We test the hypothesis that US corporations headquartered in states with greater public corruption are also prone to more unethical behavior when operating abroad. We exploit passage of Foreign Corrupt Practices Act that curtailed bribery of foreign officials and find firms in corrupt states, especially those exporting to more corrupt countries, suffer greater performance decline following FCPA, suggesting larger loss from anticipated bribery restrictions. Controlling for industry, firms in corrupt states are more likely to be targets of FCPA enforcement actions. (...) They are also more likely to have paid foreign bribes, as disclosed during pre-FCPA investigations. (shrink)

This book is about the philosophical, historical, and interpretative aspects of Mencius. It explores his influence, reception, and relevance in China from the third century BCE to the present, as well as offers comparative studies of Mencius and major figures in the history of Chinese and Western philosophy. With 34 accessible articles written by leading philosophers and scholars, the Dao Companion to the Philosophy of Mencius provides both broad pictures and in-depth discussions regarding the work of one of the most (...) important and influential Chinese philosophers. It covers his normative ethics, meta-ethics, political philosophy, epistemology and moral psychology. The last section of the volume, “Mencius and Western Philosophers: Comparative Perspectives,” explicitly puts him in dialogue with major Western philosophers. The Dao Companion to the Philosophy of Mencius serves as an essential volume for college students, graduate students, and scholars who study and teach Mencius as well as Chinese philosophy and comparative philosophy in general.​. (shrink)

In the course of an immune response, antibodies undergo affinity maturation in order to increase their efficiency in neutralizing foreign invaders. Affinity maturation occurs by the introduction of multiple point mutations in the variable region gene that encodes the antigen binding site. This somatic hypermutation is restricted to immunoglobulin genes and occurs at very high rates. The precise molecular basis of this process remains obscure. However, recent studies using a variety of in vivo and in vitro systems have revealed important (...) regulatory regions, base motifs that are preferred targets of mutation and evidence that transcription may play an active role in hypermutation. BioEssays 20:227–234, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

Antibiotic resistance in bacteria has become a great threat to global public health. Tigecycline is a next‐generation tetracycline that is the final line of defense against severe infections by pan‐drug‐resistant bacterial pathogens. Unfortunately, this last‐resort antibiotic has been challenged by the recent emergence of the mobile Tet(X) orthologs that can confer high‐level tigecycline resistance. As it is reviewed here, these novel tetracycline destructases represent a growing threat to the next‐generation tetracyclines, and a basic framework for understanding the molecular epidemiology and (...) resistance mechanisms of them is presented. However, further large‐scale epidemiological and functional studies are urgently needed to better understand the prevalence and dissemination of these newly discovered Tet(X) orthologs among Gram‐negative bacteria in both human and veterinary medicine. (shrink)

It is well known that Mozi criticizes the ritual practices of the Ru for being wasteful. However, another criticism has been less appreciated: These practices are merely conventional habituations and violate the Ru’s own moral ideals of ren 仁 , yi 義 and xiao 孝 . Xunzi responds to both criticisms in the Li Lun Pian 禮論篇 . Based on an account of Mozi’s arguments and Xunzi’s replies, this essay discusses the significance of ritual transformation in Xunzi’s moral philosophy.

本書以20世紀80年代震動一時的“潘曉討論”為中心，為當代文學研究——特別是關於80年代文學的研究——帶入新的“問題意識”，一方面挑戰既有的線性文學史描述、豐富我們的文學研究範式；一方面將廣闊的社會、 文化“大本文”引入對於80年代具有代表性的文學“小文本”的解讀之中，以從方法上賦予當代文學研究以新質。.

It has been claimed that Massimi’s recent perspectival approach to science sits in tension with a realist stance. I shall argue that this tension can be defused in the quantum context by recasting Massimi’s perspectivalism within a phenomenological framework. I shall begin by indicating how the different but complementary forms of the former are manifested in the distinction between certain so-called ‘-epistemic’ and ‘-ontic’ understandings of quantum mechanics, namely QBism and Relational Quantum Mechanics, respectively. A brief consideration of Dieks’ perspectivism (...) will then lead to a consideration of the much-maligned and typically dismissed role of the observer in the measurement process. This opens the door to London and Bauer’s presentation of a form of ‘phenomenological quantum perspectivalism’ that brings together Massimi’s two forms and explicitly eschews the ‘naïve’ realism that creates the above tension. I shall conclude with some reflections on how intersubjectivity can still be established within this framework, focusing in particular on how Massimi’s idea of ‘interlacing’ scientific perspectives can be accommodated, using the example of a ‘new cosmopolitanism’ that gave rise to Bose-Einstein statistics. (shrink)

Concentrating on the Qingdao Observatory, this paper will explore the role of scientific facility in asserting China’s sovereignty during the first half of the twentieth century. Although scholars have explained the efforts of China’s internationalization in diplomacy through the perspectives of politics, economics and culture, they have not paid attention to science. Therefore, this paper aims to shed some light on how scientific issues were solved via diplomacy during the Republic of China, while further asserting that the focus in negotiations (...) was not confined to science itself, but rather to sovereignty within a scientific context. In this process, the meaning of sovereignty has also been expanded basing on the improvement of nation’s scientific capability. Besides, the participation of different actors involved in sovereignty assertion is investigated by this paper. Although the diplomatic negotiation was held at the international level, the local government and scientific community were main promoters in this case, which calls for attention on the various subjects in sovereignty issue. Consequently, this paper argues that Asian countries, such as Republic of China, could also employ science as a means to negotiate with foreign powers and claim their due rights. (shrink)

In the only two articles on the topic of which I am aware, Chad Carlson and Scott Aikin have leveled three objections against fantasy sports—namely, that participation in fantasy sports elicits...

Plato Plato (427-347 BC) is surely the most famous of all philosophers. Little is known of his early life, except that he was born into a noble Athenian ...

What should we do about “tainted” public commemorations? Recent events have highlighted the urgency of reaching a consensus on this question. However, existing discussions appear to be dominated by two naïve opposing views – to remove or preserve them. My aims in this essay are two-fold. First, I argue that the two views are not naïve, but undergirded by concerns with securing self-respect and with the character of our engagement with the past. Second, I offer a qualified defence of vandalising (...) tainted commemorations. The defence comprises two parts. I consider two prominent suggestions – to install counter-commemorations and to add contextualising plaques – and argue that they are typically beset with difficulties. I then argue that in some circumstances, constrained vandalism is a response to tainted commemorations which effectively adjudicates the demands of the two opposing views. (shrink)

The term, "objectionable commemorations”, refers to a broad category of public artefacts – such as, and especially, memorials, monuments and statues – that are regarded as morally problematic in virtue of what or whom they honour. In this regard, they are a special class of public artefacts that are subject to public contestation. In this paper, we survey the general ethical and political issues on this topic. First, we categorise the arguments on offer in the literature, concerning the objectionable nature (...) of such commemorations. Second, we review common political responses to objectionable commemorations. Finally, we identify fruitful areas for further philosophical inquiry on this topic. (shrink)

While it is well known that Zhuangzi uses metaphor extensively, there is much less appreciation of the role that it plays in his thought-a topic that is investigated in this essay. At the same time, this investigation is closely concerned with questions about the nature of metaphor. Comparisons are made between a central metaphorical structure in the Zhuangzi on the one hand and contemporary views of the nature of metaphor by Donald Davidson and by Lakoff and Johnson on the other. (...) It is hoped that these comparisons will help to illuminate the central metaphorical structure and its role in the philosophy of the Zhuangzi. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dao Companion to the Philosophy of the Zhuangzi ed. by Kim-chong ChongLuyao Li (bio)Dao Companion to the Philosophy of the Zhuangzi. Edited by Kim-chong Chong. Dordrecht: Springer, 2022. Pp. 835. Hardcover US $133.15, isbn 978-3-030-92330-3.Dao Companion to the Philosophy of the Zhuangzi, edited by Kim-chong Chong, is the sixteenth volume in the Dao Companions to Chinese Philosophy series. This volume includes a total (...) of 34 chapters and is divided into six parts: "Authorship and Commentary" (Part I), "Concepts" (Part II), "Language and Metaphor" (Part III), "Zhuangzi in the Context of Chinese Philosophy" (Part IV), "Ethical, Social, and Epistemic Issues" (Part V), and "The Zhuangzi and Western Philosophy" (Part VI). These six parts not only provide students or non-specialists with a clear overview of the various possible aspects and approaches to Zhuangzi studies, but also present the latest discussions and diverse perspectives on crucial issues in the Zhuangzi, making the volume a valuable resource for experts in this field.Each part of the Dao Companion to the Philosophy of the Zhuangzi extensively explores diverse research perspectives on a specific theme in Zhuangzi studies. Part IV, "Zhuangzi in the Context of Chinese Philosophy," serves as an exemplary illustration of this approach. Considering the possibility that Laozi and the Logicians may have influenced the thought in the Zhuangzi to some extent, this part is comprised of two chapters that respectively examine the connections and distinctions between Zhuangzi and Laozi, and Zhuangzi and the Logicians. Regarding scholars who may have lived after Zhuangzi, Angel On Ki TING envisions Zhuangzi's response to Xunzi's criticism, exploring their respective attitudes towards rites (li 禮) through examining the motivation for action. Additionally, there are chapters that discuss the influence of Zhuangzi's thoughts after the Warring States period, on Neo-Daoism, Buddhism, and Neo-Confucianism, as well as on inner alchemy and religious Daoism.In Part II, however, such extensive exploration proves to be less satisfactory. Here, some crucial concepts in the Zhuangzi are illustrated, including heaven (tian 天) and human (ren 人), transformation (hua 化), vast or big (da 大) and minute (xiao 小), true person (zhen ren 真人) and true knowledge (zhen zhi 真知), no-emotion (wu qing 无情), and ming 命 (fate, destiny, mandate and command). It is unclear why certain concepts are chosen, whereas the central concepts of Dao (道) and de (德) are not focused on. It would perhaps be worthwhile to look closer into more of the above listed concepts, and the [End Page 1] relevance of Dao and de, particularly in terms of Dao and de's relationships to closely connected notions like heaven (tian 天) and ming (命).Furthermore, clear distinctions of themes in various parts of this edited volume overlook the connections among them. Certain terms and issues are addressed in chapters of different parts, with little or no communication between them. For example, the true person is the main concern in a number of chapters: "The True Person and True Knowledge in the Zhuangzi" (Part II, pp. 179-198); "Those Who Fly Without Wings: Depictions of the Supreme Idea Figure in the Inner Chapters of the Zhuangzi" (Part III, pp. 305-376); and "Zhuangzi's Notion of the True Master and Wittgenstein's Grammatical Investigation" (Part VI, pp.807-824). Such exploration of various perspectives on a particular theme is noteworthy. It is regrettable, however, that there is a lack of correspondence between those perspectives. Some discussion on interactions among relevant chapters would certainly enhance the volume.In addition to presenting an extensive range of studies on the Zhuangzi, the Dao Companion to the Philosophy of the Zhuangzi also makes contributions to specific issues, which will be appealing to specialists in this field. I will elaborate on three of these contributions drawing on various parts of the volume.First, this work contributes to discussions on the issue of authorship. The traditional viewpoint attributes the Inner Chapters, or at least their main part, to the historical figure Zhuang Zhou, and assumes that they were written in the Warring States period and composed earlier than other chapters. Therefore, the Inner Chapters are prioritized in studies of the Zhuangzi. Esther Klein has previously challenged the view that the Inner... (shrink)

The study expects to find a better way to improve the teaching quality of the education of college students' outlook on life, based on the theory of educational psychology. First, the relevant theories of positive psychology are introduced and expounded, and the importance of the education of college students' outlook on life is analyzed. Second, the current situations of college students' outlook on life and the education of their outlook on life are investigated through a questionnaire survey, and the problems (...) presented in the questionnaire are analyzed. Then, the correlation between positive psychology and the education of college students' outlook on life is explored, and their mutual connection is analyzed. The results are as follows: 77.4% of the college students have periodical aims and work hard for them; 80.8% of the students think that the realization of life goals rely on hard work, accounting for the largest proportion; when they encounter setbacks, more than 80% of the students choose to work hard to overcome them; 69.2% students think that their outlook on life comes from self-learning and exploration. According to college students' outlook on life in China and other countries, there are many problems in the education of college students' outlook on life, and the teaching quality of the education of college students' outlook on life is backward. The combination of positive psychology and college students' education of college students' outlook on life under the theory of educational psychology provides new ideas and ways for college students' education of college students' outlook on life. The conclusion of this study promotes the innovation of the education of college students' outlook on life. (shrink)

Weinberg's 1972 work, in his description, had two purposes. The first was practical to bring together and assess the wealth of data provided over the previous decade while realizing that newer data would come in even as the book was being printed. He hoped the comprehensive picture would prepare the reader and himself to that new data as it emerged. The second was to produce a textbook about general relativity in which geometric ideas were not given a starring role for (...) (in his words) too great an emphasis on geometry can only obscure the deep connections between gravitation and the rest of physics. (shrink)

The concept of the cheng xin in the Zhuangzi claims that the cognitive function of the heart-mind is not over and above its affective states and in charge of them in developing and controlling virtue, as assumed by the Confucians and others. This joint cognitive and affective nature of the heart-mind denies ethical and epistemic certainty. Individual perspectives are limited given habits of thought, attitudes, personal orientations and particular cognitive/affective experiences. Nevertheless, the heart-mind has a vast imaginative capacity that allows (...) the open-endedness and broadening of perspectives. (shrink)

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students from the Be Resilient to Nursing Career program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest, Med-low, Med-high, and Highest. The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role (...) models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies. (shrink)

성리학의 이기론을 체계화한 16세기 학자 율곡 이이 의 생애와 사상, 학문을 살핀 저서.

: While it is well known that Zhuangzi uses metaphor extensively, there is much less appreciation of the role that it plays in his thought—a topic that is investigated in this essay. At the same time, this investigation is closely concerned with questions about the nature of metaphor. Comparisons are made between a central metaphorical structure in the Zhuangzi on the one hand and contemporary views of the nature of metaphor by Donald Davidson and by Lakoff and Johnson on the (...) other. It is hoped that these comparisons will help to illuminate the central metaphorical structure and its role in the philosophy of the Zhuangzi. (shrink)

Consciousness is one of the most significant scientific problems today. Renewed interest in the nature of consciousness - a phenomenon long considered not to be scientifically explorable, as well as increasingly widespread availability of multimodal functional brain imaging techniques (EEG, ERP, MEG, fMRI and PET), now offer the possibility of detailed, integrated exploration of the neural, behavioral, and computational correlates of consciousness. The present volume aims to confront the latest theoretical insights in the scientific study of human consciousness with the (...) most recent behavioral, neuroimaging, electrophysiological, pharmacological and neuropathological data on brain function in altered states of consciousness such as: brain death, coma, vegetative state, minimally conscious state, locked-in syndrome, dementia, epilepsy, schizophrenia, hysteria, general anesthesia, sleep, hypnosis, and hallucinations. The interest of this is threefold. First, patients with altered states of consciousness continue to represent a major clinical problem in terms of clinical assessment of consciousness and daily management. Second, the exploration of brain function in altered states of consciousness represents a unique lesional approach to the scientific study of consciousness and adds to the worldwide effort to identify the "neural correlate of consciousness". Third, new scientific insights in this field have major ethical and social implications regarding our care for these patients. (shrink)

Some commentators hold that Xunzi's criticism of Mencius' thesis that human nature is good depends more on Xunzi's definition of xing or nature than on substantive argument. Some also claim that Xunzi is committed to accepting Mencius' thesis. A more precise account of Xunzi's critique is offered here, based on an elaboration of his distinction in the "Xing e pian" between ke yi (capacity) and neng (ability). Others have noted this distinction, but no one has sufficiently appreciated its role in (...) making Xunzi's critique more systematic and substantive than it is usually thought to be. (shrink)

Our study examines how a company’s engagement in corporate social responsibility influences word of mouth about the company on Twitter, particularly during a service delay. We use the airline industry as the study context. On the popular social medium Twitter, people post tweets about airline services and raise concerns about service delays when flights are delayed, canceled, or diverted. Drawing on the literature on legitimacy and the halo effect, we argue that a company’s CSR engagement enhances its corporate image, which (...) in turn, influences WOM about the company on Twitter. We predict and find that airlines with better CSR engagement receive more positive word of mouth and less negative word of mouth on Twitter. We also find that service delays reduce PWOM and increase NWOM, with the additional finding that the positive relationship between service delays and NWOM is less strong for airlines with better CSR engagement. We conduct additional analyses to investigate the effects of environmental, social, and governance CSR on PWOM and NWOM. Our study has practical implications in informing companies about the benefits of CSR engagement in relation to public opinion during service delays. (shrink)

A common assumption in the selection of nonhuman animal subjects for research and the approval of research is that, if the risks of a procedure are too great for humans, and if there is a so-called scientific necessity, then it is permissible to use nonhuman animal subjects. I reject the common assumption as neglecting the central ethical issue of the permissibility of using nonhuman animal subjects and as being inconsistent with the principle of justice used in human subjects research ethics. (...) This principle requires that certain classes of individuals not be subjected to a disproportionate share of the burdens or risks of research. I argue for an extension of this principle to nonhuman animal research and show that a prima facie violation of the principle occurs because nonhuman animals bear an overwhelmingly disproportionate share of the risks of research without sufficient justification or reciprocal benefit. (shrink)

As a part of job resources, work time control is essential for innovation. We examine how work time control impacts knowledge employees’ innovation in the workplace. A two-stage study was conducted to verify the mediating and moderating processes. In Study 1, adopting the job demands–resources model as a theoretical framework, we conducted a laboratory test to find the relation between work time control, job engagement, job burnout, and innovation, and verified the path between work time control and innovation. In Study (...) 2, drawing on the job demands–resources model verified by Study 1 and self-regulation theory, it is proposed that during the psychological process in the workplace, job engagement plays a mediating role, and the vocational delay of gratification plays a moderating role between work time control and innovation. A total of 254 knowledge employees from diverse organizations participated in the survey study. After taking demographic variables, job demands, and neuroticism as control variables, the results showed that job engagement would mediate the relationship between work time control and innovation. A higher level of delay of gratification buffered the effect of a higher level of work time control on innovation. All these findings verified and expanded knowledge on work time control and innovation literature, showing that work time control is important for innovation. Based on Chinese cultural background, managers should offer employees the opportunity to conduct self-control training and encourage them with great freedom to foster employee innovation. (shrink)

Daniel A. Bell’s searching for the possible alternatives to liberal democracy in light of the political progresses in the Asian countries spans two decades, culminating in his proposal of the so-called Chinese political meritocracy or xianneng zhengzhi. This article indicates the conceptual asymmetry between xianneng zhengzhi and “meritocracy” in three aspects. Firstly, xianeng zhengzhi remains at the brighter end of the spectrum of political ideas while “meritocracy” is bogged down in a highly polarized reception. Secondly, “meritocracy” lacks the quintessence of (...) xianneng zhengzhi, namely, an explicit stress on priority of moral worthiness. Thirdly, “meritocracy” is built upon foundational individualism and focuses on the individual performance and achievement. Although Confucian political tradition and the Western conception of meritocracy share some functional similarities, using the synthesized term “Confucian meritocracy” to introduce the Confucian political tradition may commit a cross-cultural hermeneutic fallacy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical CommentaryChong Siow Ann, Associate ProfessorDr. G appears to experiencing symptoms of schizophrenia, which is arguably the most severe mental disorder and which afflicts about one in a hundred people. This is a psychotic disorder that causes disturbances and distortions in thinking, including neurocognitive impairments, perception and behaviour. There is no cure for this often devastating disorder. Current antipsychotic medications can alleviate some of the symptoms but it often (...) comes at a price as these antipsychotics have burdensome side effects.A feature of this disorder is anosognosia, which is a lack of awareness or “insight” that an illness is present. This lack of insight presents a particular challenge because these individuals would, as in the case of Dr. G, refuse needed treatment as they do not perceive that they are ill. This is not necessarily an all-or-none phenomenon but is rather more complex and multidimensional; there might be an unawareness or recognition on behalf of the patient that they are suffering from a mental illness, the failure to appreciate the necessity of treatment; and/or the inability to recognise and define the psychotic symptoms like unusual thoughts and hallucinations as signs of illness1 and in many instances, all three are present. It is also by no means uncommon. Studies have found that between 60% and 80% of people with schizophrenia lack awareness of their illness to varying degrees.2This phenomenon remains an enigma. Some regard it as a form of psychological defence against the harsh reality of a psychotic illness — awareness of having a chronic and devastating illness might lead to demoralisation, hopelessness and suicide.3 Recent research, however, [End Page 250] indicates that this psychological denial plays a small part, if any, and instead has found an association with certain neuropsychological and neurocognitive deficits,4 as well as functional and structural brain abnormalities in the frontal lobe of the brain.5The prevailing clinical view thus is that this is an intrinsic and organic aspect of the schizophrenic illness which has nothing to do with wilfulness but rather the incapacity to perceive the presence of the illness. Edwin Fuller Torrey, an eminent psychiatrist and executive director of the Stanley Medical Research Foundation, calls anosognosia the “single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications”, and he has remarked that “to keep talking about civil liberty is illogical. Patients are anything but free when they’re at the beck and call of their own delusions”.6It is also this view that it is a product of a brain disorder that some — particularly patients — find unacceptable. At one level, it does not take into context the person’s own experiences, and at a deeper level it calls into question the conception of the self with its capacity to exercise judgements and the autonomy to make decisions.This is a perennial ethical issue in psychiatry when people with severe mental illnesses refuse treatment. This becomes a Catch-22 situation where part of the illness that needs treatment is also preventing any treatment to be given: implicit in the principle of informed consent for treatment is that the person should be aware of the nature and course of their illness and acknowledge the need for treatment. While there are laws for involuntary commitment, the bar is usually high in that there must be a clear and present risk of harm to the person or others. Alan Stone, a professor of law and psychiatry at Harvard University proposed a possible justification for involuntary treatment based on his “thank-you theory” which assumes that patients will become well and subsequently agree that the intervention was in their best interests but research suggests that only half of these patients would admit so.7One suggested mechanism is the use of advance directives — psychiatry’s version of the living will in which people can specify what sort of medical care they would like should they become mentally unwell and unable to exercise appropriate judgement. An intrinsic part of this might include a “Ulysses contract” — just as Ulysess instructed his crew to lash him to the mast of the his ship so that he could... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)