In the past decade, the Norwegian government has emphasized user participation as an important goal in the care of mentally ill patients, through governmental strategic plans. At the same time, the governmental documents request normalization of psychiatric patients, including the re‐socialization of psychiatric patients back into society outside the psychiatric hospital. Milieu therapy is a therapeutic tool to ensure user participation and re‐socialization. Based on an ethnographic study in a long‐term psychiatric ward in a psychiatric hospital, we identified how staff (...) tried to implement user participation in their milieu‐oriented therapy work. We have identified three major tensions and challenges in implementing user participation in milieu‐therapeutic work. First, it is difficult to implement individual‐based user participation and at the same time take collective house rules and codes of conduct into consideration. Second, user participation proved a difficulty when patients’ viewpoints challenged staff judgements on proper conduct and goals for which patients might aim. Third, user participation becomes a challenge when trying to establish relationships based on equality when using milieu therapy in a biomedical hierarchical hospital structure. These tensions and challenges are seen in light of paradoxical political frames and demands on one side, and milieu therapy as a complex tradition anchored in different ideologies on the other. (shrink)

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health (...) and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness.". (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Objective Reality of Ideas in Descartes, Caterus, and Su irez NORMAN j. WELLS IT HAS LONG BEEN ACKNOWLEDGEDthat Francisco Sufirez's distinction between a formal and an objective concept exercised some influence upon Descartes's teaching on 'idea'.' It would appear, however, that not enough attention has been given to that distinction of Sufirez (and especially to another to be mentioned shordy) to aid in dispelling what I take to (...) be a widespread confusion and misunderstanding with regard to 'idea' in Descartes, especially with respect to 'idea' taken 'objectively'. Much, if not all, of the confusion in question has to do with Descartes's admittedly equivocal use of the term 'idea'. For he had allowed that 'idea' could be taken 'materially' (materialiter), on the one hand, for the knowing activity of the intellect. On the other hand, it could be taken 'objectively' (objective) for the thing (res) represented by that knowing activity.' At this point, the contemporary reader can only be brought up short, See E. Gilson, Index scolastico-cart~sien (New York: Burt Franklin Reprint, 1912), 48-49; Discours de la m~thode: Texte et commentazre (Paris: J. Vrin, 1947), 321; G. Rodis-Lewisin her edition of Meditationes de Prima PhRosoph.m (Paris: J. Vrin, 1953), 41 n. 1; L'oeuure de Descartes (Paris: J. Vrin, 1971), 53~ n. 8; J. Collins, Modern European Philosophy (Milwaukee: Bruce, 1954), 165;T.J. Cronin, S.J., Objecttve Being m Descartes and SuArez (Rome: Gregorian University Press, 1966); "Objective Reality of Ideas in Human Thought: Descartes and Su~rez," Wisdom in Depth: Essays in Honor of Henri Renard, SJ., eds. V. F. Daues, S.J., M. R. Holloway, S.J., L. Sweeney, S.J. (Milwaukee : Bruce, 1966), 68-79; L. Gilen, S.J., "Uber die Beziehungen Descartes zur zeitgenossischen Scholastik," Scholastik 32 (1957): 41-66; R. Dalbiez, "Les sources scolastiques de la th~orie cart6sienne de l'&re objectif," Revue d'histoire de la philosophic 3 (1929): 464-72;J. Owens, C.S.S.R., in The Cambridge HtstoU of Later Medu,val Philosophy, eds. N. Kretzmann, A. Kenny, J. Pinborg (Cambridge University Press, 1982), 459; G. Nuchelmans,Judgment and Propositwnfrom Descartesto Kant (Amsterdam: North Holland Publishing Co., 1983), 36-54. " Oeuvres de Descartes, ed. C. Adam et P. Tannery, 11 vols. (Paris: J. Vrin, 1897-19o9; hereafter cited according to volume, page and line), Praefatio ad Lectorem, 7: 8. 19-251 "Sed respondeo hic subesse aequivocationem in voce ideae: sumi enim potest vel materialiter, pro operatione intellectus, quo sensu me perfectior dici nequit, vel objective, pro re per istam operationem repraesentata, quae res, etsi non supponatur extra intellectum existere, potest tamen me esse perfectior ratione suae essentiae." It is clear that two realities are to be causally accounted for. The [33] 34 JOURNAL OF THE HISTORY OF PHILOSOPHY 28"1 JANUARY 1990 conditioned as we are by an appreciation of 'objectivity' altogether extramental! It makes for a considerable wrench of perspective to do justice to Descartes's acknowledged doctrine of intramental objectivity and an intramental 'thing represented' (resrepraesentata). 'Idea', then, in traditional Cartesian fashion, designates the act of representing as well as the 'thing represented '. S Yet, for all this, and despite repeated expressions of the same doctrine, there is a persistent tendency in the history of Cartesianism and its scholarship to interpret 'idea' taken 'objectively' as in some way representative. Contrary to what I take to be Descartes's constant position, such a rendering unwittingly transfers that function which is proper to the cognitive activity, mind is the efficient cause of its cognitive activity. With respect to ideas taken 'objectively', such as the ideas of God and the triangle on the levels of metaphysical and mathematical intelligibility, an efficient cause, extrinsic to the mind, is certainly at issue. For here we are in the presence of what is independent of the mind, however intramental it may be. On the triangle, see Medit. 5; 7: 64. ]4s7 : "...est tamen profecto determinata quaedam ejus natura, sire essentia, sive forma, immutabUis et aeterna, quae a me non efficta est, nec a mente mea dependet." For the idea of God, see Medit. 5; 7: 68. l o-12: "Nam sane multis modis inteUigo illam [ideam... (shrink)

Independently of any eighteenth century work on the geometry of parallels, Thomas Reid discovered the non-euclidean "geometry of visibles" in 1764. Reid's construction uses an idealized eye, incapable of making distance discriminations, to specify operationally a two dimensional visible space and a set of objects, the visibles. Reid offers sample theorems for his doubly elliptical geometry and proposes a natural model, the surface of the sphere. His construction draws on eighteenth century theory of vision for some of its technical features (...) and is motivated by Reid's desire to defend realism against Berkeley's idealist treatment of visual space. (shrink)

Arnauld's criticisms as "a model of confusion confounded.” In a review of Wilson's book, R. McRae refers to "the difficult and not too coherent subject of material falsity. '' J. Cottingham describes the Descartes-Arnauld debate on the material falsity of adventitious ideas as "an involved and rather inconclusive exchange " and claims that the example of the material falsity of such ideas espoused by Descartes in Meditation III is "needlessly complicated. " A. Kenny, in turn, notes that several things are (...) "confusing in Descartes' account of false ideas. " Later reference is made to the fact that "Descartes appears confused. [...] and that "Descartes, it seems, cannot give a consistent answer. '' As will become clear, I take issue with each of these assessments. When Descartes' position on material falsity is understood in the light of late Scholastic sources, especially Suarez, whence it draws its strength and inspiration, the alleged confusion and incoherency vanishes. .. (shrink)

In this article we examine the changing relationship to risk as revealed by the covid-19 pandemic and the ways this has, and may in future, alter sacramental practice, considering the radical effects this could have on traditional Christian practice. We consider the cultural trends that may lie behind this developing approach to risk, examining this in the context of an emergent transhuman identity that is technologically moderated and seeks to overcome risks of human mortality.

Response to Gopal Sreenivasan, “Health Care and Equality of Opportunity".

A technique for the bilateral activation of neural nets that leads to a functional asymmetry of two simulated ''cerebral hemispheres'' is described. The simulation is designed to perform object recognition, while exhibiting characteristics typical of human consciousness-specifically, the unitary nature of conscious attention, together with a dual awareness corresponding to the ''nucleus'' and ''fringe'' described by William James (1890). Sensory neural nets self-organize on the basis of five sensory features. The system is then taught arbitrary symbolic labels for a small (...) number of similar stimuli. Finally, the trained network is exposed to nonverbal stimuli for object recognition, leading to Gaussian activation of the ''sensory'' maps-with a peak at the location most closely related to the features of the external stimulus. ''Verbal'' maps are activated most strongly at the labeled location that lies closest to the peak on homologous sensory maps. On the verbal maps activation is characterized by both excitatory and inhibitory Gaussians (a Mexican hat), the parameters of which are determined by the relative locations of the verbal labels. Mutual homotopic inhibition across the ''corpus callosum'' then produces functional cerebral asymmetries, i.e., complementary activation of homologous ''association'' and ''frontal'' maps within a common focus of attention-a nucleus in the left hemisphere and a fringe in the right hemisphere. An object is recognized as corresponding to a known label when the total activation of both hemispheres (nucleus plus fringe) is strongest for that label. The functional dualities of the cerebral hemispheres are discussed in light of the nucleus/fringe asymmetry. (shrink)