Advances in applications of artificial intelligence and the use of data analytics technology in biomedicine are creating optimism, as many believe these technologies will fill the need-availability gap by increasing resources for mental health care. One resource considered especially promising is smartphone psychotherapy chatbots, i.e., artificially intelligent bots that offer cognitive behavior therapy to their users with the aim of helping them improve their mental health. While a number of studies have highlighted the positive outcomes of using smartphone psychotherapy chatbots (...) to handle various anxiety related problems no conclusive data illustrate their effectiveness or warrant their use in mental illness diagnosis and treatment settings. Yet smartphone psychotherapy is highly endorsed by experts in the field of mental health research. In this paper, I focus on the specific features of smartphone psychotherapy chatbots intended for the diagnosis and treatment of mental illness and criticize three popular promises; i.e., they enable early diagnosis and intervention through digital phenotyping; they defy the stigma of mental illness diagnosis and treatment; they offer increased access to mental health treatment globally. Going against the popular enthusiasm, I argue smartphone psychotherapy chatbots have epistemic and ethical limitations in the diagnosis and treatment of illnesses. In light of these, I encourage researchers, clinicians, policy makers, patients, and caregivers to pause before jumping on the artificial intelligence bandwagon to seek solutions for mental illness on the grounds of these three promises. (shrink)

This paper challenges the exclusion of patients from epistemic practices in psychiatry by examining the creation and revision processes of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a document produced by the American Psychiatric Association that identifies the properties of mental disorders and thereby guides research, diagnosis, treatment, and various administrative tasks. It argues there are epistemic—rather than exclusively social/political—reasons for including patients in the DSM revision process. Individuals with mental disorders are indispensable resources to enhance psychiatric epistemology, (...) especially in the context of the crisis, controversy, and uncertainty surrounding mental health research and treatment. (shrink)

Background: Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered (...) by nurses nor a study conducted on the issue. Aim/objective: The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level. Method: The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. Results: In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Conclusion: Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care. (shrink)

Various traditions in mental health care, such as phenomenological, and existential and cognitive-behavioral psychotherapy, implicitly or explicitly acknowledge that a disruption of the self, or the person, or the agent is among the common denominators of different mental disorders. They often emphasize the importance of understanding patients as reasonsresponsive, in their full mental health relevant complexity, if their mental disorder is to be treated successfully. The centrality of the concept of the self is not mirrored in the mainstream scientific approaches (...) in psychiatry however; the self has rarely been considered as the object of scientific research, the empirical investigation of which might yield successful explanations of and interventions in mental disorders. Thus, even though self-related phenomena are clinically relevant in so far as they give important information about a mental disorder to the clinician and help the development of effective interventions, they are not considered among the scientifically relevant properties of mental disorders. Leaving the self-related phenomena out of the scientific research on mental disorders can be attributed to the presupposition that the self is not empirically tractable and its use will hinder psychiatry’s goal to be scientific. In this paper, taking issue with this, I argue the self is empirically tractable, and its use as a target of research will not hinder psychiatry’s scientific commitments. (shrink)

his article develops a set of recommendations for the psychiatric and medical community in the treatment of mental disorders in response to the recently published fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, that is, DSM-5. We focus primarily on the limitations of the DSM-5 in its individuation of Complicated Grief, which can be diagnosed as Major Depression under its new criteria, and Post-Traumatic Stress Disorder (PTSD). We argue that the hyponarrativity of the descriptions of these disorders (...) in the DSM-5, defined as the abstraction of the illness categories from the particular life contingencies and personal identity of the patient (e.g., age, race, gender, socio-economic status), constrains the DSM-5's usefulness in the development of psychotherapeutic approaches in the treatment of mental disorders. While the DSM-5 is useful in some scientific and administrative contexts, the DSM's hyponarrativity is problematic, we argue, given that the DSMs are designed to be useful guides for not only scientific research, but also for the education of medical practitioners and for treatment development. our goal therefore is to offer suggestions for mental health practitioners in using the DSM-5, so that they can avoid or eliminate the problems that may stem from the limitations of hyponarrativity. When such problems are eliminated, we believe that effective psychotherapeutic strategies can be developed, which would be successful in repairing the very relationships that are strained in mental disorder: the patient's relationship to herself, her physical environment, and her social environment. (shrink)

Educators who start a philosophy of medicine or medical ethics class with a philosophical discussion on the definition of basic concepts in medicine, such as health and disease, might relate to this anecdotal account. Students initially find the topic engaging because of the ubiquity of the concept of disease regulating not only their direct encounter with health-related contexts, for example, when veterans returning to school receive accommodations after being diagnosed with Post Traumatic Stress Disorder (PTSD), but also their social world, (...) say, when they get in an argument with their classmates about whether vaccines cause or prevent diseases, or when they join the campus gym to improve their health. Yet their enthusiasm wanes when they read the seminal naturalist and normative accounts of disease. This happens not because such conceptual work does not have any philosophical sophistication and value but because the discussion seldom makes direct contact with the common uses of the disease concept in the medical, social, moral and institutional contexts in which the students are heavily embedded. As the authors of ‘Rethinking ‘Disease’: A Fresh Diagnosis and a New Philosophical Treatment’ argue, the notion of disease central to the naturalist and normativist positions is conceptually insulated from its applications in various institutional settings in healthcare and also from its personal, social and economic contexts. This insularity largely stems from the fact that traditional conceptual analysis in philosophy assumes a lot more than it can show, including the assumption that concepts, such as disease, have necessary and sufficient conditions that exist independently of the world as we encounter it and are accessed through our intuitions. This is a problem, because the concept of disease plays a crucial role in medical epistemology, scientific research, and ethical and policy-related issues; a philosophical account of disease that does not directly engage …. (shrink)

The question “What is the relationship between the self and mental disorder?” is especially important for mental health professionals interested in understanding and treating patients, as most mental disorders are intimately tied to self‐related concerns, such as loss of self‐esteem and self‐control, or diminished agency and autonomy. Philosophy, along with the cognitive and behavioral sciences, offers a wealth of conceptual and empirical resources to answer this question, as the concepts of the self and psychopathology have occupied a central place in (...) these fields since their inception. Interestingly, and unfortunately, however, scientific psychiatry, in its approach to mental disorder as primarily a cluster of signs and symptoms has been slow in acknowledging the advances in conceptualizing and investigating mental disorders in relation to the self. The article addresses this problem and offers solutions for better cross‐fertilization between empirical and philosophical inquiry into the self and psychiatric research on mental disorders. The first part evaluates what empirically informed philosophical inquiry and philosophically informed empirical inquiry offer to the examination of the relationship between the self and mental disorders. The second part argues that scientific psychiatry has missed opportunities to find effective treatments for mental disorders because of its insularity from debates in naturalistic philosophy and cognitive and behavioral sciences. Psychiatry has much to gain from the conceptual, scientific, and clinical resourcefulness of philosophy's collaboration with the cognitive and behavioral sciences. (shrink)

In their article, “Patients’ beliefs about deep brain stimulation (DBS) for treatment resistant depression,” Lawrence, Kaufmann, DeSilva, and Appelbaum analyze the responses of 24 psychiatric inpat...

Mental disorder is an urgent and growing public health problem.1 Scientific investigation of this problem has the pragmatic goals of identifying the causes of mental disorders and developing strategies to effectively treat them. Philosophers of psychiatry have participated in the inquiry into the empirical examination of mental disorders, predominantly by debating whether psychopathology is a legitimate target of scientific inquiry and, if so, how mental disorders should be explained, predicted, and intervened on. However, as I show in this paper, these (...) philosophical discussions have mostly neglected the actual state of inquiry in psychiatry and relevant disciplines, as well as the first-person experiences... (shrink)

The review of literature on stakeholders reveals that there is need to understand more about firm-stakeholder relationships especially from stakeholders’ point of view. Market integration in the European Union (EU) provides an excellent context for increasing such understanding since it is creating opportunities and threats for firms and their stakeholders. This research aims to make a contribution in this direction by analyzing strategic responses of primary stakeholders to selected threat events in the history of Volkswagen (VW) since 1960.

Recent advances in brain imaging methods as well as increased sophistication in neuroscientific modeling of the brain’s reward systems have facilitated the study of neural mechanisms associated with addiction such as processes associated with motivation, decision-making, pleasure seeking, and inhibitory control. These scientific activities have increased optimism that the neurological underpinnings of addiction will be delineated, and that pharmaceuticals that target and change these mechanisms will by themselves facilitate early intervention and even full recovery. In this paper, we argue that (...) it is misguided to construe addiction as just or primarily a brain chemistry problem, which can be adequately treated by pharmaceutical interventions alone. (shrink)

This paper explores the factors that contribute to the degree of a mood disorder patient’s self- insight, defined here as her understanding of the particular contingencies of her life that are responsive to her personal identity, interpersonal relationships, illness symptoms, and the relationship between these three necessary components of her lived experience. I consider three factors: (i) the Diagnostic Statistical Manual of Mental Disorders (DSM), (ii) the DSM culture, and (iii) the cognitive architecture of the self. I argue that the (...) symptom-based descriptions of mood disorders which eliminate the subjective features of the patient’s illness experience, in conjunction with the features of the DSM-culture and the cognitive biases that guide the patient, contribute to the impoverishment of her self-insight. The resulting impoverished self-insight would prevent her from developing resourceful responses to her interpersonal problems. In analyzing how these factors combine to influence the patient’s self-insight, I distinguish the therapeutic impact of receiving a psychiatric diagnosis, which facilitates patient’s clinical treatment, from its reflective impact, how the diagnosis informs the patient’s reflection on who she is, how her mental disorder is expressed, and how her interpersonal relationships proceed. I substantiate my argument by considering a patient’s memoir of psychopathology. (shrink)

The scientific investigation of mental disorders is an invigorating area of inquiry for philosophers of mind and science who are interested in exploring the nature of typical and atypical cognition as well as the overarching scientific project of ‘carving nature at its joints’. It is also important for philosophers of medicine and bioethicists who are concerned with concepts of disease and with the development of effective and ethical treatments of mental disorders and the just distribution of mental health services. Philosophical (...) worries surrounding mental health and its care have recently extended beyond the bounds of academia, becoming a vigorous topic of debate in a variety of public domains in the wake of the publication of the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , the psychiatric classification system used by mental health professionals in the USA, and increasingly, by those around the world.The DSM-5 lists mental disorders according to the observable symptoms presented by patients. It is designed for pragmatic use across a variety of settings to accomplish several tasks: to facilitate clinical treatment, to provide clear criteria of eligibility for various administrative and policy related purposes ), and primarily, to further scientific research into mental disorder aetiology. Although designed to meet the needs and interests of various stakeholders , the recently revised manual has not fully satisfied any of them. This failure challenges the assumption that a single manual …. (shrink)

In a compelling and provocative paper, ‘Solving the Self-Illness Ambiguity: The Case for Construction Over Discovery,’ Sofia M.I. Jeppsson distinguishes two ways of addressing the self-illness ambiguty problem. The first is the Realist Solution, which postulates a pre-existing border between the self and the illness and frames the goal of treatment in psychiatry as helping the patient ‘discover’ this boundary. Addressing the shortcomings of the Realist Solution, both in terms of its feasibility and possible outcomes, Jeppsson proposes and defends the (...) Constructivist Solution, according to which the patient, through self-reflection and deliberation with others, including the clinicians, decides, which parts of her experiences they identify with themselves and which parts they attribute to their illness. This paper critically evaluates Jeppson’s arguments and addresses some of the shortcomings of Jeppsson’s positive argument, i.e. the Constructivist Solution. (shrink)

The special issue, “Psychiatry and Its Philosophy,” focuses on addressing the mindbrain dualism and connected problems in the clinical and scientific contexts of psychiatry. Authors in this special issue address the theoretical disagreements that are manifest in the clinical and scientific goals of psychiatry and explore the possibility of reconciling the claim that research on psychopathology needs to be scientific with the claim that it needs to address the needs of patients in the clinic. Our approach is forward looking and (...) concerned with drawing on ideas and methods from the philosophy of science and philosophy of mind to promote pluralism in psychiatry. (shrink)

Bu çalışmada Feminist teologların Yahudilik ve Hıristiyanlıkta var olduğunu iddia ettikleri eril Tanrı anlayışına yönelik getirdikleri eleştiriler ve bunların tutarlılığı objektif bir biçimde ele alınacaktır. Ayrıca Yahudilik ve Hristiyanlıkta ataerkil ve toplumsal baskılardan dolayı oluşan, teolojiye atfedilmiş kadın karşıtı görüşler ve ortaya çıkardıkları sonuçlar araştırılmaktadır. Eleştirel, yorumlayıcı ve bütüncül yöntemler perspektifinde analizlerden faydalanılarak bir bağlam oluşturulmaya gayret gösterdiğimiz bu makalede, Feminist teologların iddia ettiği gibi Yahudilik ve Hıristiyanlık dinlerinin erkeklerin tekelinde olup/olmadığı, bu konuda ataerkil zihniyetin baskınlığı iddiası, din dilinin daima (...) erkekler tarafından kullanıldığı gibi meseleler incelenmiş, bu sorulara yanıtlar aranmıştır. Bunun yanı sıra cinsiyet rolleri konusunda farklı öğretilerin mevcudiyeti, günümüzde birçok toplumda kadın-erkek rollerinin eşitliği üzerine odaklanan tartışmalar, Yahudilik ve Hıristiyanlığın kadın ve erkek rollerine geliştirdiği tanımlar üzerinde durulmuştur. Bu perspektifte Feminist teoloji, genellikle dini metinlerin cinsiyetle ilişkilendirilmesi, kadının da teolojik alanda söz sahibi olmasını vurgulamaktadır. Feminist teoloji, bu düşüncenin Yahudilik ve Hıristiyanlıkta var olduğu savını, eril Tanrı anlayışına ve erkek egemen zihniyetine getirdiği birtakım argümanlarla eleştirmektedir. Feminist teolojinin amacı özellikle de teolojik alanda kadınlar için oluşturulmuş genellemeleri ortadan kaldırmaktır. Ayrıca Feminist teoloji, kadınların da erkekler gibi teolojik alanda söz sahibi olduklarını ortaya koyma düşüncesindedir. Feminist teoloji, cinsiyet konularını dini alanda inceleyen ve eleştiren bir tür disiplindir. Bu disiplin, geleneksel olarak eril bir bakış açısıyla yorumlanmış olan dini metinleri ve uygulamaları yeniden ele alarak bir eleştiriye tâbi tutmaktadır. Feminist teologlar, çağlar boyu, nesilden nesile aktarılan teolojik öğretilerin tek bir cinse isnat edilmesini eleştirmektedir. Feminist teolojinin amacı, dini deneyimi ve inancı cinsiyet eşitliği ve adaleti temel alarak yeniden şekillendirmektir. Bu disiplin, geleneksel olarak erkek egemen olarak kabul edilen dini doktrinleri, metinleri ve uygulamaları eleştirel bir bakış açısıyla değerlendirmektedir. Bu bağlamda mevcut uygulamaların değişmesini temenni etmektedir. Dinin cinsiyet alanında önemli bir role sahip olan feminist teoloji, daha adil ve eşitlikçi bir yapıya doğru ilerlemeye katkı sağlamakta ve kadınların dini alanda daha fazla görünürlük ve etki alanı elde etmelerini desteklemektedir. Cinsiyet ve dini konular arasındaki ilişkileri daha derinlemesine anlamak ve toplumda daha adil bir yapı oluşturmak için önemli bir katkı sağlamaktadır. Bu makalede de Feminist teolojinin ele aldığı sorunlar, bunların çözümleri ve Eril tanrı anlayışına yönelik eleştirileri ele alınacaktır. (shrink)

Philosophers and psychologists have advanced a plethora of explanations of the self in relation to narratives, positing varying degrees of connection between them. For some, narratives created by a subject about herself shape her self-constitution (Flanagan 1991; Fivush 1994). For others, they help the subject to participate in social cognition (Hutto 2008). Some represent narratives as merely one basis of personal identity and consider them cognitive tools used by the subject to construct self-concepts (Neisser 1997; Tekin 2011); others render narratives (...) the basis for self-constitution (Dennett 1992; MacIntyre 1981; Schechtman 1996). Some require that the subject create her ‘whole life narrative’ unifying her .. (shrink)

, Looping Effects, the Self, Psychopathology.

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout (...) Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine. (shrink)

Background Several ethical issues are associated with providing living organ transplantation services, and there is limited information on these issues faced by the teams providing service to refugees or asylum seekers. Aim To determine the challenges healthcare professionals face in organ transplant centers providing services to Syrians under temporary protection status and discern whether these difficulties align with ethical issues in living organ transplantation. Research design This study employed a qualitative design and conducted individual semi-structured, in-depth interviews with 18 transplant (...) team members in Istanbul between September and November 2022. Data analysis was based on Braun and Clarke’s thematic analysis. Participants and research context The participants comprised 18 healthcare professionals, including 6 physicians and 12 nurses working in organ transplant teams in Istanbul. Ethical considerations The University’s Ethics Committee provided approval. Participants were informed regarding confidentiality and signed an informed consent form. Results Three themes emerged from the data on ethical issues faced by organ transplantation services to Syrians: (a) beneficence or double equipoise, (b) autonomy, and (c) justice. Transplant teams experience problems related to preserving double equipoise in the provision of living donor organ transplantation because of language barriers, poor socioeconomic conditions, and cultural factors, which increases transplant teams’ individual and indirect social burden. Although problems arise from the language barrier when obtaining informed consent in the autonomy theme, institutional and national policies in preventing donor abuse have a comforting effect. Health workers had the least problems with the justice theme, wherein national health policies are determined. Conclusion Fewer issues related to autonomy and justice were reported in providing organ transplantation services to Syrians, with the most intense reported issues being maintaining double equipoise. The results revealed the need to develop institutional, national, and international policies with individual solutions to prevent difficulties healthcare professionals face in this process. (shrink)

Sadrüşşerîa’nın (ö. 747/1346) Fahreddin er-Râzî’nin (ö. 606/1210) insanın ihtiyârî fiillerini nefyettiği argümanını çü- rütmeye çalıştığı ve Hanefî-Mâtürîdî geleneğin bu husustaki prensiplerini nazarî bir dille yeniden temellendirdiği dört mu- kaddimesi (mukaddimât-ı erba‘) ile Mehmed Birgivî’nin (ö. 981/1573) bu mukaddimeler üzerinden geliştirdiği açıklamaları, diyar-ı Rum’daki düşünürlerin insan fiilleri ve cüz’î iradeye dair tartışmalarına yön vermiştir. On yedinci yüzyılda Hicaz topraklarında faaliyet gösterip Eş‘arî-Ekberî geleneği merkeze alarak ihtiyârî fiillere dair yazdığı eserleriyle bu geleneğin nispeten güçlü olduğu Hicaz, Şam ve Kuzey Afrika’da etki uyandıran (...) İbrâhîm el-Kûrânî (ö. 1101/1690), Hanefî-Mâtürîdî gelenekte Sadrüşşerîa ve Birgivî’nin görüşleri etrafında cereyan eden tartışmalara da bigâne kalmamış, bu âlimlerin me- tinlerini merkeze alarak kaleme aldığı Cilâü’l-enzâr risalesiyle o zamana kadar dolaylı ve nispeten zayıf irtibatının olduğu diyar-ı Rum havzasındaki tartışmalara dahil olmuştur. Kûrânî, bu eserle yaşadığı dönemdeki hâkim Hanefî-Mâtürîdî gele- neğe yönelik eleştiri ve değerlendirmelerde bulunmuş, bu çerçevede insanın sorumluluğunun cüz’î irade ve îkâ üzerinden ispatlanıp ispatlanamayacağı, hallerin yaratmaya konu olup olmadığı ve iradenin tercihinde bir sebebe bağlı olup olmadığı gibi belli meseleleri ele almıştır. Ayrıca mutlak hürriyet (tefvîz) ile mutlak zorunluluk (cebr) arasındaki orta yolun nasıl tesis edileceği konusuna da yoğunlaşmıştır. Kûrânî’nin diğer ilim havzalarıyla kurduğu irtibatlarda olduğu gibi Hanefî-Mâtürîdî geleneğin eleştirisi üzerinden diyar-ı Rum ile kurduğu ilişkinin aynı zamanda kendisinin eğilim ve mezhepleri uzlaştıran fikirlerine alan açmaya matuf olduğunu iddia eden bu çalışma, zikri geçen risalede yer verilen eleştiri ile değerlendirmelerin ortaya çıkarılmasını ve bunun tarihî-fikrî bağlamına yerleştirilmesini amaçlamaktadır. (shrink)

In “Mad Narratives: Self-Constitutions Through the Diagnostic Looking Glass,” by using narrative approaches to the self, I explore how the diagnosis of mental disorder shapes personal identities and influences flourishing. My particular focus is the diagnosis grounded on the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM). I develop two connected accounts pertaining to the self and mental disorder. I use the memoirs and personal stories written by the subjects with a DSM diagnosis as illustrations to bolster (...) my claims. First, expanding on the narrative approaches to the self, I explain how narratives about a subject shape her self-constitution. I elucidate how this process is generated by drawing on research in developmental psychology, cognitive science, and social psychology. Next, using this account as a springboard, I argue that the DSM diagnosis of mental disorder serves as a source of narrative, entering into the patients’ autobiographical and social narratives. This plays an important role in the diagnosed subjects’ self-understanding, self-constitution and flourishing. In this vein, how mental disorders are classified is not only a theoretical question about accurately taxonomizing the various experiences related to mental distress but also an ethical question about which ways of talking about mental disorders will allow subjects to respond effectively to their psychological distress, to flourish and to live autonomous and fulfilling lives. Finally, I suggest that the DSM-based narratives wield a double-edged sword when it comes to the subject’s flourishing: On the one hand, there are problems with some DSM-based narratives that stem from the DSM diagnostic schema and the culture of DSM diagnoses. These problems render these DSM-based narratives unbeneficial for flourishing as they constrain the range of adoptive social, cognitive and emotional responses the subjects can give to their mental disorders. On the other hand, there are grounds to believe that some DSM-based narratives help subjects to flourish. For instance, they provide certainty to subjects' otherwise puzzling symptoms and help them reach out to others with similar experiences. Understanding how the DSM-based narratives can both benefit and harm will help us address problems with psychiatric diagnoses and the dissemination of knowledge about mental disorders in popular culture. The project aims to convince both philosophers and psychiatrists that no plausible theory of the self can be developed without attending to the topic of mental disorder and that no theory of mental disorder can be complete without devising the tools provided by the philosophical approaches to the self as well as developmental and social psychology. It also calls for methodological alterations in mental health ethics research, arguing that a careful scrutiny of mental disorder memoirs can advance the ethical underpinnings to the practice of psychiatry. (shrink)

Words we use to characterize mental states matter; they affect, for better or worse, the individual whose mental states are in question. For example, referring to a child whose behavior seems a bit...

1. Imagine the following hypothetical scenario: Sarah is often called an expert on depression: after all, she graduated from medical school and has a PhD in neuroscience. She knows all theories of...

The aim of this study was to assess the opinions and role of intensive care unit (ICU) nurses regarding the distribution of ICU beds. We conducted this research among 30% of the attendees at two ICU congresses in Turkey. A self-administered questionnaire was used, which included 13 cases and allocation criteria. Of the total (136 nurses), 53.7% participated in admission/discharge decisions. The most important criterion was quality of life as viewed by the physician; the least important was the patient’s social (...) status. According to the findings, the nurses thought that medical benefit and avoiding discrimination were important. On the other hand their ignorance of patients’ autonomous preferences arouses suspicions about these nurses’ role in advocating for patients’ rights. For this reason, nurses’ role in allocation decisions should be clearly described and should also be the basis on which intensive care nurses’ duties in allocation decisions should be determined. (shrink)

When considering the principle of medical confidentiality, disclosure of genetic information constitutes a special case because of the impact that this information can have on the health and the lives of relatives. The aim of this study is to explore the attitudes of Turkish physicians and patients about sharing information obtained from genetic tests.

Background Undergraduate medical education is beginning to concern itself with educating students about professional attributes as well as about clinical knowledge and skills. Defining these characteristics, and in particular seeking the help of the students themselves to define them, can be a useful starting point when considering how to incorporate aspects of professional behaviour into the medical curricula. Method This study explores the views of first-year medical students at Kocaeli University Faculty of Medicine in the 2007–8 academic year. The students (...) were asked the open-ended question: ‘What, in your opinion, are the attributes a good physician should have?’ Four topics were defined by researchers based on the undergraduate and graduate education projects. The attributes expressed by the students were evaluated by the researchers according to these topics and compared with the topics covered in the undergraduate and graduate education projects. Results A total of 127 students responded, and between them suggested 756 attributes. The majority of these attributes (54.6%) were concerned with interpersonal relations and communication, whereas the category representing the fewest attributes (12.3%) was that involving scientific knowledge and medical practice. In general, students' perception corresponded to the concept of the ‘competent physician’ as described in the professionalism projects, but attributes reflecting their world-view were also expressed. Conclusion Experience suggests that the active participation of students in determining which attributes are necessary for a good physician is a positive way of ensuring they embrace the importance of such qualities and attributes in themselves. (shrink)

Hayata gözlerini açan insanoğlu, kendisini bir dinî geleneğin ve kültürün içerisinde bulur. Dinî sözler ve telkinlerle karşılaşır, dinî nesne ve mekânları müşahede eder, dindar kimselerle görüşür ve onlarla iletişim içerisinde hayatını sürdürür. Din hakkında ailesinden, çevresinden çeşitli bilgiler öğrenir; dinî ibadetlerini yerine getiren insanları görür ve zaman zaman bu ibadetlere kendisi de katılır. Sorular sorar, araştırmalar yapar, dinî söz ve kavramları kullanmaya yönelir. Çocukluk dönemi, yetişkinlik dönemi dinî inanç, tutum ve davranışlarının oluşmasında başka bir deyişle dinî kimliği inşasında önemli etkiye (...) sahiptir. Bu çalışma kapsamında bireysel ve kolektif dinî kimliğin kökenleri, çocukluktan yetişkinliğe kadar olan dinî deneyimler ve kültürel bağlamlar incelenmiştir. Böylece, katılımcıların dinî anlatılar ve geleneklerden edindiği referans çerçevelerini anlamlandırarak dinî kimliklerini nasıl inşa ettikleri araştırılma yoluna gidilmiştir. Bu bağlamda dinî kimliğin inşasını şekillendiren ve tanımlamaya yardımcı olan faktörler teorik ve alan araştırması olmak üzere iki boyutta analiz edilmiştir. 2021-2022 yılları arasında Kahramanmaraş’ta ikamet eden 25-75 yaş arasında 60 katılımcı ile görüşülmüştür. Çalışmada yetişkin dindar bireylerin dinî kimliklerini nasıl inşa ettikleri ile ilgili elde edilen bulguların analizi nitel veri toplama yöntemlerinden fenomenolojik desen kullanılarak gerçekleştirilmiştir. Çalışmada fenomenolojik desenle özdeşleşmiş olan amaçlı örneklem yöntemi ile katılımcılar seçilmiş, 5 ana kategori ve 13 alt kategori için ayrı ayrı hazırlanmış yarı yapılandırılmış sorularla 40-160 dakika arasında yüz yüze derinlemesine görüşmeler yapılmıştır. Elde edilen veriler MAXQDA 12 paket programı ile analiz edilmiş ve kategoriler oluşturulmuştur. Bu noktada araştırmamızda Bir insanın dinî kimliğinin şekillenmesinde ve sürdürülmesinde etkili olan faktörler nelerdir? sorusuna araştırma bulguları çerçevesinde cevap aranmaktadır. Rol kuramının temel yaklaşımlarından hareket eden çalışma sonucunda elde edilen bulgulardan hareketle bireyin dini kimliğini inşasında “aile” faktörünün önemli olduğu gözlemlenmiştir. Dinî kimliğin şekillenmesinde aile üyelerinden etkili olanlar anne-baba olmasının yanında bazı katılımcıların üzerinde ailenin diğer büyüklerinden büyük-anne, büyük-baba gibi aile fertlerinin de etkisi olduğu gözlemlenmiştir. Bunun yanı sıra ailenin veya çevrenin yönlendirmesi ile gidilen okul ve kursların, tanışılan din görevlisi ve dini grupların, takip edilen medya programlarının aileden sonra bireyin dinî kimliği inşasını etkileyen faktörler olduğu tespit edilmiştir. Çalışmada aynı zamanda dinî metinlerin ve folklorik öğelerin, bireyin yaşantısında sembolik olarak yansıtılan kılık kıyafet tarzı, yeme içme gibi seçimlerin yapılmasında, dinî emirlerinin ve ahlâkî ilkelerin uygulanmasında kısacası dinî kimliğinin inşasında kalıp roller sağladığı tespit edilmiştir. (shrink)

The work named Fusûlü'l-İmadî, which belongs to Ebü'l-Feth Zeynüddîn el-İmadî, the grandson of Burhaneddin el-Mergînânî, the owner of the famous Hidaye, which includes the subjects of Fürû-i Fiqh and the law of trial, has been one of the main works that has been applied by influencing many mufti, kadi and jurists, especially the Ottoman sheikhs. The work is also important in terms of being a source for many fatawa and fürû-i fiqh works. The fact that the work written in the (...) Fergana region is one of the main sources referenced both in the Ottoman geography and in other Muslim geographies also shows that the work is valuable. In this study, by pointing out the importance and value of the work, it was tried to determine the contribution of the work to the Ottoman period fetâvâ mecmuas and Hanafi fiqh literature. In the study, the life of Ebü'l-Feth Zeynüddîn el-İmadî was mentioned, and his work Fusûlü'l-İmadî was examined in detail. The contribution of the Ottoman Fetvâhâne, which uses Fusûlü'l-İmadî as a source, to some of the fetâva works, which are accepted as one of the most respected fetâva journals, is discussed and some quotations from the work are included with their examples. In addition, the contribution of the work to the Hanafi fiqh literature was examined on the basis of some fürû-i fiqh works of the Ottoman period and the work called Mir'ât-ı Mecelle. Thus, by pointing out the importance of Fusûlü'l-İmadî and his contribution to the literature of fiqh and fatwa, this work was drawn attention to new studies. (shrink)