Background: Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing (...) surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods: An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results: Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally, brokers' roles in follow up care, their prices, and the speed of surgery were the most commonly included business dimensions on the reviewed websites. Conclusion: Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implications for the informed consent and consequent safety of Canadian medical tourists. (shrink)

Este artículo profundiza en los debates históricos y actuales en Canadá sobre la historia nacional y la enseñanza de la historia en el complicado escenario de trece jurisdicciones educativas de Canadá. En este trabajo se analizan los debates sobre los contenidos en la enseñanza de la historia y en los libros de texto, así como los enfoques en la escuela. Se analizan las formas en que un enfoque de pensamiento histórico está consolidándose en todo el país en el período actual, (...) con una mayor atención a la investigación en la enseñanza de la historia y su difusión y su mayor presencia en los planes provinciales. Se considera el papel del gobierno federal en estos cambios, las organizaciones privadas sin fines de lucro, y los proyectos financiados por el gobierno nacional, tales como el Historical Thinking Project y The History Education Network. (shrink)

The book is full of insights for undergraduate, post-graduate and research students of Philosophy and all those who are interested in the Philosophy of religion and ethics of Wittgenstein.

This article examines the evidence for the empirical argument that there is a slippery slope between the legalization of voluntary and non-voluntary euthanasia. The main source of evidence in relation to this argument comes from the Netherlands. The argument is only effective against legalization if it is legalization which causes the slippery slope. Moreover, it is only effective if it is used comparatively-to show that the slope is more slippery in jurisdictions which have legalized voluntary euthanasia than it is in (...) jurisdictions which have not done so. Both of these elements are examined comparatively. (shrink)

Slippery slope arguments appear regularly whenever morally contested social change is proposed. Such arguments assume that all or some consequences which could possibly flow from permitting a particular practice are morally unacceptable.Typically, “slippery slope” arguments claim that endorsing some premise, doing some action or adopting some policy will lead to some definite outcome that is generally judged to be wrong or bad. The “slope” is “slippery” because there are claimed to be no plausible halting points between the initial commitment to (...) a premise, action, or policy and the resultant bad outcome. The desire to avoid such projected future consequences provides adequate reasons for not taking the first step.Thus the legalization of abortion in limited circumstances is asserted to lead down the slippery slope towards abortion on demand and even infanticide; and the legalization of assisted suicide to lead inexorably to the acceptance of voluntary euthanasia and subsequently to the sanctioning of the practice of nonvoluntary euthanasia – even involuntary euthanasia of “undesirable” individuals. (shrink)

Much of the time, human beings seem to rely on habits. Habits are learned behaviours directly elicited by context cues, and insensitive to short-term changes in goals: therefore they are sometimes irrational. But even where habitual responses are rational, it can seem as if they are nevertheless not done for reasons. For, on a common understanding of habitual behaviour, agents’ intentions do not play any role in the coming about of such responses. This paper discusses under what conditions we can (...) say that habitual responses are, after all, done for reasons. We show how the idea that habitual behaviour cannot be understood as ‘acting for reasons’ stems from a widely but often implicitly held theoretical framework: the causal theory of action. We then propose an alternative, Anscombean understanding of intentional action, which can account for habitual responses being done for reasons. (shrink)

Procedures such as organ or tissue donation, elective ventilation and non‐therapeutic research can be said to be against the medical interests of the participant. Competent adults can consent to procedures such as these that are against their medical interests, but when, if ever, should incompetent persons participate in such procedures? Legal approaches to decision‐making in the area of the medical care of incompetent persons are generally based on respect for the patient's autonomy, or protection of her welfare, or some combination (...) of the two. The limitations of these approaches become apparent upon examination of their application in this context. Societal interests are also used to justify the participation of the incompetent in procedures which are against their medical interests, for example, the societal interest in pursuing non‐therapeutic research on incompetents in order to benefit future incompetents. These types of approaches are implicit in much current policy and reform proposals on non‐therapeutic research, contributing to the disrespect for incompetent persons that is implicit in many research projects and much argument on the categorization of risks, and the repeated failure to consider the burdens imposed on incompetent persons in the interests of society. (shrink)

In the wake of the brave voices of the #metoo movement, Buddhist responses to sexual abuse have led to important questions about Buddhist sexual ethics and the female consort in Tibetan cultures. One issue raised by current debates is the question of who is an appropriate consort, a discourse that has historical precedent. These debates highlight the gaps left by the understudied history of consorts in Tibetan tantric communities. This research addresses that history through a study of female consort discourse (...) in key scriptures of the Great Perfection from the fourteenth century. The text studied is The Ḍākki’s Path and Fruit, which is part of a corpus known as The Seminal Heart of the Ḍākinī. The scriptures are analyzed in terms of taxonomic discourse, interpreted with attention to structures of knowledge production as described by Foucault. It addresses the discursive transformations that facilitated the inclusion of women in the androcentric world of esoteric Tibetan Buddhism. Overall, the argument is made that this scripture sheds light on how knowledge of women and sexuality was constructed in a web of ever-changing, contradicting, competing discourses that reflect an ambivalent misogyny that simultaneously promoted and subjugated women. (shrink)

Some form of assisted dying (voluntary euthanasia and/or assisted suicide) is lawful in the Netherlands, Belgium, Oregon, and Switzerland. In order to be lawful in these jurisdictions, a valid request must precede the provision of assistance to die. Non-adherence to the criteria for valid requests for assisted dying may be a trigger for civil and/or criminal liability, as well as disciplinary sanctions where the assistor is a medical professional. In this article, we review the criteria and evidence in respect of (...) requests for assisted dying in the Netherlands, Belgium, Oregon, and Switzerland, with the aim of establishing whether individuals who receive assisted dying do so on the basis of valid requests. We conclude that the evidence suggests that individuals who receive assisted dying in the four jurisdictions examined do so on the basis of valid requests and third parties who assist death do not act unlawfully. However, further research on the elements that may undermine the validity of requests for assisted dying is warranted. More research on the reasons why requests for assisted dying are refused is also desirable. (shrink)

This inspiring and practical manual shows how applying yoga's timeless principals to modern life can lead to radiant health and inner peace. Using engaging anecdotes from her students and her own challenges on the path, author Kali Om shares accessible and simple tools for self-transformation that have a deep and lasting impact.

In faith and practice, Pentecostals put emphasis on practical issues as well as spiritual experience in their theological understanding and doctrinal teachings. The Pentecostals take their doctrine from certain empirical events. One of the spiritual experiences often underlined is the baptism of the Holy Spirit. In interpreting the Book of Acts, Pentecostals tend to emphasise the theological character of the narratives and seldom their historical uniqueness. That is why Pentecostals stress the normative theological intent of the historical record for contemporary (...) Christian experience. This article therefore examines critically Pentecostal paradigm of the baptism of the Holy Spirit, deriving examples from the Acts of the Apostles. It is concluded that the practice of the baptism of the Holy Spirit carried out by Christians today, arguably, has no biblical basis. This is because, there is nowhere the Bible commands people to seek baptism in the Holy Spirit. The observation is that, all the events or experiences of Christians baptised in the Holy Spirit in Acts are not necessarily universal normative for every Christian and for this reason, there is no need to be dogmatic.Contribution: This article challenges the practice of the baptism of the Holy Spirit in church today. This study supports the fact that the baptism of the Holy Spirit is not a universal experience for every Christians and there is no need to be dogmatised. (shrink)

Some form of assisted dying (voluntary euthanasia and/or assisted suicide) is lawful in the Netherlands, Belgium, Oregon, and Switzerland. In order to be lawful in these jurisdictions, a valid request must precede the provision of assistance to die. Non-adherence to the criteria for valid requests for assisted dying may be a trigger for civil and/or criminal liability, as well as disciplinary sanctions where the assistor is a medical professional. In this article, we review the criteria and evidence in respect of (...) requests for assisted dying in the Netherlands, Belgium, Oregon, and Switzerland, with the aim of establishing whether individuals who receive assisted dying do so on the basis of valid requests. We conclude that the evidence suggests that individuals who receive assisted dying in the four jurisdictions examined do so on the basis of valid requests and third parties who assist death do not act unlawfully. However, further research on the elements that may undermine the validity of requests for assisted dying is warranted. More research on the reasons why requests for assisted dying are refused is also desirable. (shrink)

Recently, two apparent truisms about self-control have been questioned in both the philosophical and the psychological literature: the idea that exercising self-control involves an agent doing something, and the idea that self-control is a good thing. Both assumptions have come under threat because self-control is increasingly understood as a mental mechanism, and mechanisms cannot possibly be good or active in the required sense. However, I will argue that it is not evident that self-control should be understood as a mechanism, suggesting (...) that we might also argue the other way around: if we have independent reason to hold onto the idea that self-control is inherently good and active, the conclusion might be that self-control cannot be a mechanism. I will show that Aristotle's original analysis of self-control actually offers grounds for both assumptions: he took there to be conceptual connections between self-control and goodness/activity. By examining these connections, I argue that an Aristotelian approach could offer promising leads for a contemporary non-mechanistic understanding of self-control as a normative capacity. (shrink)

This article focuses on both daily forms of weakness of will as discussed in the philosophical debate and psychopathological phenomena as impairments of decision making. We argue that both descriptions of dysfunctional decision making can be organized within a common theoretical framework that divides the decision making process in three different stages: option generation, option selection, and action initiation. We first discuss our theoretical framework, focusing on option generation as an aspect that has been neglected by previous models. In the (...) main body of this article, we review how both philosophy and neuropsychiatry have provided accounts of dysfunction in each decision-making stage, as well as where these accounts can be integrated. Also, the neural underpinnings of dysfunction in the three different stages are discussed. We conclude by discussing advantages and limitations of our integrative approach. (shrink)

When research concludes, post-trial access to the trial intervention or standard healthcare can be crucial for participants who are ill such as those in resource-poor countries with inadequate healthcare, British participants testing ‘last-chance drugs’ unavailable on the National Health Service and underinsured US participants. Yet, many researchers are unclear about their obligations regarding the post-trial period, and many research ethics committees do not know what to require of researchers. Consequences include participants who reasonably expect but lack PTA to the trial (...) intervention, unplanned financial liabilities for NHS Trusts forced to fund this, negative press and potential to undermine public trust.1–3,iOne reason for the lack of clarity is controversy over whether and when participants should have access, after the study, to the study intervention. At one extreme is the view that continued access should be ensured when the intervention has benefited the participant or when it has proven safe and effective for the participant population, irrespective of the cost and burden of ensuring continued access. At the other extreme is the view that continued access need never be provided so long as non-availability of the study intervention post-trial was adequately disclosed when participants were invited to participate.6 There is also disagreement about when poststudy access to the study intervention should be considered beneficial for participants. The spectrum ranges from the view that the intervention should be regarded as beneficial for a proposed use only after the …. (shrink)

This book explores classic philosophical questions regarding the phenomenon of weakness of will or ‘akrasia’: doing A, even though all things considered, you judge it best to do B. Does this phenomenon really exist and if so, how should it be explained? Nacht van Descartes -/- The author provides a historical overview of some traditional answers to these questions and addresses the main question: how does the phenomenon of 'going against your own judgment' relate to the idea that we are (...) rational beings? She elaborates on the notion of rational agency and shows how different types of behaviour express or fail to express our rational agency. This leads to the speculation of what is needed for akratic action to be free action. -/- A novel position is developed, stating that certain widespread philosophical accounts of free action must conclude that 'going against your own judgment' is necessarily unfree. This also requires a reflection on possible implications for moral responsibility. Would it mean that people cannot be held accountable for irrational behaviour? -/- Kalis offers insight on whether everyday irrational behaviour differs from irrational behaviour occurring in the context of psychiatric dysfunction, and develops a view on how we should understand ourselves when we do something other than what we judge best. -/- Written for philosophers, psychologists and psychiatrists interested in issues of irrationality and philosophy of action, this is an indispensable book for both professionals and students interested in interdisciplinary endeavours in the science of mind and behaviour. (shrink)

Recently, two apparent truisms about self‐control have been questioned in both the philosophical and the psychological literature: the idea that exercising self‐control involves an agent doing something, and the idea that self‐control is a good thing. Both assumptions have come under threat because self‐control is increasingly understood as a mental mechanism, and mechanisms cannot possibly be good or active in the required sense. However, I will argue that it is not evident that self‐control should be understood as a mechanism, suggesting (...) that we might also argue the other way around: if we have independent reason to hold onto the idea that self‐control is inherently good and active, the conclusion might be that self‐control cannot be a mechanism. I will show that Aristotle's original analysis of self‐control actually offers grounds for both assumptions: he took there to be conceptual connections between self‐control and goodness/activity. By examining these connections, I argue that an Aristotelian approach could offer promising leads for a contemporary non‐mechanistic understanding of self‐control as a normative capacity. (shrink)

Care after research is for participants after they have finished the study. Often it is NHS-provided healthcare for the medical condition that the study addresses. Sometimes it includes the study intervention, whether funded and supplied by the study sponsor, NHS or other party. The NHS has the primary responsibility for care after research. However, researchers are responsible at least for explaining and justifying what will happen to participants once they have finished. RECs are responsible for considering the arrangements. There are (...) ethical and practical issues, in particular when participants may wish to continue on the study intervention after the study. There are also various guidelines and legislation. This document presents a framework of questions to help NHS RECs and their applicants. Information on this document’s development is here. (shrink)

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed (...) participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values. (shrink)

According to ecological psychology, agency is a crucial feature of living organisms: therefore many ecological psychologists maintain that explaining agency is one of the core aims of the discipline. This paper aims to contribute to this goal by arguing that an ecological understanding of agency requires an account of intention. So far, intentions have not played a dominant role in ecological accounts of agency. The reluctance to integrate a notion of intention seems to be motivated by the widespread assumption that (...) intentions should be understood as internal states with representational content. This assumption goes against two main tenets of ecological psychology: its anti-representationalist stance and its claim that perception is direct (in the sense of not being mediated by inferential processes). Ecological psychology thus needs a different answer to the question what intentions are. In this paper, we aim to show that Elizabeth Anscombe’s theory of intention can be fruitfully brought to bear on an ecological theory of agency. We will argue that Anscombe’s account can meet the two challenges of bringing intentions into the framework of ecological psychology: firstly it can explain what intentions are, if not representational states; and, secondly, it can show how our perception of affordances is guided by intention without undermining the idea of direct perception. (shrink)

This article discusses the merits of teaching legal analysis and writing and of developing a legal writing program at a faculty of law, and recommends that law faculties around the world incorporate this subject. Once absent from the American law school curriculum, this subject has become a required subject in all American law schools over the past 25+ years. The article suggests steps for implementing a legal writing course or program, and offers a variety of resources for doing so.

According to Oude Maatman (2020), our recent suggestion (Borsboom et al., 2019) that symptom networks are irreducible because they rely on folk psychological descriptions, threatens to undermine the main achievements of the network approach. In this article, we take up Oude Maatman’s challenge and develop an argument showing in what sense folk psychological concepts describe features of reality, and what it means to say that folk psychology is a causal language.

Mental states in psychology Many of our thoughts, emotions and motivations have intentional content: they are ‘about’ something. In this paper I present my VENI research project, which starts from the observation that the everyday practice of empirical psychological research is built on the idea that mental states have content. However, empirical psychology lacks a clear view on how mental content should be understood and how mental states could be causally efficacious in virtue of their content. I focus on mental (...) states that play a role in psychiatric symptomatology, and develop an interpretivist answer to these questions. I also offer some suggestions showing how an interpretivist notion of mental content could be used in empirical research on psychiatric symptoms. (shrink)

What attitude does someone manifesting implicit bias really have? According to the default representationalist picture, implicit bias involves having conflicting attitudes (explicit versus implicit) with respect to the topic at hand. In opposition to this orthodoxy, dispositionalists argue that attitudes should be understood as higher-level dispositional features of the person as a whole. Following this metaphysical view, the discordance characteristic of implicit bias shows that someone’s attitude regarding the topic at hand is not-fully-manifested or ‘in-between’. However, so far few representationalists (...) have been convinced by dispositionalist arguments, largely because dispositionalism cannot provide explanations in terms of underlying processes. We argue that if dispositionalism wants to be a genuine contender, it should make clear what it has to offer in terms of understanding of implicit bias. As a concrete proposal, we combine dispositionalist metaphysics with the idea that our normative practices of attitude ascription partly determine what it means to have an attitude. We show that such regulative dispositionalism can account for two prominent normative features of implicit bias. We conclude by suggesting that in order to engage in a meaningful debate with representationalism, dispositionalists might have to put the question ‘what counts as a good explanation?’ back on the table. (shrink)

In recent years, the philosophy and psychology of reasoning have made a ‘social turn’: in both disciplines it is now common to reject the traditional picture of reasoning as a solitary intellectual exercise in favour of the idea that reasoning is a social activity driven by social aims. According to the most prominent social account, Mercier and Sperber’s interactionist theory, this implies that reasoning is not a normative activity. As they argue, in producing reasons we are not trying to ‘get (...) things right’; instead our aims are to justify ourselves and persuade others to accept our views. I will argue that even if interactionism has played a crucial role in bringing about the ‘social turn’ in our thinking about reasoning, it does not convince in its claim that reasoning is not a normative activity. Moreover, I argue that it is in fact perfectly possible to understand reasoning as a social tool that is also aimed at getting things right. I will propose that Gilbert Ryle’s conceptualization of reasoning as ‘didactic discourse’ offers one possible way to understand reasoning as both social and normative activity, and that as such his ideas could be of great value for the social turn in our thinking about reasoning. (shrink)

As we all know, people often do not do what would be the rational thing to do. Both psychologists and philosophers have long been interested in explaining this aspect of the human condition. Also, the relation between everyday irrationality and pathological breakdowns of rationality is a familiar topic of discussion in psychiatry. It is not merely the failures themselves that present interesting questions; there is also the hope that, by understanding when and why we violate rational norms, we might get (...) a firmer grasp on what it means to meet such norms, and thus gain a deeper understanding of the rational capacities of human beings. The capacity we focus on herein is our capacity for practical rationality... (shrink)

Do Heidegger-teabags give philosophy a bad name? An essay about philosophy for the general public Among many academic philosophers, philosophy for the general public has a bad reputation. In this paper I give an overview of the main points of criticism, and use these to develop a positive account of what good philosophy for the general public could be. As a first step towards such an account, I outline different views on how philosophy for the general public can relate to (...) academic philosophy. Subsequently, I argue that what makes philosophy for the general public ‘good’, is just what makes philosophical work in general ‘good’: good philosophical work has a philosophical aim, employs philosophical methods and employs these methods in a sound way. Finally I argue that communicability of philosophical ideas should not be seen as a bonus feature but as the sine qua non of philosophical thinking: if academic philosophy paid more attention to communicability, we might not even need a distinct discipline of philosophy for the general public. I conclude with some concrete suggestions for improving such communicability. (shrink)