BackgroundCentral to ethically justified clinical trial design is the need for an informed consent process responsive to how potential subjects actually comprehend study participation, especially study goals, risks, and potential benefits. This will be particularly challenging when studying deep brain stimulation and whether it impedes symptom progression in Parkinson’s disease, since potential subjects will be Parkinson’s patients for whom deep brain stimulation will likely have therapeutic value in the future as their disease progresses.MethodAs part of an expanded informed consent process (...) for a pilot Phase I study of deep brain stimulation in early stage Parkinson’s disease, an ethics questionnaire composed of 13 open-ended questions was distributed to potential subjects. The questionnaire was designed to guide potential subjects in thinking about their potential participation.ResultsWhile the purpose of the study (safety and tolerability) was extensively presented during the informed consent process, in returned responses 70 percent focused on effectiveness and 91 percent included personal benefit as potential benefit from enrolling. However, 91 percent also indicated helping other Parkinson’s patients as motivation when considering whether or not to enroll.ConclusionsThis combination of responses highlights two issues to which investigators need to pay close attention in future trial designs: (1) how, and in what ways, informed consent processes reinforce potential subjects’ preconceived understandings of benefit, and (2) that potential subjects see themselves as part of a community of Parkinson’s sufferers with responsibilities extending beyond self-interest. More importantly, it invites speculation that a different paradigm for informed consent may be needed. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

Canada is six years into a new era of legalized medical assistance in dying (MAiD). The law continues to evolve, following a pattern in which Canadian courts rule that legal restrictions on eligibility for MAiD are unconstitutional and Parliament responds by gradually expanding eligibility for MAiD. The central tension underlying this dialogue between courts and government has focused on two conceptions of how to best promote and protect the interests of people who are vulnerable by virtue of intolerable and irremediable (...) suffering due to an illness, disease, or disability. Do we, as a society, have a duty to protect vulnerable people from seeking certain medical procedures that are contrary to their interests, as those are perceived by others? Or do we have a duty to uphold their rights to autonomy, including the right to make choices within a range that may be constrained by many factors, some of which may be socially unjust? This is a recurrent problem in bioethics and medical law, which we explore through the lens of how Canadian courts and Parliament have grappled with defining eligibility for MAiD. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

African American spirituality provides a rich lens into the heart and soul of the black church experience, often overlooked in the Christian spiritual formation literature. By addressing this lacuna, this essay focuses on three primary shaping qualities of history: the effects of slavery, the Civil Rights Movement under Dr. Martin Luther King's leadership, and the emergence of the Black Church. Four spiritual practices that influence African American spirituality highlight the historical and cultural context of being “forged in the fiery furnace,” (...) including worship, preaching and Scripture, the community of faith and prayer, and community outreach. The essay concludes by recognizing four areas of the lived experiences of African Americans from which the global church can glean: persevering in pain and suffering, turning to God for strength, experiencing a living and passionate faith, and affirming God's intention for freedom and justice to be afforded to every individual. (shrink)

The telos of Christian spiritual formation is to love God and to love one’s neighbor as oneself. However, racism undermines loving one’s neighbor, which weakens the Christian witness and contributes to division within American culture and the church. Unfortunately, racism is seldom viewed as a spiritual formation issue, nor is it specifically addressed as such in the spiritual formation literature. Therefore, this essay focuses on four primary areas: spiritual formation and race from a biblical perspective, including a definition of terms; (...) biblical examples of racial reconciliation; four critical periods of US history that have contributed to racial trauma and inequality; and suggested steps toward racial reconciliation. Healing collective racial wounds begins with recognizing the truth related to America’s past and requires a disposition to listen, learn, lament, repent, repair, and relate to one another. (shrink)

Edited by Marthe Chandler and Ronnie Littlejohn, this work is a collection of expository and critical essays on the work of Henry Rosemont, Jr., a prominent and influential contemporary philosopher, activist, translator, and educator in the field of Asian and Comparative Philosophy. The essays in this collection take up three major themes in Rosemont's work: his work in Chinese linguistics, his contribution to the theory of human rights, and his interest in East Asian religion. Contributions include works by the (...) leading scholars in Chinese philosophy in the Western world and Rosemont's close associates: Roger T. Ames, Bao Zhiming, Mary Bockover, Marthe Chandler, Ewing Y. Chinn, Erin M. Cline, Fred Dallmayr, Jeffrey Dippmann, Herbert Fingarette, Harrison Huang, Eric Hutton, Philip J. Ivanhoe, David Jones, William La Fleur, Ronnie Littlejohn, Ni Peimin, Michael Nylan, Harold Roth, Sumner Twiss, Tu Weiming, David Wong, with responses from Henry Rosemont, Jr. and a brief Reminiscence by Noam Chomsky. (shrink)

Preface Introduction Christopher J. Berry: Adam Smith: Outline of Life, Times, and Legacy Part One: Adam Smith: Heritage and Contemporaries 1: Nicholas Phillipson: Adam Smith: A Biographer's Reflections 2: Leonidas Montes: Newtonianism and Adam Smith 3: Dennis C. Rasmussen: Adam Smith and Rousseau: Enlightenment and counter-Enlightenment 4: Christopher J. Berry: Adam Smith and Early Modern Thought Part Two: Adam Smith on Language, Art and Culture 5: Catherine Labio: Adam Smith's Aesthetics 6: James Chandler: Adam Smith as Critic 7: Michael (...) C. Amrozowicz: Adam Smith: History and Poetics 8: C. Jan Swearingen: Adam Smith on Language and Rhetoric: The Ethics of Style, Character, and Propriety Part Three: Adam Smith and Moral Philosophy 9: Christel Fricke: Adam Smith: The Sympathetic Process and the Origin and Function of Conscience 10: Duncan Kelly: Adam Smith and the Limits of Sympathy 11: Ryan Patrick Hanley: Adam Smith and Virtue 12: Eugene Heath: Adam Smith and Self-Interest Part Four: Adam Smith and Economics 13: Tony Aspromourgos: Adam Smith on Labour and Capital 14: Nerio Naldi: Adam Smith on Value and Prices 15: Hugh Rockoff: Adam Smith on Money, Banking, and the Price Level 16: Maria Pia Paganelli: Commercial Relations: from Adam Smith to Field Experiments Part Five: Adam Smith on History and Politics 17: Spiros Tegos: Adam Smith: Theorist of Corruption 18: David M. Levy & Sandra J. Peart: Adam Smith and the State: Language and Reform 19: Fabrizio Simon: Adam Smith and the Law 20: Edwin van de Haar: Adam Smith on Empire and International Relations Part Six: Adam Smith on Social Relations 21: Richard Boyd: Adam Smith, Civility, and Civil Society 22: Gavin Kennedy: Adam Smith on Religion 23: Samuel Fleischacker: Adam Smith and Equality 24: Maureen Harkin: Adam Smith and Women Part Seven; Adam Smith: Legacy and Influence 25: Spencer J. Pack: Adam Smith and Marx 26: Craig Smith: Adam Smith and the New Right 27: Tom Campbell: Adam Smith: Methods, Morals and Markets 28: Amartya Sen: The Contemporary Relevance of Adam Smith. (shrink)

Introduction to one of the most important, controversial, and suggestive works of moral philosophy ever written.

Questions about the status of literary truth are as old as literary criticism, but they have become both more intricate and more compelling as literature has grown progressively more self-conscious and labyrinthian in its dealings with "reality." One might perhaps read The Iliad or even David Copperfield without raising such issues. But authors like Gide , Nabokov, Borges, and Robbe-Grillet seem continually to remind their readers of the complex nature of literary truth. How, for instance, are we to deal with (...) a passage like the following from William Demby's novel The Catacombs:"When I began this novel, I secretly decided that, though I would exercise a strict selection of the facts to write down, be they 'fictional' facts or 'true' facts taken from newspapers or directly observed events in my own life, once I had written something down I would neither edit not censor it ."1What does this sentence mean? When an apparently fictional narrator distinguishes between "fictional" and "true" facts, what is the status of the word "true"? It clearly does not mean the same as "fictional," for he opposes it to that term. Yet it cannot mean "true" in the sense that historians would use, for he calls what he is writing a novel, and even if he quotes accurately from newspapers, the events of a narrator's life are not "historically" true. · 1. William Demby, The Catacombs , p.93. Peter J. Rabinowitz, assistant professor at Kirkland College, is currently working on articles on Raymond Chandler, Faulkner, and Dostoyevsky and is, as well, a music critic for the Syracuse Guide. He wrote his doctoral dissertation in comparative literature on the philosophical implications of Nabokov's use of humor and terror. "Truth in Fiction" is the first article he has had published in a scholarly journal. (shrink)

Universals: Loux, M. J. The existence of universals. Russell, B. The world of universals. Quine, W. V. O. On what there is. Pears, D. F. Universals. Strawson, P. F. Particular and general. Wolterstorff, N. Qualities. Bambrough, R. Universals and family resemblances. Donagan, A. Universals and metaphysical realism. Sellars, W. Abstract entities. Wolterstorff, N. On the nature of universals.--Particulars: Loux, M. J. Particulars and their individuation. Black. M. The identity of indiscernibles. Ayer, A. J. The identity of indiscernibles. O'Connor, D. J. (...) The identity of indiscernibles. Allaire, E. B. Bare particulars. Chappell, V. C. Particulars re-clothed. Allaire, E. B. Another look at bare particulars. Meiland, J. W. Do relations individuate? Long, D. C. Particulars and their qualities. Copi, I. Essence and accident. Chandler, H. S. Essence and accident. Plantinga, A. World and essence. (shrink)

To be sure, I agree that Nabokov creates a "sense of dizzying complexity," but I don't see how Dowling accounts for it at all. First of all, the passage he cites from Pnin is not an instance of the Liar's Paradox. The Liar's Paradox occurs when a single person claims that he or she always lies—for in that case, there is no logically consistent way to call the claim either true or false. In Pnin, however, we have something quite different: (...) a person, whom we suspect of often filtering the truth to serve his own ends, claims that someone else has called him a liar. That's confusing, perhaps, but not logically inconsistent; for instance, it would be logically inconsistent to say that Pnin is wrong, or is at least exaggerating, when he says that you shouldn't believe anything that the narrator says. Indeed, Pnin is wrong, and the careful reader can sort out the narrator's claims with a fair degree of accuracy, at least on the second reading. The odd sensation that Pnin inspires comes not because there's no logically consistent way to determine the truth or falsity if the narrative but rather because we can figure out when and how the narrator has slanted his statements only once we have finished the book, for only the last chapter gives us the evidence we need to interpret the earlier chapters properly. Peter J. Rabinowitz, assistant professor of comparative literature at Hamilton College, is the author of articles on Raymond Chandler, Faulkner and Dostoyevsky, and literary borrowing and is, as well, a music critic for Fanfare. (shrink)

This comprehensive and important volume includes contributions by activists, journalists, lawyers and scholars from twenty-one countries. The essays map the directions the movement for women's rights is taking--and will take in the coming decades--and the concomittant transformation of prevailing notions of rights and issues. They address topics such as the rapes in former Yugoslavia and efforts to see that a War Crimes Tribunal responds; domestic violence; trafficking of women into the sex trade; the persecution of lesbians; female genital mutilation; and (...) reproductive rights. (shrink)

The mechanistic theory of life.--Criticism of the mechanistic theory.--Biology and the physical sciences.--Personality.

Hereditary structural completeness is established for a range of substructural logics, mainly without the weakening rule, including fragments of various relevant or many-valued logics. Also, structural completeness is disproved for a range of systems, settling some previously open questions.

The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory – providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, (...) all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence. (shrink)

The influence which the Pythagorean society and its leading doctrines exercised upon Athenian intellectual and political developments in the late fifth century leads us to seek in Pythagoras a figure of greater stature and more clear-cut features than modern scholarship is prepared to allow. To us he is a great name but little more, the large body of detailed information about his life which is available in later writers being dismissed as fabulous. This scepticism was reasonable enough when the reader (...) was faced with the garbled hotchpotch of an Iamblichus or a Porphyry. But since the task has been put in hand of determining what portions of this tradition can safely be attributed to the various authorities who concerned themselves with the Pythagorean story in the fourth century, and of considering the respective historical value of these authorities, the scepticism of, for example, Burnet's account becomes unjustified. It is now possible to present a fairly detailed account of Pythagoras' activity, which has at least as much claim to credence as a great deal of what we now readily accept as ancient history, and is furthermore consistent with the general picture of the man that emerges from a careful scrutiny of classical sources. Not only for its own sake, but in the context of the increasingly fruitful investigation of fifth-century Athenian movements, I feel that it may be useful to put together such an account of Pythagoras. It will certainly be regarded by some as mere fiction, but may nevertheless provide others with a convenient summary of what the fifth- and fourth-century writers thought and believed about a man and a movement that had profound influence upon their times. I hope at the same time to suggest some links between what Pythagoras thought and did and the main tradition of Greek social behaviour. If Pythagoras was, as I believe, not so much an innovator as a reformer and developer of some of the central institutions of Greek life, the possibility will be opened of regarding various phenomena in mainland Greece which we have been asked to call Pythagorean, e.g. the Socratic phrontisterion as it appears in the Clouds, not as deriving from Pythagoras but as a parallel growth to the Pythagorean synedria and nourished by the same root. (shrink)