The Mental Capacity Act (2005) was designed to protect and empower patients with impaired capacity. Despite an estimated 40% of medical inpatients lacking capacity, it is unclear how many patients undergo capacity assessments and treatment under the Act. We audited the number of capacity assessments on the general medical wards of an English-teaching hospital. A total of 95 sets of case notes were reviewed: the mean age was 78.6 years, 57 were female. The most common presenting complaints were feeling ‘unwell’ (...) (n = 25) and confusion (n = 24). In all, 52 patients had conditions, such as delirium (n = 26) and dementia (n = 15), which often impair capacity. Capacity was assessed in seven (7.4%) patients, all of whom disagreed with the medical team about their treatment. The number of documented assessments fell short of the estimated rate of incapacity, suggesting that some means of improving capacity assessment in busy medical environments is required. (shrink)

How does microbiota research impact our understanding of biological individuality? We summarize the interdisciplinary summer school on "Microbiota, Symbiosis and Individuality: Conceptual and Philosophical Issues" (July 2019), which was supported by a European Research Council starting grant project "Immunity, DEvelopment, and the Microbiota" (IDEM). The summer school centered around interdisciplinary group work on four facets of microbiota research: holobionts, individuality, causation, and human health. The conceptual discussion of cutting-edge empirical research provided new insights into microbiota and highlights the value of (...) incorporating into meetings experts from other disciplines, such as philosophy and history of science. (shrink)

Alice Dunbar-Nelson is mostly remembered as a poet, activist, and ex-wife of Paul Laurence Dunbar. Her volume The Goodness of St. Rocque and Other Stories (1899) has been largely overshadowed as a result. Yet, the collection contains a portfolio of heroines analogous and contemporaneous to the famed New Woman figure of the fin de siècle. In this article, I consider Dunbar-Nelson’s heroines in light of their New Woman-esque agency and autonomy as they find remedies and power in objects and materials (...) steeped in New Orleans’s cultural heritage. Ceded neither social nor political self-governance nor domestic comfort, this article reads these transcendental, metaphysical objects as sources of self-care. With close analysis of “The Goodness of St. Rocque,” “Tony’s Wife,” and “Little Miss Sophie,” I argue that Dunbar-Nelson’s protagonists exert influence over their lives, specifically in the negotiation of romantic relationships, through voodoo charms, Catholic candles, tarot cards, sewing machines, and knitting needles. Covering courtship, break-ups, and unhappy marriages, I demonstrate the ways in which these empowering spiritual objects respond to health concerns, including malnutrition and domestic violence, in turn, situating them as alternatives to patriarchal and historically racist medical institutions. Valorizing the cultural milieu of New Orleans and the customs of the Caribbean and European heritage, and thereby conveying Dunbar-Nelson’s resistance to white and male supremacist ideologies in late-nineteenth-century Southern America, the article ultimately assesses the parallels with (predominantly white) New Woman fiction, through shared themes of fraught heterosexual dynamics and women’s declining health. (shrink)

Digital mental health can be understood as the in situ quantification of an individual’s data from personal devices to measure human behavior in both health and disease (Huckvale, Venkatesh and Chr...

Models of global governance abound: expert governance, networked governance, algorithmic governance, and old-fashioned juridico-political governance vie for explanatory power. This article takes up style as a way of analysing configurations of governance that do not readily fit a particular model of governance. Style is particularly revealing when it comes to deliberately unspecified or over-specified, genre-busting, and bet-hedging ways of imagining governance. The UN’s use of the phrase ‘convening power’ is a case in point. This article looks at how the UN (...) has styled itself as a convening power in the area of counter-terrorism governance. A visual analysis of promotional materials for the UN’s Counter-Terrorism Week suggests that the UN’s self-styling as a convening power is shaped by anxieties as well as aspirations. (shrink)

What does the unofficial artist see from the public seats of a courtroom? I have drawn occasionally in the UK Supreme Court, with the court’s permission. I have also drawn proceedings in other courts, such as nude appearances of the Naked Rambler, but these sketches have to be from memory: despite calls for greater transparency, it is still illegal to draw in any UK court below the UK Supreme Court. Official court artists seek to draw a newsworthy moment to please (...) their paymasters—news outlets, or lawyers who like a flattering image. I can please myself and pick out private human moments or elements of coded theatre. I write as a non-lawyer, representing the view of the lay person. What are the public, lawyers, parties and judges doing? How do performance nerves affect people? What can a drawing say? I take a practical rather than a theoretical look: I literally get my hands dirty. (shrink)

In stark opposition to this anti-aesthetic project, Isobel Armstrong evolves a new poetics, forging an alternative aesthetic discourse by remaking its ...

In 1847, Johanne Luise Heiberg, a thirty-year old Danish actress and friend of Søren Kierkegaard, performed the role of Juliet in Shakespeare’s Romeo and Juliet in the Copenhagen theatre. She had played Juliet once before, aged 16, and it was this first performance which helped to launch her prestigious career. The 1847 performance prompted Kierkegaard to write an article for the newspaper Fædrelandet , called 'The Crisis and a Crisis in the Life of an Actress' under the name of Inter (...) et Inter. Its publication contradicted Kierkegaard’s resolve to cease his literary authorship and to write directly under his own name as a religious author. This essay shows what was at stake for Kierkegaard in publishing 'The Crisis and a Crisis in the Life of an Actress' and its pivotal status for him both as a writer and a Christian. Both ‘crises’ of the title refer to a metamorphosis as a return to ‘the beginning’ effected through a series of elliptical characters: the actress, Juliet, Inter et Inter, Kierkegaard himself and the reader. Kierkegaard’s commentary on Frau Heiberg’s performance of Juliet brings together categories of repetition and anxiety in order to understand how “the metamorphosis of the actress” is effected as a return to the 'beginning', mirroring Kierkegaard's own transition from 'literary' to 'religious' writer and ultimately reflecting back on the reader’s own condition as existing individual. (shrink)

Social workers form part of many healthcare teams. This role can involve in-depth conversations with clients and home visits. These encounters can reveal sensitive information, not all of which may be accessible to other members of the healthcare team. Most modern healthcare systems employ shared care records, which are populated by, and accessible to, multiple members of the healthcare team. Shared care records are valued for their capacity to enhance inter-professional communication and improve patient care. But this very capacity may (...) increase an underlying tension between privacy and efficient, effective care. Ethical tensions can arise for health social workers between comprehensive documentation and protecting client privacy by limiting access to privileged information obtained in the context of a social work encounter. This qualitative empirical ethics study investigated health social workers' experiences of tensions between client privacy and maintaining complete records, and how they thought the tension should be resolved. Participant testimony informed a pragmatist approach to identify principles governing recording of sensitive information in shared care records. Three principles were identified: necessity, accuracy, and neutrality. Participants' reports of moral concerns about recording indicate that ethical tensions can occur. The identified principles offer a starting point for managing such tensions. (shrink)

This lecture argues that new optical experiences created by the lens and what we now call the virtual image were the foundation alike of ‘high’ science, associated at this historical moment with the telescope, and popular spectacle. They precipitated and renewed an enquiry into the nature and status of the image as the technologies of the phantasmagoria, the kaleidoscope and the diorama penetrated deep into the poets' worlds and words. The projected image, without a correspondence in reality, was a troubling (...) aspect of this modern technology, provoking new understandings of materiality and immateriality. Colour, reflection and refraction became central concerns as a corollary of the debate. Some poets assimilated this imagery into their work, albeit skeptically. Others violently resisted it. The lecture looks closely at image-making in poetic language, and argues that there were both ontological and political stakes in this enquiry. (shrink)

The majority of biomedical and biological research relies on a few molecular biology techniques. Here we show that eight key molecular biology techniques would not exist without basic biological research.We also find that the scientific reward system does not sufficiently value basic biological research into molecular mechanisms.

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

This paper takes James David Forbes’ Encyclopaedia Britannica entry, Dissertation Sixth, as a lens to examine physics as a cognitive, practical, and social enterprise. Forbes wrote this survey of eighteenth- and nineteenth-century mathematical and physical sciences between 1852 and 1856, when British “physics” was at a pivotal point in its history, situated between a field identified by its mathematical methods – originating in France – and a discipline identified by its university laboratory institutions. Contemporary encyclopedias provided a nexus for publishers, (...) the book trade, readers, and men of science in the formation of physics as a field. Forbes was both a witness, whose account of the progress of physics or natural philosophy can be explored at face value, and an agent, who exploited the opportunity offered by the Encyclopaedia Britannica in the mid nineteenth century to enroll the broadly educated public and scientific collective, illuminating the connection between the definition of physics and its forms of social practice. Forbes used the terms “physics” and “natural philosophy” interchangeably. He portrayed the field as progressed by the natural genius of great men who curated it within an associational culture that engendered true intellectual spirit. Although this societal mechanism was becoming ineffective, Forbes did not see university institutions as the way forward. Instead, running counter to his friend William Whewell, he advocated inclusion of the mechanical arts, and a strictly limited role for mathematics. He revealed tensions when the widely accepted discovery-based historiography conflicted with intellectual and moral worth, reflecting a nineteenth-century concern with spirit that cuts across twentieth-century questions about discipline and field. (shrink)

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We welcome Ballantyne & Schaefer’s discussion of the issues concerning consent and use of health data for research. In response to their acknowledgement of the need for public debate and discussion, we provide evidence from our own public consultation on this topic.

The influence of Ibn 'Arabi, the 12th century Andalusian mystic philosopher extended beyond the Muslim world from Spain, to China, to Indonesia. Interest in Ibn 'Arabi in the west has grown over the last century. Ibn Arabi and the Contemporary West examines 'Arabi's teachings through the work of the Beshara Trust and the Muhyiddin Ibn 'Arabi Society. The study investigates how the Beshara School has used Ibn 'Arabi's teachings in assisting a range of students from around the world towards personal, (...) spiritual development and how the Muhyiddin Ibn 'Arabi Society has evolved into an international organisation with increasing influence in both the West and the Muslim world. (shrink)

This paper reports a psychological study of human categorization that looked at the procedures used by expert scientists when dealing with puzzling items. Five professional botanists were asked to specify a category from a set of positive and negative instances. The target category in the study was defined by a feature that was unusual, hence situations of uncertainty and puzzlement were generated. Subjects were asked to think aloud while solving the tasks, and their verbal reports were analyzed. A number of (...) problem solving strategies were identified, and subsequently integrated in a model of knowledge‐guided inductive categorization. Our model proposes that expert knowledge influences the subjects' reasoning in more complex ways than suggested by earlier investigations of scientific reasoning. As in previous studies, domain knowledge influenced our subjects' hypothesis generation and testing; but, additionally, it played a central role when subjects revised their hypotheses. (shrink)

Ennead I. 4. 3: Plotinus is arguing that happiness is fullness and completeness of life, and continues, according to the MSS. , οϋτω γρ ν οùδέ έπακτòν τò γαθòν ύπάρΧοι, ούδ' λλο τò ύποκείμενον άλλαΧόθεν γενόμενον παρέξει αύτò ν άγαθεναι. Mr. MacKenna translates the last phrase by ‘a life needing no foreign substance called in from a foreign realm to establish it in good ’; Ficinus by ‘neque aliud quicquam aliunde adueniens efficiet ut subiectum collocetur in bono.’ Ficinus is undoubtedly (...) right. τò ύποκειμέν means ‘the subject,’ which a few lines above has been identified with the λογικ ζωή. The passage should be corrected by writing τ, ύποκειμέν, dependent on γενόμενον, for τò úποκείμενον. (shrink)