantation genetic diagnosis and prenatal diagnosis to select for or against deafness. Hearing children of deaf adults (...) straddle both the deaf and hearing worlds, and this dual perspective makes them ideally placed to add to the academic discourse concerning the use of genetic selection for or against deafness. The study incorporated two complementary stages, using initial, semistructured interviews with key informants as a means to guide the subsequent development of an electronic survey, completed anonymously by 66 individuals. The participants shared many of the same views as deaf individuals in the D/deaf community. The similarities extended to their opinions regarding deafness not being a disability, their ambivalence towards having hearing or deaf children and their general disapproval of the use of genetic technologies to select either for or against deafness. (shrink)

Since the mid-1800s, clergy, doctors, other clinicians, and military personnel who specifically facilitate their work have been designated “non-combatants”, protected from being targeted in return for providing care on the basis of clinical need alone. While permitted to use weapons to protect themselves and their patients, they may not attempt to gain military advantage over an adversary. The rationale for these regulations is based on sound arguments aimed both at reducing human suffering, but also the ultimate advantage of the nation-state (...) fielding non-combatant staff. However, this is sometimes not immediately apparent to combatant colleagues. Clinicians in the armed force are also military officers, owing a “dual loyalty” that can create conflict if their non-combatant status is not well understood. Historical examples of doctors breaching their responsibilities include prioritisation of combat capability over the rights of individual soldiers (as occurred when scarce medical resources were allocated to soldiers more likely to return to battle in preference to those most likely to die without them), use of physicians to facilitate prisoner interrogation, medical research or treatment to enhance physical performance at the expense of health, application of Medical Rules of Eligibility according to factors other than clinical need, provision of treatment contingent upon support for military objectives, and use of medical knowledge to enhance weapons. However, not being a combatant party to a conflict does not imply that the non-combatant clinician cannot act in the national interest. Indeed, by adhering to the same universal ethics as their civilian colleagues, military clinicians provide optimal care to their own troops, facilitate freedom of action in host nations, and build positive international relationships during the conflict and in the post-conflict state. (shrink)

Preschool children have been proven to possess nonsymbolic approximate arithmetic skills before learning how to manipulate symbolic math and thus before any formal math instruction. It has been assumed that nonsymbolic approximate math tasks necessitate the allocation of Working Memory (WM) resources. WM has been consistently shown to be an important predictor of children's math development and achievement. The aim of our study was to uncover the specific role of WM in nonsymbolic approximate math. For this purpose, we conducted a (...) dual-task study with preschoolers with active phonological, visual, spatial, and central executive interference during the completion of a nonsymbolic approximate addition dot task. With regard to the role of WM, we found a clear performance breakdown in the central executive interference condition. Our findings provide insight into the underlying cognitive processes involved in storing and manipulating nonsymbolic approximate numerosities during early arithmetic. (shrink)

Next SectionBiodefence, broadly understood as efforts to prevent or mitigate the damage of a bioterrorist attack, raises a number of ethical issues, from the allocation of scarce biomedical research and public health funds, to the use of coercion in quarantine and other containment measures in the event of an outbreak. In response to the US bioterrorist attacks following September 11, significant US policy decisions were made to spur scientific enquiry in the name of biodefence. These decisions led to a number (...) of critical institutional changes within the US federal government agencies governing scientific research. Subsequent science policy discussions have focused largely on ‘the dual use problem’: how to preserve the openness of scientific research while preventing research undertaken for the prevention or mitigation of biological threats from third parties. We join others in shifting the ethical debate over biodefence away from a simple framing of the problem as one of dual use, by demonstrating how a dual use framing distorts the debate about bioterrorism and truncates discussion of the moral issues. We offer an alternative framing rooted in social epistemology and institutional design theory, arguing that the ethical and policy debates regarding ‘dual use’ biomedical research ought to be reframed as a larger optimisation problem across a plurality of values including, among others: (1) the production of scientific knowledge; (2) the protection of human and animal subjects; (3) the promotion and protection of public health (national and global); (4) freedom of scientific enquiry; and (5) the constraint of government power. (shrink)

Blanshard analyzes and criticizes contemporary ethical theories including those of Moore and Ross, Perry, Dewey, the emotivists, and recent linguistic philosophers. Goodness can be understood only against the background of human life, and has the dual character of satisfaction and fulfillment. There are many kinds of intrinsic goods, but Reason threads its way throughout, arbitrating claims upon our attention and seeking out the type of life which is most satisfying and fulfilling. Written in Blanshard's distinctively urbane style, this book balances (...) synoptic vision with systematic analysis.--R. C. N. (shrink)

The tendency to neglect base-rates in judgment under uncertainty may be as Barbey & Sloman (B&S) suggest, but it is neither inevitable (as they document; see also Koehler 1996) nor unique. Here we would like to point out another line of evidence connecting ecological rationality to dual processes, the failure of individuals to appropriately judge cumulative probability.

In lieu of an abstract, here is a brief excerpt of the content:Anorexia and the MacCAT-T Test for Mental Competence:Validity, Value, and EmotionLouis C. Charland (bio)Keywordsmental competence, decisional capacity, anorexia, value, emotionValidity of the MacCAT-THow does one scientifically verify a psychometric instrument designed to assess the mental competence of medical patients who are asked to consent to medical treatment? Aside from satisfying technical requirements like statistical reliability, results yielded by such a test must conform to at least some accepted pretheoretical (...) desiderata; for example, determinations of competence, as measured by the test, must capture a minimal core of accepted basic intuitions about what competence means and what a theory of competence is supposed to do. The concepts of "face validity" and "content validity" are both important here. Face validity "indicates that an instrument appears to test what it is supposed to and that it is a plausible method for doing so" (Portney and Watkins 2000, 82). Content validity "means that the test contains all the elements that reflect the variable being studied" (Portney and Watkins 2000, 83). An adequate instrument for measuring mental competence must at minimum satisfy both of these requirements.What Tan and her colleagues (2006) have shown is that the MacArthur Competence Assessment Tool—Treatment (MacCAT-T) test for mental competence may not be an empirically valid measure of mental competence for some cases of anorexia. The data they report show that "competence," as measured by the MacCAT-T, does not conform sufficiently well with what is wanted of a clinical medical theory of competence. More specifically, the MacCAT-T is deficient in both face and content validity. This result is extremely significant; previous challenges to the validity of the MacCAT-T have often been largely theoretical in nature. My own objection that the MacCAT is inadequate because it omits the influence of emotion is based on a combination of empirical theory (Charland 1998a) and philosophical argument (Charland 1998b). However, it is entirely theoretical in nature. So is my argument that in ignoring emotion the MacCAT misses a crucial contributing ingredient in competence, namely, value (Charland 2001, see especially 136 note 2). Tan's study provides valuable empirical evidence for the second of these challenges, which deals more specifically with value. On the one hand, the study clearly demonstrates that patients sometimes do [End Page 283] base their treatment decisions on reasons derived from values. And on the other hand, it also nicely illustrates the centrality of values—"utilities" or "preferences"—in the decision-making process generally; a basic assumption of standard decision theory for which, paradoxically, there appears to be no satisfactory counterpart in the MacCAT-T model of reasoning and decision making.Thus, values figure among the reasons that patients actually use in reasoning when they weigh the risks and benefits of proposed treatment options. The MacCAT-T must be amended to incorporate this fact if it is to be a satisfactory clinical medical tool. Without such a correction, the concept of mental competence it measures is empirically invalid. At the root of the problem is a clash of intuitions. Tan's data provide convincing evidence that some of the patients who are deemed to be mentally competent by MacCAT-T standards should not in fact be considered competent. Note that the language in which this clash is expressed—"should not in fact"—involves a combination of descriptive and prescriptive elements, reminding us that the concept of competence is dual in nature: it is both prescriptive and descriptive (Freedman 1981). These problems underscore the need for greater clarity about what pretheoretically we want a clinical theory and test of competence to capture. It is of course reasonable to say that such a test must be consistent with major tenets of the relevant case law (Appelbaum 1998). But a legally valid concept of competence of this sort is too thin and arbitrary a foundation on which to build a clinical medical theory of competence. An empirically valid theory and test of the latter sort must incorporate the role of values if it is be truly helpful in medical practice.Value and the MacCAT-TI agree with Tan and her colleagues that some notion of "pathological value" needs to be... (shrink)

The great spiritual traditions unanimously affirm that beyond the boundaried egoic consciousness, typically identified along the psychological spectrum as 'myself' ,lies a more spacious, unboundaried selfhood whose attainment comprises the true fulfilment of our human journey. In this paper, Cynthia Bourgeault expounds that the way toward this state is through nurturing the heart in its foundational role as the seat of non-dual perception.

Alchemy is central to Jung's hypothesis of the collective unconscious. In this volume he begins with an outline of the process and aims of psychotherapy, and then moves on to work out the analogies between alchemy, Christian dogma and symbolism and his own understanding of the analytic process. Introducing the basic concepts of alchemy, Jung reminds us of the dual nature of alchemy, comprising both the chemical process and a parallel mystical component. He also discusses the seemingly deliberate mystification of (...) the alchemists. Finally, in using the alchemical process as providing insights into individuation, Jung emphasises the importance of alchemy in relating to us the transcendent nature of the psyche. (shrink)

BackgroundDistorted gambling-related cognitions are tightly related to gambling problems, and are one of the main targets of treatment for disordered gambling, but their etiology remains uncertain. Although folk wisdom and some theoretical approaches have linked them to lower domain-general reasoning abilities, evidence regarding that relationship remains unconvincing.MethodIn the present cross-sectional study, the relationship between probabilistic/abstract reasoning, as measured by the Berlin Numeracy Test, and the Matrices Test, respectively, and the five dimensions of the Gambling-Related Cognitions Scale, was tested in a (...) sample of 77 patients with gambling disorder and 58 individuals without gambling problems.Results and interpretationNeither BNT nor matrices scores were significantly related to gambling-related cognitions, according to frequentist analyses, performed both considering and disregarding group in the models. Correlation Bayesian analyses largely supported the null hypothesis, i.e., the absence of relationships between the measures of interest. This pattern or results reinforces the idea that distorted cognitions do not originate in a general lack of understanding of probability or low fluid intelligence, but probably result from motivated reasoning. (shrink)