Zenpen Kyūsō Sensei bunshū -- Hoi Kyūsō Sensei bunshū -- Kōhen Kyūsō Sensei bunshū -- Furoku Kyūsō ikkō.

In lieu of an abstract, here is a brief excerpt of the content:Clinical CommentaryChong Siow Ann, Associate ProfessorDr. G appears to experiencing symptoms of schizophrenia, which is arguably the most severe mental disorder and which afflicts about one in a hundred people. This is a psychotic disorder that causes disturbances and distortions in thinking, including neurocognitive impairments, perception and behaviour. There is no cure for this often devastating disorder. Current antipsychotic medications can alleviate some of the symptoms but it often (...) comes at a price as these antipsychotics have burdensome side effects.A feature of this disorder is anosognosia, which is a lack of awareness or “insight” that an illness is present. This lack of insight presents a particular challenge because these individuals would, as in the case of Dr. G, refuse needed treatment as they do not perceive that they are ill. This is not necessarily an all-or-none phenomenon but is rather more complex and multidimensional; there might be an unawareness or recognition on behalf of the patient that they are suffering from a mental illness, the failure to appreciate the necessity of treatment; and/or the inability to recognise and define the psychotic symptoms like unusual thoughts and hallucinations as signs of illness1 and in many instances, all three are present. It is also by no means uncommon. Studies have found that between 60% and 80% of people with schizophrenia lack awareness of their illness to varying degrees.2This phenomenon remains an enigma. Some regard it as a form of psychological defence against the harsh reality of a psychotic illness — awareness of having a chronic and devastating illness might lead to demoralisation, hopelessness and suicide.3 Recent research, however, [End Page 250] indicates that this psychological denial plays a small part, if any, and instead has found an association with certain neuropsychological and neurocognitive deficits,4 as well as functional and structural brain abnormalities in the frontal lobe of the brain.5The prevailing clinical view thus is that this is an intrinsic and organic aspect of the schizophrenic illness which has nothing to do with wilfulness but rather the incapacity to perceive the presence of the illness. Edwin Fuller Torrey, an eminent psychiatrist and executive director of the Stanley Medical Research Foundation, calls anosognosia the “single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications”, and he has remarked that “to keep talking about civil liberty is illogical. Patients are anything but free when they’re at the beck and call of their own delusions”.6It is also this view that it is a product of a brain disorder that some — particularly patients — find unacceptable. At one level, it does not take into context the person’s own experiences, and at a deeper level it calls into question the conception of the self with its capacity to exercise judgements and the autonomy to make decisions.This is a perennial ethical issue in psychiatry when people with severe mental illnesses refuse treatment. This becomes a Catch-22 situation where part of the illness that needs treatment is also preventing any treatment to be given: implicit in the principle of informed consent for treatment is that the person should be aware of the nature and course of their illness and acknowledge the need for treatment. While there are laws for involuntary commitment, the bar is usually high in that there must be a clear and present risk of harm to the person or others. Alan Stone, a professor of law and psychiatry at Harvard University proposed a possible justification for involuntary treatment based on his “thank-you theory” which assumes that patients will become well and subsequently agree that the intervention was in their best interests but research suggests that only half of these patients would admit so.7One suggested mechanism is the use of advance directives — psychiatry’s version of the living will in which people can specify what sort of medical care they would like should they become mentally unwell and unable to exercise appropriate judgement. An intrinsic part of this might include a “Ulysses contract” — just as Ulysess instructed his crew to lash him to the mast of the his ship so that he could... (shrink)

Mal ŭi him -- Kŏjinmal ch'ammal kŭrigo ch'immuk.

Hobbes’s own justification for the existence of governments relies on the assumption that, without a government, our lives in the state of nature would result in a state of war of every man against every man. Many contemporary scholars have tried to explain why universal war is unavoidable in Hobbes’s state of nature by utilizing modern game theory. However, most game-theoretic models that have been presented so far do not accurately capture what Hobbes deems to be the primary cause of (...) conflict in the state of nature – which is uncertainty, rather than people’s egoistic psychology. Any game- theoretic model that does not incorporate uncertainty into the picture is, therefore, I claim, the wrong model. In this paper, I use Bayesian game-theory to show how universal conflict can break-out in the state of nature - even when the majority of the population would strictly prefer to cooperate and seek peace with other people - due to uncertainty about the other person’s type. Along the way, I show that the valuation of one’s own life is one of the central mechanisms that drives Hobbes’s pessimistic conclusion. (shrink)

One of John Rawls’s major aims, when he wrote A Theory of Justice, was to present a superior alternative to utilitarianism. Rawls’s worry was that utilitarianism may fail to protect the fundamental rights and liberties of persons in its attempt to maximize total social welfare. Rawls’s main argument against utilitarianism was that, for such reasons, the representative parties in the original position will not choose utilitarianism, but will rather choose his justice as fairness, which he believed would securely protect the (...) worth of everybody’s basic rights and liberties. In this paper, I will argue that, under close formal examination, Rawls’s argument against utilitarianism is self-defeating. That is, I will argue that Rawls’s own reasons, assumptions, and the many theoretical devices he employs demonstrably imply that the representative parties in the original position will choose utilitarianism instead of justice as fairness. (shrink)

本书是一本关于陈冲体验人生感悟人生的书法集子。内容包括:悟道篇;明理篇;做人篇;处世篇等。.

Ever since the publication of Harry Frankfurt’s “Equality as a Moral Ideal” :21–43, 1987), the doctrine of sufficiency has attracted great attention among both ethical theorists and political philosophers. The doctrine of sufficiency consists of two main theses: the positive thesis states that it is morally important for people to have enough; and the negative thesis states that once everybody has enough, relative inequality has absolutely no moral importance. Many political philosophers have presented different versions of sufficientarianism that retain the (...) general spirit of what Frankfurt had proposed in his seminal work. However, all of these different versions of sufficientarianism suffer from two critical problems: they fail to give right answers to lifeboat situations, and they fail to provide continuous ethical judgments. In this paper, I show a version of utilitarianism that solves these problems while retaining the major attractions of sufficientarianism. I call it “prospect utilitarianism.” In addition, I show that prospect utilitarianism can avoid standard objections to utilitarianism and has aspects that can appeal to both prioritarians and egalitarians as well. (shrink)

John Rawls’s most mature notion of political order is “stability for the right reasons.” Stability for the right reasons is the kind of political order that Rawls hoped a well-ordered society could ideally achieve. In this paper, I demonstrate through the tools of modern game theory, the instability of “stability for the right reasons.” Specifically, I will show that a well-ordered society can completely destabilize by the introduction of an arbitrarily small number of non- compliers whenever individuals fail to achieve (...) full common knowledge ever so slightly. (shrink)

Public reason liberalism takes as its starting point the deep and irreconcilable diversity we find characterizing liberal societies. This deep and irreconcilable diversity creates problems for social order. One method for adjudicating these conflicts is through the use of rights. This paper is about the ability of such rights to adjudicate disputes when perspectival disagreements—or disagreements over how to categorize objects in the world—obtain. We present both formal possibility and impossibility results for rights structures under varying degrees of perspectival diversity. (...) We show that though perspectival diversity appears to be a troubling problem for the prospect of stable social order, if rights are defined properly then disagreements can likely be resolved in a consistent manner, achieving social cooperation rather than conflict. (shrink)

In a recently published paper entitled, “The Difference Principle Would Not Be Chosen behind the Veil of Ignorance”, Johan E. Gustafsson attempts to demonstrate that the parties in Rawls’s original position would not choose the difference principle. Gustafsson’s main strategy was to show that Rawls’s difference principle in both of its ex post and ex ante versions imply counterintuitive distributional prescriptions in a few contrived examples. The purpose of this paper is to precisely demonstrate exactly how Gustafsson’s arguments have failed (...) to show that the difference principle would not be chosen behind the veil of ignorance. (shrink)

The original position together with the veil of ignorance have served as one of the main methodological devices to justify principles of distributive justice. Most approaches to this topic have primarily focused on the single person decision-theoretic aspect of the original position. This paper, in contrast, will directly model the basic structure and the economic agents therein to project the economic consequences and social outcomes generated either by utilitarianism or Rawls’s two principles of justice. It will be shown that when (...) the differences in people’s productive abilities are sufficiently great, utilitarianism dominates Rawls’s two principles of justice by providing a higher level of overall well-being to every member of society. Whenever this is the case, the parties can rely on the Principle of Dominance (which is a direct implication of instrumental rationality) to choose utilitarianism over Rawls’s two principles of justice. Furthermore, when this is so, utilitarianism is free from one of its most fundamental criticisms that it ‘does not take seriously the distinction between persons’ (Rawls 1971 [1999]: 24). (shrink)

A defining characteristic of a liberal democratic society is the assignment of basic rights and liberties that protect each person’s private sphere. Hence, social choice made in a liberal democratic society must at the very least be consistent with the exercise of each person’s basic rights. However, even when everybody agrees to this basic principle, there could still remain irreconcilable social conflict and disagreement when it comes to the specific assignment of basic rights. This is especially so in a pluralistic (...) society where there is a clash among radically different and incompatible world views. Philosophers have now started to focus on this issue, which now goes by the name “perspectival diversity.” This paper extends the basic social choice theoretic framework of liberal rights by extending the domain to include individual perspectives alongside individual preferences. In this new framework, different individuals are able to see or perceive the same social alternative differently based on their own unique perspectives. The formal results of the paper imply that generating a viable social choice that is consistent with the assignment of basic rights can quickly break down once we start to increase the level of perspectival diversity in society. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

This paper intends to append the frame of dialectic upon St. John of the Cross’ delineation of mysticism. Its underlying hypothesis is that the dialectical structuring of St. John’s mystical theology promises to unravel the web of relational concepts embedded within his immense writings on this unique phenomenon. It is hoped that as a consequence of this undertaking, relevant pairs of correlative opposites that figure prominently in mysticism can be elucidated and perhaps come to some form of resolution.