Do political concerns belong in psychodynamic treatment? How do class and politics shape the unconscious? The effects of an increasingly polarized, insecure and threatening world mean that the ideologically enforced split between the political order and personal life is becoming difficult to sustain. This book explores the impact of the social and political domains at the individual level. The contributions included in this volume describe how issues of class and politics, and the intense emotions they engender, emerge in the clinical (...) setting and how psychotherapists can respectfully address them rather than deny their significance. They demonstrate how clinicians need to take into account the complex convergences between psychic and social reality in the clinical setting in order to help their patients understand the anxiety, fear, insecurity and anger caused by the complex relations of class and power. This examination of the psychodynamics of terror and aggression and the unconscious defences employed to deny reality offers powerful insights into the microscopic unconscious ways that ideology is enacted and lived. _Psychoanalysis, Class and Politics_ will be of interest to all mental health professionals interested in improving their understanding of the ideological factors that impede or facilitate critical and engaged citizenship. It has a valuable contribution to make to the psychoanalytic enterprise, as well as to related scholarly and professional disciplines. (shrink)

In this paper we aim to shed light on the dynamics of regional identity construction and deconstruction. We will argue that four forms of identity can be identified that are linked through various processes of change. To that end, we will theoretically conceptualise 'identity' by discussing historical and current scholarly debates on identity in a variety of scientific disciplines. Then, we will argue that the mutual contradiction of the current theories is a paradox if seen from the angle of regional (...) identity construction and deconstruction. Building upon elements from the various theoretical approaches, we propose a heuristic model describing the dynamics of identity construction and deconstruction, which will be explored by means of the example of the Green Heart region, a spatial planning concept in western Holland. (shrink)

In this paper we aim to shed light on the dynamics of regional identity construction and deconstruction. We will argue that four forms of identity can be identified that are linked through various processes of change. To that end, we will theoretically conceptualise 'identity' by discussing historical and current scholarly debates on identity in a variety of scientific disciplines. Then, we will argue that the mutual contradiction of the current theories is a paradox if seen from the angle of regional (...) identity construction and deconstruction. Building upon elements from the various theoretical approaches, we propose a heuristic model describing the dynamics of identity construction and deconstruction, which will be explored by means of the example of the Green Heart region, a spatial planning concept in western Holland. (shrink)

In this paper we aim to shed light on the dynamics of regional identity construction and deconstruction. We will argue that four forms of identity can be identified that are linked through various processes of change. To that end, we will theoretically conceptualise 'identity' by discussing historical and current scholarly debates on identity in a variety of scientific disciplines. Then, we will argue that the mutual contradiction of the current theories is a paradox if seen from the angle of regional (...) identity construction and deconstruction. Building upon elements from the various theoretical approaches, we propose a heuristic model describing the dynamics of identity construction and deconstruction, which will be explored by means of the example of the Green Heart region, a spatial planning concept in western Holland. (shrink)

A great deal of effort has been, and continues to be, devoted to developing consciousness artificially (A small selection of the many authors writing in this area includes: Cotterill (J Conscious Stud 2:290–311, 1995 , 1998 ), Haikonen ( 2003 ), Aleksander and Dunmall (J Conscious Stud 10:7–18, 2003 ), Sloman ( 2004 , 2005 ), Aleksander ( 2005 ), Holland and Knight ( 2006 ), and Chella and Manzotti ( 2007 )), and yet a similar amount of effort (...) has gone in to demonstrating the infeasibility of the whole enterprise (Most notably: Dreyfus ( 1972/1979 , 1992 , 1998 ), Searle ( 1980 ), Harnad (J Conscious Stud 10:67–75, 2003 ), and Sternberg ( 2007 ), but there are a great many others). My concern in this paper is to steer some navigable channel between the two positions, laying out the necessary pre-conditions for consciousness in an artificial system, and concentrating on what needs to hold for the system to perform as a human being or other phenomenally conscious agent in an intersubjectively-demanding social and moral environment. By adopting a thick notion of embodiment—one that is bound up with the concepts of the lived body and autopoiesis (Maturana and Varela 1980 ; Varela et al. 2003 ; and Ziemke 2003 , 2007a , J Conscious Stud 14(7):167–179, 2007b )—I will argue that machine phenomenology is only possible within an embodied distributed system that possesses a richly affective musculature and a nervous system such that it can, through action and repetition, develop its tactile-kinaesthetic memory, individual kinaesthetic melodies pertaining to habitual practices, and an anticipatory enactive kinaesthetic imagination. Without these capacities the system would remain unconscious, unaware of itself embodied within a world. Finally, and following on from Damasio’s ( 1991 , 1994 , 1999 , 2003 ) claims for the necessity of pre-reflective conscious, emotional, bodily responses for the development of an organism’s core and extended consciousness, I will argue that without these capacities any agent would be incapable of developing the sorts of somatic markers or saliency tags that enable affective reactions, and which are indispensable for effective decision-making and subsequent survival. My position, as presented here, remains agnostic about whether or not the creation of artificial consciousness is an attainable goal. (shrink)

My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

The Rejected Body argues that feminist theorizing has been skewed toward non-disabled experience, and that the knowledge of people with disabilities must be integrated into feminist ethics, discussions of bodily life, and criticism of the cognitive and social authority of medicine. Among the topics it addresses are who should be identified as disabled; whether disability is biomedical, social or both; what causes disability and what could 'cure' it; and whether scientific efforts to eliminate disabling physical conditions are morally justified. Wendell (...) provides a remarkable look at how cultural attitudes towards the body contribute to the stigma of disability and to widespread unwillingness to accept and provide for the body's inevitable weakness. (shrink)

: Chronic illness is a major cause of disability, especially in women. Therefore, any adequate feminist understanding of disability must encompass chronic illnesses. I argue that there are important differences between healthy disabled and unhealthy disabled people that are likely to affect such issues as treatment of impairment in disability and feminist politics, accommodation of disability in activism and employment, identification of persons as disabled, disability pride, and prevention and "cure" of disabilities.

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

ABSTRACT Because of the existence of severely defective humans it is commonly held that whatever consideration is due to all humans is also due to many other animals, and that therefore speciesism, or the readiness to prefer the interest of humans to those of other animals, is unjustified. After criticism of this reasoning a ‘naturalised’ speciesism, acknowledging, for example, the affinities between species, is articulated and defended. A key to this defence is the separation of the task of specifying morally (...) significant differences between humans and other animals from the task of justifying the extension of consideration to defective humans. The conclusion is that more traditional vices than speciesism are chiefly to blame for the shabby treatment of animals by humans. (shrink)

Only human beings have a rich conceptual repertoire with concepts like tort, entropy, Abelian group, mannerism, icon and deconstruction. How have humans constructed these concepts? And once they have been constructed by adults, how do children acquire them? While primarily focusing on the second question, in The Origin of Concepts , Susan Carey shows that the answers to both overlap substantially. Carey begins by characterizing the innate starting point for conceptual development, namely systems of core cognition. Representations of core (...) cognition are the output of dedicated input analyzers, as with perceptual representations, but these core representations differ from perceptual representations in having more abstract contents and richer functional roles. Carey argues that the key to understanding cognitive development lies in recognizing conceptual discontinuities in which new representational systems emerge that have more expressive power than core cognition and are also incommensurate with core cognition and other earlier representational systems. Finally, Carey fleshes out Quinian bootstrapping, a learning mechanism that has been repeatedly sketched in the literature on the history and philosophy of science. She demonstrates that Quinian bootstrapping is a major mechanism in the construction of new representational resources over the course of childrens cognitive development. Carey shows how developmental cognitive science resolves aspects of long-standing philosophical debates about the existence, nature, content, and format of innate knowledge. She also shows that understanding the processes of conceptual development in children illuminates the historical process by which concepts are constructed, and transforms the way we think about philosophical problems about the nature of concepts and the relations between language and thought. (shrink)

Au cours des deux dernières décennies, les études sur Stanley Milgram ont connu une véritable renaissance interdisciplinaire, qui a conduit à modifier profondément le débat sur ces expériences de psychologie sociale parmi les plus controversées du xxe siècle. L’intérêt considérable pour les conditions expérimentales de ses travaux constitue une nouvelle perspective, qui a des implications pour la philosophie de la psychologie sociale. L’ontologie sociale (ou ontologie historique), de différents styles, peut mettre en lumière les caractéristiques contingentes de l’« obéissance à (...) l’autorité» et d’autres expériences classiques de la psychologie sociale nord-américaine. Dans ce numéro de Philosophia Scientiæ consacré à Milgram, ma contribution consiste à montrer comment une approche empirique de l’interaction sociale peut aider à éclairer – « à partir de la base» -– les relations de pouvoir dans le laboratoire de Milgram, ainsi que les résistances à la poursuite de l’expérience. Tout d’abord, je présente le pouvoir comme une caractéristique multidimensionnelle de la sociabilité humaine, en soulignant son aspect performatif. Dans le laboratoire, les sujets jouant le rôle des Enseignants sont contraints à exercer leur pouvoir de différentes façons très contrastées, soit en exerçant ce pouvoir sur l’Apprenant (en se conformant à la volonté de l’expérimentateur), soit contre l’expérimentateur (c’est-à-dire en lui résistant). Deuxièmement, je propose que, comme la moralité, le pouvoir au sens performatif peut être compris à l’aide de la distinction entre premier-plan et arrière-plan (dans le vocabulaire Gestaltiste, la distinction figure/fond), les deux aspects du phénomène étant empiriquement fondés, et orientés vers les pratiques concrètes des agents en interaction. Troisièmement, je précise la notion de pouvoir performatif, en relation avec la pratique de ceux qui, parmi les sujets en position d’Enseignants, s’opposent à la continuation de l’expérience. En conclusion, l’article illustre la valeur de l’analyse éthnométhodologique conversationnelle, en tant que style d’ontologie sociale adapté tant à l’étude des relations de pouvoirs, à celle des prétentions à la connaissance en psychologie sociale, qu’à la reconstruction des présupposés de la psychologie sociale nord-américaine classique. (shrink)

There is a balance between the amount of (weak) indestructibility one can have and the amount of strong cardinals. It’s consistent relative to large cardinals to have lots of strong cardinals and all of their degrees of strength are weakly indestructible. But this necessitates the destructibility of the partially strong cardinals. Guaranteeing the indestructibility of the partially strong cardinals is shown to be harder. In particular, this work establishes an equiconsistency between: 1.a proper class of cardinals that are strong reflecting (...) strongs; and2.weak indestructibility for (κ+2)-strength for all cardinals κ in the presence of a proper class of strong cardinals.These have a much higher consistency strength than: 3.weak indestructibility for all degrees of strength for a proper class of strong cardinals.This discrepancy holds even if we weaken (2) from the presence of a proper class to just two strong cardinals. (2) is also equivalent to weak indestructibility for all λ-strength for λ far beyond (κ+2); well beyond the next measurable limit of measurables above κ, but before the next μ that is (μ+2)-strong.One direction of the equiconsistency of (1) and (2) is proven using forcing and the other using core model techniques from inner model theory. Additionally, connections between weak indestructibility and the reflection properties associated with Woodin cardinals are discussed, and similar results are derived for supercompacts and supercompacts reflecting supercompacts.Abstract prepared by James Holland.E-mail: [email protected]: https://sites.math.rutgers.edu/~jch258/assets/dis.pdf. (shrink)

Was Malthus a ‘Utilitarian’? This apparently simple-minded question is justified by on-going debate in the secondary literature. For example, in his study, The Classical Economists, D. P. O'Brien maintains that ‘only the two Mills, apart from Bentham himself, were really Utilitarians’. Against this we have the view of Lord Robbins that ‘We get the picture badly out of focus if we conceive that reliance on the principle of utility was confined to Bentham and his immediate circle.’ In this paper we (...) shall demonstrate the justice of the Robbins perspective with specific reference to the population issue. (shrink)

Re-consent in research, the asking for a new consent if there is a change in protocol or to confirm the expectations of participants in case of change, is an under-explored issue. There is little clarity as to what changes should trigger re-consent and what impact a re-consent exercise has on participants and the research project. This article examines applicable policy statements and literature for the prevailing arguments for and against re-consent in relation to longitudinal cohort studies, tissue banks and biobanks. (...) Examples of re-consent exercises are presented, triggers and non-triggers for re-consent discussed and the conflicting attitudes of commentators, participants and researchers highlighted. We acknowledge current practice and argue for a greater emphasis on ‘responsive autonomy,’ that goes beyond a one-time consent and encourages greater communication between the parties involved. A balance is needed between respecting participants' wishes on how they want their data and samples used and enabling effective research to proceed. (shrink)

The phrase 'beyond historicism' is usually associated with Bielefeld historians like Hans Ulrich Wehler and Jürgen Kocka, who attempted to turn the study of history into a social science, but a better candidate would be the sociologist Niklas Luhmann, who happened to teach as well in Bielefeld during the 1970's and 1980's. Luhmann had little affinity with the project of his colleagues from the history department. He took the opposite view that the social sciences suffered from a naive enlightenment view (...) and should become more history minded. Like the historicists of the early nineteenth century Luhmann was indirectly inspired by the philosophy of Leibniz. Although Luhmann's theory of social systems may seem miles away from the daily interests of most historians, it can be interpreted as an Aufhebung of historicism. This will be demonstrated for two important concepts, the autopoietic system which incorporates the historicist notion of individuality and the concept of second order observation which can be read as an abstract redescription of what historicists meant by the historical method. (shrink)

Where research was once strictly confined to one laboratory or office, investigators now widely share and compare their plans, analyses, and results. With the advent of genomic knowledge, researchers are seeking to understand the genetics and genomics of complex human disease. They are combining their efforts into international consortia in order to take on problems that face individuals around the world, such as cancer and malaria — problems that are too large to solve by one country alone. These consortia bring (...) together diverse research groups from different parts of the world to focus on a common goal. Their projects may all focus on one disease or condition, but examine it from different perspectives and share the newly gained information with each other and the wider scientific community. (shrink)

The lexicographic power ΔΓ of chains Δ and Γ is, roughly, the Cartesian power Πγ∈Γ Δ, totally ordered lexicographically from the left. Here the focus is on certain powers in which either Δ = R or Γ = R, with emphasis on when two such powers are isomorphic and on when ΔΓ is 2-homogeneous. The main results are: (1) For a countably infinite ordinal α, Rα* +α ≃ Rα. (2) RR ≄ RQ. (3) For Δ a countable ordinal ≥ 2. (...) ΔR, with its smallest element deleted, is 2-homogeneous. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Tincture of the Doctor's TimeHolland KaplanI first thought of Mr. H as a "difficult patient" while reading the written hand-off I received on him as I was preparing to take over an inpatient general medicine service—"He leaves all the time to smoke." I don't think the statement was meant to imply anything about the patient; if anything, it may have been included for context to prepare me for (...) the patient's intermittent absence. But, reading this, I felt a familiar sense of annoyance rising in my chest. Every few months, I take care of a patient who seems to never be in his room. The patient is consistently out smoking, in the cafeteria, or in another unknown location, seemingly doing an undisclosed activity. This is frustrating because it means I have to work around the patient's schedule of smoke breaks and jaunts to the cafeteria to evaluate the patient on a daily basis. The thoughts inevitably cross my mind: Does this patient even want care in the hospital if he's never in his room? Is he actually sick enough to need to be in the hospital if he's able to spend so much time outside of the hospital? Why is he leaving so frequently—is he doing drugs?This particular patient had been in perfect health until two months before I met him when he was shot multiple times during an encounter at a gas station. One of the bullets had lodged in his back, shattering a vertebra. Another had decimated the bones in his right upper arm, which were now held in place by screws and plates. Several had landed in his abdomen, necessitating the removal of part of his bowel. Finally, a bullet had sliced through the lower part of his right kidney, shredding his ureter and mandating surgical reconstruction of his urinary system. After over a month in the intensive care unit with multiple reparative surgeries, he was discharged to a rehabilitation facility. But he started having fevers and fast heart rates; ultimately, he was admitted to the hospital again for multiple infected fluid collections that had formed at the sites of his surgeries. He left the hospital prior to getting treated for these infections, purportedly "against medical [End Page 12] advice." And now, several weeks later, he was here in the hospital for the same reason.The first time I went to see Mr. H, he was, of course, not in his room. I went to the nursing station to ask if the clerk knew where he was. She knowingly said, "Oh yeah, he goes out a lot. I can give him a call to let him know the doctor is here to see him if you'd like." I assented, thanked the clerk for calling him, and proceeded, annoyed, in seeing the rest of my patients. I considered how I would address Mr. H's behavior when I was finally able to talk to him. I had seen others take many different approaches—negotiation about the timing and frequency of these extramural expeditions, ultimatums about getting discharged, mandating urine drug screens upon return, and silent, frustrated tolerance. I resolved to wait to speak to him to determine which approach might be most suitable. An hour later, I received a call from the clerk that Mr. H had returned to his room to see me.The first time I met Mr. H, he informed me he had taken the bus to midtown to make a run to the grocery store. I was internally incredulous. He felt well enough to go to the grocery store? Why was he in the hospital then? At that moment, I opted not to discuss his frequent departures yet, as I was frustrated and realized I wouldn't be able to identify the best way to address them. I reviewed his medical issues with him, asked specific questions about how he was feeling, performed a physical exam, and reiterated his current plan of care. Mr. H made it very clear that he would like to get out of the hospital as soon as possible. I tried to set the expectation that he... (shrink)

This article considers Hugo Grotius’s ideas on a specific topic of commercial law, analysing his position and potential contributions to early modern Dutch insolvency legislation. It might be questioned how ‘Hollandic’ Grotius’s interpretations of legal solutions for insolvency as presented in the Inleidinge tot de Hollandsche Rechts-Geleerdheid actually were. Grotius’s treatment of cessie van goede is relatively strict, whereas compositions are hardly mentioned. A rather different image rises from his later work. Here, Grotius displays a more radical view, in specific (...) cases allowing the sovereign to interfere in private property rights and to restructure debts for the common good. It is an intriguing question if and to what extent these ideas can be related to contemporary Dutch insolvency practices. (shrink)

The phenomenon of episodic memory has been studied for over 30 years, but it is only recently that its constructive nature has been shown to be closely linked to the processes underpinning imagination. This paper builds on recent work by the authors in developing architectures for a form of imagination suitable for use in artifacts, and considers how these architectures might be extended to provide a form of episodic memory.

To address the burden of maternal morbidity and mortality in low‐ and middle‐income countries (LMICs), research with pregnant women in these settings is increasingly common. Pregnant women in LMIC‐context may experience vulnerability related to giving consent to participate in a clinical trial. To recognize possible layers of vulnerability this study aims to identify factors that influence the decision process towards clinical trial participation of pregnant women in an urban middle‐income setting. This qualitative research used participant observation, in‐depth interviews, and focus (...) group discussion with medical staff and pregnant women eligible for trial participation, at a regional hospital in Accra, Ghana. Besides lack of familiarity with modern scientific concepts, specific factors influencing the decision‐making process were identified. These include a wide power difference between health provider and patient, and a different perception of risk through externalization of responsibility of risk management within a religious context as well as a context shaped by authority. Also, therapeutic misconception was observed. The combination of these factors ensued women to rely on the opinion of the medical professional, rather than being guided by their own motivation to participation. Although being a (pregnant) woman per se should not render the label of being vulnerable, this study shows there are factors that influence the decision process of pregnant woman towards trial participation in a LMIC context that can result in vulnerability. The identification of context‐specific factors that can create vulnerability facilitates adaptation of the design and conduct of research in a culturally competent manner. (shrink)

In this book, Susan Mendus seeks to address these important questions to assess whether this apparent tension between morality and politics is real and, if so, ...