Patients with borderline personality disorder (BPD) sometimes request to be admitted to hospital under compulsory care, often under the argument that they cannot trust their suicidal impulses if treated voluntarily. Thus, compulsory care is practised as a form of Ulysses contract in such situations. In this normative study we scrutinize the arguments commonly used in favour of such Ulysses contracts: (1) the patient lacking free will, (2) Ulysses contracts as self-paternalism, (3) the patient lacking decision competence, (4) Ulysses contracts as (...) a defence of the authentic self, and (5) Ulysses contracts as a practical solution in emergency situations. In our study, we have accepted consequentialist considerations as well as considerations of autonomy. We conclude that compulsory care is not justified when there is a significant uncertainty of beneficial effects or uncertainty regarding the patient’s decision-making capacity. We have argued that such uncertainty is present regarding BPD patients. Hence, Ulysses contracts including compulsory care should not be used for this group of patients. (shrink)

Introduction Compulsory care is controversial, since respect for the patient’s autonomy is a standard requirement in health care. Many psychiatrists have experienced that patients with borderline personality syndrome sometimes demand compulsory care for themselves in order not to exert self-harm—like Ulysses contracts. The aim of this study was to examine the possible existence and extent of borderline personality syndrome-patient demands for Ulysses contracts regarding compulsory care in acute psychiatry, and how external influences and demands could affect the caregivers’ decisions about (...) compulsory care. Method An anonymous questionnaire, with three questions with fixed answers, was distributed to 42 licensed medical doctors on call at the psychiatric emergency unit in the city of Stockholm. Thirty-three questionnaires were answered, giving a response rate of 79%. Results Ninety-four percent of the respondents recognized the phenomenon of borderline personality syndrome patients requesting compulsory care, 21% stated that this request had affected their clinical decision, and 55% had used compulsory care for other reasons than the patient’s best interest. Discussion The results indicate that compulsory care is sometimes given in the form of Ulysses contracts for borderline personality syndrome patients. Also, compulsory care is sometimes used for other reasons than the borderline personality syndrome patient’s best interest. Psychological mechanisms affect the decisions of both patients and caregivers. More research should be done concerning to whom, why, and with what consequences compulsory care is prescribed. (shrink)

IntroductionBorderline personality disorder patients are often subjected to inpatient compulsory care due to suicidal behaviour. However, inpatient care is usually advised against as it can have detrimental effects, including increased suicidality.AimTo investigate what motives psychiatrists have for treating borderline personality disorder patients under compulsory care.Materials and MethodsA questionnaire survey was distributed to all psychiatrists and registrars in psychiatry working at mental health emergency units or inpatient wards in Sweden. The questionnaire contained questions with fixed response alternatives, with room for comments, (...) about the respondents’ motives for practising compulsory care of borderline personality disorder patients. The responses were analysed quantitatively with descriptive statistics, and comments were analysed with qualitative descriptive content analysis.ResultsThe psychiatrists’ views were divided on when it was justified to treat borderline personality disorder patients under compulsory care, as were their views on borderline personality disorder patients’ decision competence. When there was an assessed risk of harm, 53% were positive to compulsory care of decision-competent borderline personality disorder patients and another 31% because they considered the patients to be decision incompetent in such situations. Adding the risk of harm caused many respondents to alter their assessment of the patient from decision competent to decision incompetent.ConclusionThe large variations in doctors’ opinions indicate that the care of borderline personality disorder patients is arbitrary. Further, the assessed risk of harm increases the use of compulsory care, even though such care is advised against in clinical guidelines, has questionable legal support, and could lead to an increased suicide risk over time. (shrink)

Suicide is considered a global public health issue and compulsory admission is a commonly used measure to prevent suicide. However, the practice has been criticised since several studies indicate that the measure lacks empirical support and may even increase suicide risk. This paper investigates whether the practice has enough empirical support to be considered proportionate. To that end, arguments supporting compulsory admission as a suicide-preventive measure for most suicidal patients are scrutinized. The ethical point of departure is that the expected (...) benefits of compulsory admission should outweigh the potential harms of the measure to be proportionate and defensible. It is concluded that, for most suicidal patients, suicide-preventive compulsory admission cannot be presumed to be a proportionate measure. To be so, the expected medical benefits of the measure should be greater than the potential increase in suicide risk and other harms that compulsory admission could entail. Instead of using compulsory admission as a suicide-preventive measure, extra safety measures may be needed during and after compulsory admission to prevent the risk of hospitalisation-induced suicide. (shrink)

Two related aspects of the present ‘knowledge capitalism’ stage of globalisation are discussed in this article: the transformation of education to make it more directly supportive of educational growth and competition, and the growing demands on educational research to provide scientific evidence for education policy and practice, using narrowly defined methods and techniques. It is argued that both developments have profound consequences for the construction and use of educational theory, and the vital need for critical discussion and communication in this (...) respect is emphasised. (shrink)

Patients with borderline personality disorder (BPD) are overrepresented in compulsory inpatient care for suicide-protective reasons. Still, much evidence indicates negative effects of such care, including increased suicide risk. Clinical guidelines are contradictory, leaving clinicians with difficult ethical dilemmas when deciding on compulsory care. In this study, we analyse the arguments most commonly used in favour of compulsory care of BPD patients, to find out in what situations such care is ethically justified. The aim is to guide clinicians when deciding on (...) compulsory care for BPD patients and reduce the use of potentially harmful care. The arguments analysed are (a) the patients lack decision competence, (b) the patients lack authenticity, (c) compulsory care saves the patient from suicide, (d) compulsory care safeguards against litigation, complaints, or doctor's anxiety, (e) compulsory care is a practical solution in emergencies, and (f) it is better for the caregiver to ‘err on the safe side’. We conclude that compulsory care is not ethically justified in most cases unless the clinician has probable reason to believe that the patient lacks decision capacity by suffering from a severe mental co-morbidity and stands to benefit from such care. (shrink)

According to the alternative semantics for focus, the semantic reflec of intonational focus is a second semantic value, which in the case of a sentence is a set of propositions. We examine a range of semantic and pragmatic applications of the theory, and extract a unitary principle specifying how the focus semantic value interacts with semantic and pragmatic processes. A strong version of the theory has the effect of making lexical or construction-specific stipulation of a focus-related effect in association-with-focus constructions (...) impossible. Furthermore, while focus has a uniform import, the sources of meaning differences in association with focus are various. (shrink)

The contribution of this work is a classification of corporate social action underlying the Social Ratings Data compiled by Kinder Lydenburg Domini Analytics, Inc. We compare extant typologies of corporate social action to the results of our exploratory factor analysis. Our findings indicate four distinct latent constructs that bear resemblance to concepts discussed in prior literature. Akey finding of our research is that positive and negative social action are both empirically and conceptually distinct constructs and should not be combined in (...) future research. Additionally, we recommend that some prior research results be reconsidered to determine whether these newly derived measures might clarify some previous findings. (shrink)

Epigrams of Lingayat saints of the 16th century espousing the Advaita school in Hindu philosophy; transcribed from a palm-leaf manuscript preserved in the Karnatak University.

In this essay, I examine Heidegger’s interpretation of Nietzsche, focusing centrally on his understanding of the Nietzschean “body.” Nietzsche’s status as the culminating figure of Western metaphysics depends on the notion that the body, in Nietzsche’s thought, is the last Western subject. I confirm Heidegger’s sense of the importance of the Nietzschean body, and, in particular, the centrality of the word “incorporation”, to a proper understanding of Nietzsche. I argue, however, through a critique of Heidegger’s own understanding of “incorporation” in (...) Nietzsche’s work, that an investigation of the body in Nietzsche does not reveal him to be an unwilling participant in the metaphysical tradition beyond which Heidegger seeks to move; rather, we should see in the Nietzschean body a human finitude that has more resonances in Heidegger’s own thought than Heidegger would care to admit. Ultimately, I show, an investigation of the actual dynamics of the Nietzschean body, as read through the careful tracing of the word “incorporation” to which Heidegger invites us, yields a fundamentally delimited body that operates according to what we might call a kind of physiological asceticism. (shrink)

Reflexive Methodology established itself as a groundbreaking success, providing researchers with an invaluable guide to a central problem in research methodology – how to put field research and interpretations in perspective, paying attention to the interpretive, political, and rhetorical nature of empirical research. Now thoroughly updated, the Second Edition includes a new chapter on positivism, social constructionism, and critical realism, and offers new conclusions on the applications of methodology. It provides further illustrations and updates that build on the acclaimed and (...) successful First Edition. (shrink)

Measures of happiness are increasingly being used throughout the social sciences. While these measures have attracted numerous types of criticisms, a crucial aspect of these measures has been left largely unexplored—their calibration. Using Eran Tal’s recently developed notion of calibration we argue first that the prospect of continued calibration of happiness measures is crucial for the science of happiness, and second, that continued calibration of happiness measures faces a particular problem—The Two Unknowns Problem. The Two Unknowns Problem relies on the (...) claim that individuals are necessarily a part of the measurement apparatus in first person measures of happiness, and the claim that we have no reason to believe that the evaluation standards people employ are invariant across individuals and time. We argue that calibrating happiness measures therefore involves solving an equation with two unknowns—an individual’s degree of happiness, and their evaluation standards—which is, generally, not possible. Third, we consider two possible escape routes from this problem and we suggest that the most promising route requires yet unexplored empirical and theoretical work on linking happiness to behavioral or neural evidence. (shrink)

It was recognized almost from the original formulation of general relativity that the theory was incomplete because it dealt only with classical, rather than quantum, matter. What must be done in order to complete the theory has been a subject of considerable debate over the last century, and here I just mention a few of the various options that have been suggested for a quantum theory of gravity. The aim of what follows is twofold. First, I address worries about the (...) consistency and physical plausibility of hybrid theories of gravity—theories involving a classical gravitational field and quantum matter fields. Such worries are shown to be unfounded. These hybrid theories—mongrel gravity—in fact comprise the only current, actual theories of gravity that incorporate quantum matter, and they also offer legitimate promise as tools for discovering the full theory of gravity. So my second aim is to highlight these theories as providing an interesting example of scientific revolution in action. I begin to try to draw some philosophical lessons from mongrel gravity theories, but more importantly I try to convince philosophers of physics that they should pay more attention to them. (shrink)

Evolutionary theodicies are attempts to explain how the enormous amounts of suffering, premature death and extinction inherent in the evolutionary process can be reconciled with belief in a loving and almighty God. A common strategy in this area is to argue that certain very valuable creaturely attributes could only be exemplified by creatures that are produced by a partly random and uncontrolled process of evolution. Evolution, in other words, was the only possible way for God to create these kinds of (...) creatures. This article presents and examines two versions of the “only way”-argument. The anthropocentric version tries to justify God’s use of evolution by reference to the value of human freedom, and argues that freedom presupposes that God lets go of full control over the process of creation . The non-anthropocentric version presents a similar argument with respect to more inclusive creaturely properties, such as that of being “truly other” than God, or of being a “creaturely self” with a certain degree of autonomy in relation to God . With the help of a number of thought-experiments of the “Twin-Earth”-type, the author argues that both the anthropocentric and the non-anthropocentric only way-arguments fail. (shrink)

**A newly revised edition of two seminal works on Imperial Rome** Undeniably one of Rome’s most important historians, Tacitus was also one of its most gifted. *The Agricola* is both a portrait of Julius Agricola-the most famous governor of Roman Britain and Tacitus’s respected father-in-law-and the first known detailed portrayal of the British Isles. In the *Germania*, Tacitus focuses on the warlike German tribes beyond the Rhine, often comparing the behavior of "barbarian" peoples favorably with the decadence and corruption of (...) Imperial Rome. (shrink)

The empirical basis for this article is threeyears of experience with ethical rounds atUppsala University Hospital. Three standardapproaches of ethical reasoning are examined aspotential explanations of what actually occursduring the ethical rounds. For reasons given,these are not found to be satisfyingexplanations. An approach called ``imaginativeethics'', is suggested as a more satisfactoryaccount of this kind of ethical reasoning. Theparticipants in the ethical rounds seem to drawon a kind of moral competence based on personallife experience and professional competence andexperience. By listening to (...) other perspectivesand other experiences related to one particularpatient story, the participants imaginealternative horizons of moral experience andexplore a multitude of values related toclinical practice that might be at stake. Inhis systematic treatment of aesthetics in theCritique of Judgement, Kant made use ofan operation of thought that, if applied toethics, will enable us to be more sensitive tothe particulars of each moral situation. Basedon this reading of Kant, an account ofimaginative ethics is developed in order tobring the ethical praxis of doctors and nursesinto sharper relief. The Hebraic and theHellenic traditions of imagination are used inorder to illuminate some of the experiences ofethical rounds. In conclusion, it is arguedthat imaginative ethics and principle-basedethics should be seen as complementary in orderto endow a moral discourse with ethicalauthority. Kantian ethics will do the job if itis remembered that Kant suggested only amodest, negative role of principle-baseddeliberation. (shrink)

A social conception of science -- The pursuit of forms -- Beyond the doctrine of signs -- Structures of mediation -- Signs in action -- Prospects of communication -- From a rhetorical point of view.

An ambitious new model of experimentation that will reorient our understanding of the key features of experimental practice. What is experimental knowledge, and how do we get it? While there is general agreement that experiment is a crucial source of scientific knowledge, how experiment generates that knowledge is far more contentious. In this book, philosopher of science James Mattingly explains how experiments function. Specifically, he discusses what it is about experimental practice that transforms observations of what may be very localized, (...) particular, isolated systems into what may be global, general, integrated empirical knowledge. Mattingly argues that the purpose of experimentation is the same as the purpose of any other knowledge-generating enterprise—to change the state of information of the knower. This trivial-seeming point has a non-trivial consequence: to understand a knowledge-generating enterprise, we should follow the flow of information. Therefore, the account of experimental knowledge Mattingly provides is based on understanding how information flows in experiments: what facilitates that flow, what hinders it, and what characteristics allow it to flow from system to system, into the heads of researchers, and finally into our store of scientific knowledge. (shrink)

This study attempts to establish the importance of firm-level interactions with sociopolitical stakeholders in explaining firms prospects for survival. Institutional arguments are proposed to explain the effects of internal structures-both organizational and phenomenological-on firms sociopolitical relational strategies, whereas arguments grounded in the stakeholder view of the firm are advanced to explain effects of sociopolitical stakeholder relations on firm performance. Findings indicate that firms tended to adopt cooptative relationships with sociopolitical stakeholders. Furthermore, firms cooperativeness toward sociopolitical stakeholders had little effect on (...) financial performance but, under some conditions, had positive effects on social performance. Implied is that markets may not be an effective governance mechanism to ensure firms alignment with democratic institutions in a plural society and that public policies may be needed to address these failures. (shrink)

The European Legacy, Volume 17, Issue 5, Page 685, August 2012.

This article analyses the orientation of gaze as a significant communicative resource in televised political interviews. The study explores how interviewees use their gaze, in coordination with talk, in receiving and answering adversarial questions. It is guided by conversation analysis, Goffman’s work on gaze in interaction, and the approach on embodied actions developed primarily by Goodwin. Gaze is described as a flexible recipient and speaker resource available for stance-taking, the downgrading and upgrading of actions, and the claiming of the floor. (...) The study is based on taped and transcribed data from two formats of election campaign interviews on Swedish television, including 350 question and response sequences. (shrink)

Previous studies of corporate environmental and social action identify exactly three similar patterns of activity. They provide divergent structural explanations for these patterns, as networks of institutional constraint, and networks of local inter-dependence, respectively. A theory of sociocultural viability, known in anthropology and policy science as Cultural Theory, explains that social systems consist of four patterns of social interaction, shaped by two distinct structural factors. Our own analysis of 45 items of environmental, social, and governance factors reconcile extant studies’ findings (...) with Cultural Theory’s expectations. Although earlier studies of corporate social action observed only three patterns of activity, our analysis uncovered the fourth, and that diverging structural explanations of earlier studies are partial and complementary, clarified by Cultural Theory. Our call for further study leverages the normative dimension of Cultural Theory, which specifies policy processes that privilege human decency over parochial preference functions. (shrink)

Research on incompetent humans raises ethical challenges, especially when there is no direct benefit to these research subjects. Contemporary codes of research ethics typically require that such research must specifically serve to benefit the population to which the research subjects belong. The article critically examines this “same-population condition”, raising issues of both interpretation and moral justification. Of particular concern is the risk that the way in which the condition is articulated and rationalized in effect disguises or downplays the instrumentalization of (...) incompetent individuals. (shrink)

Treatise on Yoga, according to the Nātha sect in Hinduism.

Between the 1870s and the 1920s, the dye industry was at the center of claims about the productivity of organic chemistry. Dyestuffs were widely represented as the most complex molecules to find commercial application, and positioned at the center of nationalist projects to establish chemical industry, especially in Britain and the United States. By the later twentieth century, the complex of scientific hopes which surrounded dyestuffs had largely disappeared. In Hans-Jörg Rheinberger’s terms, they had changed from “epistemic things” to, at (...) best, “technical objects,” and lost their future-bearing status as the lynchpin of organic chemistry. Although developments in dyeing continue, dyestuffs have vacated the scientifically and culturally dynamic position that they once occupied; any restoration of this status would require a radical change in economic and material conditions. This paper considers the senses in which this change of status should be considered as the death of dyestuffs as a scientific object. (shrink)

This paper examines how different forms of performance evaluation relate to aspects of the creative climate in a major pharmaceutical company. The study was based on a large employee-attitude survey that was distributed to all company employees. The study analyses survey results from 5,333 employees at five R&D sites. The results indicate that management’s evaluation of employees (either dialogue-based or control-based) relates to the type of motivation (intrinsic or extrinsic) that drives employees, to their style of thinking (value-focused thinking) and (...) on their attitudes to organizational creativity. The paper then discusses implications of these findings for HRM. (shrink)

En teoría del valor y en teoría normativa, es común considerar que lo positivo y lo negativo tienen la misma importancia. Algunas rechazan esta idea y consideran que lo negativo tiene mayor importancia. Aquí se presentarán algunos de los argumentos en favor de la asimetría. Tras esto, daré cuenta de los diferentes tipos de posiciones asimétricas defendibles. Explicaré cuáles son las características de cada teoría y qué puntos a favor y en contra de estas posiciones se pueden postular. Por último, (...) consideraré que no hay razones para creer que haya una posición asimétrica claramente superior a las demás. (shrink)

This focused review is based on earlier studies which have shown that both children and adults diagnosed as having developmental coordination disorder (DCD), benefited from sensorimotor therapy according to the method Retraining for Balance (RB). Different approaches and assessments for children and adults in regard to DCD are scrutinized and discussed in comparison to RB which mainly includes (a) vestibular assessment and stimulation (b) assessment and integration of aberrant primary reflexes and (c) assessment and stimulation of auditory and visual perception. (...) Earlier results indicate that the process of sensorimotor therapy using RB techniques could be described according to a conceptual Kinesthetic-Vestibular Developmental Model (KVDM) whereby the training elicited temporary physical and psychological regressions followed by transformations i.e. positive physical and psychological development. We have also seen that this recurring pattern is similar for children and adults. In our conceptual model vestibular stimulation (perceptual priming) stimulates the nervous system, which might enhance object-related priming. This perceptual priming will also assist the suppression of persistent aberrant primary reflexes. In order to develop effective methods for assessment and intervention of DCD over the life span the importance of primary reflex inhibition and vestibular stimulation as well as a combination of bottom-up and top-down approaches have to be considered. (shrink)

This article is a detailed discourse analytic study about the transformation of three social research reports into television news, above all through the reporter–source interview. The focus is on how questions are used to probe responses and explanations and how these are either omitted from or incorporated into the final news stories. By this unique research design the interactional conduct of the reporter–source interview as well as some aspects of question design applied in the interview are described. It is argued (...) that both the interviews as well as the editing of the news stories are guided by ‘narrative relevance’, i.e. the reporter’s preliminary idea of what the emerging story should/could look like, rather than by the actual outcome of the interviews. (shrink)

The mouthparts of anuran tadpoles are highly derived compared to those of caecilians or salamanders. The suprarostral cartilages support the tadpole's upper beak; the infrarostral cartilages support the lower beak. Both supra‐ and infrarostral cartilages are absent in other vertebrates. These differences reflect the evolutionary origin of a derived feeding mode in anuran tadpoles. We suggest that these unique cartilages stem from the evolution of new articulations within preexisting cartilages, rather than novel cartilage condensations. We propose testing this hypothesis through (...) a search for similarities in the development of the suprarostral and infrarostral cartilage articulations and of the primary jaw joint. In Xenopus, the gene zax is expressed in a region corresponding to the infrarostral cartilage. This gene is related to the bapx1‐gene, which regulates jaw joint development. Further investigation of these genes, as well as other genes with joint‐related functions, in anuran craniofacial development may provide a connection between the morphological diversity seen in the vertebrate head and the corresponding diversity in genetic regulatory processes. We believe that the evolution of larval jaws in anurans may shed light on the general evolutionary mechanisms of how new articulations, not only in the jaw region, could have arisen in the vertebrate skull. BioEssays 27: 526–532, 2005. © 2005 Wiley periodicals, Inc. (shrink)