For eradication of acute poverty, it is vital to factor in the human experience of it. Building social capital and networks that nurture, empower, and consistently reinforce a new shared economic identity can provide rich socioeconomic dividends. For states tackling extreme poverty at scale, building and strengthening social capital are essential public goods investments.

We studied the dynamics of large networks of spiking neurons with conductance-based (nonlinear) synapses and compared them to net- works with current-based (linear) synapses. For systems with sparse and inhibition-dominated recurrent connectivity, weak external inputs in- duced asynchronous irregular firing at low rates. Membrane potentials fluctuated a few millivolts below threshold, and membrane conductances were increased by a factor 2 to 5 with respect to the resting state. This combination of parameters characterizes the ongoing spiking activity typ- ically recorded in (...) the cortex in vivo. Many aspects of the asynchronous irregular state in conductance-based networks could be sufficiently well characterized with a simple numerical mean field approach. In particular, it correctly predicted an intriguing property of conductance-based net- works that does not appear to be shared by current-based models: they exhibit states of low-rate asynchronous irregular activity that persist for some period of time even in the absence of external inputs and with- out cortical pacemakers. Simulations of larger networks (up to 350,000 neurons) demonstrated that the survival time of self-sustained activity increases exponentially with network size. (shrink)

Isolated feedforward networks (FFNs) of spiking neurons have been studied extensively for their ability to propagate transient synchrony and asynchronous firing rates, in the presence of activity independent synaptic background noise (Diesmann et al., 1999; van Rossum et al., 2002). In a biologically realistic scenario, however, the FFN should be embedded in a recurrent network, such that the activity in the FFN and the network activity may dynamically interact. Previously, transient synchrony propagating in an FFN was found to destabilize the (...) dynamics of the embedding network (Mehring et al., 2003). Here, we show that by modeling synapses as conductance transients, rather than current sources, it is possible to embed and propagate transient synchrony in the FFN, without destabilizing the background network dynamics. However, the network activity has a strong impact on the type of activity that can be propagated in the embedded FFN. Global synchrony and high firing rates in the embedding network prohibit the propagation of both, synchronous and asynchronous spiking activity. In contrast, asynchronous low-rate network states support the propagation of both, synchronous spiking and asynchro- nous, but only low firing rates. In either case, spiking activity tends to synchronize as it propagates, challenging the feasibility to transmit information in asynchronous firing rates. Finally, asynchronous network activity allows to embed more than one FFN, with the amount of cross talk depending on the degree of overlap in the FFNs. This opens the possibility of computational mechanisms using transient synchrony among the activities in multiple FFNs. (shrink)

From the financial year 2014-15, the Indian corporate sector was made to comply with a newly introduced Sect. 135 (5) by the Companies Act of 2013. The rule required select companies to spend 2% of their average net profits on CSR initiatives. This paper tries to find if the companies have complied with the provision based on data for six financial years starting 2014-15. CSR performance of the top thirty companies forming part of the Bombay Stock Exchange (BSE) Sensex was (...) evaluated and a CSR Spend-to-Obligation (CSR SO) Index was calculated comparing the actual spend vis-à-vis the obligatory requirement. A quantitative and a qualitative methodology were used for the analysis. The quantitative method involved computation of the CSR SO index at various levels. The “quality” of the CSR expenditure was also assessed by speaking to twelve experts from the Corporate to find out if the expenditure was in the right direction. The results show that the aggregate average six-year CSR SO index for the 30 Sensex companies is 0.98, suggesting that companies comply with the requirements of mandatory CSR. Moreover, the experts confirm that CSR spending is in the right spirit and direction. It certainly has a long-term orientation and qualifies as quality spending. A novel CSR-SO index is presented that compares CSR performance by comparing actual CSR spending with obligatory requirements. This index can act as a barometer for CSR performance and facilitate objective evaluation. Additionally, the qualitative assessment of CSR spending shows a holistic approach to evaluating CSR. (shrink)

This research focuses on (a) introducing and exploring ethically effective leadership, (b) introducing and testing theory on triad of typical–maximal–ideal ethically effective leadership performances, (b) theorizing and empirically testing that each of typical–maximal–ideal ethically effective leadership performance is different from each others, in other words exploring mean differences between each pair of typical–maximal–ideal effective leadership performances, (c) introducing, theorizing, and testing mechanism to quantify respondents’ intrinsic desire and inherent potential to enhance their ethically effective leadership performances, (d) exploring precedents of (...) each of typical–maximal–ideal ethically effective leadership performances, and finally (e) exploring bases and feasibility of virtual, robotic, and mixed reality ethically effective leadership that may or may not be same as conventional ethically effective leadership. This paper explores global leadership aspect of ethically effective leadership performance at three data collection levels (via typical, maximal, and ideal effective leadership performances) adding precision to assessment of ethically effective leadership and resolving an important challenge (precise assessment) to ethical leadership development. It explores respondents’ typical ethically effective leadership performance E_T, their maximal ethically effective leadership performance E_M, and their ideal ethically effective leadership performance E_I. It presents non-western perspectives on ethically effective leadership disregarding homogenization of leadership behavior. It advances our insight into ethical leadership development by empirically identifying presence, direction and magnitude of respondents’ (a) intrinsic desire and (b) existing intrinsic potential for alteration of their ethically effective leadership. Means of typical ethically effective leadership performance E_T, maximal ethically effective leadership performance E_M, and ideal ethically effective leadership performance E_I are distinct. Typical ethically effective leadership performance E_T is positively associated with maximal ethically effective leadership performance E_M and ideal ethically effective leadership performance E_I. This article concludes that the selected leaders report their ideal ethically effective leadership performance E_I to be higher than their typical ethically effective leadership performance E_T and maximal ethically effective leadership performance E_M depicting significant intrinsic desire for 14 % enhancing their ethically effective leadership performance. Respondents have significant existing intrinsic potential for 10 % enhancing their ethically effective leadership performance. Regression constants for regression models for typical ethically effective leadership performance E_T, maximal ethically effective leadership performance E_M and ideal ethically effective leadership performance E_I are significant depicting that the researchers have to look for other variables to fully explain variance in typical ethically effective leadership performance E_T, maximal ethically effective leadership performance E_M and ideal ethically effective leadership performance E_I. Regression coefficient of typical ethically effective leadership performance E_T is significant in model for ideal ethically effective leadership performance E_I as well as maximal ethically effective leadership performance E_M and vice versa. So, the paper suggests that training strategies may be feasible to alter typical ethically effective leadership performance E_T and maximal ethically effective leadership performance E_M in such a way as to bring it closer to ideal ethically effective leadership performance E_I but for this, researchers have to look for other variables too. (shrink)

This paper argues that existing food security and food sovereignty approaches are inadequate to fully understand contradictory human development, nutrition, and productivity trends in Nepalese small-scale agriculture. In an attempt to bridge this gap, we developed a new food wellbeing approach that combines insights from food security, food sovereignty, and social wellbeing perspectives. We used the approach to frame 65 semi-structured interviews in a cluster of villages in Kaski district in the mid-hills of Nepal on various aspects of food security, (...) agriculture, off-farm livelihood opportunities, and women’s wellbeing. Our results indicate that context-specific subjective and social relational factors highlighted by the food wellbeing approach are key to understanding a paradox of increased food security, yet decreasing sustainability of small-scale agriculture. Increased levels of male out-migration and opportunities for local off-farm work have increased local capacity to purchase food. The positive consequences for food security are indicated by evidence that households with non-farm income sources had better food sufficiency, absorption capacity, nutritional quality, and stability of food supply. These off-farm employment opportunities have also led to the greater involvement of low caste groups and women in small-scale agriculture. This has been empowering for both groups and led to an increase in wellbeing, particularly for those women who have become de facto heads of household. Yet, small landholdings, persistent patterns of unequal and absentee land ownership, sharecropping, women’s overwork, and the aspirations of low caste farmers and women away from agriculture are simultaneously driving the erosion of local small-scale agricultural productivity and ecological sustainability. (shrink)

In Bancoult, a majority of the House of Lords upheld the British government's use of the royal prerogative to expel the population of the Chagos Islands from their homeland. The majority acknowledged that the government's treatment of the Chagossians was disturbing, but held that the law left them with no choice but to hold the orders valid. In this article, I draw a parallel between this decision and the 18th-century judicial response to the Zong affair—where over a hundred slaves were (...) thrown off a ship to drown in the sea. Both decisions are cloaked in formalist rhetoric but, as I show through an examination of the law as it stood prior to each of the decisions, the actual legal reasoning in both decisions is so without basis as to be unsustainable on any formalist or legalist account. Rather, the decision in Bancoult, like the decision in the Zong, shows all the hallmarks of being a purely pragmatic one, prompted by broader concerns as to the practical impact of a contrary decision and the precedent it would set. The inherent limitations of this mode of judicial reasoning make its deployment in Bancoult troubling. (shrink)

Comments on: JRE Focus on The 50th Anniversary of the Universal Declaration ofHuman Rights, Journal of Religious Ethics 26.2 “Rethinking Human Rights: A Review Essay on Religion, Relativism, and Other Matters” by David Little, Journal of Religious Ethics 27.1.

The aged in India have conventionally enjoyed privileges within the framework of a social economy where the needs of the old remained a moral responsibility of family, kith and kin. However the present changing times have forced a shift in the approach to old age care. The old person finds him- or herself in a sticky situation, in between an insensitive state and the demands of globalization. The present paper situates this problem within the framework of globalization and systematically measures (...) the strategic response of the state to this daunting challenge, with respect to economic security and health care in particular. In the conclusion, the paper argues for a rejection of the conventional welfare approach and it advocates an integrated approach based on a coherent social development perspective within the valuation framework of social quality. (shrink)

Arguing that intellectual movements, such as deconstruction, postsecular theory, and political theology, have different implications for cultures and societies that live with the debilitating effects of past imperialisms, Arvind Mandair ...

The primary purpose of Institutional Review Boards (IRBs) is to protect the rights and welfare of human research participants. Evaluation and measurement of how IRBs satisfy this purpose and other important goals are open questions that demand empirical research. Research on IRBs, and the Human Research Protection Programs (HRPPs) of which they are often a part, is necessary to inform evidence-based practices, policies, and approaches to quality improvement in human research protections. However, to date, HRPP and IRB engagement in empirical (...) research about their own activities and performance has been limited. To promote engagement of HRPPs and IRBs in self-reflective research on HRPP and IRB quality and effectiveness, barriers to their participation need to be addressed. These include: extensive workloads, limited information technology systems, and few universally accepted or consistently measured metrics for HRPP/irb quality and effectiveness. Additionally, institutional leaders may have concerns about confidentiality. Professional norms around the value of participating in this type of research are lacking. Lastly, obtaining external funding for research on IRBs and HRPPs is challenging. As a group of HRPP professionals and researchers actively involved in a research consortium focused on IRB quality and effectiveness, we identify potential levers for supporting and encouraging HRPP and IRB engagement in research on quality and effectiveness. We maintain that this research should be informed by the core principles of patient- and community-engaged research, in which members and key stakeholders of the community to be studied are included as key informants and members of the research team. This ensures that relevant questions are asked and that data are interpreted to produce meaningful recommendations. As such, we offer several ways to increase the participation of HRPP professionals in research as participants, as data sharers, and as investigators. (shrink)

There has recently been a surge of development in augmented reality (AR) technologies that has led to an ecosystem of hardware and software for AR, including tools for artists and designers to accelerate the design of AR content and experiences without requiring complex programming. AR is viewed as a key “disruptive technology” and future display technologies (such as digital eyewear) will provide seamless continuity between reality and the digitally augmented. This article will argue that the technologization of human perception and (...) experience of reality, coupled with the development of artificial intelligence (AI)–based natural language assistants, may lead to a secular re‐enchantment of the world, in the sense outlined by Charles Taylor, where human existence is shaped through AR inhabited by advanced personal and social AI agents in the form of digital avatars and daemons, and that enchantment has been persistent throughout the formation of modernity and is being rekindled by the integration of AI in the plane of AR. (shrink)

Fused, elongated mitochondria are more efficient in generating ATP than fragmented mitochondria. In diverse C. elegans longevity pathways, increased levels of fused mitochondria are associated with lifespan extension. Blocking mitochondrial fusion in these animals abolishes their extended longevity. The long‐lived C. elegans vhl‐1 mutant is an exception that does not have increased fused mitochondria, and is not dependent on fusion for longevity. Loss of mammalian VHL upregulates alternate energy generating pathways. This suggests that mitochondrial fusion facilitates longevity in C. elegans (...) by increasing energy metabolism. In diverse animals, ATP levels broadly decreases with age. Substantial evidence supports the theory that increasing or maintaining energy metabolism promotes the survival of older animals. Increased ATP levels in older animals allow energy‐intensive repair and homeostatic mechanisms such as proteostasis that act to prevent cellular aging. These observations support the emerging paradigm that maintaining energy metabolism promotes the survival of older animals. (shrink)

The rapid advancement of artificial intelligence (AI) has led to renewed ambitions of developing artificial general intelligence. Alongside this has been a resurgence in the development of virtual and augmented reality (V/AR) technologies, which are viewed as “disruptive” technologies and the computing platforms of the future. V/AR effectively bring the digital world of machines, robots, and artificial agents to our senses while entailing the transposition of human activity and presence into the digital world of artificial agents and machine forms of (...) intelligence. The intersection of humans and machines in this shared space brings humans and machines into ontological continuity as informational entities in a totalizing informational environment, which subsumes both cyber and physical space in an artificially constructed virtual world. The reconstruction of mind (through AI) and world (through V/AR) thus has significant epistemological, ontological, and anthropological implications, which constitute the underlying features in the artificialization of mind and world. (shrink)

Slow money, or patient nurturing capital directly invested locally in small firms in food and basic industries, is a new term but an old notion. It gains revival in times of crisis, especially after the recent financial crisis, as people search for meaning and a way out of the ruinous effects of uncontrolled capitalism. This article traces the roots of the movement to Gandhian thought. It examines the cases of the CIGALES clubs of microangels in France and the more recent (...) case of the slow money alliance to ferret out the basic principles and strategies of these movements and how they are aligned with Gandhian values. (shrink)

Recent literature on Islam and the digital covers a wide range of topics and themes; however, what is yet to be developed from an Islamic perspective is a broader philosophical framework that accounts for the nature, exigencies and affordances of contemporary digital technologies. In advance of such a framework, this article is an attempt to open the way to philosophical engagement with issues of digital ethics from an Islamic perspective. After a brief review of recent literature on Islam and the (...) digital and a significantly earlier work by Ziauddin Sardar, in which he proposed an information strategy for the Muslim world, this paper provides some background to Islamic ethics and the wide field of ethical theories in the Islamic tradition. This paper then proceeds by identifying and outlining examples of contemporary themes in Islam and the digital which conceal underlying philosophical and theological issues. Finally, this paper considers the significant scale and scope of the transformations involved in the ongoing transposition to the ‘onlife’ and highlights several areas where Islamic perspectives may be seen to converge or diverge with other strands of scholarship on digital ethics. (shrink)

This study examines if, how, and when workplace spirituality promotes employee ethical voice. Specifically, it tests a mediated moderation model with psychological ownership as a mediator of the relationship between workplace spirituality and ethical voice, and moral identity internalization as a moderator of this indirect relationship. The hypothesized model was tested on two different samples from the IT (Study 1) and Hotel industry (Study 2). Study 1 adopted a cross-sectional time-lagged design to test the proposed hypotheses while Study 2 used (...) a more robust longitudinal cross-lagged design to validate the results of Study 1. The conceptual model was tested using structural equation modeling (SEM) and the results established a direct as well as an indirect effect of workplace spirituality on ethical voice via psychological ownership. However, moral identity internalization failed to moderate the effect of workplace spirituality on ethical voice through psychological ownership in both studies. The results established that workplace spirituality stimulates ethical voice through psychological ownership irrespective of the moral identity of employees. The study identifies workplace spirituality as a novel and significant predictor of ethical voice in organizations and advances the understanding of the psychological processes and contingencies of this relationship. Implications for theory and practice are discussed. (shrink)

This paper encapsulates the debate as to whether or not tarka is an additional source of knowledge. In this regard, Jaina thinkers opine that they are, unlike Buddhists and Nyāya thinkers, an additional source of knowledge, for what we come to know through tarka is not known through any other means of knowledge. En route, Jaina’s understanding of tarka is put forth, thereafter their criticism of others’ understanding is supplied. Eventually, some recent discussions over this debate are intimated that seem (...) to go in support of Jaina understanding of tarka. These recent discussions hint at the direction in which Jaina thinkers need to advance their stand. (shrink)

गेटिअर के शोध-पत्र "Is Justified Treu Belief Knowledge" जो कि ANALYSIS में 1963 में प्रकाशित हुआ था उसका यह हिन्दी अनुवाद है। .

What did science make possible for colonial rule? How was science in turn marked by the knowledge and practices of those under colonial rule? Here I approach these questions via the social history of Madras Observatory. Constructed in 1791 by the East India Company, the observatory was to provide local time to mariners and served as a clearinghouse for the company’s survey and revenue administration. The astronomical work of Madras’ Brahmin assistants relied upon their knowledge of jyotiśāstra [Sanskrit astronomy/astrology], and (...) can be seen as a specialized form of the kind of South Indian scribal labor and knowledge that also staffed the company’s tax offices. If at Greenwich the division of labor meant observatory work bore resemblances to the factory and the accounts office, in Madras, astronomy and accounting drew on similar labor forms because they were part of the same enterprise. But the company did not just adapt preexisting forms of labor, it also attempted to produce its own at a school built near the observatory to train “half-caste” orphans as apprentice surveyors and assistant computers. The school, staffed by the Brahmins, drew upon knowledge and pedagogical practice associated with the tinnai, the schools in which upper-caste children learned to read, write, and calculate. For a time, the observatory’s social order was literally “half-caste.” The paper also considers how the relationship between caste, status, and instrument was reflected in the visual and material culture of the observatory, such as in Indian-language inscriptions on its central pillar. For company astronomers, the measurement of time meant reworking the relationships among the Indian past, the colonial present, and an imperial posterity. Science under colonial rule spanned multiple temporal and social registers because it was the result of negotiations between the demands of political economy and the knowledge and practices of colonized others. (shrink)

BackgroundIn this study, medical errors are defined as unintentional patient harm caused by a doctor’s mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.MethodsThis cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to (...) measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as “No Disclosure”, “Partial Disclosure” or “Full Disclosure”. Data was keyed in and analysed using STATA v 13.0.ResultsOnly 10.1% intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors.ConclusionMost doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure. (shrink)

The principal aim under the U.N. Framework Convention on Climate Change (UNFCCC) has been to establish a legally-binding regime regulating emission of greenhouse gas. The hopes were tempered at Copenhagen which charted no clear path towards a treaty with binding commitments. The result, instead, was the Copenhagen Accord, a non-binding agreement that captured political consensus on a number of core issues absent its formal adoption by the Conference of the Parties. Thus, the achievement of an agreement in the climate summit (...) at Cancun seemed a herculean task. However, after two weeks of hectic UN-led parleys, the nations of the world arguably reached a forward-looking deal that leaves open an extension of the Kyoto Protocol as well as the crucial question of the level of emission limitation and reduction commitments. Cancun outcome can be perceived in twin contexts; (a) As a continuation of series of efforts since the establishment of UNFCCC to have a legally binding regime; and (b) as a resurgent hope to get on board after a failed effort at Copenhagen. The dynamics of climate change presents varied dilemmas of justice. The paper, in particular, delves upon the issue of distributive justice in reference to Cancun agreements, to intuit the viability of a new era that would lead to a climate responsible pathway. (shrink)

With the improvements in medical care and resultant increase in life expectancy of the intellectually disabled, it will become more common for healthcare providers to be confronted by ethical dilemmas in the care of this patient population. Many of the dilemmas will focus on what is in the best interest of patients who have never been able to express their wishes with regard to medical and end-of-life care and who should be empowered to exercise surrogate medical decision-making authority on their (...) behalf. A case is presented that exemplifies the ethical and legal tensions surrounding surrogate medical decision making for acutely ill, never-competent, profoundly intellectually disabled patients. (shrink)

Phenomenological approaches to space have consistently made a distinction between a plurality of inhabited spaces and the single homogenous extendedness of Euclidean space. Martin Heidegger and Maurice Merleau-Ponty postulate unique spatial wholes pertaining to human life that pose a counterpoint to objective space and provide the necessary context for understanding all our spatial relations. However, the spatial wholes that are posited to clarify these relations are themselves far from univocal. Specifically, differences exist regarding what precisely unites various entities into a (...) meaningful spatial whole and how any such whole relates to others. Showing how Heidegger’s idea of Ort and Merleau-Ponty’s notion of espace vécu rely on multiple senses of nearness, this paper argues that the privileged sense of nearness in each case fails to delimit the spatial context, thereby putting into question the very possibility of a unified and distinct spatial whole. (shrink)

The visual system is a source of sensory information that perceives environmental stimuli and interacts with other sensory systems to generate visual and postural responses to maintain postural stability. Although the three sensory systems; the visual, vestibular, and somatosensory systems work concurrently to maintain postural control, the visual and vestibular system interaction is vital to differentiate self-motion from external motion to maintain postural stability. The visual system influences postural control playing a key role in perceiving information required for this differentiation. (...) The visual system’s main afferent information consists of optic flow and retinal slip that lead to the generation of visual and postural responses. Visual fixations generated by the visual system interact with the afferent information and the vestibular system to maintain visual and postural stability. This review synthesizes the roles of the visual system and their interaction with the vestibular system, to maintain postural stability. (shrink)

Despite a growing focus on processes to promote gender equity, women remain significantly underrepresented in leadership positions in the Global South. In the present study we focus on the role of familial experiences in shaping and contesting gender ideologies of Pakistani women in the workplace. We specifically examine the reciprocal ways in which women leaders and their family members shape each other’s gender ideologies regarding the workplace. Data collected and analyzed for this study were semi-structured interviews with eight women in (...) positions of leadership in Lahore, Pakistan, and interviews with one family members of each of the women leaders. Using thematic narrative analysis, we identified three thematic phases: learning gender expectations, resistance, and familial transformation. These phases reflect the progression of developing, resisting, and influencing individual and familial gender ideologies. We document the manifestation of these phases in three specific domains: education, marriage and motherhood, and the workplace. We then discuss how these findings contribute to understanding the experiences of women leaders and perceptions of their family members regarding women’s role in the workplace. Findings from our research provide novel insights into the ways globalization and capitalism continue to shape the socio-cultural context for women leaders in the Global South. (shrink)

Despite the prevalence of post-colonial theory in the humanities and social sciences, why is it that the two main secular formations in the study of religion(s), as philosophy of religion and history of religions, continue to deploy very similar mechanisms that reconstitute past imperialisms such as the hegemony of theory as specifically Western and/or the division of labor between universal and particular knowledge formations? To answer this question this paper stages an oblique engagement between the seemingly divergent discourses: (i) philosophy (...) of religion, (ii) history of religion—more specifically the area specialism called South Asian religions, and (iii) post-colonial theory especially where these discourses intersect with the discipline of Indology and the representation of Indic phenomena. A different version of this engagement occurs in Hegel’s Lectures on the Philosophy of Religion (LPR). A post-colonial reading of the LPR reveals closer and often unacknowledged connections between the birth of these two disciplines. More importantly the LPR anticipates the auto-immunizing mechanism that underpins the continued lack of engagement between the various disciplines of contemporary religions. Ironically, this mechanism, it will be argued, is located in the very heart of the comparative enterprise itself. (shrink)

The concept śabad (Word) is central to Sikh scripture, doctrine, philosophy and spiritual praxis. This lecture offers a postsecular interpretation of this important concept and examines the passage of śabad from premodern scriptural sources to its entanglement in contemporary "wars of scholarship".

At the end of life, pain management is commonly a fundamental part of the treatment plan for patients where curative measures are no longer possible. However, the increased recognition of opioid diversion for secondary gain coupled with efforts to treat patients in the home environment towards the end of life creates the potential for ethical dilemmas in the palliative care management of terminal patients in need of continuous pain management. We present the case of an end-stage patient with rectal cancer (...) who required a continuous residential narcotic infusion of fentanyl for pain control due to metastatic disease. His functional status was such that he had poor oral intake and ability to perform other activities of daily living, but was able to live at home with health agency nursing care. The patient presented to this institution with a highly suspect history of having lost his fentanyl infusion in a residential accident and asking for a refill to continue home therapy. The treating physicians had concerns of diversion of the infusion medication by caregivers and were reluctant to continue the therapeutic relationship with the patient. This case exemplifies the tension that can exist between wanting to continue with palliative care management of an end-stage patient and the fear of providers when confronted by evidence of potential diversion of opioid analgesic medications. We elucidate how an ethical framework based on a combination of virtue and narrative/relationship theories with reference to proportionality can guide physicians to a pragmatic resolution of these difficult situations. (shrink)

India now constitutes approximately 17% of the world’s population and has a high proportion of younger people. Philosophy for school children aims to create better citizens of the future. In this article, I establish the need to teach philosophy to children in schools, especially in India. Subsequently, I discuss the readiness of Indians to accept philosophy in the school curriculum, their conundrum in understanding the need for philosophy in a school setting, and the East-West dilemma concerning the teaching of philosophy (...) in schools. The concept of self-realization is important in education. Socrates claimed that an unexamined life is not worth living. However, the self-realization concept of the West differs from that in India. While the former perceives self-realization as a way to construct a good individual, the latter has always emphasized the cessation of the individual and focused on the incomprehensible truth human languages cannot capture. Western philosophy is concerned with questioning, inquiry, and the problems of philosophy. The East is concerned with bringing such questioning to an end. Matthew Lipman focuses on increasing curiosity, accelerating the thinking process, teaching logic and formal reasoning, and the intellectual enhancement of children. Indian philosophy, yoga, and meditation are all concerned with the cessation of consciousness. The key question concerns the approach one may choose to adopt in teaching philosophy – accelerating or decelerating the thought processes of children? Indian parents are the primary decision-makers in their children’s education, and sometimes throughout their careers and lives. Unless clarity emerges in the Indian and global community regarding this issue, there is no clear starting point for teaching philosophy to children in India. This article aims to raise critical awareness among global citizens regarding this conundrum in the collective Indian psyche. Unless the world’s psyche is inserted into the place of the Indian psyche, the great barrier between the West and the East regarding philosophy in the school curriculum cannot be bridged. (shrink)

With the aging of the general population and the ability of intensivists to support patients using ventilator support, tracheostomy has become a vital tool in the medical management of critically ill patients. While much of the medical literature on tracheostomy has focused on the optimal timing of and indications for performing this procedure, little is written on the ethical tensions that can revolve around decisions by patients, surrogates, and physicians on its use. This article will elucidate the ethical dilemmas that (...) can arise surrounding the use of tracheostomy in critically ill patients and how ethics consultants and committees can approach these cases to allow resolution. (shrink)

Attempted suicide represents a personal tragedy for the patient and their loved ones and can be a challenge for acute care physicians. Medical professionals generally view it as their obligation to aggressively treat patients who are critically ill after a suicide attempt, on the presumption that a suicidal patient lacks decision making capacity from severe psychiatric impairment. However, physicians may be confronted by deliberative patient statements, advanced directives or surrogate decision makers who urge the withholding or withdrawal of life sustaining (...) treatments based on the patient’s underlying medical condition or life experience. How acute care providers weigh these expressions of patient wishes versus their own views of beneficence, non–maleficence and professional integrity poses a significant ethical challenge. This article presents a case that exemplifies the medical and ethical tensions that can arise in treating a patient following a suicide attempt and how to approach their resolution. (shrink)

Social media is known to be one of the finest achievements of the 21st century. However, it is no surprise that there are two sides to every coin. While there are a lot of advantages of social media in our day-to-day life it is difficult to ignore its negative consequences. As the interactions between people have increased so have the standards and expectations of people and undoubtedly, so has the mental distress that people constantly face. Multiple researches conducted on the (...) negative impacts of social media indicate towards the downside of social media, especially it's negative footprint on people's identities, social life, mental health and emotional well-being. Although there are various modalities that have been used to identify and solve the problems that people experience with social media, there are other modalities of counseling that have the potential to be effective and helpful but have not been explored in this regard. One such modality is Logic-Based Therapy. Logic-Based Therapy and Consultation is a philosophy-based practice that aims to help identify the different emotional and behavioral ways in which people upset themselves by their own faulty thinking. LBT identifies a number of fallacies or incorrect reasonings that people use very frequently in their lives and also suggests ways in which individuals can learn to cope with these fallacies. A lot of the fallacies identified by LBT can be seen in practice through social media. This paper aims at providing an insight into the reality of social media and online presence while highlighting the most common fallacies that people commit in emotional and behavioral reasoning as identified by LBT. The paper will also explore how and why people often commit these fallacies and suggest some antidotes to combat these fallacies. (shrink)