This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

Introduction.--Aristotle.--The seventeenth century.--The eighteenth century.--Biology.--Nature.--Evolution.--The problem.--The three elements.--The teleological order.--Appendix: Clerk Maxwell on determinism and free will. Fechner on the tendency to stability.

Background: Neurotypical young adults show task-based modulation and stability of their eye movements across tasks. This study aimed to determine whether persons with aphasia (PWA) modulate their eye movements and show stability across tasks similarly to control participants. Methods: Forty-eight PWA and age-matched control participants completed four eye-tracking tasks: scene search, scene memorization, text-reading, and pseudo-reading. Results: Main effects of task emerged for mean fixation duration, saccade amplitude, and standard deviations of each, demonstrating task-based modulation of eye movements. Group by (...) task interactions indicated that PWA produced shorter fixations relative to controls. This effect was most pronounced for scene memorization and for individuals who recently suffered a stroke. PWA produced longer fixations, shorter saccades, and less variable eye movements in reading tasks compared to controls. Three-way interactions of group, aphasia subtype, and task also emerged. Text-reading and scene memorization were particularly effective at distinguishing aphasia subtype. Persons with anomic aphasia showed a reduction in reading saccade amplitudes relative to their respective control group and other PWA. Persons with conduction/Wernicke’s aphasia produced shorter scene memorization fixations relative to controls or PWA of other subtypes, suggesting a memorization specific effect. Positive correlations across most tasks emerged for fixation duration and did not significantly differ between controls and PWA. Conclusions: PWA generally produced shorter fixations and smaller saccades relative to controls particularly in scene memorization and text-reading respectively. The effect was most pronounced recently after a stroke. Selectively in reading tasks, PWA produced longer fixations and shorter saccades relative to controls, consistent with reading difficulty. PWA showed task-based modulation of eye movements, though the pattern of results was somewhat abnormal relative to controls. All subtypes of PWA also demonstrated task-based modulation of eye movements. However, persons with anomic aphasia showed reduced modulation of saccade amplitude and smaller reading saccades, possibly to improve reading comprehension. Controls and PWA generally produced stabile fixation durations across tasks and did not differ in their relationship across tasks. Overall, these results suggest there is potential to differentiate among PWA with varying subtypes and from controls using eye movement measures of task-based modulation, especially reading and scene memorization tasks. (shrink)

The basic principles of scientific research from the great French physiologist whose contributions in the 19th century included the discovery of vasomotor nerves; nature of curare and other poisons in human body; more.

The seventh edition of this pragmatic guide to determining right and wrong in the workplace is updated with new case studies and ancillary materials to combine stakeholder perspectives with a deep dive on workplace ethics issues. Using a unique stakeholder-based approach, this book takes business ethics out of the theory realm and provides practical ways to analyze any business decision. Including dozens of cases, Joseph Weiss looks beyond the impacts of ethical lapses on share price and profit to focus (...) on relationships between stakeholders, including individuals, groups, corporations, and governments. The new seventh edition includes seven new cases and ten new Point/Counterpoint exercises, which challenge students to argue both sides of a contemporary issue. It incorporates the latest research as well as updated cases dealing with recent scandals at organizations such as Boeing, Facebook, and Uber. Professors will have access to online support, including teaching notes, PowerPoint slides, and sample tests. The book is equipped with a step-by-step guide to implementing stakeholder analysis, tips to help students apply ethical principles in their personal and professional lives, and comprehensive coverage of employee workplace issues. Addressing relevant topics such as risk management, preferential hiring, and sexual harassment in conjunction with the digital divide, bribery, the environment, and more, Business Ethics, seventh edition explores ethical implications in today's increasingly interconnected global business environment. (shrink)

(2013). Life, the Unhistorical, the Suprahistorical: Nietzsche on History. International Journal of Philosophical Studies: Vol. 21, No. 1, pp. 64-91. doi: 10.1080/09672559.2012.744532.

Nietzsche was a philosopher who prided himself, in deliberate contradistinction with previous philosophers, on his ‘historical sense’. But this leaves many questions unanswered about the precise role of the historical in Nietzsche’s philosophy. Perhaps most importantly, can the conception of genealogy in Nietzsche’s later philosophy, as a revised historical method, be taken to represent his mature philosophical methodology in general? I argue, firstly, that there is considerable continuity between Nietzsche’s conceptions of history in the early essay ‘On the uses and (...) disadvantages of history for life’ and those of his later philosophy. The former can therefore be used as a resource for understanding the latter. Through a reading of the early history essay I demonstrate that Nietzsche’s conception of the historical here is intimately bound up with the notion of the ‘unhistorical’ and that it is precisely renewed access to the unhistorical which is required in order for history to be conducive to the flourishing of humanity. I go on to contend that this holds for Nietzsche’s later writings as well, and that genealogy, being purely historical, must therefore be seen as one subsidiary part of a broader philosophy in which the unhistorical will play, literally, a vital role. (shrink)

ABSTRACT:What more can be said about COVID-19 and the social determinants of health? This article describes neglected perspectives that derive from the history of social epidemiology, a field that identifies the social etiology of disease and variations in disease incidence among people differentially located in the social structure. The "discovery" of social determinants of diseases like COVID-19 is nothing new for epidemiology: debate over how to analyze structural determinants versus individual-level risk factors persisted throughout the 19th and 20th centuries. By (...) the late 20th century, research had highlighted fundamental causes of health disparities, such as social conditions and structural racism; these are structural factors, embedded in the social fabric of life. Measurement of structured inequalities within systems faces complex and challenging problems, as research aims to better account for these lived realities at different levels of analysis and as multiple factors merge to influence outcomes (revealed in intersectionality theory). At each of these intersections, there are opportunities for bioethicists to consider their ethical implications. It is imperative to understand the social and ethical roots of our present conversations about health inequalities, in order to partner intelligently with researchers on the forefront of advocating for change. (shrink)

The book combines philosophical exposition and legal analysis, and pays special attention to issues of tort law.

This book critically assesses arguments for the existence of the God of classical theism, develops an innovative account of objects’ persistence, and defends new arguments against classical theism. The authors engage the following classical theistic proofs: Aquinas’s First Way, Aquinas’s De Ente argument, and Feser’s Aristotelian, Neo-Platonic, Augustinian, Thomistic, and Rationalist proofs. The authors also provide the first systematic treatment of the ‘existential inertia thesis’. By connecting the thesis to relativity theory and recent developments in the philosophy of physics, and (...) by developing a variety of novel existential-inertia-friendly explanations of persistence, they mount a formidable new case against classical theistic proofs. Finally, they defend new arguments against classical theism based on abstract objects and changing divine knowledge. The text appeals to students, researchers, and others interested in classical theistic proofs, the existence and nature of God, and the ultimate explanations of persistence, change, and contingency. (shrink)

In recent decades, scholars have come to see 1 Corinthians as a rhetorically unified response to the problem of divisions among Corinthian believers. This essay explores the ways in which Paul presents the cross as the organizing principle that can bind together three different forms of community division: the cult of the personality ; the freedom to eat idol meat ; and economic disparities when gathered for a meal. In each case, Paul appeals implicitly or explicitly to the cross as (...) a remedy for the all-too-familiar strains on the fractured community. In the end, Paul’s countercultural message about the cross offers a word of exhortation for the American church today, as it navigates a society that shares much in common with first-century Corinth. (shrink)

The dictum ‘“ought” implies “can”’ has a status in moral philosophy in some respects like that of ‘a good player needs good co-ordination’ in talk about ball-games. Clearly, you say something important but not conclusive about proficiency in playing a ball-game when you say that it requires good co-ordination: similarly, you say something important but not conclusive about obligation when you say that it implies a certain possibility or power or ability. Each dictum is a reminder: the one about such (...) courses of physical instruction, the other about such exhortations to duty, as are worth persevering with. It would be hopeless to keep on teaching a boy the moves and tricks of rugby football if he could never co-ordinate well enough to get his eye in, so to speak. Correspondingly, it would be meaningless to recommend that someone ought to do something the specification of which involved a contradiction, and pointless to suggest that he ought to do something which, for quite general reasons, was not, and was certain to remain not, within his power. So each dictum expresses a bluff, no-nonsense wisdom which we should count on before involving ourselves in certain more detailed commitments. But probably this is as far as the comparison between the two sayings can well be taken. (shrink)

BackgroundChildhood abuse increases risk for high levels of distress in response to future stressors. Interpersonal social support is protective for health, particularly during stress, and may be particularly beneficial for individuals who experienced childhood abuse.ObjectiveInvestigate whether childhood abuse predicts levels of posttraumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic, and test whether the perceived availability of social companionship preceding the pandemic moderates this relationship.MethodsDuring Phase 1, adults (N= 120; AgeM[SD] = 19.4 [0.94]) completed a retrospective measure of childhood (...) adversity along with a measure of perceived availability of opportunities for social engagement immediately preceding the pandemic. Two weeks after the COVID-19 pandemic declaration, participants completed the Impact of Event Scale-Revised (IES-R) with respect to the pandemic. Hierarchical linear regression analyses examined the interaction between childhood abuse and the perceived availability of social companionship preceding the pandemic as a predictor of PTSD symptoms.ResultsAdjusting for covariates, the interaction between childhood abuse and perceived availability of others to engage with before the onset of the pandemic was a significant predictor of IES-hyperarousal (β = −0.19,t= −2.06,p= 0.04, ΔR2= 0.032, CI: [−0.31 to −0.01]).ConclusionLevels of perceived opportunities for social companionship before the pandemic associates with levels of hyperarousal related to the pandemic, particularly for individuals who experienced high levels of childhood abuse. More research is needed to understand how to mitigate the higher levels of distress related to the pandemic for these individuals in order to reduce risk for future psychiatric disorders. (shrink)

This essay deals with plague and plagues in renaissance and early modern Europe over the longue durée, principally from a methodological perspective. I shall combine an historiographical approach with an historical account of developing reactions to plague and in passing compare measures to cope in the early sixteenth century with reactions to the impact of the Great Pox or the Mal de Naples. I shall concentrate on southern Europe and in particular on Italy and my aim is to re-assess the (...) historiography of plague through the lens of some of the more recent Anglo-Saxon literature in this field. In the process I shall outline some of the debates within the field and end with some general methodological observations drawn from early modern Italy. (shrink)

This paper examines three medical student poems about death to explore how medical students use poetry to understand their encounters with dying patients and to discuss how these poems function as elegies in the context of medical culture.

[1] Biographie, Philosophie, Praxis -- [2] Het spel van het naamloze / naar een concept van Joseph Kosuth.

While engaging in rich discussion, Conspiracy Theories analyzes current arguments and evidence while providing real-world examples so students can contextualize and visualize the debates. Each chapter addresses important current questions, provides conceptual tools, defines important terms, and introduces the appropriate methods of analysis.

A key philosophical feature of Peter Jackson’s film interpretation of J.R.R. Tolkien’s The Lord of the Rings is its use of fantasy to inspire a “recovery” of the actual or, in other words, a reawakening to the beauty of nature and the many possible ways of living in healthier ecological relation to the world. Though none of these ways is perfectly achieved, this pluralistic view is demonstrated in the various lifeways of Hobbits, Elves, Men, and Ents. All of the positive (...) relationships embodied in the films—to trees, mountains, horses, and vegetable gardens—involve loving care and attention, receiving nourishment and livelihood without instrumentalization, or reducing nature to mere resource. The films also vividly display a variety of ugly and destructive ways of using the land to accrue power and wealth. These noxious ways, specifically because they actively destroy the lands that they use, always need more. They will thus eventually annihilate the beautiful ways of being if they are not actively resisted. Some of those who would rather be tending their own trees, gardens, or horses or even wandering in the wild forests must therefore turn their attention to struggle and resistance instead. This is a struggle full of grief, and at times even verging on despair, but it is marked by the refusal to give up hope. Indeed, what Jackson and Tolkien have to say about hope is as important in responding to the ecological crisis as anything they have to say about nature, inasmuch as they help to remind us that even in our own times, “there is still hope.”. (shrink)

We examine two competing solutions to Benardete paradoxes: causal finitism, according to which nothing can have infinitely many causes, and the unsatisfiable pair diagnosis (UPD), according to which such paradoxes are logically impossible and no metaphysical thesis need be adopted to avoid them. We argue that the UPD enjoys notable theoretical advantages over causal finitism. Causal finitists, however, have levelled two main objections to the UPD. First, they urge that the UPD requires positing a ‘mysterious force’ that prevents paradoxes from (...) arising. Since such a force is implausible, the UPD is in trouble. Second, they employ recombination or patchwork principles to argue that paradoxical situations would be possible if causal finitism were false. Since such situations are not possible, causal finitism is true, and so a substantive metaphysical thesis is needed to avoid the paradoxes. We argue that the UPD proponent can successfully respond to these objections. (shrink)