Brain death has been accepted worldwide medically and legally as the biological state of death of the organism. Nevertheless, the literature has described persistent problems with this acceptance ever since brain death was described. Many of these problems are not widely known or properly understood by much of the medical community. Here we aim to clarify these issues, based on the two intractable problems in the brain death debates. First, the metaphysical problem: there is no reason that withstands critical scrutiny (...) to believe that BD is the state of biological death of the human organism. Second, the epistemic problem: there is no way currently to diagnose the state of BD, the irreversible loss of all brain functions, using clinical tests and ancillary tests, given potential confounders to testing. We discuss these problems and their main objections and conclude that these problems are intractable in that there has been no acceptable solution offered other than bare assertions of an ‘operational definition’ of death. We present possible ways to move forward that accept both the metaphysical problem - that BD is not biological death of the human organism - and the epistemic problem - that as currently diagnosed, BD is a devastating neurological state where recovery of sentience is very unlikely, but not a confirmed state of irreversible loss of all [critical] brain functions. We argue that the best solution is to abandon the dead donor rule, thus allowing vital organ donation from patients currently diagnosed as BD, assuming appropriate changes are made to the consent process and to laws about killing. (shrink)

This paper examines the madness of Gerard de Nerval, the nineteenth-century French writer. It looks at his account of mental disturbance, how he responded to the psychiatric profession and how he reacted to being diagnosed as insane. It considers his autobiographical novella of madness, Aurelia, which he began at the suggestion of his alienist, Dr Emile Blanche, and while he was still an asylum inmate. Nerval's story raises important questions about the nature of madness. Is it, as he contended, a (...) mystical experience revealing truths about spiritual worlds inaccessible to the ‘sane’? Does psychiatry fail to understand it and inappropriately reduce it to the categories of scientific reason? Or are such notions of the spiritual value of madness guilty of the charge that they romanticise insanity? Do they make extravagant claims for an experience that is often disturbing and debilitating? What is the relationship between madness and recovery? Should an individual try to forget their experience of mental disturbance once they recover, or should they examine what the event reveals about themselves? Can the language of madness be decoded to unveil profound truths as Carl Jung and R.D. Laing have suggested, or is it, as the psychiatrist German Berrios maintains, merely a series of ‘empty speech acts’, signifying nothing? And finally, how does one avoid writing about madness, and instead write madness? (shrink)

Thetext of the de Caelo was the subject of an interesting article in the Rivista Storia Antica, N.S. IX, by Dr. R. Rubrichi; he showed that where the manuscriptsdiverge, we ought to bring in the evidence of Simplicius, and that when we look closely into the sense, the commentator's reading is in most cases decidedly preferable; he also established a fact which is familiar from editions of the othér physical treatises, namely that there is some specially close affinity between the (...) text of E and that used by Simplicius. (shrink)

Chantal Mouffe har altid sat spørgsmålet om sociale bevægelser i relation til spørgsmålet om demokratisering. Hendes ideer om agonistisk og radikalt demokrati har fået gennemslag i den europæiske samfundsmæssige debat, men i den sammenhæng glemmer man måske, at hun først og fremmest er engageret i en radikalisering af det liberale demokrati. I hendes nuancerede debatstil kan de mange begreber, nogle af hvilke hun selv er ophavet til, godt få læseren til at fokusere på enkelte træer, som for eksempel netop agonistisk (...) og radikalt demokrati. Dermed kan selve skoven, det liberale demokrati og dets udvikling, forsvinde ud af fokus. Det gør det imidlertid ikke i dette interview, der fandt sted i hendes hjem i Hampstead, Nordlondon, primo 2012, omtrent samtidig med, at hendes seneste bog Agonistics blev afsluttet. (shrink)

The Liverpool Care Pathway for the Dying Patient (LCP) was an integrated care pathway for patients in the final days or hours of life, developed at the Royal Liverpool University Hospital in conjunction with the Marie Curie Palliative Care Institute, Liverpool. The LCP became increasingly the normative style of care for patients in the terminal stage across NHS England from the 1990s onwards. Following significant questions raised in Parliament, by the media and other stakeholders, an independent review panel was established (...) under Baroness Neuberger in 2013 to investigate the LCP. The findings of the panel were published as More Care Less Pathway: a Review of the Liverpool Care Pathway identifying significant failings in the delivery of the LCP thus leading to it being phased out some six months later. Rather than being euthanasia through the backdoor, many of the criticisms of the LCP and its poor implementation are indicative of poor communication, limited knowledge of the dying process and a paucity of death education. (shrink)

In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines in (...) ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines. (shrink)

Kojève has been known as the most brilliant, profound, controversial, and influential commentator on Hegel in the twentieth century. "Commentator" is perhaps too neutral a word, for Kojève's lectures on Hegel have been a vehicle for articulating and defending a view of what philosophy and wisdom essentially are. Kojève's lectures on the Phenomenology of Spirit at the Ecole des Hautes Etudes from 1933-1939 were primarily responsible for the Hegelian influence on a number of major French intellectuals. The present translation which (...) consists of a selection from the collection of writings edited by Queneau, is certainly not an introduction in any ordinary sense of the term. But for those who have been caught by the power of Hegel's Phenomenology--and their number seems to be growing in the Anglo-Saxon world--an encounter with Kojève, who is clearly one of the most serious readers of Hegel, will prove immensely rewarding. It is a bit surprising that Allan Bloom whose own approach to scholarship places such a high priority on careful textual analysis has edited a rather chopped up version of the French text.--R. J. B. (shrink)

Essentialism is one of the most pervasive problems in mental health research. Many psychiatrists still hold the view that their nosologies will enable them, sooner or later, to carve nature at its joints and to identify and chart the essence of mental disorders. Moreover, according to recent research in social psychology, some laypeople tend to think along similar essentialist lines. The main aim of this article is to highlight a number of processes that possibly explain the persistent presence and popularity (...) of essentialist conceptions of mental disorders. One such process is the general tendency of laypeople to essentialize conceptual structures, including biological, social, and psychiatric categories. Another process involves the allure of biological psychiatry. Advocating a categorical and biological approach, this strand of psychiatry probably reinforced the already existing lay essentialism about mental disorders. As such, the question regarding why we essentialize mental disorders is a salient example of how cultural trends zero in on natural tendencies, and vice versa, and how both can boost each other. (shrink)

Schuklenk and van de Vathorst's paper is a very welcome addition to the literature on the assisted dying debate and will be of great interest to clinicians working in the field of mental health.1 Many psychiatrists will have had patients who have asked them to allow them to die, to desist in their efforts to prevent their suicide, and one of us has had personal experience, outside of professional life, of being asked to aid in someone's attempt to end their (...) life in the context of an episode of mood disorder. The person with depression asking professionals, friends and family members to aid them in ending their life is a very real phenomenon. In their discussion, Schuklenk and van de Vathorst's paper uses two principles that we endorse and add weight to their argument: namely, the reality of suffering in depression and the parity of mental and physical illness. Indeed, the case Schuklenk and van de Vathorst make is a strong one and our commentary will focus on the premise of the argument around choosing death and some empirical clarification about competence in depression and the nature of treatment-resistant depression (TRD) and its prognosis. The conceptual concern we wish to discuss in relation to assisted dying, endorsed by the state and legislature, is not linked to any moral or religious concern, or even on grounds related to ‘slippery slope’ or ‘abuse’ arguments. Rather the worry is how one could operationalise decisions around assisted dying as based on competence and capacity and view such decisions as rational. I think this concern is not limited to depressive illness, but to all decisions regarding choosing non-existence. Schuklenk and van de Vathorst offer the following useful criteria to regulate assisted suicide:1. (shrink)

Maladapting Minds discusses a number of reasons why philosophers of psychiatry should take an interest in evolutionary explanations of mental disorders and, more generally, in evolutionary thinking. First of all, there is the nascent field of evolutionary psychiatry. Unlike other psychiatrists, evolutionary psychiatrists engage with ultimate, rather than proximate, questions about mental illnesses. Being a young and youthful new discipline, evolutionary psychiatry allows for a nice case study in the philosophy of science. Secondly, philosophers of psychiatry have engaged with evolutionary (...) theory because evolutionary considerations are often said to play a role in defining the concept of mental disorder. The basic question here is: Can the concept of mental disorder be given an objective definition, or is it rather a normative concept? Thirdly and finally, evolutionary thinking in psychiatry has often been a source of inspiration for a philosophical view on human nature. Thus evolutionary psychiatrists have suggested, for example, that man's vulnerability to mental disorders may well be one of the defining features of our species. -/- Written by leading authors in philosophy, psychiatry, biology and psychology, this volume illustrates that many debates in contemporary philosophy of psychiatry are profoundly influenced by evolutionary approaches to mental disorders. Conversely, it also reveals how philosophers can help contribute to the burgeoning field of evolutionary psychiatry. It is important reading for a wide range of readers interested in mental health care and philosophy. (shrink)

This paper, which gives continuity to another article, analyzes the content of I Dialogus V, 14-22 and, in an appendix, presents our Portuguese translation of this excerpt. In these chapters, the Inceptor Venerabilis discusses whether St. Peter and the Roman Church possess primacy over all other apostles and churches; andwhether this primacy is granted by God himself. Ockham first presents, not ad litteram, the opinion of those who refute the thesis that Christ did not give primacy to Peter and the (...) Roman Church. Then, because this thesis fully deflates papal power, he proposes a contrary thesis based on five proofs. We conclude that Ockham’s unnamed opponent is Marsilius of Padua, whose opinions are in his Defensor Pacis. (shrink)

The way students perceive a learning climate (e.g. controlling or stimulating) is significantly influenced by feedback and assessment. However, at present much is unclear about the relation between feedback and motivational state. More specifically, the interplay with student characteristics is unclear. Since there is a strong increase of group work, the central research question is what are the effects of positive, neutral or negative feedback presented to collaborating teams of students, on students? intrinsic motivation, performance and on group processes? One (...) hundred thirty?eight higher education students participated in this study. There were no significant differences in performance across conditions. Multi?level analysis enabled a detailed comparison between groups and individual members of groups. Amongst others, it was found that feelings of competence facilitate the effect of positive feedback at the group level, which suggests that positive feedback boosts interest especially in groups of highly competent students. (shrink)

Resumo: O propósito geral do presente texto consiste em introduzir o sentido e o alcance que noção de improvisação musical pode adquirir no filosofar nietzschiano, e, em especial, no assim chamado período de maturidade de seu itinerário intelectual. Tenciona-se indicar que tal ideia assume uma função reguladora em seu pensamento, possibilitando lançar uma intensiva luz sobre o seu legado e enfatizar, sobretudo, o caráter pluralista e dinâmico deste último.: The present text aims at introducing the meaning and the scope that (...) the notion of musical improvisation may acquire within Nietzsche’s thought - especially in the light of thehis latter writings. It also intends to show that such idea performs a regulatory function within his thought and allows us, at the same time, to shed a bright light on his legacy, serving first and foremost to emphasize its pluralistic and dynamic character. (shrink)

The Adverse Outcome Pathway (AOP) concept is a knowledge assembly and communication tool to facilitate the transparent translation of mechanistic information into outcomes meaningful to the regulatory assessment of chemicals. The AOP framework and associated knowledgebases (KBs) have received significant attention and use in the regulatory toxicology community. However, it is increasingly apparent that the potential stakeholder community for the AOP concept and AOP KBs is broader than scientists and regulators directly involved in chemical safety assessment. In this paper we (...) identify and describe those stakeholders who currently—or in the future—could benefit from the application of the AOP framework and knowledge to specific problems. We also summarize the challenges faced in implementing pathway-based approaches such as the AOP framework in biological sciences, and provide a series of recommendations to meet critical needs to ensure further progression of the framework as a useful, sustainable and dependable tool supporting assessments of both human health and the environment. Although the AOP concept has the potential to significantly impact the organization and interpretation of biological information in a variety of disciplines/applications, this promise can only be fully realized through the active engagement of, and input from multiple stakeholders, requiring multi-pronged substantive long-term planning and strategies. (shrink)

The present paper aims at investigating the meaning and scope of the idea of musical dissonance in The Birth of Tragedy. In reviewing the possible explanatory definitions of this concept, within and outside the speculative-theoretical framework proper to Nietzsche’s first book, we hope to open a path that leads us to rethink the so-called “artist metaphysics”, and, specially, what is generally understood as Dionysian music.

Resumo Longe de pretender esgotar possíveis semelhanças entre Nietzsche e Quine, o texto que se segue tenciona mostrar, mediante comparações paradigmáticas e admissíveis convergências metodológicas, como ambos os autores, lançando mão de hipóteses naturalistas para interpretar o conhecimento e a estética, respectivamente, tornam possível pensar num naturalismo menos confinante e mais inventivo, livre dos prejuízos do cientificismo e mais condizente com a sensibilidade artística em geral.Far from intending to exhaust all the possible similarities between Nietzsche and Quine, the following text (...) aims at showing, through paradigmatic comparisons and admissible methodological convergences, how both authors - by making naturalistic assumptions to interpret knowledge and aesthetics respectively - allow us to think of a less confining and more creative naturalism, free from the prejudices of scientism and more compatible with the artistic sensibility in general. (shrink)