BackgroundThe assessment of patients’ decision-making capacity is ubiquitous in contemporary healthcare. This paper examines the ethics of undisclosed probing of capacity by psychiatrists. The discussion will refer to the law in England and Wales, though the highlighted issues are likely to be relevant in similar jurisdictions.Main textDecision-making capacity is a private attribute, and patients may not necessarily be aware that one of their personal abilities is being explored. Routine exploration of capacity has not historically been a part of psychiatric examination, (...) but it is now difficult to avoid during psychiatric interview.Ethical practice and shared decision-making require patients to be aware that their decision-making may be evaluated by the doctor at some point, and the potential implications of an objective professional conclusion of incapacity. Case law directs that patients should be informed about any assessment of their decision-making ability, though the extent to which this has translated into practice is unclear. However, explanation about the assessment may cause a patient to react negatively, which may impede therapeutic engagement and constitute an ethical dilemma. It is argued that in the absence of systemic measures, professionals should retain the discretion to decide whether a particular patient should be informed about the impending probe into their decision-making ability, or not. In the latter instance, concealment of information about the assessment or its purpose should be subject to the caveats and safeguards associated with any recourse to therapeutic exception.ConclusionThe necessity to mandatorily inform patients about assessment of their capacity introduces a novel ethical dilemma for psychiatrists. The negotiation of this dilemma should not be the prerogative of the clinician, and requires systemic initiatives to ensure universal awareness of patients about the possibility of their capacity being assessed during their journeys through healthcare systems. (shrink)

This article argues against the conflation of digital and computational that ails contemporary critical discourse. Searching for a common logic among the three modes of computing (namely analog, digital, and quantum), it ends up finding an answer in the individuating backbone that runs through histories of postal, civic, and technological addresses. Borrowing the concept of addressability from computer science and adapting it to explain procedures of identificatory mapping at large, the article theorizes addressability as a cultural technique that can be (...) traced back to the origins of the modern disciplinary state. In doing so, it not only posits addressability as one of the core operational logics for all computation and an alternative analytic to the digital but also suggests a longer arc of computation that considers the ubiquitous digitality as a mere subset of modern state apparatuses and their urban infrastructures. The article concludes by reflecting on this computational addressability and its relationship with ideological interpellation, proposing computation as a multiscalar assemblage of political techniken. (shrink)

The 2015 UK Supreme Court judgment in Montgomery v Lanarkshire reinforces the importance of informed consent to medical treatment. This paper suggests that Montgomery recognises the challenge faced by vulnerable individuals in choosing between treatment options and making decisions with appreciation of information about material risks. The judgment endorses a form of weak paternalism to safeguard such persons, which is not disrespectful of the aggregate principles of the Mental Capacity Act 2005. But ethical practice requires professionals to tread carefully between (...) weak and hard paternalism in the context of therapeutic interactions with vulnerable patients, while ensuring their awareness of material risks. (shrink)

Upholding cooperative norms via punishment is of central importance in organizations. But what effect does punishing have on the reputation of the punisher? Although previous research shows third parties can garner reputational benefits for punishing transgressors who violate social norms, we proposed that such reputational benefits can vary based on the perceived motive for the punishment. In Studies 1 and 2, we found that individuals who endorsed a consequentialist (versus deontological) motive for punishing were seen as more trustworthy. In Study (...) 3, the results showed that when pitted against one another, a person who endorsed a consequentialist (versus deontological) motive for punishing was chosen more often as a partner in a Trust Game. In Study 4, we found that a manager who expressed a consequentialist reason for punishing an employee was seen as having less psychopathic tendencies, and this related to the manager being perceived as more trustworthy and a superior cooperation partner. Using a recall methodology, Study 5 results showed that employees who perceived their managers as having more consequentialist (versus deontological) motives for punishing also perceived their managers as being less psychopathic and more trustworthy. Theoretical and practical implications are discussed. (shrink)

Comparative study of philosophy of Islam, Sufism, Christianity in relations to Adi Granth.

Pancreatic beta cells secrete insulin in response to elevated plasma glucose levels in a Ca2+‐dependent fashion. Released insulin may act on the beta cell itself to promote further insulin synthesis and release. Recent studies by Johnson and Misler,1 Masgrau et al.2 and Mitchell et al.3 provide strong evidence (1) for the existence of intracellular Ca2+ stores sensitive to NAADP, a potent Ca2+‐mobilizing messenger, and (2) that these Ca2+ stores are involved in both glucose‐ and insulin‐mediated signal transduction. NAADP may therefore (...) play an important role in controling secretion of insulin from pancreatic beta cells. BioEssays 25:430–433, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

This essay is concerned with what Abbinnett1 described as fundamental to the discourses of social science: truth and its construction. The central problem around which the narrative is built is a growing disconnection in one area of social science, management research, between how truth is frequently defined and used and the approaches taken to constructing that truth. The result of this is an intellectual impurity whereby management research occupies an incoherent intellectual space somewhere between modernism and postmodernism. Our argument is (...) that, for a host of probable reasons, management research in many areas is dominated by the search for rational and scientific truth through the use of quantitative methodologies underpinned by a positivist philosophy. The result of this is frequently truth diluted rather than truth distilled. The essay discusses different routes to establishing a type of truth, the location of management research within a modern-postmodern continuum and the implications of this for management researchers. We begin, however, with a brief discussion of the nature of truth in social science. (shrink)

Threshold- and signal-detection-based models have dominated theorizing about recognition memory. Building upon these theoretical frameworks, we have argued for a dual-process model in which conscious recollection and familiarity contribute to memory performance. In the current paper we assessed several memory models by examining the effects of levels of processing and the number of presentations on recognition memory receiver operating characteristics . In general, when the ROCs were plotted in probability space they exhibited an inverted U shape; however, when they were (...) plotted inzspace they exhibited a U shape. An examination of the ROCs showed that the dual-process model could account for the observed ROCs, but that models based solely on either threshold or signal-detection processes failed to provide a sufficient account of the data. Furthermore, an examination of subjects' introspective reports using the remember/know procedure showed that subjects were aware of recollection and familiarity and were able to consistently report on their occurrence. The remember/know data were used to accurately predict the shapes of the ROCs, and estimates of recollection and familiarity derived from the ROC data mirrored the subjective reports of these processes. (shrink)

Background Nonanonymized direct contact between organ recipients and donor families is a topic of international interest in the adult context. However, there is limited discussion about whether direct contact should be extended to pediatric settings due to clinician and researcher concerns of the potential harms to pediatric patients.Methods We interviewed pediatric organ recipients, their families, and donorfamilies in British Columbia, Canada, to determine their views on direct contact. Interviews were conducted in two stages, with those who were further removed from (...) the transplant process informing the approach to interviews with those who more recently went throughthe transplant process.Results Twenty-nine individuals participated in twenty in-depth interviews. The study included participants from three major organ systems: kidney, heart, and liver. Only five participants expressed that direct contact might cause harm or discomfort, while twenty-three indicated they saw significant potential for benefits. Nearly half focused on the harms to others rather than themselves, and nearly two-thirds focused on the benefits for others rather than themselves.Conclusion There appears to be a community desire for direct contact in pediatric organ transplant programs among those living in British Columbia, Canada. These results suggest a need to revisit the medical community’s assumptions around protection and paternalism in our practice as clinicians and researchers. (shrink)

The interview to Ranabir Samaddar – translated from the original in Bengali by V. Ramaswamy – deals with the Naxalite decade in the perspective of the history it grew from, the history it was part of, and the history it created. The underlying question is: has this decade inaugurated a new phase in the Indian history of rebellions? Samata Biswas and Sandip Bandopadhyay, speaking on behalf of the Calcutta Research Group, engage in a deep dialogue on the novelties and (...) the legacy of the “dangerous decade” that the rulers have only wanted to put to death. The interview explores the evolving modes of popular politics of the past as well, shedding light on the unprecedented and stark opposition between activism and pacifism including submission to law and order. The answers are as much historical as political. (shrink)