This study investigated the performance of boys with psychopathic tendencies and comparison boys, aged 9 to 17 years, on two tasks believed to be sensitive to amygdala and orbitofrontal cortex func- tioning. Fifty-one boys were divided into two groups according to the Psychopathy Screening Device (PSD, P. J. Frick & R. D. Hare, in press) and presented with two tasks. The tasks were the gambling task (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) and the Intradimensional/ (...) Extradimensional (ID/ED) shift task (R. Dias, T. W. Robbins, & A. C. Roberts, 1996). The boys with psychopathic tendencies showed impaired performance on the gambling task. However, there were no group differences on the ID/ED task either for response reversal or extradimensional set shifting. The implications of these results for models of psychopathy are discussed. (shrink)

Systemic autoimmune diseases are characterized by the production of antibodies against a broad range of self-antigens. Recent evidence indicates that the majority of these autoantigens are modified in various ways during cell death. This has led to the hypothesis that the primary immune response in the development of autoimmunity is directed to components of the dying cell. In this article, we summarize data on the modification of autoantigens during cell death and the possible consequences of this for autoimmunity. BioEssays 22:627–636, (...) 2000. © 2000 John Wiley & Sons, Inc. (shrink)

This study investigates the ability of individuals with psychopathy to perform passive avoidance learning and whether this ability is modulated by level of reinforcement/punishment. Nineteen psychopathic and 21 comparison individuals, as defined by the Hare Psychopathy Checklist Revised (Hare, 1991), were given a passive avoidance task with a graded reinforcement schedule. Response to each rewarding number gained a point reward specific to that number (i.e., 1, 700, 1400 or 2000 points). Response to each punishing number lost a point punishment specific (...) to that number (i.e., the loss of 1, 700, 1400 or 2000 points). In line with predictions, individuals with psychopathy made more passive avoidance errors than the comparison individuals. In addition, while the performance of both groups was modulated by level of reward, only the performance of the comparison population was modulated by level of punishment. The results are interpreted with reference to a computational account of the emotional learning impairment in individuals with psychopathy. (shrink)

This article presents the new German law on advance directives from 1 September 2009. The history of the parliamentary process of this law is described, the present regulations are explained, their relevance for medical practice discussed and shortcomings are identified. Finally, the new law is compared with other regulations in the international context. Previously established legal practice in Germany has now become largely confirmed by the new law: An advanced directive must be respected in any decision concerning medical treatment, regardless (...) of the stage of the illness. It can be informally revoked at any time, even with limited decision-making capacity. Nobody may be obliged to issue a directive in any way. Advance directives do not need notarisation or routine updating after certain time intervals. Provided that the patient, who is no longer mentally competent, has issued a lasting power of attorney, or provided that the patient has been appointed a healthcare proxy by the courts, this authorised surrogate must assert the patient's will. The role of the guardianship court is clarified: it only needs to be involved in cases of disagreement as to the patient's will. The new German law thus combines more legal certainty with a liberal emphasis on patient autonomy and flexible, adaptable regulations. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

The title of this work evokes suspicion: how can Soll aim at one "part"--metaphysics--of a philosophy such as Hegel's? How would one go about introducing only Hegel's metaphysics? One might, with some validity, go about discussing Hegel's metaphysics ; but how would one, assuming his reader's general unfamiliarity with Hegel, introduce his "metaphysics," and that alone? Alas, one's worst fears are soon realized: the opening sentence reads, "Hegel's method is best approached by asking what he was trying to accomplish with (...) it." Bifurcation. The operant supposition which guides the work is that Hegel "has" a method with which he attempts to "do" various things. This view is utterly un-Hegelian, as even a cursory reading of the introduction to the Logic, to cite only one source, illustrates. No guide to Hegel is going to be useful that clouds this fundamental point. The whole texture of Hegel's integrated and integrative system is never rescued. Soll's presentation approaches, and treats of, Hegel from the standpoint of pedestrian philosophizing, leaning heavily on the collected tradition to make distinctions in a glib and altogether external way. From his starting point, Soll proceeds, drawing on a handful of secondary sources, to deliver an extended series of facile, shotgun commentaries: but if one already has the ability to adjudge which of them find their mark, he does not need the book in the first place. The primary problem a book of this kind faces is the perhaps insuperable difficulty of creating a suitable "introduction" to Hegel's thought. And to be fair, one might say that most of the shortcomings of Soll's book are attributable to this problem. Where does one start, if not where Hegel did; and whither does one proceed, except in the direction Hegel did? One should either attempt to go that path, or elect not to go at all. It is too easy to lose one's way in so dense a forest.--R. J. G. (shrink)

This book is a collection of essays, and is an exercise in literary criticism. Most of the entries couple a philosopher with a literary artist, and the majority of these have an emphasis on the philosophical partner which one frequently fails to find in this sort of study. While few of the critics are capable of sustaining their subtle distinctions, a task properly required of a philosopher, it is nonetheless true that few philosophers can likewise do this. The ability to (...) systematically sustain these distinctions is what characterizes those first-order thinkers whom the body of philosophers and critics alike study. Granting this, the fact still remains that first-rate criticism is vastly more palatable intellectual fodder than is less than first-rate philosophizing. Studies such as the current one bring philosophy back into reality; the relation of a philosopher’s thought to his period, in all of the latter’s diversity, gives to that thought a realistic character that more transparently informs the creations of the fine arts than it does the original products of thought. And if thought is to avoid the sterility which so antagonized both a Sterne and a Hegel, and to become genuinely meaningful, this larger context will be forever indispensable.—R. J. G. (shrink)

Background: Doctor–patient sexual relationship is considered to be unfair because the first party would be abusing the second party’s vulnerability. The prohibition of this relationship is noted in the Hippocratic oath. Currently, a reprise of the use of oaths in medical schools can be observed.Aim: To determine whether the prohibition has been maintained and how its expression has varied in the oaths during different periods.Methods: 50 oaths were studied: 13 ancient–medieval and 37 modern–contemporary. Of the 50 texts, 19 were versions (...) of the original oaths. The oaths that pointed out the prohibited doctor–patient relationship referred to any sexual aspect or included paragraphs that began as the Hippocratic oath does were noted.Results: Of the 24 texts that expressed the prohibition, 8 were ancient–medieval and 16 were modern–contemporary. Some expressly call it Hippocratic oath, many use general terminology and others describe it in association with other commitments .Conclusions: The clause on the prohibition of the doctor–patient sexual relationship in Hippocratic oath was included to be for legal, economic and social reasons at the time. That the clause is found mostly in the ancient–medieval oaths can be attributed to the influence of the original. This commitment is generalised and associated with others by contemporary formulas. Currently, sexual relationships are the subject of legal and ethical analysis and their inclusion in the oaths is being debated. (shrink)

Professor Hall with this work supplements the earlier bibliography of T. E. Jessop, who has collaborated on some of the entries in the current work. There is an overlap of some ten years, inasmuch as Hall’s work commences with the year 1930; entries run through early 1971. The bibliography is extensive, containing some 800 items in all the various Western languages as well as transliterated Japanese. In addition, attention is directed to critical studies of many of the listings. An eighteen-page (...) subject index contributes further to making this a quite useful and valuable addition to the field of Hume scholarship.—R. J. G. (shrink)