BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should be communicated (...) to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists’ age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.ConclusionsThe present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective. (shrink)

Norms have been widely enacted in human and agent societies to regulate individuals’ actions. However, although legislators may have ethics in mind when establishing norms, moral values are only sometimes explicitly considered. This paper advances the state of the art by providing a method for selecting the norms to enact within a society that best aligns with the moral values of such a society. Our approach to aligning norms and values is grounded in the ethics literature. Specifically, from the literature’s (...) study of the relations between norms, actions, and values, we formally define how actions and values relate through the so-called value judgment function and how norms and values relate through the so-called norm promotion function. We show that both functions provide the means to compute value alignment for a set of norms. Moreover, we detail how to cast our decision-making problem as an optimisation problem: finding the norms that maximise value alignment. We also show how to solve our problem using off-the-shelf optimisation tools. Finally, we illustrate our approach with a specific case study on the European Value Study. (shrink)

This thesis studies collider phenomenology of physics beyond the Standard Model at the Large Hadron Collider (LHC). It also explores in detail advanced topics related to Higgs boson and supersymmetry - one of the most exciting and well-motivated streams in particle physics. In particular, it finds a very large enhancement of multiple Higgs boson production in vector-boson scattering when Higgs couplings to gauge bosons differ from those predicted by the Standard Model. The thesis demonstrates that due to the loss of (...) unitarity, the very large enhancement for triple Higgs boson production takes place. This is a truly novel finding. The thesis also studies the effects of supersymmetric partners of top and bottom quarks on the Higgs production and decay at the LHC, pointing for the first time to non-universal alterations for two main production processes of the Higgs boson at the LHC-vector boson fusion and gluon-gluon fusion. Continuing the exploration of Higgs boson and supersymmetry at the LHC, the thesis extends existing experimental analysis and shows that for a single decay channel the mass of the top quark superpartner below 175 GeV can be completely excluded, which in turn excludes electroweak baryogenesis in the Minimal Supersymmetric Model. This is a major new finding for the HEP community. This thesis is very clearly written and the introduction and conclusions are accessible to a wide spectrum of readers. (shrink)

Jesus embodies for the Christian the model of true service, which should be discernibly distinct from secular service. Even for non-Christian services, the Church offers relevant models and teaching. Contemporary service structures often lose sight of the dignity of served and server, and have grown dependent upon technology and technique, straying outside the realm of relationality. An example of this within certain service fields is reliance on physical and mechanical restraints to restrict movement, causing harm to recipients and to the (...) relationship between server and served. Such techniques overshadow the nature of Christian service, which is personal, relational, and communal. Catholic social doctrine, and many personalist frameworks, build on the pillars of dignity, responsibility, and subsidiarity. Rules alone will not be protective against service-mediated harm; however, principled servers can protect vulnerable people, particularly when guided by a concern for the common good, fraternity and solidarity. (shrink)

A new comprehensive model of mind and its nearly infinite possibilities • Recasts psychology as a vehicle not for mental health but for higher consciousness • Shows that we have consciousness for a reason; it is humanity’s unique contribution to the cosmos • Integrates the work of Freud, Jung, Gurdjieff, Tony Robbins, Rudolf Steiner, the Dalai Lama as well as ESP, the Kabbalah, tarot, dreams, and kundalini yoga The culmination of 30 years of research, Where Does Mind End? takes you (...) on an inward journey through the psyche­--exploring the highest states of consciousness; the insights and theories of ancient and modern philosophers, psychologists, and mystics; the power of dreams, chi energy, tarot, and kundalini yoga; and proof of telepathy and other facets of parapsychology--to explain the mystery of consciousness and construct a comprehensive model of mind and its nearly infinite possibilities. Starting with the ancients and early philosophers such as Zoroaster, Aristotle, Descartes, and Leibniz, the author examines models of mind that take into account divine and teleological components, the problem and goal of self-understanding, the mind/body conundrum, and holographic paradigms. Seifer then moves to modern times to explain the full range of Freud’s psychoanalytic model of mind, exploring such ideas as the ego, superego, and id; the unconscious; creativity; and self-actualization. Using Freud’s psychoanalytical model as framework, he reveals an overarching theory of mind and consciousness that incorporates such diverse concepts as Jung’s collective psyche; ESP; the Kabbalah; Gurdjieff’s ideas on behaviorism and the will; the philosophies of Wilhelm Reich, P. D. Ouspensky, and Nikola Tesla; the personality redevelopment strategies of Tony Robbins; and the Dalai Lama’s and Rudolf Steiner’s ideas on the highest states of consciousness. Recasting psychology as a vehicle not for mental health but for higher consciousness, he shows that by casting off the mechanical mental operation of day-to-day life, we naturally attain the self-integration to which traditional psychology has long aspired. By entering the true path to fulfillment of the soul’s will, we help the planet by transforming ourselves and raising our energy to a higher realm. (shrink)

In 'Philosophy of Mind, Brain and Behaviour' wordt het begrip 'cognitiefilosofie' voor het eerst in Nederland op de kaart gezet als een combinatie van de Angelsaksische en de fenomenologische philosophy of mind. Onderwerpen op het snijvlak van filosofie, sociale en neurowetenschappen komen aan bod, zoals sociale cognitie, persoonlijke identiteit, het lichaam-geestprobleem en theorieën over bewustzijn, emoties en vrije wil. Om een breed academisch publiek te bedienen, verschijnt dit boek in het Engels.00Marc Slors is hoogleraar cognitiefilosofie aan de Radboud Universiteit Nijmegen. (...) Eerder verscheen van hem bij Uitgeverij Boom 'Dat had je gedacht!'. Leon de Bruin en Derek Strijbos werken als onderzoeker en docent aan diezelfde universiteit. (shrink)

What altered states of consciousness—the dissolution of feelings of time and self—can tell us about the mystery of consciousness. During extraordinary moments of consciousness—shock, meditative states and sudden mystical revelations, out-of-body experiences, or drug intoxication—our senses of time and self are altered; we may even feel time and self dissolving. These experiences have long been ignored by mainstream science, or considered crazy fantasies. Recent research, however, has located the neural underpinnings of these altered states of mind. In this book, neuropsychologist (...) Marc Wittmann shows how experiences that disturb or widen our everyday understanding of the self can help solve the mystery of consciousness. Wittmann explains that the relationship between consciousness of time and consciousness of self is close; in extreme circumstances, the experiences of space and self intensify and weaken together. He considers the emergence of the self in waking life and dreams; how our sense of time is distorted by extreme situations ranging from terror to mystical enlightenment; the experience of the moment; and the loss of time and self in such disorders as depression, schizophrenia, and epilepsy. Dostoyevsky reported godly bliss during epileptic seizures; neurologists are now investigating the phenomenon of the epileptic aura. Wittmann describes new studies of psychedelics that show how the brain builds consciousness of self and time, and discusses pilot programs that use hallucinogens to treat severe depression, anxiety, and addiction. If we want to understand our consciousness, our subjectivity, Wittmann argues, we must not be afraid to break new ground. Studying altered states of consciousness leads us directly to the heart of the matter: time and self, the foundations of consciousness. (shrink)

We defend the moral and legal right to secede in accordance with plebiscitary theory. Our paper has three main goals. First, by offering a schematic characterization of plebiscitary theory, the main arguments in its favour (and the main objections to them), we contribute to clarify the structure of this complex debate. Second, we stress the point that, if the moral right to secede is established, the resistance for its inclusion into positive law is unjustified. Finally, by addressing old and new (...) objections to plebiscitary theory, we hope to make a compelling case for a wider recognition of secessionist rights. (shrink)

Lynne Baker's concept of a first-person perspective is not as clear and straightforward as it might seem at first glance. There is a discrepancy between her argumentation that we have first-person perspectives and some characteristics she takes first-person perspectives to have, namely, that the instances of this capacity necessarily persist through time and are indivisible and unduplicable. Moreover, these characteristics cause serious problems concerning personal identity.

Marc Hauser puts forth the theory that humans have evolved a universal moral instinct, unconsciously propelling us to deliver judgments of right and wrong independent of gender, education, and religion. Combining his cutting-edge research with the latest findings in cognitive psychology, linguistics, neuroscience, evolutionary biology, economics, and anthropology, Hauser explores the startling implications of his provocative theory vis-à-vis contemporary bioethics, religion, the law, and our everyday lives.

Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than (...) generic drugs). In Medicine, Money and Morals, Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change. (shrink)

Our ability to acknowledge and recognise our own identity - our 'self' - is a characteristic doubtless unique to humans. Where does this feeling come from? How does the combination of neurophysiological processes coupled with our interaction with the outside world construct this coherent identity? We know that our social interactions contribute via the eyes, ears etc. However, our self is not only influenced by our senses. It is also influenced by the actions we perform and those we see others (...) perform. Our brain anticipates the effects of our own actions and simulates the actions of others. In this way, we become able to understand ourselves and to understand the actions and emotions of others. -/- This book is the first to describe the new field of 'Motor Cognition' - one to which the author's contribution has been seminal. Though motor actions have long been studied by neuroscientists and physiologists, it is only recently that scientists have considered the role of actions in building the self. How consciousness of action is part of self-consciousness, how one's own actions determine the sense of being an agent, how actions performed by others impact on ourselves for understanding others, differentiating ourselves from them and learning from them: these questions are raised and discussed throughout the book, drawing on experimental, clinical, and theoretical bases. -/- The advent of new neuroscience techniques, like neuroimaging and direct electrical brain stimulation, together with a renewal of behavioral methods in cognitive psychology, provide new insights into this area. Mental imagery of action, self-recognition, consciousness of actions, imitation can be objectively studied using these new tools. The results of these investigations shed light on clinical disorders in neurology, psychiatry and in neuro-development. -/- This is a major new work that will lay down the foundations for the field of motor cognition. (shrink)

Können wir als Personen irreversible Gedächtnisverluste überleben? Wie steht es mit Teletransportationen? Wie mit jahrelangem Einfrieren? Fragen wie diese sind weit davon entfernt, bloße Denksportaufgaben für Science-Fiction-Fans zu sein. Vielmehr verraten uns Antworten darauf, welche unserer Eigenschaften uns wirklich wichtig sind und was unser Wesen ausmacht. -/- Unglücklicherweise beantworten Vertreter unterschiedlicher Theorien personaler Identität diese Fragen auf völlig verschiedene Weise. Manche schöpfen die Plausibilität ihrer Positionen aus phantasievollen Gedankenexperimenten; anderen sind dieselben Gedankenexperimente für eine ernsthafte Einbeziehung in die philosophische Theoriebildung (...) schlicht zu wirklichkeitsfern. Es überrascht daher kaum, dass jene Anhänger unterschiedlicher Theorien einander oft wenig zu sagen haben. Im ersten Teil des Buches wird untersucht, unter welchen Umständen Gedankenexperimente aussagekräftige philosophische Werkzeuge sind. Auf der Basis dieser Analyse werden die diversen zeitgenössischen Theorien personaler Identität dann im zweiten Teil einer Neubewertung unterzogen – nicht ohne dass dabei mit vielen selbstverständlich erscheinenden Überzeugungen aufgeräumt wird. (shrink)

English summary: The idea of a negative dialectics encapsulates the critical theory of Theodor W. Adorno in its entirety. In a critical engagement with Hegel's philosophy, Adorno develops a dialectic that is no longer tied to the idealistic concept of a speculative identity of subject and object, yet nevertheless aims at a concept of the absolute. So far neither the scope nor the argumentative consistency of this model of dialectics has been taken into account. Marc Nicolas Sommer reconstructs negative (...) dialectics through its engagement with Hegelian dialectics and defends its central claim: that negative dialectics liberates dialectics from its idealistic shackles and in doing so develops a viable concept of the absolute after Auschwitz. German description: Die kritische Theorie Theodor W. Adornos findet ihre vollstandige Artikulation im Konzept einer negativen Dialektik. In kritischer Auseinandersetzung mit der hegelschen Philosophie entwickelt Adorno die Idee einer Dialektik, die nicht mehr an das idealistische Konzept einer spekulativen Identitat von Subjekt und Objekt gebunden ist, deren gedankliche Bewegung dennoch auf einen Begriff des Absoluten ausgerichtet ist. Konzeptueller Anspruch, begrifflicher Umfang und argumentative Konsistenz dieses zweiten grossen Modells dialektischen Denkens sind bis heute nicht geklart.Marc Nicolas Sommer rekonstruiert negative Dialektik aus der Auseinandersetzung mit Hegel und verteidigt ihren Anspruch, den eigentlichen Gehalt der hegelschen Dialektik von seinen idealistischen Schlacken befreit zu haben und aus dieser Denkbewegung einen nach Auschwitz tragfahigen Begriff des Absoluten zu entwickeln. (shrink)

Policy-makers must sometimes choose between an alternative which has somewhat lower expected value for each person, but which will substantially improve the outcomes of the worst off, or an alternative which has somewhat higher expected value for each person, but which will leave those who end up worst off substantially less well off. The popular ex ante Pareto principle requires the choice of the alternative with higher expected utility for each. We argue that ex ante Pareto ought to be rejected (...) because it conflicts with the requirement that, when possible, one ought to decide as one would with full information. We apply our argument in an analysis of US policy on screening for breast cancer. -/- . (shrink)

A consideration of how segments of Orthodox society rewrite the past by eliminating that which does not fit in with their contemporary world-view. This wide-ranging and original review of how this policy is applied in practice adds a new perspective to Jewish intellectual history and to the understanding of the contemporary Jewish world.

We are currently observing a shift in the relevance of ethical concerns regarding security screening systems. Due to technological progress, so my hypothesis goes, more direct consequences that such systems may have on the screening subjects' health and bodily privacy become increasingly unimportant compared to more indirect ones resulting from unrestrained information processing and excessive proliferation. However, a specific technical design of a screening system may help to prevent ethically unacceptable applications.

What philosophers have in mind when they think about vagueness are sorites cases. Unlike vague scientific or artificial expressions, however, vague natural language expressions do not display the kind of vagueness that we associate with the sorites; they rather display what I call cluster vagueness. A non-trivial consequence of this is that those legal definitions that state precisifications of natural language concepts not only add aspects of meaning to existing expressions but also effectively change the meanings of these expressions. From (...) this, in turn, it follows that we should avoid precisifying ordinary expressions with the help of legal definitions to the extent that we wish legal language to be in line with natural language. And being in line with natural language may help us to deal with gaps in our laws at the very moment we become aware of them, and not just afterwards. (shrink)

This paper concerns how motor actions are neurally represented and coded. Action planning and motor preparation can be studied using a specific type of representational activity, motor imagery. A close functional equivalence between motor imagery and motor preparation is suggested by the positive effects of imagining movements on motor learning, the similarity between the neural structures involved, and the similar physiological correlates observed in both imaging and preparing. The content of motor representations can be inferred from motor images at a (...) macroscopic level, based on global aspects of the action and the motor rules and constraints which predict the spatial path and kinematics of movements. A more microscopic neural account calls for a representation of object-oriented action. Object attributes are processed in different neural pathways depending on the kind of task the subject is performing. During object-oriented action, a pragmatic representation is activated in which object affordances are transformed into specific motor schemas. Animal as well as human clinical data implicate the posterior parietal and premotor cortical areas in schema instantiation. A mechanism is proposed that is able to encode the desired goal of the action and is applicable to different levels of representational organization. (shrink)

This chapter contains sections titled: Notes.

Why do physicians have financial conflicts of interest? They arise because society expects physicians to act in their patients’ interest, while simultaneously, financial incentives encourage physicians to practice medicine in ways that promote their own interests or those of third parties. Because physicians’ clinical choices, referrals, and prescriptions affect the fortune of third parties, these third parties may offer physicians financial incentives to make income-driven clinical choices. In the past, physicians and scholars typically conceived of conflicts of interest as an (...) ethical issue to be resolved according to individual judgment or professional and organizational norms. However, society can mitigate or eliminate conflicts of interest by changing financial and organizational arrangements in medicine. Conflicts of interest, therefore, are as much matters of public policy and management as individual choices or social norms. (shrink)

The federal government indirectly subsidizes the pharmaceutical industry by funding basic research, various tax credits and deductions, patent rules, grants of market exclusivity, and other means, in order to spur drug development, promote public health, and improve medical care. But today, the pharmaceutical industry often neglects these goals and sometimes even undermines them, due to what Lawrence Lessig refers to as institutional corruption — that is, widespread or systemic practices, usually legal, that undermine an institution’s objectives or integrity. A key (...) source of institutional corruption is improper dependence by the institution or its key actors on the actions of third parties that have fundamentally different interests. It is the health care system’s improper dependency on pharmaceutical firms that allows them to displace some public policy goals and to compromise the attainment of others. (shrink)

In this paper, I aim to show that agency-based accounts of moral status are more plausible than many have previously thought. I do this by developing a novel account of moral status that takes agency, understood as the capacity for intentional action, to be the necessary and sufficient condition for the possession of moral status. This account also suggests that the capacities required for sentience entail the possession of agency, and the capacities required for agency, entail the possession of sentience. (...) Thus on this account sentient beings possess agency and agents possess sentience. If this is correct, it will show that an Agency Account of moral status can offer a plausible defence of the moral status of all sentient beings, something that previous Agency Accounts have not succeeded in doing. What is more, this account could establish that all sentient animals are not just moral status holders per se, but that they are owed pro tanto obligations regarding continued existence and liberty, similar in kind, though not always in strength, to those owed to humans. (shrink)

Improper dependencies slant policy over a drug's life span, biasing the development of new drugs, the testing and marketing approval for new drugs, and the monitoring of patient safety after drugs are marketed. This article examines five ways in which the public improperly depends on pharmaceutical firms that compromise the integrity of pharmaceutical policy. Today the public relies on pharmaceutical firms: (1) to set priorities on drug research and development; (2) to conduct clinical trials to test whether drugs are safe (...) and effective; (3) to decide what clinical trial data to disclose to the public; (4) to monitor post marketing drug safety; (5) to supply product information to physicians and to finance continuing medical education and other professional activities. The article suggests options to overcome each of these dependencies. (shrink)

The Food and Drug Administration authorizes the marketing of a drug only for uses that the manufacturer has demonstrated to be safe and effective, based on evidence from at least two clinical trials. However, the FDA does not regulate the practice of medicine, so physicians may prescribe drugs in any manner they choose. Prescribing drugs in ways that deviate from the uses specified in the FDA-approved drug label, package insert, and marketing authorization is referred to as off-label prescribing. This occurs (...) when physicians prescribe a drug for a therapeutic purpose other than the one approved by the FDA; treat patients in a different age cohort or gender than the population on which it was tested; or prescribe a different dose, for a different duration of use, or a different mode of administration than indicated on the label. (shrink)

Although scholars have invoked the escalation framework as a means of explaining the occurrence of numerous organizationally undesirable behaviors on the part of decision makers, to date no empirical research on the potential influences of escalating commitment on the likelihood of unethical behavior at the individual level of analysis has been reported in either the escalation or the ethical decision-making literatures. Thus, the main purpose of this project is to provide a theoretical foundation and empirical support for the contention that (...) escalating commitment situations can induce unethical behavior in decision makers. An experimental research design utilizing a computerized investment task was administered to 155 undergraduate business majors as a means of assessing the hypotheses presented here. Results from a hierarchical logistic regression analysis found strong support for the contention that exposure to an escalation situation increases the likelihood of unethical behavior on the part of decision makers. Further, results also supported previous ethical decision-making findings by confirming the effects of locus of control (LOC) on ethical behavior. Specifically, the data indicated that individuals with an external LOC orientation were significantly more likely to select the unethical option than were individuals with an internal LOC orientation. Interestingly, support was not found for the effects of Machiavellianism or gender on ethical decision-making. (shrink)

Ce livre a pour objet principal de décrire le sport en tant qu’art de vivre. L’art de vivre pose la question de la vie bonne, du sens, de la qualité de vie. Jadis, les Hellènes en avaient déjà soulevé l’importance d’un point de vue philosophique et pratique. Ainsi, la quête de cette vie bonne n’est possible que si elle prends en compte la dimension du soin du corps. Notre tradition occidentale a trop souvent éliminé la corporéité, le besoin de prendre (...) soin de son corps. Les maladies actuelles de la civilisation (stress, dépressions,...) en sont la preuve. Or, le corps est notre manière primaire d’être-dans-le-monde. L’art de vivre est également synonyme d’harmonie, de juste mesure, de dialogue avec l’environnement. Le sport en tant qu’art de vivre n’a pour dire pas de but; il est le but. Ce qui compte, ce n’est pas de penser en termes de quantité ou d’efficacité, mais en termes de qualité, de bien-être. La manière dont Marc Van den Bossche aborde le sport en tant qu’art de vivre est novatrice. En effet, rares sont les auteurs qui ont présenté l’art de vivre avec cette dimension du soin du corps, ou bien le sport nécessite de performances. (shrink)

In this volume, three aspects are examined: a) normal subjects, where new findings on spatial behavior are described. b) brain-lesioned subjects, where the ...

This paper explores the nature of the relationship between corporate social responsibility (CSR) and competitiveness. We start with the commonly held view that firm competitiveness is defined by the market. That is, the question of what are the critical competitiveness factors is answered by looking at how companies and financial analysts describe and evaluate a firm. To analyze this, we review the current state of the art on the relationship between CSR and competitiveness. Second, CSR criteria used by financial analysts (...) is identified and compared with company valuation methods. Third, the results of a multi-stakeholder dialogue on CSR and competitiveness of the European financial sector are presented. As a conclusion, we argue that CSR and competitiveness relate through a learning and innovation cycle, where corporate values, policies and practices are permanently defined and re-defined. Thus, we propose that learning takes place as CSR is embedded in business processes, and that once it has been integrated, in turn, it generates innovative practices, and finally, competitiveness. At the end of the paper, we propose that CSR in practice consists of managing inherent paradoxes generated by the tension between CSR and business policies. (shrink)

Prescribing drugs for uses that the FDA has not approved — off-label drug use — can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy should address the (...) cause and control the practice. To manage inappropriate off-label drug use, off-label prescriptions must be tracked in order to monitor the risks and benefits and the manufacturers’ conduct. Even more important, reimbursement rules should be changed so that manufacturers cannot profit from off-label sales. When off-label sales pass a critical threshold, manufacturers should also be required to pay for independent testing of the safety and effectiveness of off-label drug uses and for the FDA to review the evidence. Manufacturers should also finance, under FDA supervision, programs designed to warn physicians and the public about the risks of off-label drug use. (shrink)

The heart of the matter -- The evolution of the French medicine -- Coping with physicians' conflicts of interest in France -- The rise of a protected medical market : the United States before 1950 -- The commercial transformation : the United States, 1950-1980 -- The logic of medical markets : the United States, 1980 to the present -- Coping with physicians' conflicts of interest in the United States -- The evolution of Japanese medicine -- Coping with physicians' conflicts of (...) interest in Japan -- Reforms -- Professionalism reconsidered. (shrink)

Through the 1960s, many people claimed that drug advertising was educational and physicians often relied on it. Continuing Medical Education (CME) was developed to provide an alternative. However, because CME relied on grants, industry funders chose the subjects offered. Now policymakers worry that drug firms support CME to promote sales and that commercial support biases prescribing and fosters inappropriate drug use. A historical review reveals parallel problems between advertising and industry-funded CME. To preclude industry influence and improve CME, we should (...) ensure independent funding by taxing medical industries, facilities and physicians. Independent public and professional authorities should create CME curricula. An independent agency should allocate all funds to educational institutions for approved curricula. (shrink)

Public policy tries to promote appropriate drug use by allowing firms to market drugs in interstate commerce only for uses that the Food and Drug Administration has found to be safe and effective. Because of their medical knowledge, physicians are authorized to prescribe drugs even for uses unapproved by the FDA. Nevertheless, physicians have relied on drug firms for information on appropriate prescribing despite the inherent tension between drug firm dissemination of information to promote sales and rational prescribing. In the (...) past, physicians often relied particularly on drug firm advertising for information on drug use. Today, physicians rely on drug firms to finance continuing medical education. A historical review reveals connections between these two different ways commercial interests have influenced the information that physicians receive and points the way to needed reforms. (shrink)

Logical puzzles like the doctrinal paradox raise the problem of how to aggregate individual judgements into a collective judgement, or alternatively, how to merge collectively inconsistent knowledge bases. In this paper, we view judgement aggregation as a function on propositional logic valuations, and we investigate how logic constrains judgement aggregation. In particular, we show that there is no non-dictatorial decision method for aggregating sets of judgements in a logically consistent way if the decision method is local, i.e., only depends on (...) the individual judgements on the proposition under consideration. (shrink)

La morale est une création discontinuée. Elle n'est pas codifiable dans de gros livres moralisateurs. Elle n'est rien avant qu'une conscience humaine ne la suscite par des occasions qui la font exister en singularité ici et maintenant. Cet ouvrage désigne la morale non comme une manière possible d'agir que l'on devrait ou non confirmer par l'action mais comme la réponse de principe que donne, dans un réflexe mental, tel homme en prise à tel cas de conscience.

Informational theories of semantic content have been recently gaining prominence in the debate on the notion of mental representation. In this paper we examine new-wave informational theories which have a special focus on cognitive science. In particular, we argue that these theories face four important difficulties: they do not fully solve the problem of error, fall prey to the wrong distality attribution problem, have serious difficulties accounting for ambiguous and redundant representations and fail to deliver a metasemantic theory of representation. (...) Furthermore, we argue that these difficulties derive from their exclusive reliance on the notion of information, so we suggest that pure informational accounts should be complemented with functional approaches. (shrink)

This paper is concerned with the problem of selfidentification in the domain of action. We claim that this problem can arise not just for the self as object, but also for the self as subject in the ascription of agency. We discuss and evaluate some proposals concerning the mechanisms involved in selfidentification and in agencyascription, and their possible impairments in pathological cases. We argue in favor of a simulation hypothesis that claims that actions, whether overt or covert, are centrally simulated (...) by the neural network, and that this simulation provides the basis for action recognition and attribution. (shrink)