Neuropsychiatric disorders introduce distinct challenges to clinical decision-making. Affected patients often experience impairments or absences in rationality, lucidity and cogni-emotional capacities, rendering it difficult for them to engage in the decision-making process. In turn, dynamics of the patient-physician relationship become strained, including when physicians employ bioethical principlism or moral case deliberation to arrive at ethically justified courses of action–both of which require sufficient communication and rationality that may be impaired or altogether absent in the presence of psychopathology. The complexity of (...) neuropsychiatric conditions therefore compels interrogation towards how ethics consultations are currently constructed and conducted when full communication or rational decision-making cannot be assumed. Delany et al, for example, present a robust, methodical framework for ethical deliberation.1 Such methodologies for facilitating ethical decision-making, although valuable in predominant contexts, assume full participant engagement and decision-making capacities (eg, independent moral agency). Neuropsychiatric disorders complicate this assumption, making it difficult for patients with limited decision-making capacity to engage meaningfully in proposed ethics consultations.2 This paper will explore how neuropsychiatric disorders complicate the assumptions of full participant engagement underlying ethical frameworks. It will argue that, by adapting ethics consultations to function as a ‘mental prosthesis’, clinicians can better navigate the ethical challenges posed by neuropsychiatric disorders, helping to ensure that patient autonomy is upheld even in cases of impaired cognitive …. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

Provability, Computability and Reflection.

Context: In the digital era, it is important to investigate the potential impact of digital technologies in education and how such tools can be successfully integrated into the mathematics classroom. Similarly to many others in the constructionism community, we have been inspired by the idea set out originally by Papert of providing students with appropriate “vehicles” for developing “Mathematical Ways of Thinking.” Problem: A crucial issue regarding the design of digital tools as vehicles is that of “transfer” or “bridging” i.e., (...) what mathematical knowledge is transferred from students’ interactions with such tools to other activities such as when they are doing “paper-and-pencil” mathematics, undertaking traditional exam papers or in other formal and informal settings. Method: Through the lens of a framework for algebraic ways of thinking, this article analyses data gathered as part of the MiGen project from studies aiming at investigating ways to build bridges to formal algebra. Results: The analysis supports the need for and benefit of bridging activities that make the connections to algebra explicit and for frequent reflection and consolidation tasks. Implications: Task and digital environment designers should consider designing bridging activities that consolidate, support and sustain students’ mathematical ways of thinking beyond their digital experience. Constructivist content: Our more general aim is to support the implementation of digital technologies, especially constructionist learning environments, in the mathematics classroom. (shrink)

Based on two workshops held February 1990 in New York and March 1990 in San Francisco. Following the presentation and discussion of three clinical case histories, psychotherapists James F. Masterson, Marian Tolpin, and Peter E. Sifneos compare and contrast developmental, self, and object relations.

This essay, as the title suggests, is not just a reply to Richard Ashcraft -- although it is certainly that too. Its intention is to say something about the political theory of Locke, about his historical context and about the methodological question of contexts in general. About his political theory, I want to make two or three main points which, I think, have important consequences for our understanding of Locke: that he both appropriates and, on critical issues, deliberately neutralizes the (...) radical �discourses� of his time -- so that, for example, he adopts Leveller premises to arrive at something more like Cromwell's (or even more conservative) conclusions; and that he deprives these radical discourses of their most democratic implications less by excluding people from membership in the political nation than by restricting the rights of membership itself. This means, among other things, that the relevant debate is not the one that has so preoccupied Locke scholars -- namely, the controversy about who is a �freeman� or who belongs to the �people�. The decisive question is rather what political rights the �people� have. (shrink)

In [3] F. P. Ramsey proved as a theorem of Zermelo-Fraenkel set theory (ZF) with the Axiom of Choice (AC) the following result:(1) Theorem. Let A be an infinite class. For each integer n and partition {X, Y} of the size n subsets of A, there exists an infinite subclass of A all of whose size n subsets are contained in only one of X or Y.

A guide for everyone involved in medical decision making to plot a clear course through complex and conflicting benefits and risks.

While agreeing with Poteat that the modern Western culture has gone awry in a humanly destructive way, the paper contends tha the culprit was not, as Poteat claims, Enlightenment critical philosophy, but the materialistic values of the bourgeois form of life and the puritanical view of knowledge and the naturalistic worldview that they generated. Accordingly, the solution proposed is not Poteat's unreflected experience and commonsense worldview but a shift to a humanistic culture-generating stance and a critical humanistic philosophy.