Background Self-binding directives (SBDs) are psychiatric advance directives that include the possibility for service users to consent in advance to compulsory care in future mental health crises. Legal provisions for SBDs exist in the Netherlands since 2008 and were updated in 2020. While ethicists and legal scholars have identified several benefits and risks of SBDs, few data on stakeholder perspectives on SBDs are available. Aims The aim of the study was to identify opportunities and challenges of SBDs perceived by stakeholders (...) who have personal or professional experience with legally enforceable SBDs. Methods Data collection was carried out in the Netherlands from February 2020 to October 2021 by means of semi-structured interviews. Participants were selected through purposive sampling and snowball methods. Interviews were conducted with mental health service users (n = 7), professionals (n = 13), and an expert on SBD policy (n = 1), resulting in a total number of 21 interviews. The data were analyzed thematically. Results Perceived benefits of SBDs included increased autonomy, improvement of the therapeutic relationship, possibility of early intervention and prevention of harm, prevention of compulsory care, reduction of the duration of compulsory care and recovery, mitigation of negative experiences around compulsory care, and guidance for professionals in providing compulsory care. Perceived risks included infeasibility of SBD instructions, difficulty in decision-making around SBD activation, limited accessibility of SBDs, disappointment of service users due to non-compliance with SBDs, and limited evaluation and updating of SBD content. Barriers to SBD completion included lack of knowledge of SBDs among professionals, lack of motivation or insight among service users, and lack of professional support for SBD completion. Facilitators of SBD completion and activation included support for SBD completion, involvement of relatives and peer experts, specification of SBD content, and evaluation of compulsory care and SBD content. The new legal framework was regarded as having both positive and negative effects on SBD implementation. Conclusions Stakeholders who have personal or professional experience with legally enforceable SBDs perceive SBDs as having important benefits and tend not to articulate the fundamental ethical concerns about SBDs which can be found in the ethics and legal literature. Instead, they perceive ethical and practical challenges that can be addressed through the implementation of suitable safeguards. (shrink)

Approximately three decades ago the question was first answered whether parasitoids are able to assess the number or origin of eggs in a host for a solitary parasitoid, Leptopilina heterotoma, by fitting theoretically derived distributions to empirical ones. We extend the set of different theoretically postulated distributions of eggs among hosts by combining searching modes and abilities in assessing host quality. In the models, parasitoids search either randomly (Poisson) (1) or by vibrotaxis (Negative Binomial) (2). Parasitoids are: (a) assumed to (...) treat all hosts equally, (b) able to distinguish them in unparasitised and parasitised hosts only, (c) able to distinguish them by the number of eggs they contained, or (d) able to recognise their own eggs. Mathematically tractable combinations of searching mode (1 and 2) and abilities (a,b,c,d) result in seven different models (M1a, M1b, M1c, M1d, M2a, M2b and M2c). These models have been simulated for a varying number of searching parasitoids and various mean numbers of eggs per host. Each resulting distribution is fitted to all theoretical models. The model with the minimum Akaike's information criterion (AIC) is chosen as the best fitting for each simulated distribution. We thus investigate the power of the AIC and for each distribution with a specified mean number of eggs per host we derive a frequency distribution for classification.Firstly, we discuss the simulations of models including random search (M1a, M1b, M1c and M1d). For M1a, M1c and M1d the simulated distributions are correctly classified in at least 70% of all cases. However, in a few cases model M1b is only properly classified for intermediate mean values of eggs per host. The models including vibrotaxis as searching behaviour (M2a, M2b and M2c) cannot be distinguished from those with random search if the mean number of eggs per host is low. Among the models incorporating vibrotaxis the three abilities are detected analogously as in models with random search. (shrink)

Spatial relations are central to geometrical thinking. With respect to the classical elementary geometry of Euclid’s Elements, a distinction between co-exact, or qualitative, and exact, or metric, spatial relations has recently been advanced as fundamental. We tested the universality of intuitions of these relations in a group of Senegalese and Dutch participants. Participants performed an odd-one-out task with stimuli that in all but one case display a particular spatial relation between geometric objects. As the exact/co-exact distinction is closely related to (...) Kosslyn’s categorical/coordinate distinction, a set of stimuli for testing all four types was used. Results suggest that intuitions of all spatial relations tested are universal. Yet, culture has an important effect on performance: Dutch participants outperformed Senegalese participants and stimulus layouts affect the categorical and coordinate processing in different ways for the two groups. Differences in level of education within the Senegalese participants did not affect performance. (shrink)

With technological possibilities in healthcare steadily increasing, more tools for digital cognitive rehabilitation become available. Acceptance of such technological advances is crucial for successful implementation. Therefore, we examined technology acceptance specifically for this form of rehabilitation in a sample of healthcare providers involved in cognitive rehabilitation. An adjusted version of the Technology Acceptance Model questionnaire was used, including the subscales for perceived usefulness, perceived ease of use, subjective norm, and intention to use, which all contribute to actual use of a (...) specific technology. Results indicate a generally favorable attitude toward the use of digital cognitive rehabilitation and positive responses toward the TAM constructs. Only for subjective norm, a neutral mean response was found, indicating that this could pose a potential obstacle toward implementation. Potential differences between subgroups of different age, gender, and professional background were assessed. Age and gender did not affect the attitude toward digital cognitive rehabilitation. Occupational therapists showed lower scores than healthcare psychologists and physiatrists with regard to perceived usefulness, possibly linked to a difference in operational and managerial tasks. The findings of his study stimulate further implementation of digital cognitive rehabilitation, where the role of subjective norms should be specifically considered. (shrink)

In language evolution research, the use of computational and experimental methods to investigate the emergence of structure in language is exploding. In this review, we look exclusively at work exploring the emergence of structure in speech, on both a categorical level, and a combinatorial level. We show that computational and experimental methods for investigating population-level processes can be effectively used to explore and measure the effects of learning, communication and transmission on the emergence of structure in speech. We also look (...) at work on child language acquisition as a tool for generating and validating hypotheses for the emergence of speech categories. Further, we review the effects of noise, iconicity and production effects. (shrink)

Purpose – The purpose of this paper is to develop a novel approach for the ethical analysis of data collected from an online file-sharing site known as The PirateBay. Since the creation of Napster back in the late 1990s for the sharing and distribution of MP3 files across the Internet, the entertainment industry has struggled to deal with the regulation of information sharing at large. Added to the ethical questions of censorship and distributive justice are questions related to the use (...) of data collected from such file-sharing sites for research purposes. Design/methodology/approach – The approach is based on previous work analysing the use of data from online social networking sites and involves value analysis of the collection of data throughout the data’s various life cycles. Findings – This paper highlights the difficulties faced when attempting to apply a deontological or utilitarian approach to cases like the one used here. With this in mind, the authors point to a virtue ethics approach as a way to address ethical issues related to data sharing in the face of ever-changing data gathering and sharing practices. Practical implications – This work is intended to provide a concrete approach for ethical data sharing practices in the domain of Internet security research. Originality/value – The approach presented in this paper is a novel approach combining the insights from: the embedded values concept, value-sensitive design and the approach of the embedded ethicist. (shrink)

The cognitive processing of spatial relations in Euclidean diagrams is central to the diagram-based geometric practice of Euclid's Elements. In this study, we investigate this processing through two dichotomies among spatial relations—metric vs topological and exact vs co-exact—introduced by Manders in his seminal epistemological analysis of Euclid's geometric practice. To this end, we carried out a two-part experiment where participants were asked to judge spatial relations in Euclidean diagrams in a visual half field task design. In the first part, we (...) tested whether the processing of metric vs topological relations yielded the same hemispheric specialization as the processing of coordinate vs categorical relations. In the second part, we investigated the specific performance patterns for the processing of five pairs of exact/co-exact relations, where stimuli for the co-exact relations were divided into three categories depending on their distance from the exact case. Regarding the processing of metric vs topological relations, hemispheric differences were found for only a few of the stimuli used, which may indicate that other processing mechanisms might be at play. Regarding the processing of exact vs co-exact relations, results show that the level of agreement among participants in judging co-exact relations decreases with the distance from the exact case, and this for the five pairs of exact/co-exact relations tested. The philosophical implications of these empirical findings for the epistemological analysis of Euclid's diagram-based geometric practice are spelled out and discussed. (shrink)

The Russian invasion of Ukraine on February 24, 2022, has already caused large amounts of greenhouse gas (GHG) emissions and will continue to do so for manyyears after hostilities have ceased mainly because of the emissions linked to the rebuilding of destroyed or damaged housing, public buildings, infrastructure, factories, and the like. My aim in this paper is to discuss how in a time of climate emergency such emissions of war should impact the political morality of states initiating, continuing, and (...) ending war (through a just and enduring peace) as understood by just war theory (JWT). My point of departure is a study by Lennard de Klerk and six co-authors detailing the emissions of the first year of the Russo-Ukrainian war. (shrink)

To understand pre-Fregean theories of judgment and proposition, such as those found in Locke and the Port-Royal logic, it is important to distinguish between propositions in the modern sense and propositions in the pre-Fregean sense. By making this distinction it becomes clear that these pre-Fregean theories cannot be meant to solve the propositional attitude problem. Notwithstanding this fact, Locke and Arnauld are able to make a distinction between asserted and unasserted propositions (in their sense). The way Locke makes this distinction (...) turns out to be very different from the way it is made by Arnauld. (shrink)

Ernest Mandel theorised the capitalist world economy as an articulated system of capitalist, semi-capitalist and precapitalist relations of production, linked to each other by capitalist relations of exchange and domination by the capitalist world market. This seems to be an interesting starting point for an historically well-founded theory, building on and going beyond Marx's work, of the worldwide expansion of the capitalist mode of production from its origins to the present. In his attempt to formulate his theory, Mandel did not (...) succeed in resolving all difficulties, however. His main works – Marxist Economic Theory and Late Capitalism – show a number of dangling loose ends. The central question is whether these loose ends are merely technical difficulties or whether they reveal fatal flaws in the theory as a whole. In order to come a step closer to answering this question, a conference was organised in Amsterdam, November 2003. This introduction formulates the five, closely interrelated issues that were highlighted at this conference. (shrink)

The notion of cognitive act is of importance for an epistemology that is apt for constructive type theory, and for epistemology in general. Instead of taking knowledge attributions as the primary use of the verb 'to know' that needs to be given an account of, and understanding a first-person knowledge claim as a special case of knowledge attribution, the account of knowledge that is given here understands first-person knowledge claims as the primary use of the verb 'to know'. This means (...) that a cognitive act is an act that counts as cognitive from a first-person point of view. The method of linguistic phenomenology is used to explain or elucidate our epistemic notions. One of the advantages of the theory is that an answer can be given to some of the problems in modern epistemology, such as the Gettier problem. (shrink)

In this article, we sketch a new approach to law and ethics. The traditional paradigm, exemplified in the debate on liberal moralism, becomes increasingly inadequate. Its basic assumptions are that there are clear moral norms of positive or critical morality, and that making statutory norms is an effective method to have citizens conform to those norms. However, for many ethical issues that are on the legislative agenda, e.g. with respect to bioethics and anti-discrimination law, the moral norms are controversial, vague (...) or still evolving. Moreover, law proves not to be a very effective instrument. Therefore, we need a new paradigm, both for descriptive and for normative analysis. This interactive paradigm, as a normative position, can be summarised in two theses. The process of legislation on ethical issues should be structured as a process of interaction between the legislature and society or relevant sectors of society, so that the development of new moral norms and the development of new legal norms may reinforce each other. And legislation on ethical issues should be designed in such a way that it is an effective form of communication which, moreover, facilitates an ongoing moral debate and an ongoing reflection on such issues, because this is the best method to ensure that the practice remains oriented to the ideals and values the law tries to realise. (shrink)

Masters Thesis -- Stellenbosch University, 2019.

Abstract‘Social inclusion’ is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. ‘Social inclusion’ can refer simply to full equal rights, but more often it is taken to mean something like ‘community participation’. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that (...) moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

Human cognition is unique in the way in which it relies on combinatorial (or compositional) structures. Language provides ample evidence for the existence of combinatorial structures, but they can also be found in visual cognition. To understand the neural basis of human cognition, it is therefore essential to understand how combinatorial structures can be instantiated in neural terms. In his recent book on the foundations of language, Jackendoff described four fundamental problems for a neural instantiation of combinatorial structures: the massiveness (...) of the binding problem, the problem of 2, the problem of variables, and the transformation of combinatorial structures from working memory to long-term memory. This paper aims to show that these problems can be solved by means of neural “blackboard” architectures. For this purpose, a neural blackboard architecture for sentence structure is presented. In this architecture, neural structures that encode for words are temporarily bound in a manner that preserves the structure of the sentence. It is shown that the architecture solves the four problems presented by Jackendoff. The ability of the architecture to instantiate sentence structures is illustrated with examples of sentence complexity observed in human language performance. Similarities exist between the architecture for sentence structure and blackboard architectures for combinatorial structures in visual cognition, derived from the structure of the visual cortex. These architectures are briefly discussed, together with an example of a combinatorial structure in which the blackboard architectures for language and vision are combined. In this way, the architecture for language is grounded in perception. Perspectives and potential developments of the architectures are discussed. Key Words: binding; blackboard architectures; combinatorial structure; compositionality; language; dynamic system; neurocognition; sentence complexity; sentence structure; working memory; variables; vision. (shrink)

The concept of meaningful work is used to evaluate the quality of work. Typical cases of meaningless work that have been used to clarify this concept are assembly line work, and work involving other types of mindless tasks, but also David Graeber's ‘bullshit jobs’. I argue that there are at least two fundamental reasons to care about meaningful work: reasons from the wellbeing of the worker and reasons pertaining to meaningfulness of the worker's life. I first argue that a concept (...) of meaningful work needs to reflect these two values, but that these two values may come apart. Because of this, accounts that provide a single answer to the question to what extent a particular work context is meaningful work for a particular worker are unable to reflect these two values. I then survey three promising accounts of meaningful work: perfectionism, which captures the self-interested aspect of meaningful work well but fails to capture the meaningfulness aspect appropriately; consequentialism, which captures the meaningfulness aspect well but fails to capture the self-interested aspect; and Wolf's Fitting Fulfilment View of meaningful projects, which can be read as addressing both concerns but leads to implausible judgments about meaningful work. I then argue that we should conceive of the concerns that fall under the notion of meaningful work as two separate concepts and values. The best work incorporates both these dimensions but falling short on either dimension is problematic for different reasons. (shrink)

The contention in this paper is that the theological-political disputes Spinoza was concerned with 350 years ago are similar to the conspiratorial disputes we experience today. The world in Spinoza’s Tractatus theologico-politicus, a political intervention in his time, serves as a “mirror image”, that is to say, it deals with the same problem we face today albeit in a different mode. Understanding our contemporary condition under the auspices of a Spinozist perspective, problems in countermeasures to the conspiratorial disputes come to (...) light. Scholarly work and practice focus on the epistemological dimension of conspiracy theories, tying in the extent to which they are problematic to the degree in which they deal in untruth. However, the lesson from Spinoza’s analysis of the theological-political disputes is that such theories do not deal in truth, but, in affect, they do not spring from a lack of education but a lack of certainty. The work of Spinoza opens up a different approach, and if our aim is like that of the TTP, to defend political life against the threat of civil war, such a different approach is in order. (shrink)

There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

In this paper, we examine the relationship between Christian religiosity, attitudes towards corporate social responsibility, and CSR behavior of executives. We distinguish four types of CSR attitudes and five types of CSR behavior. Based on empirical research conducted among 473 Dutch executives, we find that CSR attitudes mediate the influence of religiosity on CSR behavior. Intrinsic religiosity positively affects the ethical CSR attitude and negatively affects the financial CSR attitude, whereas extrinsic religiosity stimulates the philanthropic CSR attitude. Financial, ethical, and (...) philanthropic CSR attitudes significantly affect some types of CSR behaviors. However, because religiosity has opposing effects on the three attitudes, the joint mediation effect of the three attitudes is negligible. Furthermore, we find a direct negative influence of intrinsic religiosity on diversity and a direct positive influence on charity. (shrink)

This paper is on the update semantics for might of Veltman. Threeconsequence relations are introduced and studied in an abstract setting.Next we present sequent-style systems for each of the consequence relations.We show the logics to be complete and decidable. The paper ends with asyntactic cut elimination result.

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

Sound and complete axiomatizations are provided for a number of different logics involving modalities for the knowledge of multiple agents and operators for branching time, extending previous work of Halpern, van der Meyden and Vardi [to appear, SIAM Journal on Computing] for logics of knowledge and linear time. The paper considers the system constraints of synchrony, perfect recall and unique initial states, which give rise to interaction axioms. The language is based on the temporal logic CTL*, interpreted with respect to (...) a version of the bundle semantics. (shrink)

We analyze the cognitive strategies underlying performance in the Number task, a Math game that requires both arithmetic fluency and mathematical creativity. In this game all elements in a set of numbers have to be used precisely once to create a target number with basic arithmetic operations. We argue that some instances of this game are NP complete, by showing its relation to the well-known Partition problem. We propose heuristics based on the distinction in forward and backward reasoning. The Number (...) Game is part of Math Garden, a popular online educational platform for practicing and monitoring math skills using innovations in computerized adaptive testing. These educational games generate enormous amounts of rich data on children's cognitive development. We found converging evidence for the use of forward proximity heuristics in the data of Math Garden, consisting of more than 20 million answers to 1,700 items. Item difficulties and the structure of correct answers were analyzed. (shrink)

This article provides an affirmative feminist reading of the philosophy of Henri Bergson by reading it through the work of Karen Barad. Adopting such a diffractive reading strategy enables feminist philosophy to move beyond discarding Bergson for his apparent phallocentrism. Feminist philosophy finds itself double bound when it critiques a philosophy for being phallocentric, because the setup of a master narrative comes into being with the critique. By negating a gender-blind or sexist philosophy, feminist philosophy only reaffirms its parameters, and (...) setting up a master narrative costs feminist philosophy its feminism. I thus propose and practice a different methodological starting point, one that capitalizes on “diffraction.” This article experiments with the affirmative phase in feminist philosophy prophesied by Elizabeth Grosz, among others. Working along the lines of the diffractive method, the article at the same time proposes a new reading of Bergson (as well as of Barad), a new, different metaphysics indeed, which can be specified as onto-epistemological or “new materialist.”. (shrink)

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

Theoretical models for physician-patient communication in clinical practice are described in literature, but none of them seems adequate for solving the communication problem in clinical practice that emerges in case of factitious disorder. Theoretical models generally imply open communication and respect for the autonomy of the patient. In factitious disorder, the physician is confronted by lies and (self)destructive behaviour of the patient, who in one way or another tries to involve the physician in this behaviour. It is no longer controversial (...) that the physician should communicate his consideration of a factitious disorder without insistence that the patient accepts this diagnosis. However, the balance between patient autonomy and open communication on the one hand, and the preservation of the patient's health, physician integrity and of a constructive physician-patient relationship on the other is easily disrupted. In this article, an epistemological model is described to facilitate a positive outcome of confrontation in treatment of factitious disorder. Analysing the problem in terms of systems theory will help the physician to assess what information is appropriate to use in which phase of the patient's treatment, while preserving the physician-patient relationship. (shrink)

This text explores a set of key concepts in Marxist theory as developed and read by Lacan, demonstrating links and connections between Marxist thought and Lacanian practice. The book examines the complexity of these encounters through the structure of a comprehensive vocabulary which covers diverse areas, from capitalism and communism to history, ideology, politics, work, and family. Offering new perspectives on these concepts in psychoanalysis, as well as in the fields of political and critical theory, the book brings together contributions (...) from a range of international experts to demonstrate the dynamic relationship between Marx and Lacan, as well as illuminating 'untranslatable points' which may offer productive tension between the two. The entries trace the trajectory of Lacan's appropriation of Marx's concepts and analyses how they were questioned, criticized and reworked by Lacan, accounting for the wide reach of two thinkers and worlds in constant homology. Each entry also discusses psychoanalytic debates relating to the concept and seeks to refine the clinical scope of Marx's work, demonstrating its impact on the social and individual dimensions of Lacanian clinical practice. With a practical and structured approach, The Marx Through Lacan Vocabulary will appeal to psychoanalysts and researchers in a range of fields, including political science, cultural studies, and philosophy. (shrink)