BACKGROUND: Hallucinations and delusions that complicate Parkinson’s disease could lead to nursing home placement and are linked to increased mortality. Cognitive impairments are typically associated with the presence of hallucinations but there are no data regarding whether such a relationship exists with delusions. OBJECTIVE: We hypothesized that hallucinations would be associated with executive and visuospatial disturbance. An exploratory examination of cognitive correlates of delusions was also completed to address the question of whether they differ from hallucinations. METHODS: 144 PD subjects (...) completed a neuropsychological battery to assess cognition and the SAPS to examine psychosis. Correlational analyses assessed associations between hallucinations and delusions with cognitive domains. RESULTS: 48 subjects reported psychotic symptoms: 25 experienced hallucinations without delusions, 23 had symptoms dominated by delusions. Severity and/or number of hallucination subtypes were significantly correlated with lower scores in language, memory, attention, executive functioning, and visuospatial ability. Correlations with delusions were non-significant. Tests of differences in the size of the correlations between groups revealed a significant relationship between language and visuospatial performance with hallucinations. CONCLUSIONS: Cognitive correlates of hallucinations and delusions appear to be different in PD, suggesting distinct pathogenic mechanisms and possibly anatomical substrates. Hence, delusions may not share the same associations with dementia as hallucinations. Since this is a new finding, further studies will be needed to confirm our results. (shrink)

We apply an online optimization process based on machine learning to the production of Bose-Einstein condensates. BEC is typically created with an exponential evaporation ramp that is optimal for ergodic dynamics with two-body s-wave interactions and no other loss rates, but likely sub-optimal for real experiments. Through repeated machine-controlled scientific experimentation and observations our ’learner’ discovers an optimal evaporation ramp for BEC production. In contrast to previous work, our learner uses a Gaussian process to develop a statistical model of the (...) relationship between the parameters it controls and the quality of the BEC produced. We demonstrate that the Gaussian process machine learner is able to discover a ramp that produces high quality BECs in 10 times fewer iterations than a previously used online optimization technique. Furthermore, we show the internal model developed can be used to determine which parameters are essential in BEC creation and which are unimportant, providing insight into the optimization process of the system. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Immediately after the publication of Darwin's book on the origin of species, Engels, having familiarized himself with it, wrote to Marx on December 12, 1859: "All in all, Darwin, whom I am reading right now, is superb. Teleology had hitherto not yet been destroyed in one of its aspects, and now this has been done. Moreover, hitherto there has never been so sweeping an attempt to prove historical development in nature, especially with such success." Soon Marx enlarged upon the evaluation (...) of Darwinism. In his letter of December 19, 1860, he commented that this theory "provides a foundation in natural history for our views." It is therefore no accident that Engels, in developing the principles of dialectical materialism and problems of the dialectics of nature, interested himself so deeply and comprehensively in the theory of evolution. (shrink)

This essay discusses an alternative interpretation of the term “Dasein” as Heidegger uses it in Being and Time and, in particular, the possibility that Dasein is meant to contain an inherent form of intersubjectivity to which we must “return” in order to achieve authenticity. In doing so, I build on the work of John Haugeland and his interpretation of Dasein as a mass term, while exploring the implications such an interpretation has on Heidegger’s conception of “authenticity”. Ultimately, this paper aims (...) to take seriously Heidegger’s claim to be moving past the isolated Cartesian subject and towards a view of authentic human existence that is cognizant of the way our identities are always formed within a pre-existing community. In addition, since many interpretations of Heidegger have argued that “the Anyone” is representative of all possible forms of community, I consider how this alternative understanding of Dasein as intersubjective can shed new light on critical remarks Heidegger makes about “the Anyone”. Thus, I argue that by reinterpreting Dasein as community, we can find more coherence between Heidegger’s otherwise conflicting conceptions of authenticity and “the Anyone”. (shrink)

Narrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show how entrenched patterns of (...) narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight, and pain management. From these, I argue that the use of narrative ethics without the application of a critical theory lens risks the exacerbation of what Miranda Fricker refers to as “testimonial injustice,” the prima facie harm experienced by individuals whose credibility is undermined by others’ prejudices. Finally, I suggest that narrative ethics can be a powerful tool for mitigating oppressive practices in medicine if we couple it with critical analysis that enables us to understand the power dynamics at play in storytelling. (shrink)

In Nicolaus Cusanus on Faith and the Intellect: A Case Study in 15th-Century Fides-Ratio Controversy, K.M. Ziebart presents an account of the Cusan epistemology as a fascinating late-medieval attempt to definitively harmonize faith and reason.

This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this (...) is to ask practising nurses about the real ethical problems they encounter. (shrink)

Although science supplies medicine's “gold standard,” knowledge exercised in the care of patients is, like moral knowing, a matter of narrative, practical reason. Physicians draw on case narrative to store experience and to apply and qualify the general rules of medical science. Literature aids in this activity by stimulating moral imagination and by requiring its readers to engage in the retrospective construction of a situated, subjective account of events. Narrative truths are provisional, uncertain, derived from narrators whose standpoints are always (...) situated, particular, and uncertain, but open to comparison and reinterpretation. Reading is thus a model for knowing in both morality and clinical medicine. While principles remain essential to bioethics and science must always inform good clinical practice, the tendency to collapse morality into principles and medicine into science impoverishes both practices. Moral knowing is not separable from clinical judgment. While ethics must be open to discussion and interpretation by patients, families, and society, it is nevertheless substantively and epistemologically an inextricable part of a physician's clinical practice. (shrink)

Kierkegaard's Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard's writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard's thought. Concepts have been selected on the basis of their importance for Kierkegaard's contributions to philosophy, theology, the social sciences, (...) literature and aesthetics, thereby making this volume an ideal reference work for students and scholars in a wide range of disciplines. (shrink)

Kierkegaard’s Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard’s writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard’s thought. Concepts have been selected on the basis of their importance for Kierkegaard’s contributions to philosophy, theology, the social sciences, (...) literature and aesthetics, thereby making this volume an ideal reference work for students and scholars in a wide range of disciplines. (shrink)

Kierkegaard’s Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard’s writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard’s thought. Concepts have been selected on the basis of their importance for Kierkegaard’s contributions to philosophy, theology, the social sciences, (...) literature and aesthetics, thereby making this volume an ideal reference work for students and scholars in a wide range of disciplines. (shrink)

Kierkegaard’s Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard’s writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard’s thought. Concepts have been selected on the basis of their importance for Kierkegaard’s contributions to philosophy, theology, the social sciences, (...) literature and aesthetics, thereby making this volume an ideal reference work for students and scholars in a wide range of disciplines. (shrink)

Kierkegaard’s Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard’s writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard’s thought. Concepts have been selected on the basis of their importance for Kierkegaard’s contributions to philosophy, theology, the social sciences, (...) literature and aesthetics, thereby making this volume an ideal reference work for students and scholars in a wide range of disciplines. (shrink)

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)

The aim of this literature study was to suggest a value ground for nursing anchored in two ethical principles: the principle of human value and the right to experience a meaningful life. Previous nursing research between the years 2000 and 2009 was analysed. Presented values suggested in this value ground are thus in line with the nursing context and science of today. Statements within ethical literature have been used in order to formulate arguments aimed at supporting the values that were (...) found in the study. In the literature study six values were found: trust, nearness, sympathy, support, knowledge and responsibility. These values hold equal status and are not presented in hierarchical order. They vary due to the persons involved, nursing situations and cultural surroundings, but have the common requirement of being non-excluding. In order to implement the values within the value ground, two prerequisites are discussed and claimed as essential: ethical dialogue and a caring encounter between care provider and patients. (shrink)

Medical ethics, principles, persons, and perspectives is discussed under three headings: History, Theory, and Practice. Under Theory, the author will say something about some different approaches to the study and discussion of ethical issues in medicine—especially those based on principles, persons, or perspectives. Under Practice, the author will discuss how one perspectives based approach, hermeneutics, might help in relation first to everyday ethical issues and then to public controversies. In that context some possible advantages of moving from controversy to conversation (...) will be explored; and that will then be illustrated with reference to a current controversy about the use of human embryos in stem cell therapy research. The paper begins with history, and it begins in the author’s home city of Edinburgh. (shrink)

An Institute of Medical Ethics working party argues that an ethically desirable relationship of mutual empowerment between patient and clinician is more likely to be achieved if patients understand the ground rules of medical confidentiality. It identifies and illustrates ambiguities in the General Medical Council's guidance on AIDS and confidentiality, and relates this to the practice of different doctors and specialties. Matters might be clarified, it suggests, by identifying moral factors which tend to recur in medical decisions about maintaining or (...) breaching confidentiality. The working party argues that two such factors are particularly important: the patient's need to exercise informed choice and the doctor's primary responsibility to his or her own patients. (shrink)

Investigation into the reality of time can be pursued within the ontological domain or it can also span human thought and natural language. I propose to approach time by correlating three domains of inquiry: metaphysical time, the human concept of time, and temporal reference in natural language, entertaining the possibility of what I call a ‘horizontal reduction’ and ‘vertical reduction’. I present a view of temporalityL/E as epistemic modality, drawing on evidence from the L domain and its correlates in the (...) E and M domains. On this view, the human concept of time is a complex, ‘molecular’ concept and can be broken down into primitive concepts that are modal in nature, featuring as degrees of epistemic commitment to representations of states of affairs. I present evidence from tensed and tenseless languages and point out its compatibility with the view of real time as metaphysical modality. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dogs and MonstersObservations on the Evacuation of Afghanistan and the Intersection of Human Rights and the AnthropoceneK. M. Ferebee (bio)On August 28, 2021, former Royal Marine and charity worker Pen Farthing was evacuated from Afghanistan with almost two hundred dogs and cats that his Kabul animal charity, Nowzad Dogs, had rescued. The role of the British government in this evacuation remains hotly contested: At the time, the British Ministry (...) of Defence tweeted (Fig. 1) that Farthing's escape had been assisted by the British military, but Farthing later disputed this claim and argued that his rescue was not the result of high-level intervention in the British government. In January 2022 controversy erupted around the emergence of documents suggesting that Prime Minister Boris Johnson had lied to Parliament about the personal role that he played in just such an intervention. Notably, Nowzad's Afghan staff members were not evacuated alongside Farthing and the animals, though they would eventually escape to Pakistan. Following Farthing's escape, the British government failed to evacuate hundreds of British citizens and residents (Merriman and Ghouri), as well as many more Afghans who had worked on behalf of British forces. The Nowzad Dogs evacuation became a site of symbolic struggle over Britain's respect (or lack thereof) for human rights. "What a story to tell the world: Britain values dogs more than Afghan people," the headline of an opinion piece in the Guardian (Hinsliff) read.The story of Nowzad Dogs is interesting to me not only as a tale of human-nonhuman relations, but also because I was, at the time it occurred, volunteering within the Afghan aid community to assist relatives of a friend, British Afghans who had been visiting Kabul when the government [End Page 52] collapsed. The family repeatedly asked for assistance from the British Foreign, Commonwealth and Development Office—assistance that never appeared. Ultimately, due to the generosity of donors and the coordination of a volunteer team, the family was able to flee to Pakistan, where they boarded a commercial flight to London. This case was a particularly stark and powerful illustration of the negotiations of rights and value that took place during and following the evacuation. It seemed nonsensical, in August 2021, to suppose that British citizens, including British children (the family I worked with included a six- and an eleven-year-old who were British citizens), would be abandoned while Afghan dogs had their rights prioritized. As I hope to demonstrate here, however, such an incident becomes comprehensible and even logical when it is understood as part of a specifically Anthropocene manifestation of subjectivity.Upendra Baxi suggests that 1948's Universal Declaration of Human Rights (UDHR) marks a broad shift from the era of "modern" (42) human rights (which began with the American and French Revolutions) to the era of "contemporary" (42) human rights. His periodization links these eras in human rights to shifts in the ideology of capitalism and empire. The "modern" era of human rights, he writes, "signals a whole variety of ideological 'justifications' for colonization and world domination" and "provides a register of major development in industrial capitalism" (42), while the "contemporary" era of human rights "is based on the premise of radical self-determination" (46). Such a periodization also brings human rights into close alignment with the Anthropocene, which is rooted in the capitalist-colonial Enlightenment and Industrial Revolution, yet often dated most concretely to the circa-1950 shift that some (such as J. R. McNeill and Peter Engelke) label the "Great Acceleration." Indeed, one could reasonably appropriate Baxi's terms and speak of "modern" and "contemporary" Anthropocenes mapped identically onto the global timeline.I propose to use the 2021 Afghan evacuation as a site from which to explore how human rights and the Anthropocene have together coproduced certain forms of subjectivity that are essential for the continued smooth functioning of world-ecological capitalism. These new forms of subjectivity are necessary to sustain the important fiction of individual [End Page 53] agency and value and conceal the ways in which the Anthropocene moment renders this fiction meaningless. Ultimately, I paint a picture of an Anthropocene without any human agency at all. I want... (shrink)

Philosophy of history; the idea of the not-being and the history, by K. M. Jamil.--Philosophy of history, by Khwaja Ashkar Husain.--Philosophy of history, by A. H. Kamali.--Philosophy of history, by B. H. Siddiqi.--Philosophy of history: explanation in history, by Kazi A. Kadir.

Haydar el-Herevî Horasan’dan Osmanlı topraklarına gelen önemli âlimlerdendir. Teftâzânî’nin şeçkin bir talebesi olan bu âlim I. Mehmed’ten büyük saygı görerek onun tarafından himaye edilmiştir. Herevî, Zemahşerî’nin el-Keşşâf’ı üzerine yazdığı şerhi büyük övgü ifadeleriyle I. Mehmed’e ithaf etmiş, ithafın yer aldığı mukaddimede hayat hikayesiyle ilgili önemli ayrıntılar vermiştir. Osmanlı topraklarında geçirdiği uzun yıllar sonra Timur’un oğlu Şahruh ile irtibat kuran Herevî, el-Keşşâf şerhi mukaddimesini tekrardan kaleme alarak aynı eseri bu sefer Şahruh’a ithaf etmiştir. Herevî’nin bu yeni patronaj ilişkisi mukaddimenin ikinci versiyonundan (...) öğrenilmektedir. İkinci versiyonda sadece ithaf kısmı değiştirilmemiş, yeni haminin kimliğiyle irtibatlı olarak muhteva da yeni- den kurgulanmıştır. İlk versiyonda bulunmayan önemli biyografik ayrıntılar ikinci versiyonda yer almaktadır. Mukaddimenin iki versiyonu Herevî biyografisinin neredeyse yegâne kaynağıdır. Bu makalede mukaddimenin ikinci versiyonu ilk defa gün yüzüne çıkarılmış ve her iki versiyonda verilen bilgiler bir araya getirilerek Herevî’nin biyografisi inşa edilmiştir. İki versiyonda herhangi bir tarih verilmemiş, sadece bazı şehirlerdeki ikamet süreleri belirtilmiştir. Biyografi inşa edilirken anlatıda oluşan boşluklar tarihi olaylardan hareketle doldurulmuş ve tarihlendirme yapılmıştır. Bahsedilen olaylar, yapılan nitelemeler ve verilen ikamet süreleri itibara alınarak Herevî’nin hayatının yaklaşık kırk yıllık bölümü tam olarak tarihlendirilmiş, Serahs’tan başlayarak sırasıyla Şîraz, Tebriz, Şirvan, Bursa, Edirne ve tekrar Horasan’a uzanan yıllara dair bütünlüklü bir tablo ortaya konulmuştur. Bu hayat hikayesi ulema-sultan ilişkileri, siyasî gelişmelerin ilim hayatına yansımaları ve hayatını ilim yolculuklarında geçiren bir âlimin zihin dünyası hakkında eşsiz bilgiler sunmaktadır. (shrink)

Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect (...) of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. (shrink)