This paper examines a patient with borderline mental capacity, where the healthcare team is conflicted about how to proceed. This case demonstrates the complicated intersection between undue influence and mental capacity, allowing us to explore how the law is applied in clinical practice. Patients have the right to decline or accept medical treatments offered to them. In Singapore, family members perceive a right to be involved in the decision-making process for sick and elderly patients. Elderly patients, dependent on mainly family (...) members for care and support, sometimes submit to their overbearing influence resulting in decisions that fail to protect the patients’ own best interests. However, the clinicians’ own well-intentioned influence, driven by a desire for the best medical outcome can also be undue, and neither influence should seek to be a substitution for the patient’s decision. Following Re BKR [2015] SGCA 26, we are now obliged to examine how mental capacity can be affected by undue influence. A lack of capacity can be found when a patient fails to appreciate the presence of undue influence or is susceptible to undue influence due to their mental impairment causing their will to be overborne. This then paves the way for the health care team to decide based on best interests, because the patient is determined to be lacking in mental capacity. (shrink)

Ruchkin et al. ascribe a pivotal role to long-term memory representations and binding within working memory. Here we focus on the interaction of working memory and long-term memory in supporting on-line representations of experience available to guide on-going processing, and we distinguish the role of frontal-lobe systems from what the hippocampus contributes to relational long-term memory binding.

Drug recalls and lawsuits against pharmaceutical manufacturers are accompanied by announcements emphasizing harmful drug side-effects. Those with elevated health anxiety may be more reactive to such announcements. We evaluated whether health anxiety and financial incentives affect subjective symptom endorsement, and objective outcomes of cognitive and physiological functioning during a mock drug recall. Hundred and sixty-one participants reported use of over-the-counter pain medications and presented with a fictitious medication recall via a mock Food and Drug Administration website. The opportunity to join (...) a class-action lawsuit was manipulated. We assessed health anxiety, recalled drug usage, blood pressure, heart rate, and performance on a computerized Trail Making Test. Symptom endorsement was strongly predicted by health anxiety. When combined, three health anxiety measures explained 28.5% variance. These effects remain strong after controlling for depression and anxiety. Litigation condition did not predict symptom endorsement. Blood pressure and heart rate were modestly predicted by health anxiety, but not by litigation condition. TMT performance was consistently predicted by health anxiety, with higher scores associated with poorer performance. Although there were no main effects for litigation, interactions consistently emerged for the TMT, with generally poorer performance for those with higher health anxiety in the non-litigation condition; whereas health anxiety was unrelated to performance for the litigation condition. All but one participant joined the litigation when given the opportunity, despite a healthy sample and minimal use of pain medication. Subsequent data from 67 individuals with no mention of the FDA scenario or litigation showed that health anxiety still significantly predicts symptom endorsement, but the explained variance is less than half that obtained in the FDA scenario. The findings suggest that health anxiety plays a significant role in adverse symptom reporting, beyond anxiety or depression, and this effect is independent of the presence of the FDA recall. The lack of differences for health anxiety and symptom endorsement between litigation and non-litigation conditions rules out malingering. Although it is general practice in drug recalls to list potential adverse side effects caused by medications, this may elicit unintended symptom experiences and health anxious individuals may be more susceptible. (shrink)

Although O'Regan & Noë (O&N) claim that the world may serve as the viewers' external visual memory, findings from the field of memory research have demonstrated the existence of internal visual representations. These representations are stored in the viewer's brain, contain information regarding visual objects and their relations, guide subsequent exploration of the visual world and promote change detection.

Black Panther, directed by Ryan Coogler, became one of the highest grossing films of all time. It also received a lot of critical attention for its direct engagement with black experience and black politics. It speaks to the legacy of slavery and the exploitation of African-Americans and the ongoing post-colonial struggle represented most starkly by the Black Lives Matter Movement. However, the film was also criticised for supposedly leaving that radical black politics behind, even demonising it in its lead (...) antagonist, Killmonger, and instead proposing a liberal, reformist agenda very much in keeping with current forms of sovereign power, bolstered under the current neoliberal regime by the charity of billionaires. To some extent this is understandable, but it is also a very limited reading of what happens in the film and does a disservice to the radical dissent that the character of Killmonger represents. To address this, the paper uses the concept of sovereignty and asks how superheroes can help us unpack this concept. It argues that rather than seeing superheroes as vigilantes, thinking of them as sovereigns helps us unpack the complex knot of law, authority and violence that is key to understanding it. In particular it draws on Agamben’s discussion of sovereignty and the politics of the exception, and how this might be relevant to Fanon’s work on counter-colonial violence to show how the film remains true to radical protest throughout. On the way it also addresses the important cultural politics of the original comic. (shrink)

Triage situations and other occurrences in which rationing of medical care is necessary require careful distribution of medical equipment, services, or resources. However, the evolution of triage has failed to eliminate certain biases in the standards of care, particularly for groups already facing societal disenfranchisement and discrimination. This article explores the use of triage calculators and other systems of rationing care, their implicit biases, and how to avoid allowing those biases to influence care.

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

There is a persisting tension that exists between the block universe conception of time in modern physics and philosophy and the conception of time that stems naturally from experience, and entropic asymmetries have been proposed to explain this tension. This article argues that as biochemical processes in the brain depend upon spontaneous entropy increases in the forward-time direction, this should provide an entropic basis for the unidirectionality of psychological processes. As this view does not depend on considerations of abstract information (...) processing or a past hypothesis, it provides advantages over previous entropy-based proposals attempting to explain asymmetries in temporal experience. (shrink)

The integral role of royal women in political systems structured by diplomatic marriage is revealed in a series of legal verdicts from a case that involved the rulers of Late Bronze Age Ugarit, Amurru, and Ḫatti. These verdicts adjudicate the divorce, loss of political status, and execution of a royal woman who was the wife of the king of Ugarit, the daughter and sister of two successive kings of Amurru, and the granddaughter and niece of two successive Hittite Great Kings. (...) The undoing of her multivalent political status destabilized the regional and imperial system in which she was enmeshed. Protracted negotiations were required to restore equilibrium to the system. Examination of the rhetorical and legal strategies through which these negotiations took place reveals the extent to which the relative power of royal men depended on their relationships to royal women. (shrink)

Name der Zeitschrift: Kant-Studien Jahrgang: 108 Heft: 3 Seiten: 427-453.

Since the eighteenth century, the study of plants has reflected an increasingly mechanized and technological view of the natural world that divides the humanities and the natual sciences. In broad terms, this article proposes a context for research into flora through an interrogation of existing literature addressing a rapprochement between ways to knowledge. The natureculture dichotomy, and more specifically the plant-to-human sensory disjunction, follows a parallel course of resolution to the schism between objective and subjective forms of knowledge. The foundations (...) of taxonomic botany, as well as the allied fields of environmental studies, ethnobotany and economic botany, are undergirded by universalizing, sensorylimited visual structuring of the natural world. As the study of everyday embodied interactions of humans with flora, expanding upon the lens of cultural ecology, "cultural botany" provides a transdisciplinary research approach. Alternate embodied cultural engagements with flora emerge through a syncretic fusion of diverse methodologies. (shrink)

The aim of this paper is to provide a preliminary defence of the use of the concept of dignity in legal and ethical discourse. This will involve the application of three philosophical insights: (1) Ludwig Wittgenstein’s notion of language-games; (2) his related approach to understanding the meanings of words (sometimes summarised as ‘meaning is use’); and (3) Jeremy Waldron’s layered understanding of property wherein ‘property’ consists in an abstract concept fleshed out in numerous particular conceptions. These three insights will be (...) applied, in the first place, to the concept of ‘dignity’, which is chosen here as a good example of a concept which is both vague and contested in legal and ethical discourse, but which can nevertheless be rendered workable by the application of the aforementioned insights. Later, the analysis will be extended briefly to some other troublesome concepts in order to demonstrate its general application. This paper is concerned primarily with formal, rather than substantive questions about dignity. Matters of content will be touched on only insofar as is necessary to illustrate and illuminate my argument about how we ought to approach (rather than answer) questions about dignity. It should be emphasised that because there is no intention of exploring substantive questions in any depth, the discussion here will not delve into the criticisms of ‘speciesism’ often levelled against the idea of ‘human dignity’. ‘Speciesist’ theories are those that claim that the status, value, or rights of human beings can be regarded as being higher than that of other animals, purely on the basis of their membership of the human species, and without justifying the distinction by pointing to any relevant capacity or characteristic possessed by all and only human beings. For a critical description of speciesism see, e.g., Singer [18] Chapter Three passim; for present purposes, the term ‘dignity’ will be used synonymously with ‘human dignity’, and concerns about speciesism will not be considered. (shrink)

In this paper I intend to do two things. The first is to discuss a method of doing philosophy, the method of ‘ordinary language’ philosophy, as it is commonly and misleadingly called. (Its other common title: ‘Oxford Philosophy’ is even more misleading, since the roots of the method lie in Cambridge, and many of the most flourishing branches are in the United States rather than England.)If it needs a name, perhaps the best is—adapting Popper to our purpose—‘piecemeal philosophical engineering’. Such (...) a title would emphasise the attention to detail and the caution about conclusions that characterise the best of such work. The second aim of this paper is to apply the method thus discussed and defended to three questions connected with the concept of freedom. These problems arise out of three recent discussions of freedom—Thought and Action and Spinoza and the Idea of Freedom by Professor Hampshire, and Two Concepts of Liberty by Professor Berlin. (shrink)

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

This paper will attempt to explain the relationship between disaster and human deprivation and trace the ills that result from it to institutional or policy failures. It then proposes grassroots leadership as a way of bridging the gap that faulty and undemocratic structural mechanisms make. The paper argues that democratic leadership is crucial in creating resilient and sustainable communities.

Botanical illustration combines scientific knowledge and artistic technique. However, whereas illustrated botanical images record static visual qualities, such as form and color, written botanical narratives supply crucial sensory, ecological, historical, and cultural contexts that complement visual representation. Understanding the text-image interface—where images and words intersect—contributes to humanities-based analyses of botanical illustration and illustrators. More specifically, a process philosophy perspective reveals the extent to which botanical representations engage the temporality, cyclicality, and contextuality of the living plants being illustrated. This article takes (...) up these themes through a comparative theoretical study of three female Western Australian botanical illustrators, Georgiana Leake, Emily Pelloe, and Philippa Nikulinsky, whose lives together span the 183 year history of the Swan River Colony and the state of Western Australia. I apply a processist framework to examine the text-image interface of their works. All three illustrators use some form of textuality: marginalia, annotations, written accompaniments, introductory statements, and other narrative materials. In examining their written commentaries and traces, I identify the emergence of a process mode of botanical illustration that represents plants as ecological, historical, cultural, and temporal organisms. (shrink)