Implanting deep brain stimulation (DBS) electrodes in patients with Parkinson’s disease often results in the appearance of a non-infectious, delayed-onset edema that disappears over time. However, the time window between the DBS electrode and DBS stimulating device implant is often used to record local field potentials (LFPs) which are used both to better understand basal ganglia pathophysiology and to improve DBS therapy. In this work, we investigated whether the presence of post-surgery edema correlates with the quality of LFP recordings in (...) eight patients with advanced Parkinson’s disease implanted with subthalamic DBS electrodes. The magnetic resonance scans of the brain after 8.5 ± 1.5 days from the implantation surgery were segmented and the peri-electrode edema volume was calculated for both brain hemispheres. We found a correlation (ρ = −0.81, p < 0.0218, Spearman’s correlation coefficient) between left side local field potentials of the low beta band (11–20 Hz) and the edema volume of the same side. No other significant differences between the hemispheres were found. Despite the limited sample size, our results suggest that the effect on LFPs may be related to the edema localization, thus indicating a mechanism involving brain networks instead of a simple change in the electrode-tissue interface. (shrink)

Mental simulation — such as imagining tilting a glass to figure out the angle at which water would spill — can be a way of coming to know the answer to an internally or externally posed query. Is this form of learning a species of inference or a form of observation? We argue that it is neither: learning through simulation is a genuinely distinct form of learning. On our account, simulation can provide knowledge of the answer to a query even (...) when the basis for that answer is opaque to the learner. Moreover, through repeated simulation, the learner can reduce this opacity, supporting self-training and the acquisition of more accurate models of the world. Simulation is thus an essential part of the story of how creatures like us become effective learners and knowers. (shrink)

This paper aims to reconfigure the place of memory in epistemology. I start by rethinking the problem that memory systems solve; rather than merely functioning to store information, I argue that the core function of any memory system is to support accurate and relevant retrieval. This way of specifying the function of memory has consequences for which structures and mechanisms make up a memory system. In brief, memory systems are modeling systems. This means that they generate, update and manage a (...) series of overlapping, simplified, relational representations that map out features of the world. Succeeding at building and maintaining models requires the kind of active knowledge generation traditionally associated only with deliberative reasoning. (shrink)

People often answer why-questions with what we call experiential explanations: narratives or stories with temporal structure and concrete details. In contrast, on most theories of the epistemic function of explanation, explanations should be abstractive: structured by general relationships and lacking extraneous details. We suggest that abstractive and experiential explanations differ not only in level of abstraction, but also in structure, and that each form of explanation contributes to the epistemic goals of individual learners and of science. In particular, experiential explanations (...) support mental simulation and survive transitions across background theories; as a result, they support learning and help us translate between competing frameworks. Experiential explanations play an irreducible role in human cognition – and perhaps in science. (shrink)

Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make (...) recommendations to mitigate negative consequences that could arise from the unregulated development or application of novel neurotechnologies. We explore potential ethical challenges in four key areas: identity and agency, privacy, bias, and enhancement. To address them, we propose democratic and inclusive summits to establish globally-coordinated ethical and societal guidelines for neurotechnology development and application, new measures, including “Neurorights,” for data privacy, security, and consent to empower neurotechnology users’ control over their data, new methods of identifying and preventing bias, and the adoption of public guidelines for safe and equitable distribution of neurotechnological devices. (shrink)

This article examines ‘collective feelings’ by considering how ‘others’ create impressions on the surfaces of bodies. Rather than considering ‘collective feeling’ as ‘fellow feeling’ or in terms of feeling ‘for’ the collective, the article suggests that how we respond to others in intercorporeal encounters creates the impression of a collective body. In other words, how we feel about others is what aligns us with a collective, which paradoxically ‘takes shape’ only as an effect of such alignments. The article considers different (...) examples of racism in which a particular other is held in place by being aligned with other others. The ‘moment of contact’ is shaped by past histories of contact, which allows the proximity of a racial other to be perceived as threatening, at the same time as it re-shapes the bodies in the contact zone of the encounter. Feelings rehearse associations that are already in place, in the way in which they ‘read’ the proximity of others, at the same time as they establish the ‘truth’ of the reading. The article extends its analysis by showing that bodily proximity is not required to create the impressions of others, and offers an analysis of ‘collective feelings’ within virtual communities of global nomads. Proximity does not require physical co-presence: the collective can ‘surface’ through giving up on local attachments (where the screen becomes a substitute for the skin). The article concludes that collective feelings are not feelings that the collective ‘has’, as if the collective was a subject. Rather the collective is an effect of the impressions left by others on the surfaces of skins. (shrink)

This essay contends that postcolonial migrants have a right to enter their former colonizing nations, and that these should accept them. Our novel argument challenges well-established justifications for restrictions in immigration-policies advanced in liberal nationalism, which links immigration controls to the nation’s self-determination and the legitimate preservation of national identity. To do so, we draw on postcolonial analyses of colonialism, in particular on Edward Said’s notion of “intertwined histories,” and we offer a more sophisticated account of national identity than that (...) of liberal nationalists. In our view, the national identity of former colonizing nations cannot be understood in isolation from their ex-colonies. This entails that liberal nationalists cannot justify the restriction on the entrance of members of the nation’s former colonies by resorting to an argument about the preservation of national identity: the former colonized constitute an inseparable element of that national identity, because they are already historically part of it. (shrink)

Should you take a pill that gives you all the health benefits of sleep and allows you to stay awake? I argue that you shouldn’t. I propose three reasons why sleeping, conceived of as a socially and culturally embedded human activity, is valuable. First, there is aesthetic value in the rituals that typically precede sleeping; second, there is interpersonal value in the intimacy that stems from sleeping with other people; third, there is ethical value in mere presence and in retreating (...) from consciousness. In order to fully support my argument, I situate it within a conception of goodness that embraces the fragility of the human condition and the limitations stemming from our corporeal nature. I conclude with some practical implications of my view. (shrink)

This article analyses some of the governmental issues at stake in contemporary institutional politics in its confrontation with the challenges of digitalisation. Through notions such as algorithmic governmentality (Rouvroy and Berns), platformisation (Bratton, Stiegler), extractivism, and the affect theory (Massumi), and following a symptomatologic method, we will try to establish and discuss some key points that could be useful in order to update certain concepts regarding micro- and biopolitics (Deleuze and Guattari, Foucault), the public sphere, and the management of social (...) and individual bodies. Finally, we will try to understand how the manipulation of affects via the staging of possible catastrophic futures (Parisi) is used as a powerful neurosensory weapon, with performative effects for governing and modelling behaviours. If contemporary capitalism is capable of abstracting and extracting affects, of accumulating them and of creating value through this, which policies should we apply in this situation of uncertainty and of the manipulation of affectivity? Is there any place left for public institutions, or is the market the sole political actor left? (shrink)

This paper brings two fresh perspectives on Lewis’s theory of time travel. First: many key aspects and theoretical desiderata of Lewis’s theory can be captured in a framework that does not commit to eternalism about time. Second: implementing aspects of Lewisian time travel in a non-eternalist framework provides theoretical resources for a better treatment of time travel to the future. While time travel to the past has been extensively analyzed, time travel to the future has been comparatively underexplored. I make (...) progress on this topic. Along the way, I discuss Lewis’s lesser-known time travel oeuvre, especially his volume of correspondence and lectures on the topic collected in Beebee and Fisher (2020) and Janssen-Lauret & MacBride (forthcoming). Lewis’s body of unpublished work on time travel yields fruitful insights into his broader thinking on the subject. (shrink)

The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)

Where do values live in thought? A straightforward answer is that we (or our brains) make decisions using explicit value representations which are our values. Recent work applying reinforcement learning to decision-making and planning suggests that more specifically, we may represent both the instrumental expected value of actions as well as the intrinsic reward of outcomes. In this paper, I argue that identifying value with either of these representations is incomplete. For agents such as humans and other animals, there is (...) another place where reward can be located in thought: the division of the space of possibilities or ‘state space’. (shrink)

This far-ranging collection of essays represents a conference of the same name held at Emory University in conjunction with a meeting of the “Rethinking Plato’s Parmenides” seminar sponsored by the Society of Biblical Literature.In embracing authors as diverse as Plato himself, Epictetus, Ralph Cudworth, Yeats, and Levinas, to name a few of the Platonists identified herein, the volume clearly and deliberately stretches the meaning of this rubric to its outer limits. This review will reprise some of the articles from each (...) of the book’s sections—Ancient, Late Antique, Renaissance and Modern, and Post-modern Platonisms—in an effort to help readers gauge the argument of the book, which may or may not be endorsed by each of the individual contributors. The editors, at least in compiling this anthology, do so in the belief that Platonism might better be considered “as an inexhaustible mine of possible trajectories each of which helps us to see the richness of Platonic texts,” rather than “as a series of determinate doctrines” .Thomas Slezak opens the volume with a rehearsal of his programmatic way of reading Plato’s dialogues, involving two possibly competing claims: what Plato means by philosophy is not contained within the. (shrink)

There has been a long history of tension between feminists and feminist philosophy, on the one hand, and logic, on the other hand. This tension expresses itself in many ways, including claims that logic is a tool of the patriarchy, that logic/rationality/analytical tools in philosophy need to be rejected if women are to fully participate, that women = body and man = mind, that to do feminist philosophy one must do it as a situated, embodied person, not as an impersonal, (...) disembodied mind, that logic is “a masculine subject”. However the tension is expressed, it is women in logic and women logicians who are caught in between. The goal of my paper is to explore a conception of logic that not only is not inconsistent with being a feminist, but is actively welcoming of women as logicians. (shrink)

A classic and fraught question in the philosophy of film is this: when you watch a film, do you experience yourself in the world of the film, observing the scenes? In this paper, we argue that this subject of film experience is sometimes a mere impersonal viewpoint, sometimes a first-personal but unindexed subject, and sometimes a particular, indexed subject such as the viewer herself or a character in the film. We first argue for subject pluralism: there is no single answer (...) to the question of what kind of subjectivity, if any, is mandated across film sequences. Then, we defend unindexed subjectivity: at least sometimes, films mandate an experience that is first-personal but not tied to any particular person, not even to the viewer. Taken together, these two theses allow us to see film experience as more varied than previously appreciated and to bridge in a novel way the cognition of film with the exercise of other imaginative capacities, such as mindreading and episodic recollecting. (shrink)

The development of nursing ethics as a field of inquiry has largely relied on theories of medical ethics that use autonomy, beneficence, and/or justice as foundational ethical principles. Such theories espouse a masculine approach to moral decision-making and ethical analysis. This paper challenges the presumption of medical ethics and its associated system of moral justification as an appropriate model for nursing ethics. It argues that the value foundations of nursing ethics are located within the existential phenomenon of human caring within (...) the nurse/patient relationship instead of in models of patient good or rights-based notions of autonomy as articulated in prominent theories of medical ethics. Models of caring are analyzed and a moral-point-of-view (MPV) theory with caring as a fundamental value is proposed for the development of a theory of nursing ethics. This type of theory is supportive to feminist medical ethics because it focuses on the subscription to, and not merely the acceptance of, a particular view of morality. (shrink)

Yablo suggests that we can understand the possibility of mental causation by supposing that mental properties determine physical properties, in the classic sense of determination according to which red determines scarlet. Determinates and their determinables do not compete for causal relevance, so if mental and physical properties are related as determinable and determinates, they should not compete for causal relevance either. I argue that this solution won''t work. I first construct a more adequate account of determination than that provided by (...) Yablo. I then consider two common accounts of the mental, token identity theories and dispositional theories, and argue that on neither do mental and physical properties satisfy the requirements for determination. (shrink)

In this paper I argue that Marxist Buddhism may provide a novel approach to envy in society. It has been argued that envy arises in response to socio-political inequality, which is considered a problem given the social and moral harms associated with envy. Thus, achieving equality is expected to solve the problem of envy. However, anecdotal and empirical evidence suggests that is not the case, and that, in particular, societies inspired by Marxist ideals are not envy-free—if anything, the opposite seems (...) true. Buddhism has traditionally condemned envy. It shares with Marxism the idea that individual wellbeing can be obtained, paradoxically, only through lessening emphasis on individuality—Marxism by means of economic collectivism, Buddhism by means of a spiritual transformation. Both aim at shrinking the self and are keenly aware of how quickly an emphasis on one’s own desires leads to greed and exploitation of others. However, Marxist ideals have failed to yield successful large-scale flourishing communities, while Buddhism is a religion practiced by millions of people but has not advanced a politically progressive agenda in particular. Marxist Buddhism—argue—may perhaps bring together the best of the respective traditions to solve the problem of envy. However, I end by cautioning against such a radical reshaping of our psychological makeup, especially given the evidence that shows that there are morally and prudentially good types of envy, and sketch the profile of a Buddhist-friendly type of envy as an alternative to total eradication. (shrink)

When entering an environment, animals – including humans – tend to consult their memories to determine what they know about the place. This information is useful to determine: is this place safe? And what happens next? In this chapter, we argue on both empirical and conceptual grounds that memory is largely organized by space. Spatial relations determine what is recalled and which experiences are combined in generalizations. Time does not play an analogous role. We show that space and time in (...) memory are thus deeply asymmetrical. We conclude with a consequence of our view: spatial organization entails a basic form of abstraction in a way temporal organization does not, and so the spatial organization of memory reveals that memory involves generalization from the very beginning. (shrink)

Many philosophers hypothesize that our concept of personal identity is partly constituted by the one-person-one-place rule, which states that a person can only be in one place at a time. This hypothesis has been assumed by the most influential contemporary work on personal identity. In this paper, we report a series of studies testing whether the hypothesis is true. In these studies, people consistently judged that the same person existed in two different places at the same time. This result undermines (...) some widely held philosophical assumptions, supports others, and fits well with recent discoveries on identity judgments about inanimate objects and non-human animals. (shrink)

Christine Ladd-Franklin is often hailed as a guiding star in the history of women in logic—not only did she study under C. S. Peirce and was one of the first women to receive a PhD from Johns Hopkins, she also, according to many modern commentators, solved a logical problem which had plagued the field of syllogisms since Aristotle. In this paper, we revisit this claim, posing and answering two distinct questions: Which logical problem did Ladd-Franklin solve in her thesis, and (...) which problem did she think she solved? We show that in neither case is the answer “a long-standing problem due to Aristotle.” Instead, what Ladd-Franklin solved was a problem due to Jevons that was first articulated in the nineteenth century. (shrink)

In considering what it means to lead organizations effectively and ethically, the literature comprising spirituality at work and spiritual leadership theory has become highly influential, especially in the USA. It has also attracted significant criticism. While in this paper, we endorse this critique, we argue that the strand of literature which purportedly takes a Christian standpoint within the wider SAW school of thought, largely misconstrues and misapplies the teaching of its founder, Jesus. As a result, in dismissing the claims and (...) application of SAW and SLT, there is a real risk that we lose the vital contribution of Christian thought, not least some of the timeless counter-cultural wisdom of Jesus which, we contend, offers a vital foundation to the practice of ethical leadership and business ethics in organizations. In proposing a way forward, two thorny issues which face all leaders are addressed: dealing with ego and closing the gap between what we say and what we do. The more we understand about the dynamics of human nature, the more we learn about the profundity of Jesus’ teachings. We then propose a number of ways in which Jesus-centred ethical leadership can be practised. Each is radical and each implies risk: both the personal risk of inner renewal arising from repentance as a doorway to personal integrity, as well as the risk of opposing unethical practices and promoting the excellence of core practices in the workplace. (shrink)

There are several lessons that can already be drawn from the current research programs on strong AI and building conscious machines, even if they arguably have not produced fruits yet. The first one is that functionalist approaches to consciousness do not account for the key importance of subjective experience and can be easily confounded by the way in which algorithms work and succeed. Authenticity and emergence are key concepts that can be useful in discerning valid approaches versus invalid ones and (...) can clarify instances where algorithms are considered conscious, such as Sophia or LaMDA. Subjectivity and embeddedness become key notions that should also lead us to re-examine the ethics of decision delegation. In addition, the focus on subjective experience shifts what is relevant in our understanding of ourselves as human beings and as an image of God, namely, in de-emphasizing intellectuality in favor of experience and contemplation over action. (shrink)

Formal representations drawn from rational choice theory have been used in a variety of ways to fruitfully model the way in which actual agents are approximately rational. This analysis requires bridging between ideal normative theory, in which the mechanisms, representations, and other such internal parts are in an important sense interchangeable, and descriptive psychological theory, in which understanding the internal workings of the agent is often the main goal of the entire inquiry. In this paper, I raise a problem brought (...) on by this gap: for almost every theory of approximate rationality, there will be an empirically indistinguishable alternative that individuates the parts of the agent in a significantly different way. (shrink)

In a recent paper, Max Deutsch argues that there is no “qua problem” for purely causal theories of reference, according to which the extensions of some expressions are grounded in causal relations to members of their extensions during dubbing acts. The qua problem is the difficulty in specifying the facts in virtue of which the reference of “elephant” is grounded by causal contact with something _qua_ elephant and not _qua_ its other properties. If no such specification can be given, reference (...) remains unacceptably indeterminate. This has led many to abandon purely causal reference grounding. Deutsch’s argument for the dissolution of the problem goes as follows: we usually agree that an event can cause its effect _qua_ some of its properties and not _qua_ others. For example, a hot acidic solution causes a glass beaker to break due to its heat and not due to its acidity. Given this assumption, we can simply say that an event caused a dubbing act _qua_ the causally relevant property and not _qua_ the causally irrelevant properties, thus grounding the reference of the term; the qua problem has vanished. I will argue that causal mechanisms, and in particular the facts about causal relevance appealed to by Deutsch, are insufficient to dissolve the qua problem. It is not generally the case that a _unique_ property is causally relevant in purely physical cases of causation; but this is precisely what is required to avoid the referential indeterminacy highlighted by the qua problem. I will demonstrate that if we rely on causal relevance to dissolve the qua problem, there is no way to respect the uniqueness requirement: there are too many properties that are causally relevant to the occurrence of any single dubbing act, including the intentional states of the dubber. (shrink)

Charles Darwin's curiosity had a remarkable childlike enthusiasm driven by an almost compulsive appetite for a constant process of discovery, which he never satiated despite his many voyages. He would puzzle about the smallest things, from the wonders of barnacles to the different shapes, colours and textures of the beetles which he obsessively collected, from flowers and stems to birds, music and language, and would dedicate years to understanding the potential significance of everything he saw. Darwin's findings and theories relied (...) heavily on that same curiosity, on seeking and answering questions, however long these would take to clarify. His son Francis Darwin often recalls how "he would ask himself 'now what do you want to say' and his answer written down would often disentangle the confusion". In fact, "disentangling confusions" seems to have been the driving force behind Darwin's scientific pursuits, as he was struck with bewilderment when contemplating the luxuriousness of life. It was also the impetus for this book. The true implications of Darwin's legacy remain as controversial to the critics of our time as they were to his contemporaries. Darwin's impact within and beyond the biological sciences is both daunting and exhilarating, and attests to the need for an interdisciplinary approach by remaining a challenge to many scholars in the most diverse fields. The recent revival of his theories has opened a Pandora's box of different theoretical studies that are particularly receptive to exploring new and exciting angles of research. (shrink)

Some religious requirements seem genuinely arbitrary in the sense that there seem to be no sufficient explanation of why those requirements with those contents should pertain. This paper aims to understand exactly what it might mean for a religious requirement to be genuinely arbitrary and to discern whether and how a religious practitioner could ever be rational in obeying such a requirement. We lay out four accounts of what such arbitrariness could consist in, and show how each account provides a (...) different sort of baseline for understanding how obedience to arbitrary requirements could, in principle, be rational. (shrink)

Though Arthur Prior is now best known for his founding of modern temporal logic and hybrid logic, much of his early philosophical career was devoted to history of logic and historical logic. This interest laid the foundations for both of his ground-breaking innovations in the 1950s and 1960s. Because of the important rôle played by Prior's research in ancient and medieval logic in his development of temporal and hybrid logic, any student of Prior, temporal logic, or hybrid logic should be (...) familiar with the medieval logicians and their work. In this article we give an overview of Prior's work in ancient and medieval logic. (shrink)

Abstract:AbstractWomen's Liberation was a radical, multiracial feminist movement that grew directly out of the New Left, civil rights, antiwar, and related freedom movements of the 1960s. Its insight that “the personal is political,” its intentionally decentralized structure, and its consciousness raising method allowed it to grow so fast and with such intensity that it swept up liberal feminist organizations in a wildfire of change. Though women's liberation was fundamental to the emergence of a mass feminist movement, the persistent stereotypes of (...) this feminist upsurge as white, middle-class, anti-motherhood, and anti-sex have obscured the creative radicalism of this early period and erased the presence of women of color and working class women. In a period of extreme racial polarization, feminist efforts to articulate the intersections of gender with race, class, and sexuality were often deeply flawed, but they began a conversation on which later generations could build. As scholars unearth the complex history of this dynamic and revolutionary moment they complicate narratives of the so-called “second wave.”. (shrink)

Charles S. Peirce held a view of human reason as creative. The objective of this article is to explore more deeply the Peircean conception of imagination, indispensable for the correct functioning of reason. The connection of reason and imagination is necessary in order to be able to interpret the world, to advance towards the truth and to direct our own actions. In this paper I will explain the principal forms in which these faculties interact, and will provide examples taken from (...) the Peircean corpus. (shrink)

In Democracy without Shortcuts, Cristina Lafont identifies proceduralist or ‘deep pluralist’ conceptions of democracy alongside epistemic and lottocratic approaches as shortcuts that avoid the more challenging but, in her view, preferable path of engaging with and attempting to sway competing views, values and beliefs of fellow citizens. I argue that with the wholesale dismissal of proceduralist accounts of democracy Lafont herself takes two shortcuts: The first concerns the characterization of deep pluralism as unable to explain substantive disagreement after a decision (...) is settled, and the second undervalues proceduralism’s ability to evaluate and criticize the substance of the political decision-making process. While her critique is fitting for minimalist conceptions of proceduralism, a theory of normative proceduralism shares many objectives with Lafont’s vision of a participatory deliberative democracy. Integrating those approaches instead of dismissing proceduralism outright would render her project appealing to theorists who would not otherwise consider themselves deliberative democrats. (shrink)

Receiving a diagnosis of cancer can be devastating. Cancer continues to be one of the most feared diagnoses, and experiencing pain is a major fear for people diagnosed with cancer. Cancer pain is complex in aetiology and can be acute or chronic and can be caused by various compression, ischaemic, neuropathic or inflammatory processes. Many people with cancer will experience excruciating pain, which is often underreported and undertreated. The reasons for this are complex and include various factors including fears and (...) beliefs held by patients. Cognitive factors are important modulators of pain and the appraisals, meanings and beliefs that people have in relation to illness, cancer, and pain, have implications in regard to help-seeking behaviours and the coping strategies people adopt. Cancer pain can impact a range of psycho-social factors across its course. Cancer pain relates to higher rates of psychological distress, anxiety and low mood, and the perception of pain intensity is, in turn, influenced by psychological factors. Cancer pain can negatively affect psychological health, and psycho-social factors can affect the pain experience. It has been suggested that people with a life-limiting illness experience ‘total pain’, and this can encompass psychological, social, practical, spiritual domains. Research demonstrates that cancer is predominantly an illness affecting older people, yet there is a higher risk of under-treated pain in this age group and there is a paucity of research into the subjective experiences of older people managing their cancer pain. Many older people are required to self-manage cancer pain at home as outpatients, due to drivers to keep people out of inpatient care, such as the high healthcare costs of inpatient treatment, and patients wanting to manage their illness, and die, at home. Our own research into this area found that the self-management of cancer pain involves a sequential and temporal process, which centres on perceptions of control. We describe how the older people in our study experienced a perceived loss of control, followed by a sense of gaining control over pain through various experience of certain internal and external factors. The assessment and treatment of physical pain should be done in combination with assessment and treatment of psycho-social and spiritual pain, and interventions for cancer pain need to focus on increasing positive affect and reducing helplessness. No person should suffer with poorly controlled pain and we argue for the need for further research in this area to ensure adequate treatment for all.Clinical Implications: Assessment and treatment of physical pain in people with cancer needs to be conducted in combination with assessment and treatment of psycho-social issues and spiritual pain. Psychological and behavioural approaches have strong evidence supporting their efficacy for reducing cancer pain. Interventions should target helplessness and focus on increasing positive affect through positive psychological states including fighting spirit and resilience. Person-centred interventions that focus on helping people with the search for meaning may help those with cancer pain derive positive benefits. (shrink)

Volume 98, Issue 1, March 2020, Page 209-209.

Background: Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses. Aim: The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour. Research design, participants and research context: A phenomenological (...) and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses’ homes or at the hospital. Ethical consideration: Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained. Findings: The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner’s life had changed considerably. The main theme that emerged therefore was ‘oscillating in a changing relationship’. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: ‘doing the right thing in unpredictable daily situations’; ‘torn between patience and guilt’; and ‘living in a time of uncertainty, hope and despair’. Conclusion: Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses’ married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners’ well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners’ progressing illness. (shrink)