Volume 25, Issue 2, February 2025, Page 36-38.

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

On Advaita philosophy; Sanskrit text with commentary and translation.

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

Supported decision making, as outlined by Peterson et al. highlights real-world challenges in the messy context of clinical care. We agree with Peterson et al. that patients...

Enck and Condley (2025) put forward a robust and plausible account of agent-regret. The authors argue that agent-regret, originating from the work of Bernard Williams, highlights two problems with...

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral (...) action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)

While Jameton’s (1984) definition of moral distress has been embraced by researchers and scholars for recognizing the many constraints that nurses experience on their moral agency, it has also been...

Moral distress is a pervasive phenomenon in healthcare for which there is no straightforward “solution.” Rhetoric surrounding moral distress has shifted over time, with some scholars arguing that moral distress needs to be remedied, resolved, and eradicated, while others recognize that moral distress can have some positive value. The authors of this paper recognize that moral distress has value in its function as a warning sign, signaling the presence of an ethical issue related to patient care that requires deeper exploration, (...) rather than evidencing identification of the “right” course of action. Once the experience of moral distress is identified, steps ought to be taken to clarify the moral issue, and, if possible and reasonable, the patient’s values ought to be prioritized. This paper offers concrete actions steps, drawn from theory, which can be used in clinical practice to provide peer support or to facilitate self-reflection for morally distressed individuals. This approach empowers morally distressed individuals to explore ethical issues, identify concrete steps that can be taken, and mitigate feelings of powerlessness that are often associated with moral-constraint distress. The questions guide individuals and peers to reflect first on the micro-space and then more broadly on the institutional culture, facilitating meso- and macro-reflection and action. (shrink)

Herrera-Ferrá et al.’s (2023) attention to the cultural context of the neurorights movement contributes to the growing conversation on establishing neurorights in response to advancements in neuros...

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

Russell articulates compelling reasons that bioethicists and health care professionals should take individual responsibility for deconstructing structural injustices in healthcare through in...

A proposed state administrative rule would have required medical ethicists to approve certain aspects of gender-affirming care. The authors argue the proposed rule lacked appropriate justification compared to other instances of state-mandated ethics oversight and would undermine trust, raise practical challenges, and send harmful messages to society, patients, and providers.

Layers of complexity arise when a person arrives in an Intensive Care Unit (ICU) due to self-harm intended to end their life and when there is known past personal trauma. We highlight three importa...

In their article, Sankary et al. (2022) provided important preliminary findings on how research participants exiting from clinical trials engage in decisions related to the removal or post-trial us...

Sankary et al. (2022) report the results of an empirical study on research participant experiences of exiting research at the end of clinical trials of deep-brain-stimulation (DBS) and responsive n...

The combination of spirituality, meditation, and artificial intelligence (AI) has promising potential to expand people’s well-being using technology-based meditation. Proper meditation originates from Zen Buddhism and Patanjali’s Yoga Sutras and focuses on inner peace and intensified consciousness which elective personal disposition. AI, in turn, brings master means of delivering those practices in the form of self-improving systems that customize and make access to them easier. However, such an integration brings major philosophical and ethical issues into question, including the genuineness of (...) experiences that are facilitated by artificial intelligence, data sharing, concerns over over-dependence on the technology that may in turn cause reduced personal responsibility and hard work. This paper aims at analysing the critical integration of AI-driven meditation following the spiritual interpretations of traditional meditation without compromising the tenets of meditation. It presents an interdisciplinary approach based on recent findings from the field of cognitive science, moral AI, and Eastern wisdom traditions to approach these problems. Therefore, by identifying the research lacunae, it provides a groundwork for voting ethically in the integration of AI in mindfulness practice and avoiding constraining human-oriented values resulting in improved existential spiritual change. (shrink)

This research paper aims at comparing Advaita Vedānta and Descartes philosophy on what is mind and consciousness. Although, the two traditions are resourceful, literature in this area has numerous research deficits in terms of comparative analysis and assimilation. The paper points out these lacunae, including the absence of multi-disciplinary exchange, a poor appreciation of how non-dualism might be actively meaningful in contemporary society, and how the nature of consciousness is principally qualitative. The concepts like consciousness, perception and Non-Duality are explained (...) in relation to the relevant philosophical systems with the help of Descartes and Śankara in particular. The concept of mind and consciousness has also been discussed from the perspective of Buddhist Philosophy in the paper. In establishing the aim of this paper, the following research gaps have been identified: The lack of interdisciplinary collaboration and the integration of empirical knowledge with reflexivity, and the analysis of modern ethical questions using a philosophical approach. In an attempt to better understand consciousness in general and through combining insights of the two traditions, our hope is to gain a wider perspective on how this concept could affect different modern discussions. (shrink)

Despite their status as high-income food producing nations, children and their caregivers, both in the United States (U.S.) and Australia can experience food insecurity. Nutrition researchers formed a joint U.S.-Australia collaboration to help advance food security for households with young children aged 0–5 years. This study investigated food insecurity from the perspective of caregivers, especially their perceptions of the impact of food insecurity on their own childhood, their current life, and for the children in their care. Semi-structured interviews were conducted (...) from July to September 2020 during the COVID-19 pandemic. Participants were recruited in Omaha, Nebraska, U.S. (n = 19) and Melbourne, Victoria, Australia (n = 22), during periods of stay-at-home public health orders. These two case study sites enabled an exploration of some universal, and some context-specific, social, economic, and health conditions that buffer, or exacerbate, food insecurity for families in these neo-liberal political settings. An inductive thematic analysis was conducted and established six themes:growing up poor, lessons learned, feeding a family amidst a pandemic, caregiver coping strategies, food security in the early years and protecting (young) children. Perspectives on local anti-hunger strategies were organized to outline participant’s preferred solutions. Household food insecurity is conceptualized in public policy in the U.S. and Australia as a short-term crisis for people, justifying austere, time-limited and patchwork solutions. A narrative of caregivers’ lived experience of food insecurity suggests that it is inter-generational, and exacerbated by a food system shock (i.e., COVID-19). These findings from two varying cities and nations offer a different conceptualization of the timespan and nature of the phenomenon of food insecurity, challenging a dominant policy narrative and highlighting the inadequacy of current so-called solutions. (shrink)

Volume 25, Issue 2, February 2025, Page 138-139.

R. W. Ashby; XI—Entailment and Modality, Proceedings of the Aristotelian Society, Volume 63, Issue 1, 1 June 1963, Pages 203–216, https://doi.org/10.1093/aristo.

In lieu of an abstract, here is a brief excerpt of the content:R. D. Ackerman BELIEVING IN A FICTION: WALLACE STEVENS AT THE LIMITS OF PHENOMENOLOGY The "ring of men" of "Sunday Morning" will chant their "devotion to the sun, / Not as a god, but as a god might be, / Naked among them, like a savage source" (CP, pp. 69-70).' Solar nakedness is deferred even as it is named. The problem for belief is the question of appearance and (...) representation. Things appear as and like.... The phenomenological return to things is also a turn to fiction, as Husserl understood: "If anyone loves a paradox, he can really say... that the element which makes up the life of phenomenology... is fiction. ' " The sun is divine, and it is not; it is both naked and clothed, savage and civilized, source (or end) and means. But such paradox is ultimately unsatisfying, and as we will see with Stevens, the need for belief—for an image or idea of totality—forces the issue of fiction and reality. The Stevens we will have in view is not the Stevens—as if there were such a creature. Our Stevens is the one most persuaded by promises such as those of phenomenology, the one most concerned with decreation (reduction) and fresh beginnings, with discovery and recognition, with imagination, the body, and the earth. This is the Stevens for whom the barrier of language presages at last not absence and difference but fictive recovery of presence and identity, the one for whom poetry represents a way of belief beyond mysticism even as it bodes mythic proximity. Finally, this is the Stevens who predominates throughout the prose (as well as in much of the poetry), who tries mightily to secure a belief while disencumbering himself of metaphysics—but alas, I think, with small success. Although Stevens's association of the problem of belief with the idea of fiction occurs in early poems such as "A High-Toned Old Christian 79 80Philosophy and Literature Woman" and "To the One of Fictive Music," his most intensive involvement with fiction as belief dates from the early 1940s and spans the period of his major essays and his last four volumes of poems. He recounts, for instance, a 1942 conversation with a student: "I said that I thought that we had reached a point at which we could no longer really believe in anything unless we recognized that it was a fiction. The student said that that was an impossibility, that there was no such thing as believing in something that one knew was not true. It is obvious, however, that we are doing that all the time" (L, p. 430). What does it mean to believe in a fiction? That is my main subject here, as we seek out the limits of the phenomenological Stevens. His letters of this period are preoccupied with the problem of fictive belief: "If one no longer believes in God (as truth), it is not possible merely to disbelieve; it becomes necessary to believe in something else.... A good deal of my poetry recently has concerned an identity for that thing.... In one of the short poems that I have just sent to the harvard advocate, I say that one's final belief must be in a fiction. I think that the history of belief will show that it has always been in a fiction" (L, p. 370). The poem referred to, "Asides on the Oboe," begins: The prologues are over. It is a question now, Of final belief. So, say that final belief Must be in a fiction. It is time to choose. (CP, p. 250) Acknowledging that "in the long run, poetry would be the supreme fiction" (L, pp. 430-31), Stevens nonetheless singles out the nominative function of poetry as the essence of its claim to supremacy: "Poetry means not the language of poetry but the thing itself.... The subject matter is what comes to mind when one says of the month of August... 'Thou art not August, unless I make thee so'" (L, p. 377). The quoted line (also from "Asides") underscores the paradox that for Stevens the essence of fiction (the nontrue) is its capacity to nominate the true or the real. This... (shrink)

İslâm coğrafyasının genişlemesi neticesinde Arap olmayan toplulukların İslâm dini ile tanışmaları beraberinde bir takım problemleri de getirmiştir. Bu problemler arasında, Kur’ân’ın yanlış anlaşılma endişesi en başı çekmektedir. Arapçaya hâkim olmamaktan kaynaklanan dil hatalarının âyetlere kadar sirayet ettiğini gösteren birçok rivayetin varlığı da bunu teyit etmektedir. Bundan dolayı hicrî birinci yüzyılın ikinci yarısından itibaren dil ile ilgili faaliyetler aralıksız bir şekilde devam etmiştir. Bu faaliyetler arasında, Kur’ân’ın üslûbunu, âyetlerde yer alan kelimelerin delâleti ve sesletimini, cümlelerin iç bütünlüğü ile filolojik tahlillerini ele (...) alan çalışmalar bulunmaktadır. Bu çalışmalar, Arap gramerinin oluşturulması ve bazı gramer ekollerinin ortaya çıkmasıyla birlikte genellikle “Ma‘âni’l-Ḳur’ân” ve “İ‘râbü’l-Ḳur’ân” başlıkları kullanılarak daha sistemli bir şekilde hicri dördüncü yüzyılın sonlarına kadar devam etmiştir. “Ma‘âni’l-Ḳur’ân” başlığını kullanarak eser yazan âlimler arasında gramer ilmiyle birlikte tefsir alanında da önemli bir konuma sahip olan Yahyâ b. Ziyâd el-Ferrâ da bulunmaktadır. Sözü edilen eserde Ferrâ’nın, lügavî tahlilleri esnasında özellikle sözcüklerin siygası ve çok anlamlılığı doğrultusunda dil-kültür ilişkisine örnek olabilecek birçok bireysel değerlendirmesine rastlanılmaktadır. Onun bazı ayetler etrafında sergilenen çeşitli görüşlere yer verdikten sonra Arap toplumu nezdinde bir yönüyle de bile olsa kabul gören semantik tahlillere ayrıca yer vermesi, müfessirlerin, çoğu zaman anlaşılması güç ayetlerle birlikte murad edilenin dışında bir yorumun önlenmesi için dönemin kültüründen yararlanmaları gerektiği şeklinde de değerlendirilebilir. Bu bakımdan Kur’ân-ı Kerîm’in insanlığa sunduğu mesajların en doğru şekilde anlaşılabilmesi adına bazı âyetlerin tefsiri ve değerlendirmesi yapılırken başvurulacak ilmî merci ve disiplinlerin geniş tutulması önem arz etmektedir. Binâenaleyh makalede Ferrâ’nın kendisine özgü tahlilleriyle beraber, görüşlerine yer verdiği başka âlimlerin analizlerinden sadece dil-kültür ilişkisine örnek olabilecek tespitler üzerinde durularak kültür ve dil etkileşiminin âyet yorumundaki rolüne işaret edilecektir. (shrink)

This paper criticises the two prominent interpretations of utopianism in Plato's Republic. The traditional argues that it is mere utopianism, seriously proposing that Kallipolis is, in fact, the ideal city. The ironic argues that the Republic is a critique of the ability for reason to reconstruct human nature and is, therefore, a dire warning against utopian thinking in politics. I oppose these two interpretations and instead argue that the Republic implies a paradoxical necessity in the nature of utopianism: The ideal (...) cannot be theorised without itself being conditioned by the politics of theorising, and yet the politics of theorising is immanently motivated by the ideal. I locate this seemingly antonymic dynamic within the education of the learner/citizen in the Republic. Although this is centred on the notion of self-governance, it cannot be imposed and instead depends on the philosophical development of one's soul that is inextricably linked to justice in the city. Therefore, the utopianism of the Republic ought to be thought of as dialectical, being simultaneously situated and yet normatively transcending. (shrink)

Volume 25, Issue 2, February 2025, Page 140-142.

I and Thou sets out a dichotomy of human interactions between the merely objective I-It and the intense intersubjective relationship of the I-Thou, creating a problem of how one is to differentiate the I-It relations that are healthy and natural, and those that are limiting and detrimental. As a corrective to this ambiguity, I posit the principle of solidarity as a relation which retains the personhood of the Other yet still confines it to what Buber calls the I-It “relation”. To (...) do this I will discuss similar attitudes such as sympathy and camaraderie using them to draw out the meaning of solidarity in contradistinction to them, and show how solidarity functions as Gramsci’s Objectivity. (shrink)

This essay explores what it is to be a principle of charity in philosophical argumentation. In it, I explore some principles of charity found in classic and contemporary literature and textbooks on logic and philosophy. I distinguish between what I will maximal and sub-maximal principles of charity. With this distinction, I taxonomize current principles of charity on offer according to their dialectical function as rules for argument interpretation and reconstruction in philosophical argumentation. Principles of charity, I argue, are best construed (...) as pragmatic rules for argument interpretation in philosophical argumentation, not merely moral or ratio-epistemic rules. I defend this claim against some objections. (shrink)

Mealey's work has several interesting implications: It refutes the charge that sociobiology paints a cynical portrait of human nature and adopts a one-sided reductionism; it exemplifies a general theoretical scheme for constructing evolutionary biopsychosocial models of human behavior; and it has the practical effect of promoting and informing early intervention in children at risk for psychopathic disorder.

The new realities of social media, echo chambers, and partisan information sources have created social forces that challenge core assumptions about democracy. Are we in an epistemological crisis, where separate and distinct communities of inquiry limit shared understandings of truth? In this essay, I turn to the political and educational thought of John Dewey to explore this challenge. Though some of Dewey’s prescriptions are outdated, I argue that it is possible to reconstruct and extend key insights for our contemporary era. (...) Drawing on Dewey, I offer pedagogical strategies to create conditions where students are more open and able to listen, understand, and work across lines of difference. I highlight themes of structured dialogue to bridge differences, the importance of action, and faith in humankind. (shrink)

Philosophers and historians of the French Revolution have seen Rousseau's influence as the decisive link between the doctrines of the Enlightenment and the practice of its revolutionary disciples. Professor Leigh here addresses the bibliographical foundations of that question, without which all attempts to settle it in the past have lacked authority. Introducing the most advanced techniques to identify variant and pirate editions of Rousseau's writings, he establishes that there were at least 28 separate imprints and an additional 12 reprints of (...) the Contrat Social in collective editions between 1762 and 1783. Professor Leigh shows also that Rousseau's life and thought excited a fascination and interest in the last years of the Ancien Regime which was nursed by the publishers of his Oeuvres, who sought to satisfy an apparently ceaseless demand by extending their editions, while at the same time attempting to ward off both their creditors and their imitators. (shrink)

Aetiological poetry tends to be mature poetry in both a literary and a political sense. Interest in antiquarian lore belongs in general to a poet's middle and later years when youthful and audacious quests for what is avant-garde and anti-establishment have yielded to conservatism and a desire to preserve the past. Propertius and Ovid both turned to aetiological poetry after a long apprenticeship in amatory ‘nugae’ which enabled them, like their predecessor, Callimachus, to embellish their work with a diversity of (...) artistic devices founded on considerable poetic skill and literary experience. With this, a vital ploy to engage the sympathy of a sophisticated audience, went the poise and urbanity with which the aetiological poet found humour in the pose of earnest researcher, in the naivety of primitive cult and in clever literary adaptations. Moreover, dedication to a form of writing essentially nationalist and conservative encouraged a tone of patriotic pride and allusions, even compliments, to the ruling powers. In the light of such considerations we may examine Ovid's account of the ‘Ludi Megalenses’. The ‘Megalensia’ furnished Ovid with a goddess who had enjoyed fame and even notoriety in the pages of Roman literature. In addition to showing a poetic and neoteric interest in the orgiastic elements of her cult and the alien music of her retinue Roman poetry could reflect too the awe and reverence inspired of old by the Great Mother and expressed in the Greek poets, whom Lucretius claimed as his sources in his powerfully beautiful excursus on Cybele worship. Again, Cybele's importance in Rome had been augmented by her Trojan origins, concerning which a canonical Augustan theology had been established by Vergil in the Aeneid. (shrink)