Next SectionBackground There is an established link between depression and interest in hastened death in patients who are seriously ill. Concern exists over the extent of depression in patients who actively request euthanasia/physician-assisted suicide (PAS) and those who have their requests granted. Objectives To estimate the prevalence of depression in refused and granted requests for euthanasia/PAS and discuss these findings. Methods A systematic review was performed in MEDLINE and PsycINFO in July 2010, identifying studies reporting rates of depression in requests (...) for and cases of euthanasia/PAS. One author critically appraised the strength of the data using published criteria. Results 21 studies were included covering four countries. There was considerable heterogeneity in methods of assessing depression and selecting patients. In the highest quality studies, in the Netherlands and Oregon, 8–47% of patients requesting euthanasia/PAS had depressive symptoms and 2–17% of completed euthanasia/PAS cases had depressive symptoms. In the Netherlands, depression was significantly higher in refused than granted requests, and there was no significant difference in the rate of depression between euthanasia cases and similar patients who had not made a request for euthanasia. Conclusion It is unclear whether depression increases the probability of making a request for euthanasia/PAS, but in the Netherlands most requests in depressed patients are rejected, leaving a depression rate in cases that is similar to the surrounding population. Less evidence is available elsewhere, but some level of depression has been identified in patients undergoing euthanasia/PAS in all the countries studied. Whether the presence of depression is ever compatible with an ethical decision on euthanasia/PAS is discussed. (shrink)

Fifteen years into a successful career as a college professor, Ilana Blumberg encounters a crisis in the classroom that sends her back to the most basic questions about education and prompts a life-changing journey that ultimately takes her from East Lansing to Tel Aviv. As she explores how civic and religious commitments shape the culture of her humanities classrooms, Blumberg argues that there is no education without ethics. When we know what sort of society we seek to build, our (...) teaching practices follow. In vivid classroom scenes from kindergarten through middle school to the university level, Blumberg conveys the drama of intellectual discovery as she offers novice and experienced teachers a pedagogy of writing, speaking, reading, and thinking that she links clearly to the moral and personal development of her students. Writing as an observant Jew and as an American, Blumberg does not shy away from the difficult challenge of balancing identities in the twenty-first century: how to remain true to a community of origin while being a national and global citizen. As she negotiates questions of faith and citizenship in the wide range of classrooms she traverses, Blumberg reminds us that teaching - and learning - are nothing short of a moral art, and that the future of our society depends on it. (shrink)

What do we mean when we diagnose a patient with a disease? What does it mean to say that two people have the same disease? In this paper, I argue that diseases are natural kinds, using a conception of kinds derived from John Stuart Mill and Ruth Millikan. I demonstrate that each disease is a natural kind and that the shared properties occur as a result of the pathogenesis of the disease. I illustrate this with diverse examples from internal medicine (...) and compare my account to alternative ontologies. (shrink)

Nancy Levene reinterprets a major early modern philosopher, Benedict de Spinoza - a Jew who was rejected by the Jewish community of his day but whose thought contains, and critiques, both Jewish and Christian ideas. It foregrounds the connection of religion, democracy, and reason, showing that Spinoza's theories of the Bible, the theologico-political, and the philosophical all involve the concepts of equality and sovereignty. Professor Levene argues that Spinoza's concept of revelation is the key to this connection, and (...) above all to Spinoza's view of human power. This is to shift the emphasis in Spinoza's thought from the language of amor Dei to the language of libertas humana without losing either the dialectic of his most striking claim - that man is God to man - or the Jewish and Christian elements in his thought. Original and thoughtfully argued, this book offers fresh insights into Spinoza's thought. (shrink)

Doctors Pratt and de Vries propose a well-structured and courageous approach to analyse and repair an insufficiently recognised discussion about epistemologies and knowledge production in bioethics.1 The authors invite researchers, scholars, public health experts and bioethicists from the global North to reflect about their lack of imagination regarding different sources of narratives produced by the global South. There is a critical analysis of injustices and an urgent call for global bioethicists to reorient their field and focus on the analysis and (...) development of ethical interventions to achieve a comprehensive epistemic justice for global health ethics. Feminist bioethicists from the global South already argued about the importance of the voices and biographies of the people and groups in the communities to reframe the bioethical reasoning regarding the meaning of individual’s needs during public health and humanitarian emergencies.2 Over a decade ago, Diniz and Guilhem described the role and goal of feminist bioethics in Latin America, shaped in an oppressive context promoted and created by …. (shrink)

In Brazil, the epicenter of the Zika crisis, brown, black, and indigenous poor women living in municipalities with scarce resources were disproportionally affected. The gendered consequences of the epidemic exposed how intersectional lenses are central to understand the impact of public health emergencies in the lives of women and girls. The demand for Zika-affected children and women to be research participants is relevant for an ethical analysis of participant protection procedures during a crisis. We investigated how women experienced research participation (...) by analyzing their narratives. Two-year-long longitudinal qualitative study in Brazilian sites located in the epidemic's epicenter was performed using mixed methods: ethnography with women from two distinct states and individual semi-structured interviews with five women in different Zika-affected states, four of which were community leaders. All women in the study were mothers or grandmothers of Zika-affected children. Thematic analysis was used for data evaluation. Women perceived being pressured to participate in research and a lack of benefit sharing. Structural determinants of gender inequality, such as its effect on power distribution, were found to impact research participant protection. Formal procedures for research protocols approvals were insufficient in protecting participants because these instruments were unable to account for structural aspects. Communitarian mobilization, through WhatsApp groups, was found to be an important mechanism to create conditions to challenge oppressive structures. Strengthening public health, effective community-based participation in research planning and implantation of ethical strategies that promotes gender equality can have transformative effect on unequal power structures and promote participant protection. (shrink)

This paper introduces The Certainty Trap, a pervasive cognitive distortion that leads individuals to treat their knowledge and beliefs as definitive and final rather than provisional, particularly regarding contentious social and political issues. It explores three key fallacies underlying this trap, discusses its consequences, and proposes strategies for moving from certainty to confidence in thinking and discourse. By revealing the mechanisms of The Certainty Trap and its overall impact on various domains of society, this essay aims to contribute to the (...) clearer thinking that can lead to more nuanced and productive approaches to addressing complex societal challenges. (shrink)

Chater & Loewenstein argue for a shift in focus from individual- to structural-level approaches to societal ills. This is valid and important but overlooks the barriers inherent in the current US partisan context. Psychology can be applied to help people of mixed allyship join together, to effectively and quickly force institutions and corporations to accept structural change.

Due to an oversight, Ilana Raburn's article “Intrinsic Kinds in Internal Medicine,” Philosophy of Medicine 5, no. 1 (2024), https://doi.org/10.5195/pom.2024.189, failed to acknowledge the influence of Harriet Fagerberg’s characterisation of diseases as Millikanian natural kinds in “Reactive Natural Kinds and Varieties of Dependence,” European Journal for Philosophy of Science 12, article 72 (2022), https://doi.org/10.1007/s13194-022-00500-x.

Smajdor addresses the problem of inferior clinical outcomes among adults with impairments of capacity to give informed consent (AWIC). She notes that AWIC are generally excluded from clinical trials to protect them against harms and avoid exploitation and claims there is a causal link between involvement in clinical trials and favourable outcomes. She argues, given this link, that we should increase AWIC representation in clinical trials and can justifiably do so by recognising the capacity of AWIC to assent. AWIC form (...) a diverse group, with multiple aetiologies, including, for example, Down syndrome, traumatic brain injury and dementia. In some cases, the inability to consent may fluctuate so that the same person could be AWIC only at certain times. Yet despite these differences, the group has a shared unmet need. We agree with Smajdor that AWIC outcomes should be improved, but question whether simply increasing representation in clinical trials is sufficient to achieve this. We identify the following points: 1. AWIC are under-represented in clinical trials. There is evidence of widespread exclusion of AWIC in clinical trials within the UK and abroad and it is often a specific exclusion criterion.1 2. AWIC have worse clinical outcomes and a lower life expectancy. The life expectancy …. (shrink)

Linguistic forms with dedicated evidential meanings have been described for a number of Australian languages (eg. Donaldson 1980, Laughren 1982, Wilkins 1989) but there has been little written on how these are used in social interaction. This paper examines evidential strategies in ordinary Garrwa conversations, by taking into account what we know more generally about the status of knowledge and epistemic authority in Aboriginal societies, and applying this understanding to account for the ways knowledge is managed in `ordinary' interactions.

This is an ironic moment for Edouard Glissant’s growing community of readers. So many are discovering Glissant’s work for the first time, myself included, in part because a fervent commitment to a politics of recognition now dominates in many corners of the humanities. This is ironic largely because while the choice to engage with Glissant might be motivated by an all too generalized logic of recognition, to read Glissant is to learn about how the basic premises underpinning this logic are (...) deeply misguided. The politics of recognition, as a term of art, after all, is built on the conceptual planks made available by the standardizing impulses of the nation-state form and capitalism combined. Glissant, on the other hand, is nothing if not a theorist calling fervently for a path forward that does not depend on the complicities found in the conceptual imperialism inherent to the bureaucratic standardizing practices that bolster both the nation-state and contemporary capitalism. Glissant calls instead for an approach that offers the philosophical building blocks for a politics of coordination, which is described in Patchell Markell’s book, Bound by Recognition (2003) as a politics of acknowledgement. This politics entails forgingan alternative approach to the self and other, to identity and place, and to social orders in general than what the politics of recognition espouses. (shrink)

Orphei ad Musaeum -- Orphei hymni -- Procli Lycii philosophi hymni -- Magica dicta magorum ex Zoroastre.

Preferences for options that do not secure optimal outcomes, like the ones catalogued by Sunstein, derive from two sources: cognitive heuristics and deontological rules. Although rules may stem from automatic affective reactions, they are deliberately maintained. Because strongly held convictions have important behavioral implications, it may be useful to regard cognitive heuristics and deontological rules as separate sources of nonconsequential judgment in the moral domain.

Key words: code of ethics; rejected patients; terrorism; terrorist victims; terrorists; values.

"In a complex world where competing groups claim to be speaking on behalf of incommensurate versions of 'humanity, ' the authors represented in "In the Name of ...

This paper focuses on the role of regulation in the shaping new scientific facts. Fleck chose to study the origins of a diagnostic test for a disease seen as a major public health problem, that is, a ‘scientific fact’ that had a direct and immediate influence outside the closed universe of fundamental scientific research. In 1935, when Fleck wrote his book, Genesis and development of a scientific fact, he believed that the tumultuous early history of the Wassermann reaction had come (...) to an end, and that this reaction was successfully stabilized through the standardization of laboratory practices and thanks to the rise of a specific professional segment—the serologists. He could not have predicted that in the 15 years that followed the publication of his book, regulatory measures—barely metioned in his historical narrative—would play a key role in the destabilization of the original meaning of this reaction. The introduction of mass screening for syphilis—mainly via legislation that introduced obligatory premarital tests and promoted the testing of pregnant women—weakened in fine the link between Wassermann serology and infection by the etiological agent of syphilis, the bacterium Treponema pallidum. Fleck elected to study the Wassermann reaction because of its novelty, its complexity, and because it became the focus of a controversy regarding its origins. However, the Wassermann reaction was also one the first examples of a medical technology regulated by the state and incorporated into legal dispositions. It may therefore be seen as an exemplary case of the close intertwining of scientific investigations, their practical applications and regulatory practices. (shrink)

As mídias facilitam as aprendizagens e oportunizam a expressão das Habilidades Sociais dos estudantes. Este estudo objetiva caracterizar o uso das Tecnologias da Informação e Comunicação e as Habilidades Sociais de 456 estudantes de escolas privadas do Sul do Brasil. Trata-se de um estudo quantitativo, descritivo e transversal. Utilizou-se um questionário de dados sociodemográficos, Questionário de Utilização das Tecnologias de Informação e Comunicação e Inventário de Habilidades Sociais para Adolescentes Del-Prette. O celular/ smartphone e as redes sociais foram as principais (...) tecnologias utilizadas. Destaca-se maior frequência nas Habilidades Sociais de Civilidade e Desenvoltura social e menores frequências em Empatia, Autocontrole, Assertividade e Abordagem Afetiva. Além de alta dificuldade na emissão de Empatia, Autocontrole e Assertividade. Sugere-se estudos clínicos para desenvolvimento de maior repertório de habilidades sociais nesta população para fins de prevenção de comportamentos problemáticos relacionados a baixos níveis de habilidades sociais e alto uso de mídias. (shrink)

A theoretical structure for multiattribute decision making is presented, based on a dynamical system for interactions in a neural network incorporating affective and rational variables. This enables modeling of problems that elude two prevailing economic decision theories: subjective expected utility theory and prospect theory. The network is unlike some that fit economic data by choosing optimal weights or coefficients within a predetermined mathematical framework. Rather, the framework itself is based on principles used elsewhere to model many other cognitive and behavioral (...) data, in a manner approximating how humans perform behavioral functions. Different, interconnected modules within the network encode (a) attributes of objects among which choices are made, (b) object categories, (c) and goals of the decision maker. An example is utilized to simulate the actual consumer choice between old and new versions of Coca-Cola. Potential applications are also discussed to market decisions involving negotiations between participants, such as international petroleum traders. (shrink)

In 1910, Charles Richet suggested that studying individual variations in anaphylactic responses might both open a way to experimental investigation of the biological basis of individuality and help unify the immunological and physiological approaches to biological phenomena. The very opposite would happen however. In the next two decades, physiologists and immunologists interested in anaphylaxis and allergy experienced more and more difficulties in communicating. This divergence between the physiopathological and immunological approaches derived from discrepancies between the experimental systems used by each (...) of these scientific communities. Trying to develop a point of view that took into account all bodily reactions to stimuli, physiologists thought that individual variations between the laboratory animals they used (mainly dogs and cats) constituted important experimental data. Seeking to develop reproducible studies of infection, immunity and 'sensitisation', bacteriologists and immunologists considered that individual variations between the laboratory animals they used (mainly small rodents) constituted 'noise' and not a 'signal'. Each group's loyalty to the experimental models used in their discipline widened the gap between immunological and physiological explanations of allergies and led to the abandonment of studies on the biological basis of individuality. (shrink)

This article examines the ways in which 1970s French feminists who participated in the Women’s Liberation Movement (Mouvement de libération des femmes – MLF) wielded the spectre of lesbianism as an American idiosyncrasy to counteract the politicisation of lesbianism in France. It argues that the erasure of lesbian difference from the domain of French feminism was a necessary condition for making ‘woman’ an amenable subject for incorporation into the abstract unity of the French nation, wherein heterosexuality is conceived as a (...) democratic crucible where men and women harmoniously come together and differences are deemed divisive. Looking at the history of feminism from the standpoint of a lesbian perspective reveals unforeseen continuities between French ‘feminist’ and ‘anti-feminist’ genealogies insofar as they rest on common heterosexual and racial foundations. Finally, the article demonstrates that the alleged un-Frenchness ascribed to the word ‘lesbian’ in the 1970s feminist movement spectrally returned in the 1990s when the word ‘gender’ was, in its turn, deemed radically foreign to the French culture by feminist researchers. Fiercely reactionary constituencies against the legalisation of same-sex marriage have more recently taken up this rhetorical weapon against sexual and racial minorities. (shrink)

Although Ludwik Fleck is today recognized as one of the pioneers of the historical sociology of science, his historical and epistemological writings, most of them dating from the 1930s, long remained practically unknown. They were rediscovered following the mention of Fleck's principal work, the monographGenesis and Development of a Scientific Fact(1935) in the preface of Kuhn'sThe Structure of Scientific Revolutions(1962), and thanks to the efforts of W. Baldamus (1977) and his student T. Schnelle (1982) and of the editors of the (...) English translation of Fleck's book, R. K. Merton and T. J. Trenn. Fleck's work was studied by several scholars and was the subject of two meetings: “Colloquium Ludwik Fleck” (Hamburg, 1981) organized by L. Schaffer and T. Schnelle, and a symposium organized by R. S. Cohen (Berlin, 1984). Some of the papers presented at these meetings were published in Cohen and Schnelle 1986. Today, more than fifty years after the publication of his principal study, Fleck is on his way to becoming a “classic” of the sociology of science and of epistemology. (shrink)

It is commonplace in philosophy, political theory, and theology to speak of the other and the problem of the identity of the West. No one has done as much to foreground the language of the other in recent years as Emmanuel Levinas, whose works have sparked a renewed interest in ethics across the humanities. Moreover, few have advanced as forceful a critique of European otherness, not only its exclusivity (whereby the other is marginalized) but also its hegemony (whereby the other (...) is absorbed). I explore Levinas's critique of Western ethical thought in order to try to pinpoint what exactly he offers to post‐Hegelian reflection on the other, focusing on his insistence that equality must be grounded in the asymmetry of ethics. The question is: does this take one further than Europe, modernity, the West? If so, where is one thereby going? If not, what is novel or important in these claims? (shrink)

Pragmatic sociology is often read as a reaction to and an alternative to Bourdieu’s ‘critical sociology’. This article, in contrast, offers an assessment of pragmatic sociology in terms of its contribution to the theory of culture in general and its affinities with repertoire theory in particular. Whereas the tendency has been to conceive of repertoires as largely unstructured entities, pragmatic sociology has demonstrated a systematic interest in their internal contents and structure, which it has even expanded through its more recent (...) turn to historical and macro comparative analysis. In the process, however, pragmatic sociology has also been leaning towards a form of cultural sociology that actually challenges some major aspects of repertoire theory–thus also bringing into relief the dilemmas facing any attempt at further elaboration of what is now a growing strand of cultural theory. (shrink)

The principle of modernity -- A history of religion -- Artificial populations -- The collective -- Images of truth from Anselm to Badiou -- The radical enlightenment of Spinoza and Kant -- Modernity as ground zero -- Of gods, laws, rabbis, and ends.

In the present study we elucidate the emotional and executive control interactions that might underlie optimism and pessimism. Participants completed a self-report measure of optimism/pessimism and performed an emotion faces categorisation task and an emotion n-back task in which they indicated whether each of a series of faces had the same or a different emotional expression (happy, sad, neutral) as the face presented two trials before. Trials were structured to measure latency to update emotional content in working memory (WM). More (...) pessimistic individuals formed connections among positive stimuli, and broke connections among positive and sad stimuli, in WM more slowly than did less pessimistic individuals; levels of optimism/pessimism did not affect the rate with which individuals formed and broke connections among neutral representations in WM. It appears, therefore, that levels of pessimism are related to specific affective cognitive mechanisms in WM that may be involved in emotion regulation. (shrink)

In this piece, I respond to the responses provided by reviewers to my original forum article titled “Democracy and the Problem of Certainty.” I remain grateful for the editor’s and for the reviewers’ engagement.

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)

This is a review of a collection of six essays. These essays, with the exception of one, are written by the followers of Shin Buddhism. The last essay in this collection is written from the perspective of Theravada Buddhism rather than Mahayana Buddhism. This collection is a result of the initiative by Rev. Yoshiharu Tomatsu who, as a Buddhist priest, has acquired hands-on experience in dealing with grieving Temple members and became acutely aware of the discrepancy between a medical system (...) and a ritualistic Buddhist system. While a medical system overlooks the spiritual needs of the dying, a Buddhist temple system neglects the spiritual needs of the living. This book ensued from a project that was initiated in 2006 and focused on the above-mentioned missing links, aiming to bring into conversation medical and religious practitioners. (shrink)