Nonadherence to treatment continues to be one of psychiatry's greatest challenges. To improve adherence and thus improve the care of patients, clinicians and patients' family members sometimes resort to hiding medication in food or drink, a practice referred to as covert/ surreptitious medication. The practice of covert drug administration in food and beverages is well known in the treatment of psychiatrically ill world-wide but no prevalence rates exist. Covert medication may seem like a minor matter, but it touches on legal (...) and ethical issues of a patient's competence, autonomy, and insight. Medicating patients without their knowledge is not justifiable solely as a shortcut for institutions or families wishing to calm a troublesome patient and thus alleviate some of the burdens of care giving. The paramount principle is ensuring the well-being of a patient who lacks the competence to give informed consent. Ethically, covert/surreptitious administration can be seen as a breach of trust by the doctor or by family members who administer the drugs. Covert medication contravenes contemporary ethical practice. Legally, treatment without consent is permissible only where common law or statute provides such authority. The practice of covert administration of medication is not specifically covered in the mental health legislation in developing countries. Many of the current dilemmas in this area have come to public attention because of two important developments in medical ethics and the law - the increasing importance accorded to respect for autonomy and loss of the parens patriae jurisdiction of the courts [parens patriae means 'parent of the country'; it permitted a court to consent or refuse treatment on behalf of an 'incapacity', or alternatively to appoint a guardian with such powers]. (shrink)

Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased (...) tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust. (shrink)

The increasingly foreshortening of bioethics known as narrative and even literary bioethics is analyzed in article. This analysis is realized on the material of Rudyard Kipling’s story «The miracle of Purun Bhagat». Deconstruction in its ethical aspect comes out in this case as method of the overcoming of logocentrism and becomes radicalization of ethics. The talk is about consideration of bioethics not simply as the science of survival but as radical ethics of the salvation of life. The text of the (...) story is interpreted as pharrmacon, remedy, sure remedy for human consciousness, society and nature. The result of the analysis is the idea of the consideration of conservative bioethics as radical ethics of salvation and science about spiritual-moral essence of human. This essence is consciousness, which is always moral consciousness in contradiction to intellect deprivated of moral dimension and leading humankind on the way of catastrophic progress to transhumanistic, posthuman future. (shrink)

In this paper I argue that Direct realism is less prone to internal incoherence as a theory of knowledge than alternative theories. The theory of Direct realism best grounds our capacity for cognition of the external world, whereas other epistemological theories claim to ground our capacity for cognition, but end in skepticism in the final analysis. I propose to show this contrast by bringing in different theories of a well-known Indirect realist, Bertrand Russell. Illustrating this point mainly through Russell makes (...) the approach purely historical in nature even when the paper includes a brief discussion of two theories in the current debate that support Direct realism. (shrink)

The improvement of modern computer technology to achieve fundamentally new indicators can be carried out on the basis of various approaches. One of such approaches is the application of methods of physical informatics. Therefore, this paper considers the support of ensuring “digital immortality” based on physical computer science methods. On the basis of Wiener random processes, measures are proposed to ensure the security of computer nodes to ensure “digital immortality”. The calculated ratios from physical informatics adapted to determine the requirements (...) for the design of information systems to ensure the digitalization of the brain are given. (shrink)

Increasingly, national governments across the globe are prioritizing investments in neuroscience. Currently, seven active or in-development national-level brain research initiatives exist, spanning four continents. Engaging with the underlying values and ethical concerns that drive brain research across cultural and continental divides is critical to future research. Culture influences what kinds of science are supported and where science can be conducted through ethical frameworks and evaluations of risk. Neuroscientists and philosophers alike have found themselves together encountering perennial questions; these questions are (...) engaged by the field of neuroethics, related to the nature of understanding the self and identity, the existence and meaning of free will, defining the role of reason in human behavior, and more. With this Perspective article, we aim to prioritize and advance to the foreground a list of neuroethics questions for neuroscientists operating in the context of these international brain initiatives. (shrink)

"The definitive work by B.K.S. Iyengar, the world's most respected yoga teacher. B.K.S. Iyengar has devoted his life to the practice and study of yoga. It was B.K.S. Iyengar's unique teaching style, bringing precision and clarity to the practice, as well as a mindset of 'yoga for all', which has made it into the worldwide phenomenon it is today. 'Light on Yoga' is widely called 'the bible of yoga' and has served as the source book for generations of yoga students (...) around the world. It is the classic text for all serious students of yoga." --Publisher description. (shrink)