Deep Brain Stimulation is currently being investigated as an experimental treatment for patients suffering from treatment-refractory AN, with an increasing number of case reports and small-scale trials published. Although still at an exploratory and experimental stage, initial results have been promising. Despite the risks associated with an invasive neurosurgical procedure and the long-term implantation of a foreign body, DBS has a number of advantageous features for patients with SE-AN. Stimulation can be fine-tuned to the specific needs of the particular patient, (...) is relatively reversible, and the technique also allows for the crucial issue of investigating and comparing the effects of different neural targets. However, at a time when DBS is emerging as a promising investigational treatment modality for AN, lesioning procedures in psychiatry are having a renaissance. Of concern it has been argued that the two kinds of interventions should instead be understood as rivaling, yet “mutually enriching paradigms” despite the fact that lesioning the brain is irreversible and there is no evidence base for an effective target in AN. We argue that lesioning procedures in AN are unethical at this stage of knowledge and seriously problematic for this patient group, for whom self-control is particularly central to wellbeing. They pose a greater risk of major harms that cannot justify ethical equipoise, despite the apparent superiority in reduced short term surgical harms and lower cost. (shrink)

Under the current Mental Health Act of England and Wales, it is lawful to perform deep brain stimulation in the absence of consent and independent approval. We argue against the Care Quality Commission's preferred strategy of addressing this problematic issue, and offer recommendations for deep brain stimulation-specific provisions in a revised Mental Health Act.

Gilbert et al. have raised important questions about the empirical grounding of neuroethical analyses of the apparent phenomenon of Deep Brain Stimulation ‘causing’ personality changes. In this paper, we consider how to make neuroethical claims appropriately calibrated to existing evidence, and the role that philosophical neuroethics has to play in this enterprise of ‘evidence-based neuroethics’. In the first half of the paper, we begin by highlighting the challenges we face in investigating changes to PIAAAS following DBS, explaining how different trial (...) designs may be of different degrees of utility, depending on how changes to PIAAAS following DBS are manifested. In particular, we suggest that the trial designs Gilbert et al. call for may not be able to tell us whether or not DBS directly causes changes to personality. However, we suggest that this is not the most significant question about this phenomenon; the most significant question is whether these changes should matter morally, however they are caused. We go on to suggest that neuroethical analyses of novel neuro-interventions should be carried out in accordance with the levels of evidence hierarchy outlined by the Centre for Evidence-Based Medicine, and explain different ways in which neuroethical analyses of changes to PIAAAS can be evidence-based on this framework. In the second half of the paper, we explain how philosophical neuroethics can play an important role in contributing to mechanism-based reasoning about potential effects on PIAAAS following DBS, a form of evidence that is also incorporated into the CEBM levels of evidence hierarchy. (shrink)

Background -/- Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. -/- Objective -/- This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain stimulation treatments. -/- (...) Approach -/- We illustrate our analysis using a case study of the unexpected development of recurrent stereotyped events in patients following the use of deep brain stimulation (DBS) to treat severe chronic pain. Examining these unexpected complications in light of medical ethical principles, we argue that serious complications of novel DBS treatments do not necessarily make it unethical to offer the intervention to eligible patients. However, the difficulty the clinician faces in determining whether the intervention is in the patient's best interests generates reasons to take extra steps to promote the autonomous decision making of these patients. -/- Conclusion and recommendations -/- We conclude with clinical recommendations, including details of an augmented consent process for novel DBS treatment. (shrink)

'Brainjacking’ refers to the exercise of unauthorized control of another’s electronic brain implant. Whilst the possibility of hacking a Brain–Computer Interface (BCI) has already been proven in both experimental and real-life settings, there is reason to believe that it will soon be possible to interfere with the software settings of the Implanted Pulse Generators (IPGs) that play a central role in Deep Brain Stimulation (DBS) systems. Whilst brainjacking raises ethical concerns pertaining to privacy and physical or psychological harm, we claim (...) that the possibility of brainjacking DBS raises particularly profound concerns about individual autonomy, since the possibility of hacking such devices raises the prospect of third parties exerting influence over the neural circuits underpinning the subject’s cognitive, emotional and motivational states. However, although it seems natural to assume that brainjacking represents a profound threat to individual autonomy, we suggest that the implications of brainjacking for individual autonomy are complicated by the fact that technologies targeted by brainjacking often serve to enhance certain aspects of the user’s autonomy. The difficulty of ascertaining the implications of brainjacking DBS for individual autonomy is exacerbated by the varied understandings of autonomy in the neuroethical and philosophical literature. In this paper, we seek to bring some conceptual clarity to this area by mapping out some of the prominent views concerning the different dimension of autonomous agency, and the implications of brainjacking DBS for each dimension. Drawing on three hypothetical case studies, we show that there could plausibly be some circumstances in which brainjacking could potentially be carried out in ways that could serve to enhance certain dimensions of the target’s autonomy. Our analysis raises further questions about the power, scope, and necessity of obtaining prior consent in seeking to protect patient autonomy when directly interfering with their neural states, in particular in the context of self-regulating closed-loop stimulation devices. (shrink)

The dorsal anterior cingulate cortex is a key node in the human salience network. It has been ascribed motor, pain-processing and affective functions. However, the dynamics of information flow in this complex region and how it responds to inputs remain unclear and are difficult to study using non-invasive electrophysiology. The area is targeted by neurosurgery to treat neuropathic pain. During deep brain stimulation surgery, we recorded local field potentials from this region in humans during a decision-making task requiring motor output. (...) We investigated the spatial and temporal distribution of information flow within the dACC. We demonstrate the existence of a distributed network within the anterior cingulate cortex where discrete nodes demonstrate directed communication following inputs. We show that this network anticipates and responds to the valence of feedback to actions. We further show that these network dynamics adapt following learning. Our results provide evidence for the integration of learning and the response to feedback in a key cognitive region. (shrink)

Sanayi devrimi sonrası Avrupa Devletleri’nde üretimin artması, yeni pazar ve hammadde ihtiyacını da beraberinde getirmiştir. Bu ihtiyacın giderilebilmesi için sanayi ürünlerinin ve üretim araçlarının tanıtılması amacı ile uluslararası sergiler düzenlenmeye başlanmıştır. Ayrıca bu sergilerle ülkelerin bilim, sanayi, teknoloji ve tarım alanındaki gelişme ve yeniliklerinin herkese duyurulması amaçlanmıştır. Öncülüğünü Fransa ve İngiltere’nin yaptığı sanayi sergileri, ilgili ülkelerin sömürgelerinden gelen hammadde ve bu hammaddelerden üretilen sanayi ürünlerinin pazarlanmasına yönelik olarak yapılmıştır. Başlangıçta sanayi ve ticari amaçla başlatılan sergiler, Avrupa ile Avrupa dışında bulunan (...) devletlerin kültür ve yerel sanatları arasında, etkileşime de sebep olmuştur. 18. yüzyılın sonlarından itibaren Fransa'da ulusal düzeyde ve 19. yüzyılın ilk yarısında çeşitli Avrupa ülkelerinde düzenlenen benzer olayların doruk noktası olan Londra sergisi ilk uluslararası sergi olarak kayda geçmiştir. 1851 yılında Londra’da açılan sergi bundan sonra düzenlenen diğer uluslararası sergilere de ilham kaynağı olmuştur. (shrink)

The past decade has seen major movements and mobilizations against the new crop of bilateral free trade and investment agreements being pursued by governments in the wake of the failure of global (World Trade Organization) and regional (e.g. Free Trade Area of the Americas) negotiations, and the defeat of an attempted Multilateral Agreement on Investment in the 1990s. However, in spite of much scholarly, non-governmental organization (NGO) and activist focus on transnational global justice activism, many of these movements, such as (...) the major multi-sectoral popular struggle over the recently-concluded US-Korea Free Trade Agreement, are hardly acknowledged in North America and Europe. With a shift in emphasis pushing liberalization and deregulation of trade and investment increasingly favouring lower-profile bilateral agreements, this article maps the resistance movements to these latest shifts in global free market capitalist relations and discusses the disconnect between these (mainly Southern) struggles and dominant scholarly and NGO conceptions of global justice and the global justice movement as well as questions of knowledge production arising from these movements. (shrink)

While the concept of work ethic has been discussed in the Arab context :35–49, 2009), the significant conceptual and methodological limitations of the existing work ethic and work value research elucidate the need for a more robust investigation of the multidimensional work ethic construct in the Arab context. Multidimensionality of the work ethic concept has gained considerable attention in recent years as researchers attempt to move away from the religiously labeled Islamic and Protestant work ethic conceptualizations. The current study examines (...) the Arab work ethic through the use of the multidimensional work ethic profile on a sample of future business leaders in the United Arab Emirates. A total of 484 business students completed an Arabic version of the MWEP short form. The results show that centrality of work and hard work are the highest scoring work ethics followed by self-reliance, wasted time, and leisure. There are significant differences in work ethic dimensions across gender and categories of family breadwinner. No significant differences in work ethic dimensions are observed across categories of nationality and work preference groups. The findings are discussed in relation to the unique insight they offer on the nature of work ethic in an Arab context. (shrink)

The Farm to Fork (F2F) Strategy at the heart of the European Union’s Green Deal set out to create a “just transition” towards a sustainable food system, with benefits for all actors. We conducted a critical discourse analysis (CDA) to explore discourses around power in the food system and farmers’ position in the communication and implementation of the Farm to Fork Strategy. Discourse analysis encapsulates various scientific methodologies for deciphering the meaning behind the creation and communication of different forms of (...) language and identify power dynamics, amongst other aspects. We identified two prior discourses in one of the objectives of the European Union’s new Common Agricultural Policy (2023-27). Our analysis found that the discourses, namely “rebalance power in food system” and “strengthening farmers’ position in value chains,” are marginalized in favour of an innovation-investment discourse, indicative of greater financialization and technologization based on techno-finances fixes in transforming the European Union agri-food system. We argue that entities representing agri-business interests have been influential in the policymaking process and voices representing smallholder and medium-sized farmers’ transformational discourses have been excluded. (shrink)

This chapter contains sections titled: Defining the Subject The Scope of Philosophy in the Islamic Context Sources and Legacy The Political Orientation of Islamic Philosophy Some Salient Themes The Great Debate Alternative Traditions Concluding Comment Works cited.

Researchers on gender and ethical decision-making have recently emphasized the differences between men's and women's ethical perceptions. This study is concerned with the perceptions of salespeople working in clothing and medical equipment sectors in Turkey. It regards the perceptions of colleagues of opposing genders in ethically questionable situations. The evaluation of salespeople's responses for 14 ethical scenarios indicates that there is no significant difference in ethical perception based on gender. Each gender predicted that their counterpart's response would be the same (...) as their own. The study also examined the effects of some demographic factors as well as the firm's sector on the salespeople's ethical perceptions and found that there are both differences and similarities in detail between genders of salespeople within ethically questionable situations. (shrink)

Jesper Ryberg and Julian Roberts teach ethics and criminology at Roskilde University and the University of Oxford respectively. In Sentencing and Artificial Intelligence, they have curated a powerf...

The dynamics of the superior judiciary in Pakistan have undergone a drastic transformation in its approach and working in post 2007 emergency followed by a landmark movement of civil and legal fraternity for restoration of constitutional supremacy. The neo-jurisprudence is being applauded and criticized at the same time. The excessive use of Suo-motto and public interest litigation at one hand and frequent judicial review of executive and legislative action on other have been the main source of contention between judiciary and (...) other two pillars of state, legislature and executive. The Superior Court is being recognized as the ultimate savior of fundamental rights and guardian of the constitution as well as rights of the people. At the other extreme, the criticism like activist judiciary; disrespect for popular will and making rather interpreting law are most commonly attributed to Superior Judiciary. The study is qualitative in nature and presents a comparative analysis of trends in Superior Court before and after Lawyers’ movement. The study also aims in justifying the proactive approach especially in providing social justice on failure of state organs to respond to the exigency of time. (shrink)

As with many other countries, Malaysia is also developing and promoting biomedical research to increase the understanding of human diseases and possible interventions. To facilitate this development, there is a significant growth of biobanks in the country to ensure continuous collection of biological samples for future research, which contain extremely important personal information and health data of the participants involved. Given the vast amount of samples and data accumulated by biobanks, they can be considered as reservoirs of precious biomedical big (...) data. It is therefore imperative for biobanks to have in place regulatory measures to ensure ethical use of the biomedical big data. Malaysia has yet to introduce specific legislation for the field of biobanking. However, it can be argued that its existing Personal Data Protection Act 2010 has laid down legal principles that can be enforced to protect biomedical big data generated by the biobanks. Consent is a mechanism to enable data subjects to exercise their autonomy by determining how their data can be used and ensure compliance with legal principles. However, there are two main concerns surrounding the current practice of consent in biomedical big data in Malaysia. First, it is uncertain that the current practice would be able to respect the underlying notion of autonomy, and second, it is not in accordance with the legal principles of the PDPA. Scholars have deliberated on different strategies of informed consent, and a more interactive approach has recently been introduced: dynamic consent. It is argued that a dynamic consent approach would be able to address these concerns. (shrink)

Aims The study aims to test the Turkish validity and reliability of the Rushton Moral Resilience Scale (RMRS) and examine the effect of moral resilience on moral distress. Background Moral distress is a phenomenon that negatively affects health workers, health institutions, and the person receiving care. In order to eliminate or minimize the negative effects of moral distress, it is necessary to increase the moral resilience of nurses. Moral resilience involves developing systems that support a culture of ethical practice in (...) healthcare and aim to increase an individual’s capacity to cope with moral challenges. Methods A methodological and descriptive-predictive study design was adopted. Sociodemographic Information Form, Measure of Moral Distress – Healthcare Professionals (MMD-HP), and Rushton Moral Resilience Scale were used to collect data from the nurses. A total of 255 clinical nurses were recruited. Ethical considerations Hacettepe University’s non-interventional ethics committee approved the study’s protocol and informed consent was obtained from the participants. Results The original four-factor structure of the scale was tested with confirmatory factor analysis, and the index values were evaluated and found at an acceptable level. The Cronbach Alpha coefficient of the scale was found to be 0.826. Moral resilience predicted moral distress total, intensity, and frequency levels. A moderate and weak relationship was found in the negative between all sub-dimensions of moral distress and moral resilience. Conclusions The Rushton Moral Resilience Scale Turkish version showed good psychometric properties. Moral resilience has a reducing effect on moral distress. Young nurses who have less experience are at risk because they have lower moral resilience levels, while nurses working in intensive care units are at risk because of their high moral distress levels. A healthy workplace can be created by developing specific approaches to improve moral resilience in reducing the impact of moral distress in the healthcare environment. (shrink)

Youth ministry as a sub-discipline of practical theology has traditionally always had an ecclesial focus. The focus was often based on the practices of proselytisation and discipleship, a sort of ‘reach and teach’ model whereby Christian believers would do the ‘reaching and teaching’ of the ‘lost’ youth. This is most true in an evangelical context and is further undergirded by a Western concept of personal salvation nearly devoid of any communal responsibilities and context. The traditional model, therefore, in evangelical churches (...) was reaching the ‘lost’ with the Gospel of Jesus Christ, with the aim of personal salvation for the individual who would eventually become a member of the faith community through a discipleship programme. Thus, the beginning and end of the entire process were the focus on personal salvation devoid of any contextual consideration. Youth ministry as practical theology must move into the area of public theology to engage the practices inherited from the western model by engaging with the public (youths) as public theologians (those who influence the theologies of the youth), and the public faiths and spiritualities (the expression of the youth’s theologies) to be relevant to the majority and developing world.Contribution: In this study, the author suggests that this ‘reach and teach’ paradigm with an ecclesial focus in the context of the majority and developing world is no longer suitable to meet the needs of youth. In addition, the author recommends a more appropriate framework with youth ministry as public practical theology for consideration. (shrink)

This Festschrift honours Arkoun's scholarship, bringing together the contributions of eleven scholars of history, religious studies and philosophy. It offers a comprehensive selection of critical engagements with Arkoun's work, reflecting on his influence on contemporary thinking about Islam and its ideological, philosophical and theological dimensions.

Essai sur les traités philosophiques de Cicéron et leurs sources grecques.--La polémique de la nouvelle académie contre le stoīcisme.--Miskaweih, sa philosophie morale et ses sources.

Leadership and areas of influence are often reserved for the adult community. The youth are mostly regarded as developing beings, with insufficient knowledge and experience to take on leadership roles where influence can be exercised. It is often considered – especially in the context of the church – that the youth do not have the capacity to lead, while evidence from society and research studies points to the contrary. The author of this article argues that the ability to influence does (...) not depend on age or in an accumulation of experience. Instead, the ability of the youth to make a difference is attributed to their desire to do so. The author draws attention to why we need to focus on the youth and their ability to make a difference. The article presents an argument based on scriptural evidence and a theology of childhood as to why it is indeed possible and beneficial for the youth to exert their influence across various sectors of society. (shrink)