Background: Eye movement desensitization and reprocessing [EMDR] is an innovative, evidence-based and effective psychotherapy for post-traumatic stress disorder [PTSD]. As with other psychotherapies, the effectiveness of EMDR contrasts with a limited knowledge of its underlying mechanism of action. In its relatively short life as a therapeutic option, EMDR has not been without controversy, in particular regarding the role of the bilateral stimulation as an active component of the therapy. The high prevalence of EMDR in clinical practice and the dramatic increase (...) in EMDR research in recent years, with more than 26 randomized controlled trials published to date, highlight the need for a better understanding of its mechanism of action. Methods: We conducted a thorough systematic search of studies published until October 2017, using PubMed, ScienceDirect, Web of Knowledge and Scopus databases that examined the mechanism of action of EMDR or provided conclusions within the framework of current theoretical models of EMDR functioning. Results: Seventy-five studies were selected for review and classified into three overarching models; (i) psychological models (ii) psychophysiological models and (iii) neurobiological models. The evidence available from each study was analysed and discussed. Results demonstrated a reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy. Recently, more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy. Discussion: Despite the increasing number of studies that published in recent years, the research into the mechanisms underlying EDMR therapy are still in its infancy. Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions. (shrink)

Se realizó una revisión documental con el objetivo de reseñar los aspectos históricos relacionados con el surgimiento y desarrollo de la Oftalmología en Camagüey. Se utilizaron documentos de la Biblioteca Provincial “Julio Antonio Mella” y la “Casa Finlay”; así como informaciones obtenidas en entrevistas personales. Se señalaron las características fundamentales de las formas, medios y técnicas de la atención médico-quirúrgicas en cada etapa, y se destacaron las personalidades científicas y los aportes realizados a la especialidad en la docencia, asistencia e (...) investigación. A documental revision was carried out with the objective of describing the historical aspects related with the origin and development of Ophthalmology in Camagüey. Documents from the “Julio Antonio Mella” Provincial Library and the “Finlay House” were used, as well as information obtained by personal interviews. The fundamental characteristics of the forms, means and techniques of the medical-surgical care in each period were pointed out, and were remarked the scientific personalities and the contribution made to the specialty in teaching, assistance and research. (shrink)

O presente trabalho trata da relevância da justiça para a crítica/justificativa do Direito, enquanto forma de estruturar as instituições sociais. Tendo Uma Teoria da Justiça como foco, a questão central neste ensaio é: como Rawls mobiliza os conceitos jurídicos? O objetivo geral é dialogar com os elementos centrais da obra de Rawls buscando compreender qual o papel do Direito no argumento em defesa da justiça como equidade. Para tanto, primeiro, retoma-se sucintamente os objetivos gerais pretendidos por Rawls com a teoria (...) elaborada. Em seguida, articula-se o uso de conceitos jurídicos com os objetivos pretendidos pelo autor em cada uma das três partes, para, então, enfatizar a serventia da justiça como equidade e da teoria política normativa aos juristas. Percorridos esses passos, defende-se a seguinte hipótese: o Direito é um elemento central na Teoria da Justiça de Rawls. Como desdobramento da hipótese, defende-se que para sustentar seu argumento central e desenvolver os principais elementos conceituais de sua obra, Rawls precisou recorrer aos conceitos jurídicos. (shrink)

In this article, we defend two claims about the precautionary principle. The first is that there is no ‘core’ precautionary principle that unifies all its different versions. It is more plausible to think of the different versions as being related to each other by way of family resemblances. So although precautionary principle x may have much in common with precautionary principle y, and y with z, there is no set of necessary and sufficient conditions that unify all versions of the (...) principle. Our second claim is that it is sometimes appropriate to think of the precautionary principle as a midlevel principle in the sense proposed by Beauchamp and Childress in their Principles of Biomedical Ethics, i.e. as a non-rigid moral principle. We argue that if the precautionary principle is conceived as a non-rigid principle that needs to be balanced against other principles before a moral verdict can be reached, then this enables us to address some standard objections to the principle. (shrink)

Once relegated to the margins of the responsibility debate, moral influence theories have recently been rehabilitated. This paper offers a moral influence theory with two parts: a theory of responsibility as influenceability and an act-consequentialist justification of blame. I defend this account against six concerns commonly raised both by opponents and by advocates of similar views. Some concerns target act consequentialism, claiming that it 1) permits blaming innocents; 2) permits coercion, manipulation, and other objectionable forms of influence; and 3) fails (...) to capture intuitions about desert. Other concerns target responsibility as influenceability, claiming that influenceability accounts are 4) unsophisticated, 5) make ascriptions of responsibility dependent on assessments of permissible blame, and 6) have various counterintuitive implications. (shrink)

Anthropocentrism—the idea that humans are the most important beings there are—comes in many guises. One version of anthropocentrism states that only humans have full moral status. Those who argue for such a position (beyond merely assuming it) usually refer to some trait that confers moral status and that only humans have. Suggestions include linguistic ability, self-awareness or rationality. However, regardless of what trait one picks it will not track the line between Homo sapiens and other species. You will always be (...) able to find some non-human animal that possesses the trait to a greater degree than some human does— even potentially. Koplin and Wilkinson1 adopt a broadly sentientist position: moral status is conferred by some mental or cognitive function. They discuss two sources of moral uncertainty related to this. In cases of moral uncertainty of the first type, it is uncertain whether Property X confers (full) moral status. In cases of uncertainty of the second type, we assume it to be true that moral status is conferred by X, but it is uncertain whether a particular entity (such as a pig) possesses the property. There are reasons to believe …. (shrink)

When we forgive, we do so for reasons. One challenge for forgiveness theorists is to explain which reasons are reasons to forgive and which are not. This paper argues that we forgive in response to a perceived change of heart on the part of the offender. The argument proceeds in four steps. First, I show that we forgive for reasons. Second, I argue that forgiveness requires the right kind of reason. Third, I show that these two points explain a common (...) distinction between forgiving and letting go and, in doing so, solve a problem facing many accounts of forgiveness. Finally, I consider candidate reasons to forgive and argue that all of them are either the wrong kind of reason or are instances of a more general reason of the right kind, namely, a perceived change of heart. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

This article considers the foundation of nursing as a moral practice. Its basic claim is that all nursing knowledge and action reside on a moral foundation. The clinical gaze meets vulnerability in the patient’s human condition. To see a patient’s wound is to see his or her hurt and discomfort; it is a concerned observation. To see the factual and pathophysiological is at the same time to see the ethical: the moral realities of suffering, pain and discomfort. A nurse’s emotional (...) sensitivities are central to understanding a patient’s experiences of illness. Emotions reveal value and ascribe moral importance to certain situations; they are addressed centrally by vulnerability and the moral realities of illness. Hence, the essence of nursing knowledge and nursing performance cannot be understood merely as ontology (i.e. as being-with-the-other). Nursing is basically being-for-the-other; it is responsibility; it is ethics. (shrink)

Some fictions deliberately omit all fictional statements about the mental functioning of fictional agents. This presents an interpretive dilemma, as when we read fiction we ought to reconstruct the fictional minds of characters significant to the plot. Fictions that present the reader with an opaque fictional mind resist the general imaginative project prescribed by fiction-making and seem to demand a novel approach to imagining their fictional entities. Such fictional entities demand the reader commit to one of at least two different (...) ways of imagining nothing about a fictional mind, without explicitly authorizing either. One approach has already been described by H. Porter Abbott. Another can be extracted from Simone De Beauvoir, whose ethics of ambiguity is well suited to dealing with fictional entities about which nothing is fixed nor determined. (shrink)

This paper investigates the possibility of understanding the rudimentary elements of clinical sensitivity by investigating the works of Edmund Husserl and Emmanuel Levinas on sensibility. Husserl's theory of intentionality offers significant reflections on the role of pre-reflective and affective intuition as a condition for intentionality and reflective consciousness. These early works of Husserl, in particular his works on the constitution of phenomenological time and subjective time-consciousness, prove to be an important basis for Levinas’ works on an ethics of alterity and (...) infinite responsibility for the other person. In fact, it is difficult to understand the core of Levinasian ethics, of vulnerability as proximity, of ethical sensitivity as passivity and a suffering for the suffering of another, without understanding the influence from Husserl's work. Crucially, the paper will, on the basis of Levinasian ethics, establish an understanding of sensibility as vulnerability and receptivity that is fundamental also for understanding significant intuitions in clinical nursing. Clinical sensitivity and carefulness in nursing are shaped by the concrete and also bodily expressions of vulnerabilities in a receptivity that is pre-reflective and pre-ontological. (shrink)

It is often claimed both that forgiveness is elective and that forgiveness is something that we do for reasons. However, there is a tension between these two central claims about the nature of forgiveness. If forgiving is something one does for reasons, then, at least sometimes, those reasons may generate a requirement to forgive or withhold forgiveness. While not strictly inconsistent with electivity, the idea of required forgiveness strikes some as antithetical to the spirit of the concept. They argue that (...) forgiveness is essentially elective. In this paper, I dispute these arguments. I argue that the intuitive plausibility of the position diminishes upon reflection and that the best arguments fail to explain why reasons to forgive, unlike most other reasons for action, cannot generate requirements. (shrink)

This paper examines the existential context of physical and mental health. Hans Georg Gadamer and The World Health Organization’s conceptualizations are discussed, and current medicalized and idealized views on health are critically examined. The existential dimension of health is explored in the light of theories of selfhood consisting of different parts, Irvin Yalom’s approach to “ultimate concerns” and Martin Heidegger’s conceptualization of “existentials.” We often become aware of health as an existential concern during times of illness, and health and illness (...) can co-exist. The paper discusses how existential suffering in Western culture is described, to an increasing degree, as disorders or psychological deficits, and perfectionistic health goals easily can become a problem. We seek to avoid suffering rather than relate to it, with all the tension that may create. The paper argues that suffering is an unavoidable aspect of people’s experience of their lives, and actively relating to suffering must be regarded as a fundamental aspect of health. The need and usefulness of a concept of “existential health” is discussed. (shrink)

This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on (...) the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care. (shrink)

Rebecca Brown and Julian Savulescu argue in ‘Responsibility in Healthcare Across Time and Agents’ that if responsibility should play a crucial role in healthcare, then we need a concept of responsibility that reflects that an individual’s behaviour is sometimes, if not routinely, influenced by external factors in various ways. As Brown and Savulescu convincingly show, health-related behaviour in particular is often affected by other agents and typically involves multiple decisions on different occasions. Smoking and a poor diet are but two (...) examples where these factors are salient. Since health-related behaviour is often influenced by others, and often spread out over time, a notion of responsibility that does not take these two factors into account will be inadequate. In this comment to their paper I wish to raise an issue concerning Brown and Savulescu’s characterisation of individual responsibility for health-related behaviour that involves multiple choices by the same agent over a period of time. For simple acts—smoking a cigarette or eating some junk food for example—Brown and Savulescu assume two necessary conditions for responsibility: a ‘control condition’ and a ‘epistemic condition’. These conditions are intended to capture the plausible idea that …. (shrink)

The present paper is a commentary on an article by Larry Churchill [1]. Churchill has argued that the negative attitudes and adverse behavior we commonly encounter in connection with AIDS patients may be understood in terms of a dualistic myth inspiring a ritual avoidance of dirt, of dirt as something that does not belong to a clean world order. The deep-seated mythical character of attitudes and behavior here makes them less accessible to the kind of rational argument commonly employed in (...) ethics. Churchill also proposes a remedy for the dualistic mythical-ritual behavior he has focused — a remedy that may be overly intellectualistic.Three further comments are made: on the metaphorical meaning of myth, on a reductionist tendency in Churchill's deep-looking project, and on an ethically crucial ambiguity in the meaning of the other person's otherness. These comments do not, however, detract from a positive overall evaluation of Churchill's basic idea that we will understand more about adverse attitudes and behavior in connection with AIDS if we think in terms of myth, ritual, dirt, and cleanliness. (shrink)

The purpose of the present thesis is to apply philosophical methods to the ongoing debate of the precautionary principle, in order to illuminate this debate. The thesis consists of an Introduction and five papers. Paper I con-cerns an objection to the method of conceptual analysis, the Charge from Psychology. After a brief characterisation of conceptual analysis, I argue that the Charge from Psychology is misdirected. In Paper II, the method of conceptual analysis is applied to the concept of precaution which (...) is ana-lysed in terms of precautionary actions. The purpose is explicatory. A definition involving three necessary and jointly sufficient conditions is proposed, and the implications of this analysis for the debate on the pre-cautionary principle are discussed. Paper III attempts to provide an ana-lytical apparatus which may be used for finding improved formulations of the precautionary principle. The approach is lexicographical. Several exist-ing and possible formulations of the precautionary principle are examined, and four common elements and a common structure of the precautionary principle are identified. It is suggested that the analytical apparatus pre-sented can be used in negotiations of the precautionary principle. Paper IV questions the soundness of some arguments against the precautionary prin-ciple. Five common arguments are discussed and rejected. In Paper V, two of these arguments are further discussed. I argue that an attempt at rejec-tion of the precautionary principle delivered by John Harris and Søren Holm is unwarranted, because their arguments against it are based on in-terpretations of the precautionary principle that ignore context. Paper VI deals with the idea of de minimis risk. After a discussion of the distinction between disregarding a risk and accepting it, I examine one way of deter-mining how small a risk ought to be in order to be disregarded, namely the use of natural risk levels as benchmarks. I argue that this approach fails, even if the distinction between what is natural and what is not natural can be upheld. (shrink)

Abolitionism is the view that if no one is responsible, we ought to abandon the reactive attitudes. This paper defends abolitionism against the claim, made by P.F. Strawson and others, that abandoning these attitudes precludes the formation and maintenance of valuable personal relationships. These anti-abolitionists claim that one who abandons the reactive attitudes is unable to take personally others’ attitudes and actions regarding her, and that taking personally is necessary for certain valuable relationships. I dispute both claims and argue that (...) this objection exaggerates the role of the reactive attitudes and underestimates the importance of non-reactive moral emotions. (shrink)

Drawing on contemporary debates and responding to an analytic lacuna in organization and management studies and calls from organizational practice, Phenomenology of the Embodied Organization explores the fundamental and integral role of the body and embodiment in organizational life-worlds.

ABSTRACTIn Critical Discourse Studies and in other linguistics oriented scholarly journals we now see more research which draws upon multimodality as part of carrying out analyses of how text...

Stuttering is one of the most well-known speech disorders, but the underlying neurological mechanisms are debated. In addition to genetic factors there are also major non-genetic contributions. It is here proposed that infection with group A beta-hemolytic streptococcus (GAS) was a major underlying cause of stuttering until the mid 1900s, when penicillin was introduced for the treatment of streptococcal infections about 1946. The main mechanism proposed is an autoimmune reaction from tonsillitis, targeting specific molecules, for example within the basal ganglia. (...) It is here also proposed that GAS infections may have continued to cause stuttering to some extent, to the present date, though more rarely. If so, early diagnosis of such cases would be of importance. Childhood cases with sudden onset of stuttering after throat infection may be particularly important to assess for possible GAS infection. The support for this hypothesis primarily comes from three lines of argument. First, medical record data from the 1930s strongly indicates that there was one type of medical event in particular that preceded the onset of childhood stuttering with unexpected frequency: diseases related to GAS throat infections. In particular, this included tonsillitis and scarlet fever, but also rheumatic fever. Rheumatic fever is a childhood autoimmune sequela of GAS infection, which was a relatively widespread medical problem until the early 1960s. Secondly, available reports of changes of the childhood prevalence of stuttering indicates striking parallels between stuttering and the incidence of rheumatic fever, with (1) decline from the early 1900s, (2) marked decline from the introduction of penicillin about 1946, and (3) reaching a more stable level in the 1960s. The correlations between the data for stuttering and for rheumatic fever after introduction of penicillin are very high, at about 0.95. Thirdly, there are established biological mechanisms linking GAS tonsillitis to immunological effects on the brain. In addition, a small number of more recent case reports have provided further support for the hypothesis linking stuttering to GAS infection. Overall, it is proposed that the available data provides strong evidence for the hypothesis that GAS infection was a major cause of stuttering until the mid 1900s. (shrink)

Since Varian (Econometrica 50:945–973, 1982; Review of Economic Studies 50:90–110, 1983) made checking for consistency with revealed preference conditions more accessible to empirical researchers; researchers have often used revealed preference procedures to test their maintained hypotheses and narrow the scope of their demand studies. The tests developed by Varian are for the direct utility function, while researchers estimating demand systems often find it convenient to model consumer behavior with an indirect utility function. Unfortunately structure revealed in the direct utility function (...) does not necessarily follow for the indirect utility function. To remedy this problem, we set forth conditions for checking consumer data for consistency with revealed preference conditions for minimization and weak separability of the indirect utility function. (shrink)

We present a decision procedure for the ∀∃ theory of the lattice of Σ1 sentences of Peano Arithmetic.