There is general acknowledgement that both the anterior cingulate and orbitofrontal cortex are implicated in reinforcement-guided decision making, and emotion and social behaviour. Despite the interest that these areas generate in both the cognitive neuroscience laboratory and the psychiatric clinic, ideas about the distinctive contributions made by each have only recently begun to emerge. This reflects an increasing understanding of the component processes that underlie reinforcement- guided decision making, such as the representation of reinforcement expectations, the exploration, updating and representation (...) of action values, and the appreciation that choices are guided not just by the prospect of reward but also by the costs that action entails. Evidence is emerging to suggest that the anterior cingulate and orbitofrontal cortex make distinct contributions to each of these aspects of decision making. (shrink)

This article aims to contribute to the application of ethical frameworks to public health policy. In particular, the article considers the use of the Nuffield Council on Bioethics stewardship model, as an applied framework for the evaluation of evidence within public health policymaking. The ‘Stewardship framework’ was applied to a policy proposal to restrict marketing of food and beverages to children. Reflections on applying the stewardship model as a framework are provided. The article concludes that the questions used to apply (...) the stewardship model usefully introduced ethical considerations into the evidence review. However, the real value will likely come from the type of policy process within which the framework is used, identifying competing value positions and capturing local value requirements. (shrink)

Bioethics mediation training offers knowledge and skills valuable for clinical ethics consultants who are engaged in high conflict situations. Furthermore, clinicians with this training can support organizational efforts to create a culture that is centered on the values, needs, and care preferences of patients and their families, rather than on those of the clinician or organization. Patientcenteredness is a hallmark of quality and an essential component for patients’ safety. Clinicians with mediation training have the communication skills to address the myriad (...) needs of patients and their loved ones, needs that are challenging to meet in inpatient hospital settings. The author illustrates principles of mediation such as validating patients’ emotions, revealing the interests of all stakeholders, and shaping a shared solution to demonstrate how these skills have broad applicability in patient care settings. (shrink)

Exploring Augustine's Confessions as far more than autobiography, more than an elaboration and admission of guilt, more so than a chronicle and more precisely as the very act of coming into the truth in his heart, in front of God, in his confession, and in his public writings. His Confessions charts his becoming a witness to his self-witnessing, as his matter of testimony. Confession becomes an onto-existential practice. But, what is the mode or nature of the type of confession at (...) work when confession becomes ontological? Using Heidegger, the paper hinges on two poetic instances, one in Confessions, one in Being and Time, to develop an idea of ontology as testimony when being is a diligent witness to Being. It is confession as an admission of guilt insofar as being seeks absolution of its presumptions of being as a genus, as indefinable, and as the most self-evident concept, and being then acknowledges the question of Being. This acknowledgement of the obligation of the question is, then, a confession as a public declaration of faith, of the openness to question. The ontological project, for Heidegger, is then confession and testimony perhaps more fundamentally than Augustine’s Confessions, whose autobiographical detail and positing of the self as a relation to God must carefully elaborate itself so as not to be guilty of the offense of metaphysics. (shrink)

The cinematographic successes of Craig Brewer’s Black Snake Moan and Lars Von Trier's Manderlay are contingent upon the palpability of tension and attraction created by their respective, many racial and sexual relations, thus both films aggressively bring them to the fore by excessively rehearsing old stereotypes and taboos, and inverting the expected agents therein, to reveal their persistent, still-relevant power. Both films similarly test our convictions and squeamishness, but do so from entirely different moral stances. Brewer explores how an act (...) of charity and humanitarian openness can save lives, literally and spiritually. Von Trier explores how similar acts of openness can smother appreciation of the other and reenact the worst oppression. The former tells a persuasive story with wide appeal, while the latter tells a story that will make even the most desensitized viewers cringe. Using these pictures as paradigms, is either approach better for bringing prejudice into the light for thought and film? (shrink)

You may challenge this. You may say that after all scientists need gadgets. They need cyclotrons and space probes, telescopes and microscopes. They need the mechanical skills to make them work. The other day I heard a talk by a novelist who remarked that maybe you don't need to have a poignant love affair to be a writer, but it helps. I take this to mean that writers as well as scientists need data, which implies the equipment and skills for (...) its perception; but this need imply no more than the very basic human endowment. I happen to be a geologist and get a good deal of my data wandering "... lonely as a cloud o'er vales and hills," which also appears to have some poetic value. Still, there seems to be a difference. Are poignant love affairs, which inform the poetic imagination, merely disturbing to scientists? (shrink)

Neither art criticism nor a scholar’s monograph on an artist, Jean-François Lyotard’s Sam Francis: Lesson of Darkness: ‘like the paintings of a blind man’ is a reflection that engages both the painter and 43 of his works into a conversation alternating painting and aphoristic writing. Their order follows neither the chronology of the works nor a linear argument in the prose. And yet, the work generates the strongest feeling of there being a continuity in this peculiar dialogue of pictures and (...) poeticism, a continuity not clearly presented by logic, but one concerning what remains unpresented in presentation. The conversation is revelatory of their shared concerns with the energetic force of absence and is fascinating. (shrink)

Contents Acknowledgements Part 1--Medicine today 1 Why is medicine in trouble? 2 Conflicts of interest Part 2--Troublespots 3 The business of medicine 4 Sexual ...