IntroductionTranscranial magnetic stimulation is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate the (...) efficacy of TBS in geriatric depression.Clinical trial registration[https://clinicaltrials.gov/ct2/], identifier [NCT04842929]. (shrink)

Yoga is believed to have beneficial effects on cognition, attenuation of emotional intensity and stress reduction. Previous studies were mainly performed on eastern experienced practitioners or unhealthy subjects undergoing concomitant conventional therapies. Further investigation is needed on the effects of yoga per se, as well as its possible preventive benefits on healthy subjects. We investigated the effects of yoga on memory and psychophysiological parameters related to stress, comparing yoga practice and conventional physical exercises in healthy men . Memory tests, salivary (...) cortisol levels and stress, anxiety, and depression inventories were assessed before and after 6 months of practice. Yoga practitioners showed improvement of the memory performance, as well as improvements in psychophysiological parameters. The present results suggest that regular yoga practice can improve aspects of cognition and quality of life for healthy individuals. An indirect influence of emotional state on cognitive improvement promoted by yoga practice can be proposed. (shrink)

Background The concept of “health security” is often used to motivate public health responses, yet the ethical values that underpin this concept remain largely unexamined. The recent Australian responses to COVID-19 serve as an important case study by which we can analyse the pre-existing literature to see what ethical values shaped, and continue to shape, Australia’s response. Methods We conducted a critical interpretive literature review of academic and grey literatures within key databases, resulting in 2,220 sources. After screening for duplicates (...) and relevance, we analysed ninety-six sources. Results First, risk and uncertainty are a leading focus, with a heavy concentration on risks to life and health. Second, free movement, safety, and security were recurringly emphasized, albeit narrowly focused upon the safety of the population. Third, legitimacy was a recurring theme, and it is here that discussions of “health security” figured highly. Conclusion Discussions of harm from government and associated official bodies fail to adequately distinguish between various senses of harm. Moreover, while the literature often discusses the balancing of rights, the steps involved in the weighing of these rights is rarely adequately explained and defended. We suggest that decision-makers should endeavour to clearly identify and defend the values undergirding their decisions in the public sphere. (shrink)

O espaço geográfico é uma categoria da ciência geográfica que possibilita uma acentuada e complexa possibilidade de refletir a coletividade social, sendo que neste desafio são trazidas à tona inúmeras perspectivas de análises da relação homem-natureza. Dessa feita, o presente estudo elabora uma breve discussão acerca do espaço geográfico enquanto uma ferramenta de análise das relações sociais, além de evidenciar a sua centralidade no interior da Geografia. Ao longo do estudo estão colocadas algumas concepções teóricas desta categoria geográfica, com destaque (...) para os entendimentos elaborados pela Geografia Crítica, uma reflexão que propõem a necessidade de se politizar os sujeitos por intermédio do ensino, com destaque para os conteúdos geográficos ensinados por seus respectivos professores desde os primeiros anos do ensino fundamental. A busca aqui foi a de confirmar a capacidade que a Geografia possui em se utilizar do próprio espaço geográfico na qual os alunos estão inseridos enquanto materialidade para uma concepção própria de mundo, sendo que através desta conquista, se permite compreender e pensar a construção de uma sociedade pela e para a própria coletividade envolvida. É esta a grande questão discorrida no presente ensaio, pensar uma proposta de ensino na geografia que politize os sujeitos, permitindo assim a formação de sujeitos ativos e cientes do seu papel no mundo. (shrink)

The status of wild capture fisheries has induced many fisheries and conservation scientists to express concerns about the concept of using forage fish after reduction to fishmeal and fish oil, as feed for farmed animals, particularly in aquaculture. However, a very large quantity of forage fish is being also used untransformed (fresh or frozen) globally for other purposes, such as the pet food industry. So far, no attempts have been made to estimate this quantum, and have been omitted in previous (...) fishmeal and fish oil exploitation surveys. On the basis of recently released data on the Australian importation of fresh or frozen fish for the canned cat food industry, here we show that the estimated amount of raw fishery products directly utilized by the cat food industry equates to 2.48 million metric tonnes per year. This estimate, plus the previously reported global fishmeal consumption for the production of dry pet food suggest that 13.5% of the total 39.0 million tonnes of wild caught forage fish is used for purposes other than human food production. This study attempts to bring forth information on the direct use of fresh or frozen forage fish in the pet food sector that appears to have received little attention to this date and that needs to be considered in the global debate on the ethical nature of current practices on the use of forage fish, a limited biological resource. (shrink)

Making research data readily accessible during a public health emergency can have profound effects on our response capabilities. The moral milieu of this data sharing has not yet been adequately explored. This article explores the foundation and nature of a duty, if any, that researchers have to share data, specifically in the context of public health emergencies. There are three notable reasons that stand in opposition to a duty to share one’s data, relating to: (i) data property and ownership, (ii) (...) just distribution of benefits and burdens and (iii) the contemporary ethos of science. We argue each reason can be successfully met with corresponding rationale in favour of data sharing. Further support for data sharing has been echoed in policies of health agencies, funding bodies and academic institutions; in documents on the ethical conduct of biomedical research; and in discussions on the nature of public health. From this, we ascertain that sharing data is the morally sound default position. This article then highlights the key roles reciprocity and solidarity play in supporting the practice of data sharing. We conclude with recommendations to regard public health research data as a common-pool resource in order to build a framework for stable data sharing management. (shrink)

Es una obra colegiada en homenaje al doctor Jorge Alberto Silva que reúne los trabajos de juristas que cultivan diversas ramas de la ciencia jurídica. Este libro, además de numeroso artículos dedicados al análisis y exposición de casos sobre derecho internacional, el lector encontrará que la filosofía del derecho, la teoría general del derecho, la teoría de la argumentación, así como la teoría de la constitución, convergen en los trabajos que componen este extenso volumen y dan como resultado un (...) texto transdisciplinario, complejo e integral de gran valor académico. (shrink)

Through ten case studies by international specialists, this book investigates the circulation and production of scientific knowledge between 1750 and 1945 in the fields of agriculture, astronomy, botany, cartography, medicine, statistics, and zoology. The book will interest scholars and undergraduate and graduate students concerned with the connections between the history of science, imperial history, and global history.

An argument is epistemically self-defeating when either the truth of an argument’s conclusion or belief in an argument’s conclusion defeats one’s justification to believe at least one of that argument’s premises. Some extant defenses of the evidentiary value of intuition have invoked considerations of epistemic self-defeat in their defense. I argue that there is one kind of argument against intuition, an unreliability argument, which, even if epistemically self-defeating, can still imply that we are not justified in thinking intuition has evidentiary (...) value. (shrink)

The composition of nitrogen-doped hydrogenated amorphous carbon films grown in a magnetically confined rf plasma-enhanced chemical vapour deposition system has been determined by X-ray photoelectron spectroscopy and compared with that determined using a combination of elastic recoil detection analysis, Rutherford back-scattering and nuclear reaction analysis. The importance of nitrogen doping or 'incorporation' in hydrogenated amorphous carbon films is discussed in relation to the significant variation in the sp 2 -to-sp 3 ratio that takes place. At 7 at.% N in the (...) a-C : H matrix, a critical change in the microstructure is observed, which governs the resulting mechanical, optical and electronic properties. Finally, the correlation between the sp 2 and sp 3 fractions determined by a non-destructive method of obtaining the bond fractions and by electron-energy-loss spectroscopy is discussed, with a view to evaluating accurately the sp 2 fraction in a-C : H : N films. (shrink)

This study aimed to understand the expressions of fear in the journeys of health professionals who worked in the confrontation of coronavirus disease 2019 (COVID‐19), in the city of Manaus, in the Brazilian Western Amazon. This is an exploratory qualitative study that adopts interpretive description as a method to generate informed knowledge responsive to the needs of the practice. We included 56 participants, comprising 23 health managers and 33 health workers (middle and higher level) of different professional categories. The results (...) revealed three circles of experience: (1) knowledge and professional experience in dealing with the disease (unknown–known–experienced); (2) the growing proximity to death and loss (predicted–witnessed–suffered); and (3) the involvement and proximity to whatever affects the individual, their emotions, and personal transformations in the face of the threat (the collective, the neighbor, and oneself). Our results suggest that health professionals who worked during the COVID‐19 pandemic in Manaus experienced insecurity, dread, and fear, illustrating the complexity of developing their activities in the front line of care and management during the different phases of the pandemic. A contribution of the study is precisely that of capturing this complexity, which suggests the impossibility of analyzing fear only in its simple manifestation, or in each circle of experience. (shrink)

This article aims to offer a fresh analysis of two passages in the extensive necromancy episode in Lucan's Bellum Ciuile: the ritual to reanimate the dead soldier's corpse (6.667–73), and the surgical procedure Erichtho then proceeds to undertake (6.750–7), resembling the practice of a vivisection. The study will focus mostly on the strong connection of magic to medical traditions in antiquity, with a commentary on, and analysis of, these verses through the lenses of medical vocabulary, themes and motifs. It ultimately (...) concludes that Lucan was familiar with the language and characteristics of the medical tradition, enriched his report with them, and was playing with his audience's knowledge of the same. (shrink)

This paper explores the notion of reciprocity in the context of active pulmonary and laryngeal tuberculosis treatment and related control policies and practices. We seek to do three things: First, we sketch the background to contemporary global TB care and suggest that poverty is a key feature when considering the treatment of TB patients. We use two examples from TB care to explore the role of reciprocity: isolation and the use of novel TB drugs. Second, we explore alternative means of (...) justifying the use of reciprocity through appeal to different moral and political theoretical traditions. We suggest that each theory can be used to provide reasons to take reciprocity seriously as an independent moral concept, despite any other differences. Third, we explore general meanings and uses of the concept of reciprocity, with the primary intention of demonstrating that it cannot be simply reduced to other more frequently invoked moral concepts such as beneficence or justice. We argue that reciprocity can function as a mid-level principle in public health, and generally, captures a core social obligation arising once an individual or group is burdened as a result of acting for the benefit of others. We conclude that while more needs to be explored in relation to the theoretical justification and application of reciprocity, sufficient arguments can be made for it to be taken more seriously as a key principle within public health ethics and bioethics more generally. (shrink)

The amygdala is a key brain area regulating responses to stress and emotional stimuli, so improving our understanding of how it is regulated could offer novel strategies for treating disturbances in emotion regulation. As we review here, a growing body of evidence indicates that the gut microbiota may contribute to a range of amygdala-dependent brain functions from pain sensitivity to social behavior, emotion regulation, and therefore, psychiatric health. In addition, it appears that the microbiota is necessary for normal development of (...) the amygdala at both the structural and functional levels. While further investigations are needed to elucidate the exact mechanisms of microbiota-to-amygdala communication, ultimately, this work raises the intriguing possibility that the gut microbiota may become a viable treatment target in disorders associated with amygdala dysregulation, including visceral pain, post-traumatic stress disorder, and beyond. Also see the video abstract here: https://youtu.be/O5gvxVJjX18 The amygdala plays a central role in regulating many aspects of behavior in rodents and humans, from pain responding to social interaction and psychiatric function. Accumulating evidence suggests microbiota-to-amygdala communication along the gut-brain axis is a key modulator of these amygdala-dependent behaviors, with critical implications for health and disease. (shrink)

South Africa shared with the world the warning of a new strain of SARS-CoV2, Omicron, in November 2021. As a result, many high-income countries (HICs) instituted complete travel bans on persons leaving South Africa and other neighbouring countries. These bans were unnecessary from a scientific standpoint, and they ran counter to the International Health Regulations. In short, South Africa was penalized for sharing data. Data sharing during pandemics is commonly justified by appeals to solidarity. In this paper, we argue that (...) solidarity is, at best, an aspirational ideal to work toward but that it cannot ground an obligation to share data. Instead, low-and-middle income countries (LIMCs) should be guided by the principle of reciprocity, which states that we ought to return good for good received. Reciprocity is necessarily a conditional principle. LMICs, we argue, should only share data during future pandemics on the condition that HICs provide enforceable assurances that the benefits of data sharing will be equitably distributed and that LMICs won’t be penalized for sharing information. (shrink)

In May 2021, when the Delta variant of SARS-CoV2 was wreaking havoc in India, the Australian Federal Government banned its citizens and residents who were there from coming back to Australia for 14 days on penalty of fines or imprisonment. These measures were justified on the grounds of protecting the broader Australian public from potentially importing the Delta strain, which officials feared would then seed a local outbreak. Those Australians stranded in India, and their families and communities back home, claimed (...) that they were abandoned by Prime Minister Scott Morrison’s government. This case—along with other barriers used as part of border control measures in the name of public health—raises the following question: is it ever morally permissible for a state to ban its citizens and residents from entering their own country during a pandemic? I conclude that it’s impermissible. I argue that persons have a right of entry that should be understood as a security right. This security right should be non-derogable because it’s a foundational good that is necessary for life-planning purposes. Moreover, it is a right that people should be able to rely upon absolutely, even during pandemics. At the very least, should someone believe that there are rare exceptions to the right of entry on public health grounds, governments have a duty—grounded in the principle of reciprocity—to support those who are temporarily denied entry. In the case of Australians stranded in India, I will argue that the Australian Federal Government failed on all accounts. (shrink)

Powers and Faden argue that social justice ‘is concerned with securing and maintaining the social conditions necessary for a sufficient level of well-being in all of its essential dimensions for everyone’ (2006: 50). Moreover, social justice is concerned with the ‘achievement of well-being, not the freedom or capability to achieve well-being’ (p. 40). Although Powers and Faden note that an agent alone cannot achieve well-being without the necessary social conditions of life (e.g. equal civil liberties and basic material resources, such (...) as food and shelter), it seems that achievement requires that an agent actually pursue the six dimensions of well-being. In this article, I question the extent to which an individual has an obligation to achieve well-being, even if he or she would choose to do otherwise. For example, can an agent choose to forgo being healthy even if all the social conditions are met in her life, thereby choosing to not achieve well-being? It remains unclear how the dimension of self-determination coheres with the remaining five dimensions of well-being and the extent of society’s obligations toward an individual’s achievement of well-being, even in those instances when society’s actions may go against an individual’s right to self-determination. (shrink)

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such (...) innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter’s conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance. (shrink)

I explain why, from the perspective of knowledge-centric anti-luck epistemology, objective act consequentialist theories of ethics imply skepticism about the moral status of our prospective actions and also tend to be self-defeating, undermining the justification of consequentialist theories themselves. For according to knowledge-centric anti-luck epistemology there are modal anti-luck demands on both knowledge and justification, and it turns out that our beliefs about the moral status of our prospective actions are almost never able to satisfy these demands if objective act (...) consequentialism is true. This kind of applied moral skepticism introduces problematic limits on our ability to use objective act consequentialism’s explanatory power as evidence for its truth. This is, in part, a product of higher-order defeat as I explain in the final section. There is, however, a silver lining for objective act consequentialists. For there is at least one type of objective act consequentialism, prior existence consequentialism, that is poised to avoid at least some of the epistemic problems discussed in this paper. (shrink)

Although various scholars underscore the importance of innovating responsibly in view of today's societal challenges, less attention has been paid to the entrepreneurial skillset, that is, the range of individual skills and organizational capabilities, that innovation-based organizations mobilize to deliver new responsible products and services. This paper thus explores the relationships between the entrepreneurial skillsets of 16 Canadian and Brazilian for-profit and not-for-profit organizations producing Responsible Innovations in Health (RIH) and their degree of responsibility. Our mixed methods study includes interviews (...) with entrepreneurs (n = 23) and fieldnotes as well as quantitative results from the RIH Assessment Tool. Our findings identify four skillset orientations—Technical, Technical + Business, Social, and Social + Business—that not only reflect (co)founders' training and entrepreneurial motivations but also a proclivity toward the consolidation of either “Technical” or “Social” skills and capabilities. Such consolidation is made possible by recruiting high-level executives with diverse backgrounds or by tapping on external knowledge sources (e.g., boards of directors, incubators, or volunteers). As five enterprises had no formal business skills, patterns associated to their overall RIH score (ranging from 1 to 5) reveal intriguing results. Organizations with a Social + Business skillset have a slightly lower RIH score (4.1) than those with a Social skillet (4.4) and those with a Technical + Business skillset have a slightly higher score (3.5) than those with a Technical skillset (3.0). The presence of business skills thus appears to mediate the relationship between entrepreneurial skillsets and the degree of responsibility, which may be linked to the distinct roles of ordinary (“doing things right”) and dynamic capabilities (“doing the right things”). These exploratory findings have scholarly and practical implications. First, the tensions and synergies characterizing responsible value creation should be approached by examining the complementary skills and capabilities that need to be assembled and consolidated. Second, the eight cases with a Social + Business skillset clarify the unique capabilities needed to produce highly responsible health innovations. Third, entrepreneurs with a scientific or engineering background should recognize that a Technical skillset is not enough. Fourth, recognizing that “falling in love with the cause” of RIH is not sufficient, investors and boards of directors should adequately support responsible entrepreneurs towards the proper orchestration of skills and capabilities that can reconcile economic and social goals. (shrink)

The distinction between propositional and doxastic justification has been of undisputed theoretical importance in a wide range of contemporary epistemological debates. Yet there are a host of intimately related issues that have rarely been discussed in connection with this distinction. For instance, the distinction not only applies to an individual’s beliefs, but also to group beliefs and to various other attitudes that both groups and individuals can take: credence, commitment, suspension, faith, and hope. Moreover, discussions of propositional and doxastic justification (...) have rarely focused on broader meta-epistemological issues, and yet meta-epistemological positions can have important implications for first-order views about this distinction. This volume addresses these and other issues by bringing together 16 essays that advance the state-of-the-art thinking on propositional and doxastic justification and explore how such thinking shapes and is shaped by a range of issues previously neglected in contemporary epistemology. (shrink)

Background: Demand for organisational ethics capacity is growing in health organisations, particularly among managers. The role of clinical ethicists in, and perspective on, organisational ethics has not been well described or documented in the literature. Objective: To describe clinical ethicists’ perspectives on organisational ethics issues in their hospitals, their institutional role in relation to organisational ethics, and their perceived effectiveness in helping to address organisational ethics issues. Design and Setting: Qualitative case study involving semi-structured interviews with 18 clinical ethicists across (...) 13 health organisations in Toronto, Canada. Results: From the clinical ethicists’ perspective, the most pressing organisational ethics issues in their organisations are: resource allocation, staff moral distress linked to the organisation’s moral climate, conflicts of interest, and clinical issues with a significant organisational dimension. Clinical ethicists were consulted in particular on issues related to staff moral distress and clinical issues with an organisational dimension. Some ethicists described being increasingly consulted on resource allocation, conflicts of interest, and other corporate decisions. Many clinical ethicists felt they lacked sufficient knowledge and understanding of organisational decision-making processes, training in organisational ethics, and access to organisational ethics tools to deal effectively with the increasing demand for organisational ethics support. Conclusion: Growing demand for organisational ethics expertise in healthcare institutions is reshaping the role of clinical ethicists. Effectiveness in organisational ethics entails a re-evaluation of clinical ethics training to include capacity building in organisational ethics and organisational decision-making processes as a complement to traditional clinical ethics education. (shrink)

A common and driving assumption in agricultural research is that the introduction of research trials, new practices and innovative technologies will result in technology adoption, and will subsequently generate benefits for farmers and other stakeholders. In Lao PDR, the potential benefits of introduced technologies have not been fully realised by beneficiaries. We report on an analysis of a survey of 735 smallholder farmers in Southern Lao PDR who were questioned about factors that influenced their decisions to adopt new technologies. In (...) this study, we have constructed measures or states of adoption which identify key elements of an adoption decision-making nexus. Analysis was conducted to statistically group explanatory factors of adoption. The key explanatory factors represented attributes of the farmer, the factors considered when undertaking production decisions and elements of the agricultural value chain that present as opportunities or constraints. We describe the combination of farmer’s personal attributes, perceptions of the value chain, and the introduction of new technologies by external actors as an “agricultural research value chain”, where agricultural research activities intervene to derive greater benefits for local farmers. A generalised linear model, via Poisson regression analysis on the identified explanatory factors, was applied to explore how they influence adoption measures and we found several significant relationships. (shrink)

Este artigo discute o mal-estar de adolescentes de duas escolas públicas da cidade do Rio de Janeiro, no contexto de retorno presencial das aulas pós-pandemia da COVID-19. Durante o contexto de isolamento, a escola teve de se ressignificar como lugar de aprendizagem, de convivência e de mediações com tecnologias até então ausentes, e atualmente tem que se reconstruir, territorialmente, como um lugar possível de afeto e transmissão. A escola é uma das instâncias que se ocupa desta tarefa, em que o (...) jogo de forças entre os grupos e a subjetividade se faz presente. No entanto, a ausência territorial da escola no período de isolamento social foi inevitável. A questão central a que este artigo busca responder é de que maneira o pressuposto freudiano de que o mal-estar faz parte e é inerente à relação entre o sujeito e a cultura, aparece, e sob que aspectos, nesta experiência de retorno às escolas, no período pós-pandemia. Quer nas dificuldades de aprendizagem, diante do lugar do outro, no conflito entre temporalidade e demanda, nas estratégias de enfrentamento e na distância entre os projetos e a realidade, os estudantes revelam suas angústias e novos modos de lidar com a condição de mal-estar. (shrink)

The burdens of mental illnesses and substance use disorders do not lie merely with the individuals who suffer from these conditions but affect, and are affected by, their families, communities, cities and countries. The ethical and political challenges that arise in the treatment of mental illnesses and substance abuse disorders are, therefore, challenges that affect both individuals and communities.

This article has two tasks: to investigate the notions of space, time and causality in Schopenhauer’s theory of knowledge and, subsequently, to carry out a comparative study of the results obtained with the epistemological considerations between the first and second phase of Nietzsche’s thought. It is understood that conclusions concerning the world as representation had an echo in the first digressions of the author of The Birth of Tragedy on the conceptions of space, time and causality. However, the departures begin (...) to be perceived still in the first years of the 1870s. It is chosen to call the reflections on knowledge until On Truth and Lie in an Extra-Moral Sense, considering, besides the unsystematicity of the Nietzschean approaches, the maturation of the epistemological investigations in Human, All Too Human. It is discussed how the naturalistic aspects of the second phase of Nietzsche’s intellectual activity find implications in his conceptions of space, time and, above all, causality. It is emphasized, however, that it is not the intention of this work to argue that Nietzsche’s epistemology is originally derived from Schopenhauer or that it depends exclusively on the notions studied here. (shrink)

The concept of dignity has occasioned a robust conversation in recent healthcare scholarship. When viewed as a whole, research on dignity in healthcare has engaged each of the four bioethical principles popularized by Beauchamp and Childress, but has paid the least attention to beneficence. In this paper, we look at dignity and beneficence. We focus on the dignity promotion component of a model of dignity derived from a grounded theory study. After describing the study and presenting a précis of the (...) resulting model, we review the principle of beneficence and look at the ways in which the notion of dignity promotion can be used to complement our understanding of this principle. Specifically, we explore what we can learn from dignity promotion about the relational nature of beneficence in healthcare and how dignity promotion can be marshaled to help address the epistemological quandary of soft paternalism. (shrink)

Indoor smoking bans in public places is usually held as a simple and straightforward example of the application of the harm principle in public health. However, implementing indoor smoking bans in mental health centres is difficult because of the potential neurological and social benefits of smoking for persons with schizophrenia, as suggested by some empirical studies. In this article, the ethical challenges related to smoking bans in mental health centres as justified by the harm principle are explored. Particular attention is (...) given to the case of R v. Nottinghamshire Healthcare NHS Trust . The article concludes by arguing that the possible benefits of smoking for persons with schizophrenia creates a rightful interest that cannot be ignored even if one applies the harm principle to protect others from the negative effects of second-hand smoke. Applying the harm principle in the case of smoking bans in mental health centres requires protecting the interest of persons with schizophrenia to smoke via the value of reciprocity. (shrink)