Commercialism first became a major problem for medicine in the decade of the 1970s, when huge quantities of new money began to flow into the healthcare system, as a result of Medicaid and Medicare, and the rapid expansion of private, employer-based insurance. Of course, physicians benefited, but most of this new money went to insurance plans and medical care delivery institutions, like hospitals, nursing homes, diagnostic services, and ambulatory care facilities of many kinds. Many of these were newly established for-profit (...) businesses. A vast number of satellite enterprises sprang up to serve the growing needs of the new businesses by providing services like marketing and advertising, brokering, consulting, information technology, financial services, case and disease management, billing and collecting, and so forth. (shrink)

Authors, reviewers, and editors have critical responsibilities to ensure the validity and utility of published biomedical research.

A definition of ?alienation? is proposed which is a rational reconstruction of the term as it is used in primarily moral contexts. Special attention is given to the Marxist tradition. It is argued that the earliest, moral form of Marx's economic determinism can be expressed in terms of the principle of the sufficiency of unalienated labor. In this connection four main kinds of alienation are distinguished. In the final section, it is argued that while ?alienation? has and should have an (...) important theoretical role in the context of moral discourse, social scientists, and in particular sociologists, would be better off if they eliminated ?alienation? from their scientific vocabulary. (shrink)

The arguments contained in books criticizing American social scientists by C. Wright Mills ( The Sociological Imagination) and Bernard Crick (The Science of American Politics) are discussed, compared and criticized. It is argued that Mills' criteria of evaluation and constructive alternatives to the tendencies he criticizes are immeasurably sounder than those found in Crick's book. An effort to supplement Mills' argument by providing a more explicit statement of its moral underpinnings is made. Finally, it is argued that though both critiques (...) have serious empirical flaws, the authors have undeniably demonstrated that important tendencies for irresponsible thought and action do exist within the American social sciences. (shrink)

The idea of human rights gained prominence at a time when the rising bourgeoisie viewed the state as the main obstacle to commercial expansion, private property as the major protection against dependency, and material scarcity as an indelible condition of society. As moral concepts are largely shaped by the social forces that call them into being, it is not surprising that the very language of rights was early tailored to suit the needs of an expanding, acquisitive, increasingly powerful segment of (...) society. (shrink)

Examination of human activities and their outcomes is a basic function of philosophy. Historically such examination has tended to conform to one of two patterns.

ObjectiveTo apply a socioecological approach to identify risk and protective factors across levels of the “sports-ecosystem,” which are associated with mental health outcomes among athletes in para-sports and non-para sports. A further aim is to determine whether para athletes have unique risks and protective factor profiles compared to non-para athletes.MethodsA cross-sectional, anonymous online-survey was provided to all categorized athletes aged 16 years and older, registered with the Australian Institute of Sport. Mental health outcomes included mental health symptoms, general psychological distress, (...) risky alcohol consumption and eating disorder risk. Risk and protective factors across multiple levels of the socioecological model, including individual, microsystem, exosystem and macrosystem level factors were assessed via self-report.ResultsA total of 427 elite athletes participated in the study. No significant differences in the rates of mental health problems were observed between para and non-para athletes. Both differences and similarities in risk and protective factor profiles were found across the multiple levels of the sports-ecosystem. Weak evidence was also found to support the hypothesis that certain risk factors, including experiencing two or more adverse life events in the past year, sports related concussion, high self-stigma, inadequate social support and low psychological safety conferred a greater risk for poorer mental health outcomes for para athletes in particular.ConclusionRisk factors occurring across various levels of the sports ecosystem, including individual, interpersonal and organizational level risk factors were found to be associated with a range of poorer mental health outcomes. The association between mental ill-health and certain risk factors, particularly those at the individual and microsystem level, appear to be greater for para athletes. These findings have important implications for policy and mental health service provision in elite sports settings, highlighting the need for more nuanced approaches to subpopulations, and the delivery of mental health interventions across all levels of the sports ecosystem. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

Public health agencies regularly survey randomly selected anonymous students to track drug use, sexual activities, and other risk behaviors. Students are unidentifiable, but a recent project that i...

Professor Toynbee observes in his Study of History that as he walked down Whitehall one day in the spring of 1918, and passed the Board of Education offices which had been commandeered for a new department of the War Office, “improvised in order to make an intensive study of trench warfare,” he found himself repeating the passage from St. Matthew's Gospel.

Volume 20, Issue 10, October 2020, Page W4-W7.

Professor Toynbee observes in his Study of History that as he walked down Whitehall one day in the spring of 1918, and passed the Board of Education offices which had been commandeered for a new department of the War Office, “improvised in order to make an intensive study of trench warfare,” he found himself repeating the passage from St. Matthew's Gospel.

Few residency training programmes explicitly require substantive exposure to issues in medical ethics and fewer still have a formal curriculum in this area. Traditional undergraduate medical ethics courses teach preclinical students to identify ethical issues and analyse them at a theoretical level. Residency training, however, is the ideal time to establish the critical behavioural link which makes ethics truly useful in clinical medicine. The General Internal Medicine Residency Training Program at Rhode Island Hospital has developed an integrated, three-year curriculum with (...) the goals of helping residents to perceive ethical issues in clinical practice, to utilise basic philosophical principles in resolving ethical dilemmas and to communicate these issues clearly and sensitively to patients. The curriculum has been well received by residents and has had a hospital-wide impact. We believe that training residents in medical ethics and communication skills is an effective approach to developing physicians' humane qualities. (shrink)

Over the course of three decades, in works spanning questions of theory, technique, and clinical practice, Charles Brenner has emerged as one of the preeminent analysts of his generation, a thinker whose probing estimation of mental conflict has promoted the evolutionary growth of analysis as theory even as it has clarified the clinical import of analysis as therapy. In _Psychoanalysis: The Science of Mental Conflict_, distinguished theorists and clinicians pay homage to Brenner by presenting original essays that converge in their (...) estimation of analysis as "the science of mental conflict." In sections that encompass "The Theory of Psychoanalysis," "The Concepts of Psychoanalysis," "The Technique of Psychoanalysis," "The Clinical Practice of Psychoanalysis," "The Teaching of Psychoanalysis," and "The Application of Psychanalysis," the contributors show how the perspective of conflict - broadened and refined by the clinical findings of recent decades - offers a vehicle for creative theory-building and, as such, a conceptual handle for apprising the indications for, and action of, psychoanalytic therapy. Arnold Richards' comprehensive overview of Brenner's ranging contributions to theory and practice, along with Martin Willick's critical introductions to the various sections of the book, round out a collections whose scope is complimented by its unusual coherence and thematic unity. Taken together, the essays comprising this book present readers with a cogent summary of current psychoanalytic thinking, along with an exciting preview of where it is heading in the future. As such, this volume will be welcomed not only by analysts, but by all mental health professionals who draw on, and learn from, the psychoanalytic assessment of conflict in mental life. It is a work that follows Brenner's own example in promoting the critical understanding of a generation of theorists, clinicians, and educators. (shrink)

ABSTRACT:In a series of reports the United Nations Special Representative on the issue of Human Rights and Transnational Corporations has emphasized a tripartite framework regarding business and human rights that includes the state “duty to protect,” the TNC “responsibility to respect,” and “appropriate remedies” for human rights violations. This article examines the recent history of UN initiatives regarding business and human rights and places the tripartite framework in historical context. Three approaches to human rights are distinguished: moral, political, and legal. (...) It is argued that the tripartite framework’s grounding of the responsibility of TNCs to respect human rights is properly understood as moral and not merely as a political or legal duty. A moral account of the duty of TNCs to respect basic human rights is defended and contrasted with a merely strategic approach. The main conclusion of the article is that only a moral account of the basic human rights duties of TNCs provides a sufficiently deep justification of “the corporate responsibility to respect human rights” feature of the tripartite framework. (shrink)

Premodern Buddhists are sometimes characterized as veritable "mind scientists" whose insights anticipate modern research on the brain and mind. Aiming to complicate this story, Dan Arnold confronts a significant obstacle to popular attempts at harmonizing classical Buddhist and modern scientific thought: since most Indian Buddhists held that the mental continuum is uninterrupted by death, they would have no truck with the idea that everything about the mental can be explained in terms of brain events. Nevertheless, a predominant stream of (...) Indian Buddhist thought, associated with the seventh-century thinker Dharmakirti, turns out to be vulnerable to arguments modern philosophers have leveled against physicalism. By characterizing the philosophical problems commonly faced by Dharmakirti and contemporary philosophers such as Jerry Fodor and Daniel Dennett, Arnold seeks to advance an understanding of both first-millennium Indian arguments and contemporary debates on the philosophy of mind. The issues center on what modern philosophers have called _intentionality_--the fact that the mind can be about other things. Tracing an account of intentionality through Kant, Wilfrid Sellars, and John McDowell, Arnold argues that intentionality cannot, in principle, be explained in causal terms. Elaborating some of Dharmakirti's central commitments, Arnold shows that despite his concern to refute physicalism, Dharmakirti's causal explanations of the mental mean that modern arguments from intentionality cut as much against his project as they do against physicalist philosophies of mind. This is evident in the arguments of some of Dharmakirti's contemporaneous Indian critics, whose critiques exemplify the same logic as modern arguments from intentionality. Elaborating these various strands of thought, Arnold shows that seemingly arcane arguments among first-millennium Indian thinkers can illuminate matters still very much at the heart of contemporary philosophy. (shrink)

A Guide to Plato's Republic provides an integral interpretation of the Republic that is accessible even to readers approaching Plato's masterwork for the first time. Written at a level understandable to undergraduates, it is ideal for students and other readers who have little or no background in philosophy or political theory. Rice anticipates their inevitable reactions to the Republic and treats them seriously, opening the way to an appreciation of the complexities of the text without oversimplifying it. While many (...) books on the Republic never stray far from explicating Plato's text, this work contrasts Plato's responses to perennial issues in philosophy and political theory with those of several key subsequent thinkers. It uses engaging examples to show the continuing relevance of Plato's arguments and introduces some basic vocabulary of philosophy and political theory, going beyond terse dictionary definitions by illustrating what technical terms mean in the context of Plato's work. The author's interpretative posture is appreciative but respectfully critical of Plato's vision. Stressing the relationship between Plato's politics and metaphysics, Rice argues that Plato's reluctance to accept the reality and consequences of finitude accounts for much of what many readers find objectionable in his politics. Lively, relatively brief, and designed to provoke discussion in the classroom, A Guide to Plato's Republic is ideal for political theory and introduction to philosophy courses as well as other courses that assign the Republic as a primary text. (shrink)

In _Buddhists, Brahmins, and Belief_, Dan Arnold examines how the Brahmanical tradition of Purva Mimamsa and the writings of the seventh-century Buddhist Madhyamika philosopher Candrakirti challenged dominant Indian Buddhist views of epistemology. Arnold retrieves these two very different but equally important voices of philosophical dissent, showing them to have developed highly sophisticated and cogent critiques of influential Buddhist epistemologists such as Dignaga and Dharmakirti. His analysis--developed in conversation with modern Western philosophers like William Alston and J. L. Austin--offers (...) an innovative reinterpretation of the Indian philosophical tradition, while suggesting that pre-modern Indian thinkers have much to contribute to contemporary philosophical debates. In logically distinct ways, Purva Mimamsa and Candrakirti's Madhyamaka opposed the influential Buddhist school of thought that emphasized the foundational character of perception. Arnold argues that Mimamsaka arguments concerning the "intrinsic validity" of the earliest Vedic scriptures are best understood as a critique of the tradition of Buddhist philosophy stemming from Dignaga. Though often dismissed as antithetical to "real philosophy," Mimamsaka thought has affinities with the reformed epistemology that has recently influenced contemporary philosophy of religion. Candrakirti's arguments, in contrast, amount to a principled refusal of epistemology. Arnold contends that Candrakirti marshals against Buddhist foundationalism an approach that resembles twentieth-century ordinary language philosophy--and does so by employing what are finally best understood as transcendental arguments. The conclusion that Candrakirti's arguments thus support a metaphysical claim represents a bold new understanding of Madhyamaka. (shrink)

Guilt and shame are self-conscious emotions with implications for mental health, social and occupational functioning, and the effectiveness of sports practice. To date, the assessment and role of athlete-specific guilt and shame has been under-researched. Reporting data from 174 junior elite cricketers, the present study utilized exploratory factor analysis in validating the Athletic Perceptions of Performance Scale, assessing three distinct and statistically reliable factors: athletic shame-proneness, guilt-proneness, and no-concern. Conditional process analysis indicated that APPS shame-proneness mediated the relationship between general (...) and athlete-specific distress. While APPS domains of guilt-proneness and no-concern were not significant mediators, they exhibited correlations in the expected direction with indices of psychological distress and well-being. The APPS may assist coaches and support staff identify players who may benefit from targeted interventions to reduce the likelihood of experiencing shame-prone states. (shrink)

Der lebende Organismus stellt einen bestimmten, individuellen Teil des Universums dar, indem er seine Selbständigkeit abgetrennt von dem übrigen Universum erhält, durch den Teilungseffekt, welcher durch die Anordnung seiner Teile bestimmt wird. Es ist anerkannt, dass die Teilung nicht vollständig ist, jedoch eine beschränkte gegenseitige Beziehung zulässt. Es ist auch anerkannt, dass der Grad der Organisation in einer verwandten Reihe sich ändert von den tiefen Verwickelungen der einfachen Zelle zu den mannigfachen Abwandlungen wie sie beim Menschen auftreten. Die Auffassung von (...) effektiver Teilung ist ausserdem auch fest und substantiell auf der Tatsache begründet, die durch das Vorhandensein der Plasmamembran und Grenzflächen kolloidaler Aggregaten gegeben ist. Betont ist die dynamische Natur der charakteristischen Gleichgewichtszustände und es wird aufmerksam gemacht auf die kontinuierliche Bildung von effektiven Teilungen bei verschiedenen Gleichgewichtszuständen. Weitere Untersuchung der Bedeutung dieser Teilungen ergibt viele interessante Folgerungen. Schwierigkeiten finden sich, wenn man eine derartige Beschreibung auf geistige Phänomena ausdehnt. Zwar bestehen grundlegende Übereinstimmungen, aber es ist schwer sie genau zu definieren. Es ist klar, dass eine Synthese dieser Art notwendigerweise unvollständig ist, aber es schien wertvoll den Versuch zu machen, L'organisme vivant est présenté ici comme une partie définie et individualisée de l'univers maintenant son individualité propre au moyen de „l'effet de partition” déterminé par l'arrangement de ses parties. Il est entendu que la partition n'est pas complète mais permet encore des relations réciproques mais limitées. Il est reconnu aussi que le degré d'organisation varie dans le cours d'une série, des complexités profondes de la cellule aux innombrables modifications exhibées par l'organisme humain. Le concept de la partition effective est basé solidement sur l'évidence présentée par la membrane plasmatique et les limites de phases dans les aggrégations colloidales. De plus il est important de noter spécialement la nature dynamique des équilibres caractéristiques et l'on ne saurait manquer d'attirer l'attention sur la formation continue de partitions effectives aux différents niveaux d'équilibre. L'étude ultérieure de la signification de ces partitions présente un grand nombre d'implications intéressantes. Il est à noter que des difficultés sont rencontrées quand on essaie d'inclure en une description de ce genre les phénomènes mentaux et psychiques. Des stabilités fondamentales existent, mais elles sont difficiles à définir avec précision. Il est évident du reste au lecteur qu'une synthèse telle que celle-ci est nécessairement incomplète mais néanmoins intéressante à faire. (shrink)

Alfred Tarski was a nominalist. But he published almost nothing on his nominalist views, and until recently the only sources scholars had for studying Tarski’s nominalism were conversational reports from his friends and colleagues. However, a recently-discovered archival resource provides the most detailed information yet about Tarski’s nominalism. Tarski spent the academic year 1940-41 at Harvard, along with many of the leading lights of scientific philosophy: Carnap, Quine, Hempel, Goodman, and (for the fall semester) Russell. This group met frequently to (...) discuss logical and philosophical topics of shared interest. At these meetings, Carnap took dictation notes, which are now stored in the Archives of Scientific Philosophy. Interestingly, and somewhat surprisingly, the plurality of notes covers a proposal Tarski presents for a nominalist language of unified science. This chapter addresses the following questions about this project. What, precisely, is Tarski’s nominalist position? What rationales are given for Tarski’s nominalist stance—and are these rationales defensible? Finally, how is Tarskian nominalism of 1941 related to current nominalist projects? (shrink)