In a recent judgment1 the Court of Protection was highly critical of health professionals for continuing to provide clinically-assisted nutrition and hydration in the face of disagreement about the patient’s best interests, without seeking to resolve the issue. This hearing had been set up specifically to consider whether GU’s dignity had been properly protected, and if not why not, given concerns raised by the Official Solicitor about what she considered to be “a complete abrogation of responsibility to consider properly or (...) at all, and to determine whether it was in GU’s best interests and therefore lawful to continue to give him an invasive medical treatment, CANH.” In April 2014, at 63 years old and living in Thailand, GU sustained severe injuries after suffering from an electrocution accident. He sustained a cardiorespiratory arrest with a significant delay before cardiopulmonary resuscitation was started and was unconscious and unresponsive. In September 2014 he was transferred to the UK. In August 2018, GU’s brother made a request for a best interests decision concerning the continuation of CANH. The family met to discuss this and all except GU’s son, agreed that continuing CANH was not in GU’s best interests. In view of the fact that there was not unanimity among the family, a decision was made that CANH should continue. Commenting on this decision, Mr Justice Hayden said ‘the apparent assumption that in the face of family disagreement ‘ therefore will continue to be cared for by nursing staff ” is a troubling non sequitur’ and stressed that ‘family dissent to a medical consensus should never stand in the way of an incapacitated patients’ best interests being properly identified’. He also made clear that the responsibility for ensuring that a best interests assessment is undertaken rests with the …. (shrink)

In the past two decades, reinforcement learning has become a popular framework for understanding brain function. A key component of RL models, prediction error, has been associated with neural signals throughout the brain, including subcortical nuclei, primary sensory cortices, and prefrontal cortex. Depending on the location in which activity is observed, the functional interpretation of prediction error may change: Prediction errors may reflect a discrepancy in the anticipated and actual value of reward, a signal indicating the salience or novelty of (...) a stimulus, and many other interpretations. Anterior cingulate cortex has long been recognized as a region involved in processing behavioral error, and recent computational models of the region have expanded this interpretation to include a more general role for the region in predicting likely events, broadly construed, and signaling deviations between expected and observed events. Ongoing modeling work investigating the interaction between ACC and additional regions involved in cognitive control suggests an even broader role for cingulate in computing a hierarchically structured surprise signal critical for learning models of the environment. The result is a predictive coding model of the frontal lobes, suggesting that predictive coding may be a unifying computational principle across the neocortex. (shrink)

In the article “When Parents Refuse: Resolving Entrenched Disagreements with Parents and Clinicians in Situations of Uncertainty and Complexity,” Janine Winters (2018) gets a great deal right. She...

This book provides an original treatment of the concept of good and beauty in ancient Egypt. It seeks to examine the dimensions of _nefer,_ the term used to describe the good and the beautiful, within the context of ordinary life. Because the book is based upon original research on ancient Egypt it opens up space for a review of the aesthetics of other African societies in the Nile Valley. Thus, it serves as a heuristic for further research and scholarship.

Volume 20, Issue 10, October 2020, Page 85-87.

The two cases presented here may at first seem very different: one patient was an adult, making autonomous decisions for herself and her fetus; the other was a child too young to meaningfully participate in the most significant decisions regarding his health. In both cases, healthcare professionals had to determine the extent to which the parents of a dying fetus or child should be permitted to make agonizing choices about how long to maintain hope and what that death will look (...) like; and in both, health professionals’ prognostications influenced their judgments about the patients’ best interests and whether they were candidates for certain interventions. While members of both healthcare teams questioned the patients’ and families’ ability to objectively consider the risks and benefits, the families were focused on the need to be able to live with the decisions made, regardless of outcome. Clinicians expressed unwillingness to perform physical actions they felt were more likely to promote harm and suffering than benefit, and experienced attendant moral distress in the face of conflicting values. In this regard, these cases are mirror images: only in the first case did the clinician, an obstetrician, have sufficient professional authority to refuse to perform the desired intervention. In the second case, the clinicians who expressed the most distress regarding the patient’s trajectory were the nurses, who largely lacked similar autonomy. Viewed together, these cases share a core question: What does paternalism look like in the contemporary era? (shrink)

As the age of genomic medicine has advanced rapidly, many questions pertaining to the reportability of both clinical and research findings have emerged. For example, the integration of genomic test...

With the entry-level student in mind, Stuart Brown guides the reader through three main topics: whether or not there is life after death; whether or not there is a powerful, beneficent intelligence controlling the universe; and the nature and appropriate defence of religious belief or faith. Each chapter is linked to readings by commentators on religion and belief, such as David Hume, John Hick, Richard Dawkins and William James. Key features also include activities and exercises, chapter summaries and guides (...) to further reading. (shrink)

One of Ireland's foremost literary and cultural historians, Terence Brown's command of the intellectual and cultural currents running through the Irish literary canon is second to none, and he has been enormously influential in shaping the field of Irish studies. These essays reflect the key themes of Brown's distinguished career, most crucially his critical engagement with the post-colonial model of Irish cultural and literary history currently dominant in Irish Studies. With essays on major figures such as Yeats, MacNeice, (...) Joyce and Beckett, as well as contemporary authors including Seamus Heaney, Derek Mahon, Michael Longley, Paul Muldoon and Brian Friel, this volume is a major contribution to scholarship, directing scholars and students to new approaches to twentieth-century Irish cultural and literary history. (shrink)

Essays omhandlende den etiske dimension i det militære liv.

This study documents how people who inject drugs in rural Puerto Rico perceive payments for participating in HIV epidemiological studies. In-depth interviews were conducted among a subset of active PWID older than 18 years of age who had been previously enrolled in a much larger study. Findings suggest that financial compensation was the main motivation for initially enrolling in the parent study. Then, as trust in the researchers developed, participants came to perceive compensation as part of a reciprocal exchange in (...) which they assisted researchers by providing a trustful account of their experiences and researchers reciprocated with financial support. (shrink)

_Psychoanalysis Beyond the End of Metaphysics_ offers a new paradigm approach which advocates reengaging the importance of metaphysics in psychoanalytic theorizing. The emergence of the relational trend has witnessed a revitalizing influx of new ideas, reflecting a fundamental commitment to the principle of dialogue. However, the transition towards a more pluralistic discourse remains a work in progress, and those schools of thought not directly associated with the relational shift continue to play only a marginal role. In this book, Robin S. (...) Brown argues that for contemporary psychoanalysis to more adequately reflect a clinical ethos of pluralism, the field must examine the extent to which a theoretical commitment to the notion of relationship can grow restrictive. Suggesting that in the very effort to negotiate theoretical biases, psychoanalytic practice may occlude a more adequate recognition of its own evolving assumptions, Brown proposes that the profession’s advance requires a return to first principles. Arguing for the fundamental role played by faith in supporting the emergence of consciousness, this work situates itself at the crossroads of relational, Jungian, and transpersonal approaches to the psyche. Psychoanalysis Beyond the End of Metaphysics will be of significant interest to all psychodynamically oriented clinicians, alongside scholars of depth psychology and the philosophy of mind. It will also be helpful to advanced and postgraduate students of psychoanalysis seeking to orient themselves in the field at present. (shrink)

This book investigates the potential role that states can play in cosmopolitan thinking and how states could be agents for the advancement of cosmopolitan responsibilities.

In lieu of an abstract, here is a brief excerpt of the content:Deaconesses and Ritual ImpurityCatherine Brown TkaczCultural diversity underlies the differences between deaconesses of the East and of the West.1 In the West, women were recognized by their faith as able to catechize others and to assist women at baptism; in some parts of the East, only a deaconess could take these roles. Again, only in some areas of the East, women at certain times were not permitted to (...) enter the church building, but deaconesses could take the Eucharist to these housebound women. In religious life, corresponding differences existed. In the West, nuns were fitted by their vows to take various roles in the Liturgy of the Hours; in the East, in some areas, only a diaconal abbess could take these roles. In remote monasteries which might lack a priest for some time, the diaconal abbess could distribute pre-consecrated communion to the community. Long has cosmic dualism been recognized as a trait of the Eastern groups that had deaconesses. Now another trait can be identified: [End Page 187] apparently the groups which retained the Levitical laws of ritual impurity were the ones that needed the gender-specific ministry of deaconesses. Examining the theological and cultural context in which that office arose helps explain this varied history. Next, the Western deaconess is most clearly limned by comparing the pertinent Latin ceremonies. This also sheds unexpected light on how the Roman Catholic Church protected the property rights of consecrated women.The Context in Which Deaconesses AroseJesus taught a new doctrine: the call to sanctification: "Be perfect as your Father in heaven is perfect" (Matt 5:48). Again, he commanded them to imitate him, to take up their cross daily and follow him (Luke 9:23). The post-Gospels New Testament continued to suggest ways for the believer to imitate Christ (for example, Heb 13:10–15). These teachings ground the doctrine that every human person is called to be holy and like Christ. To ensure that his followers knew that this vocation to holiness concerns women equally with men, Jesus demonstrated and emphasized the spiritual equality of the sexes throughout his time on earth.2 In an unprecedented way, he provided balanced examples of male and female in his interactions with men and women, in his healings, resurrection miracles, parables, and prophecies.3 In contrast, in the Old Testament and in the Jewish Haggadah, [End Page 188] paired male and female examples are "quite rare."4 While Tannaite Jews "exempted" women from reciting Shema and other acts of ritual worship and required only domestic devotions, Jesus elicited a public profession of faith from a woman as well as from a man—Peter (John 6:69) and Martha of Bethany (John 11:27)—and hers proves to be fuller.5 This dynamically demonstrated the spiritual equality of the sexes, and Eustathios of Antioch, Chrysostom, Augustine, and others praised Martha for teaching the faith.6From the start, both men and women were instructed in the faith, baptized, and received communion.7 Women also participated with men in evangelizing others. This began at Jesus's presentation in the Temple, his first public appearance, when the prophetess Anna announced the coming of the Messiah (Luke 2:36–38). The Samaritan woman evangelized her community: as soon as she learned of Jesus through conversation with him, she actively instructed others, so that many believed in him "because of the woman's testimony" (John 4:28–30, 39–42). The evangelical work of Priscilla was reported, with the account of her teaching a man (Acts 18:2, 26). That is, Christians interacted without a strict segregation of the sexes. When the apostles learned of neglect of the Greek widows, they obviously did not think that only other women could respond to this social need, for the apostles appointed men to do so (Acts 6:1–6).8Contrast this to the Jewish understanding of the roles of men and women. In the Temple, only Jewish men were allowed inside; women were relegated to the women's court. This segregation continued in medieval synagogues.9 [End Page 189] Likewise, as noted above, the Tannaite Jews "exempted" women from public worship. In Christian churches, however... (shrink)

This book focuses on social phenomenon that impact the lives of adolescent females of color. The authors highlight the daily challenges that African-American, Chicana, and Puerto Rican teenage girls face with respect to peer and family influences, media stereotyping, body image, community violence, pregnancy, and education. The authors also emphasize the incredible resiliency that young women possess in countering many of the social barriers confronting them.

Brown, Jean Review of: Friendship, by A. C. Grayling, Yale University Press, 2014. Pb, 229p. $16.22.

This chapter focuses on the archetypal image of the necromancer: the black‐robed creator and master of the undead. The necromancer is often depicted as a mere cackling villain, using her power over death to forward her evil agenda. In this way, necromancy has been philosophically maligned. Although necromancers were traditionally considered to be evil in Dungeons Dragons (DD), the game came to accommodate the idea that necromancers, in theory, could be neutral, or even good‐aligned, with their powers used for the (...) greater good. The distaste for necromancy and its mindless minions is instead a relic of “pre‐theoretical intuition” a common‐sense belief that may not hold up to philosophical scrutiny. Films and TV series depict the walking dead as ravenous, brain‐eating monstrosities. Next to such depictions, the relatively harmless nature of Dungeons Dragons’ mindless undead is easy to overlook. (shrink)