In lieu of an abstract, here is a brief excerpt of the content:Psychiatric Hospitalization—Bridging the Gap Between Respect and ControlPaul P. ChristopherIntroductionThis issue of Narrative Inquiry in Bioethics offers varied and somewhat unique perspectives on the experience of psychiatric hospitalization. This commentary highlights a number of salient themes that emerge from reading these essays and attempts to explore how they relate to the broader academic literature on psychiatric hospitalization, particularly with regard to ethical considerations. In reading these narratives, each several (...) times, I was repeatedly struck by the courage required of the authors, both to share their stories publicly and to endure the challenges that the writing process no doubt demanded of them—revisiting and suspending themselves in deeply emotional and, at times, traumatic experiences in order to share the most compelling narrative. Their hard work clearly paid off—the stories are at once intimate and indelible. Still, in many instances, I found myself wanting to know more; to enter the story and sit with the individual through these events; to ask what they were thinking or feeling in a particular situation; to see and hear the world in which they found themselves. Such is the nature of good story telling—the reader, left with the lingering vision created in his mind, turns over the last page, eagerly hoping for more.Narrative ThemesI. Loss of Autonomy or ControlPerhaps the most notable theme had to do with the loss of control or freedom that followed from hospitalization. On first consideration, it may seem odd that this issue appears so often since patient autonomy constitutes one of the fundamental principles of medical ethics. Only under specific circumstances—e.g., when there is a risk of imminent harm—may autonomy be curtailed, and even then only to the extent that is minimally necessary. Yet, as these narratives highlight, there are a multitude of ways in which psychiatric hospitalization engenders actual or perceived restrictions in freedom (Newton-Howes & Mullen, 2011).Consistent with prior research (Goodwin et al., 1999), many of the authors describe a fear or the actual experience of not being able to leave the hospital freely, even when the admission seems to have been voluntary. For example, one writer worries, “I was so afraid that if I ever went ‘in,’ I would never get ‘out’... I thought I would never taste freedom again... alive.” Another describes:When it came time for my possible discharge they told me that I might not get discharged because I was ‘acting up the previous evenings.’ My anxiety level at this point went through the roof. The only reason I was discharged was because my father knew some politicians. If not [End Page 29] for him I would have been a patient there for perhaps years and my life would have been ruined.A third gives this example: “When I asked to sign the form to leave after three days, [the psychiatrist] told me if I did that she would have me committed.” Another writer fears not having any control of how the psychiatrist might approach the treatment: “... I was totally vulnerable... would the doctors blame me, drug me, shock me, kill me?”Somewhat surprising, however, was the fact that so few of the narratives take issue with the decision to hospitalize. This omission is especially striking in light of the fact that prior reports consistently note that a substantial minority (up to nearly half) of voluntarily admitted patients nevertheless experience their admission as coerced (Bonsack & Borgeat, 2005; Hiday et al., 1997; Katsakou et al., 2010; Rogers et al., 1993; Sheehan & Burns, 2011). Because many of these narrators had been hospitalized more than once, the relative absence of expressed resistance to being hospitalized seems strange, particularly when earlier hospital experiences or their aftermath are often described as negative. For example, one individual characterized the time after being released from the hospital as, “My sense of self was questioned. I felt as if I lost my soul.” Another put it this way:When I got out of the private hospital, I felt like my soul had been ripped out of me. I felt like I had a gaping hole in the center of my body... I felt psychically raped, dazed, and confused.Given these... (shrink)

The author traces the thought of George Santayana, Brad S. Gregory, Pierre Manent, and Rémi Brague, who addressed the transformation of the West into its modern present. They all show that by being cut off from its cultural and political inheritance in modern times, Western Civilization presently finds itself in a burning need of recovering its identity. To save its identity, the West is to challenge the errors of modernity. We used to have the example of Winston Churchill and Charles (...) de Gaulle in the darkest hours of World War II, and the remarkable example of John Paul II who through his leadership of the Solidarity movement inspired hope not only in his own people but also for others in the Soviet bloc at the time. “The cultural task awaiting Europe,” to use a phrase of Rémi Brague, challenging though it may be, may in time find its voice in another Churchill or John Paul II. At present, with no remedy in sight, all we can do is to hope. (shrink)

How to Read the Old Testament. By Etienne Charpentier. Pp.124, London, SCM Press, 1982, £3.95. How to Read the New Testament. By Etienne Charpentier. Pp.129, London, SCM Press, 1982. £3.95. Beginning Old Testament Study. Edited by John Rogerson. Pp.vi, 157, London, SPCK, 1982, £3.95. Welt aus der die Bibel kommt Welt aus der die Bibel kommt: Biblische Hil ‘swissenschaften’. By Mechthild Kellermann, Stanisław Medala, Michele Piccirillo and Eugene Sitarz. Pp.263, Kevelaer, Butzon und Bercker; Stuttgart, Verlag Katholisches Bibelwerk, 1982, DM 28. (...) The Structure of Biblical Myths. The Structure of Biblical Myths. By Heinz Westman. Pp.xxii, 477, Dallas, Spring Publications, 1983, no price given. Toward Old Testament Ethics. Toward Old Testament Ethics. By Walter C. Kaiser, Pp.xii, 345, Grand Rapids, Academie Books, 1983, £13.95. Das Evangelium and die Evangelien. Das Evangelium and die Evangelien. Edited by Peter Stuhlmacher. Pp.viii, 454, Tubingen, J.C.B. Mohr, 1983, DM 178. Once More Astonished Once More Astonished: The Parables of Jesus. By Jan Lambrecht. Pp.xiv, 245, New York, Crossroad Publishing, 1983, $9.95. Mark: The Gospel as Story. Mark: The Gospel as Story. By Ernest Best. Pp.vii, 155, Edinburgh, T & T. Clark, 1983, £8.95. The ‘Son of Man’ as The Son of God. The ‘Son of Man’ as The Son of God. By Seyoon Kim. Pp.x, 118, Tübingen, J.C.B. Mohr, 1983, DM 48. Paul and the Law. Paul and the Law. By Heikki Räisänen. Pp.xi, 320, Tübingen, J.C.B. Mohr, 1983, DM 108. Pauline Christianity. Pauline Christianity. By John Ziesler, Pp.ix, 157, Oxford University Press, 1983, £3.50. God as the Mystery of the World God as the Mystery of the World: On the Foundations of the Theology of the Crucified One in the Dispute between Theism and Atheism. By Eberhard Jüngel, translated by Darrell L. Guder.Pp. xvi, 414, Edinburgh, T. and T. Clark, 1983, £14.95. Theologia: The Fragmentation and Unity of Theological Education. Theologia: The Fragmentation and Unity of Theological Education. By Edward Farley. Pp.xiv, 206, Philadelphia, Fortress Press, 1983, $14.50. Unity in Theology Unity in Theology: Lonergan's Framework for Theology in its New Context. By Michael C. O'Callaghan. Pp.xlii, 553, Lanham, University Press of America, 1980, $24.50, $16.75. Understanding Karl Rahner, vol.1: A Theologian in Search of a Philosophy. Understanding Karl Rahner, vol.1: A Theologian in Search of a Philosophy. By George Vass. Pp.xix, 153, London, Sheed and Ward, 1985, £8.50. Understanding Karl Rahner, vol.2: The Mystery of Man and the Foundations of a Theological System. By George Vass. Pp.xvii, 200, London, Sheed and Ward, 1985, £9.50. Ignatius von Loyola Ignatius von Loyola: Die Exerzitien. By Lothar Lies, Pp. 142, Innsbruck‐Vienna, Tyrolia Verlag, 1983, DM 26. The Name of Christ The Name of Christ: The Names of Jesus Used by the Early Cristians, The Development of the Jesus Prayer. By Irenée Hausherr. Pp.viii, 358, Kalamazoo, Cistercian Publications, 1978, $8.00. The Easter Sermons of Gregory of Nyssa. The Easter Sermons of Gregory of Nyssa. Edited by Andreas Spira and Christopher Klock. Pp.x, 384, Cambridge, The Philadelphia Patristic Foundation, 1981, $10.00. Anonymus in Ecclesiasten Commentarius qui dicitur Catena Trium Patrum. Anonymus in Ecclesiasten Commentarius qui dicitur Catena Trium Patrum. Edited by Santo Lucá. Pp.lvi, 139, Turnhout, Brepols, and Leuven, University Press, 1983, no price given. The Medieval Inquistion. The Medieval Inquistion. By Albert Clement Shannon. Pp viii, 153, Washington D.C., Augustinian College Press, 1983, $10.00. John Calvin. John Calvin. Edited by G.R. Potter and M. Greengrass. Pp.xvi, 176, London, Edward Arnold, 1983, £4.95. When Fathers Ruled. Family Life in Reformation Europe. When Fathers Ruled. Family Life in Reformation Europe. By Steven Ozment. Pp.x, 238, Cambridge, Harvard University Press, 1983, £14.85. The Apocalypse in English Renaissance Thought and Literature. The Apocalypse in English Renaissance Thought and Literature. Edited by C.A. Patrides and Joseph Wittreich. Pp. ix, 452, Manchester University Press, 1984, £37.50. The Contribution of British Writers between 1560 and 1830 to the Interpretation of Revelation 13.16–18. By David Brady, Pp.vii, 335, Tubingen, J.C.B. Mohr, 1983, DM 98. Typologies in England, 1650–1820. Typologies in England, 1650–1820. By Paul J. Korshin. Pp.xvii, 437, Princeton University Press, 1982, £26.10. The Great Debate on Miracles. The Great Debate on Miracles. By R.M. Burns. Pp.305, Lewisburg, Bucknell University Press, 1981, £12.00. Coleridge's Religious Imagination. Coleridge's Religious Imagination. By Stephen Happel. Pp.xii, 943, Salzburg, Institut für Anglistik und Amerikanistik, 1983, no price given. Jacques Maritain and the French Catholic Intellectuals. Jacques Maritain and the French Catholic Intellectuals. By Bernard Doering, Pp.x, 268, Notre Dame, University of Notre Dame Press, 1983, £18.25. Dorothy Day: A Biography. Dorothy Day: A Biography. By William D. Miller. Pp.xv, 527, New York, Harper and Row, 1982, $18.00, $10.50. For God and Clarity: New Essays in Honour of Austin Farrer. For God and Clarity: New Essays in Honour of Austin Farrer. Edited by Jeffrey C. Easton and Ann Loades. Pp.xiii, 205, Allison Park, Pickwick Publications; Edinburgh, T. & T. Clark, 1983, £11.75. God, Free Will, and Morality. God, Free Will, and Morality. By Robert J. Richman. Pp.xi, 195, Dordrecht, D. Reidel, 1983, $36.95. God and Skepticism: A Study in Skepticism and Fideism. God and Skepticism: A Study in Skepticism and Fideism. By Terence Penelhum. Pp.xii, 186, Dordrecht, D. Reidel, 1983, $34.00. Religious Belief and Religious Skepticism. Religious Belief and Religious Skepticism. By Gary Gutting. Pp.xi, 192, Notre Dame, University of Notre Dame Press, 1982, £11.20. A Philosopher's Search for the Infinite. A Philosopher's Search for the Infinite. By Jules M. Brady. Pp.94, New York, Philosophical Library, 1983, $10.00 Realism and Reason: Philosophical Papers, Vol.3. Realism and Reason: Philosophical Papers, Vol.3. By Hilary Putnam. Pp.xviii, 312, Cambridge University Press, 1983, £22.50. Perception, Learning and the Self. Perception, Learning and the Self. By D.W. Hamlyn. Pp.viii, 311, London, Routledge and Kegan Paul, 1982, £14.95. Science and Speculation: Studies in Hellenistic Theory and Practice. Science and Speculation: Studies in Hellenistic Theory and Practice. Edited by Jonathan Barnes. Pp.xxvii, 351, Cambridge University Press, 1983, £25.00. Plato: Hippias Major. Plato: Hippias Major. Translated with a commentary and essay by Paul Woodruff. Pp.xvi, 211, Oxford, Basil Blackwell 1983, £12.50. Max Scheler: The Man and his Work. Max Scheler: The Man and his Work. By John H. Nota, translated by T. Plantinga and J. Nota. Pp.vii, 213, Chicago, Franciscan Herald Press, 1983, $12.00. Searching: Practices and Beliefs of the Religious Cults and Human Potential Groups. Searching: Practices and Beliefs of the Religious Cults and Human Potential Groups. By Harriet S. Mosatche. Pp.432, New York, Straven Educational Press, 1983, £10.95. (shrink)

As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...) various forms of personal benefit, altruism, and concern about study risks and inconveniences. However, a number of influences seem unique to prisoners. Participants did not report that they were not coerced into enrolling, and they have even been under pressure not to enroll. However, many sought to enroll in order to obtain access to better health care, raising a concern about whether they were unfairly exploited. (shrink)

Background: Therapeutic misconception, the misunderstanding of differences between research and clinical care, is widely prevalent among non-incarcerated trial participants. However, little attention has been paid to its presence among individuals who participate in research while incarcerated. Methods: This study examined the extent to which 72 incarcerated individuals may experience therapeutic misconception about their participation in one of six clinical trials, and its correlation with participant characteristics and potential influences on research participation. Results: On average, participants endorsed 70% of items suggestive (...) of therapeutic misconception. The tendency toward therapeutic misconception was significantly higher among African Americans and Latinos compared to Whites, among older and less educated participants, and among enrollment in a substance-abuse-related trial; it was also correlated with a belief that the trial was the only way to obtain needed treatment. Conclusions: Therapeutic misconception may be particularly high among select incarcerated individuals and is associated with a perceived lack of treatment options. Further examination of therapeutic misconception among incarcerated research participants is needed. (shrink)

While citizens often use non-instrumental arguments to support environmental protection, most governmental policies are justified by instrumental arguments. This paper explores some of the reasons. We interviewed senior policy advisors to four European governments active in global climate change negotiations and the UNCED (United Nations Conference on Environment and Development) process. In response to our questions, a majority of these advisors articulated deeply held personal environmental values. They told us that they normally keep these values separate from their professional environmental (...) policy activities. We interpret these findings within the context of the literature on environmental ethics and values. We suggest that environmental policy could be improved if widely held environmental values were articulated, validated, and admitted into the process of policy analysis and deliberation. (shrink)

Relatives play an important role in human reproduction according to evolutionary theories of reproductive behavior, but previous empirical studies show large differences in the effects of kin on fertility outcomes. In our paper we examine the effect of co-resident kin and non-kin on the length of birth intervals over the reproductive life course of Dutch women born between 1842 and 1920. We estimate Cox proportional hazard models for parity progression based on the presence of kin and non-kin in the household (...) while controlling for a large number of individual and community-level characteristics. We find that couples living with their brothers experienced shorter birth intervals whereas couples residing with a widowed father had relatively longer birth intervals. The effects of these types of kin on reproduction were most pronounced up to the birth of the fifth child, but not thereafter. We found no effect for mothers or other types of kin. (shrink)

The target article makes a compelling case for the idea that agents rely on the world for external memory in fast-paced perceptual tasks. As I argue, however, agents also rely on the external environment for computational hardware that helps to keep cognitive computations tractable. Hence the external world provides not only memory for computations involving perceptual system actions, but it provides domain-level actions that figure in cognitive computations as well.

The practice of paying prisoners to for their participation in research has long been debated, and the controversy is reflected in the differing policies in the U.S. prison systems. Empirical study of financial payments to inmates who enroll in research has focused on whether this practice is coercive. In this study, we examined whether monetary incentives have the potential to be unduly influential among fifty HIV‐positive prisoners. The majority of prisoners surveyed believed that inmates should receive some compensation for their (...) involvement in research and disagreed with statements suggesting that the offer of payment constitutes undue influence. However, a sense of potentially being susceptible to undue influence was significantly higher among participants who had spent a longer time in prison and had less education. Overall, our findings suggest that most prisoners feel that they would be able to make a decision about research enrollment that is not solely based on an offer of monetary payment. (shrink)

Inactivation of the Ca2+ extrusion mode of the retinal rod Na- Ca + K exchanger is suggested to be the mechanism that prevents lowering of cytosolic free Ca2+ to < 1 nM when rod cells are saturated for a prolonged time under bright light conditions. Under these conditions, Ca2+ fluxes across disk membranes can contribute significantly to Ca2+ homeostasis in rods.

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

In this article, we hypothesize that individuals with autism spectrum disorder (ASD) are born with a deficit in invariance detection, which is a learning process whereby people and animals come to attend the relatively stable patterns or structural regularities in the changing stimulus array. This paper synthesizes a substantial body of research which suggests that a deficit in the domain-general perceptual learning process of invariant detection in ASD can lead to a cascade of consequences in different developmental domains. We will (...) outline how this deficit in invariant detection can cause uncertainty, unpredictability, and a lack of control for individuals with ASD and how varying degrees of impairments in this learning process can account for the heterogeneity of the ASD phenotype. We also describe how differences in neural plasticity in ASD underlie the impairments in perceptual learning. The present account offers an alternative to prior theories and contributes to the challenge of understanding the developmental trajectories that result in the variety of autistic behaviors. (shrink)

What do human beings use conditional reasoning for? A psychological consequence of counterfactual conditional reasoning is emotional experience, in particular, regret and relief. Adults’ thoughts about what might have been influence their evaluations of reality. We discuss recent psychological experiments that chart the relationship between children’s ability to engage in conditional reasoning and their experience of counterfactual emotions. Relative to conditional reasoning, counterfactual emotions are late developing. This suggests that children need not only competence in conditional reasoning, but also to (...) engage in this thinking spontaneously. Developments in domain general cognitive processing (the executive functions) allow children to develop from conditional reasoning to reasoning with counterfactual content and, eventually, to experiencing counterfactual emotions. (shrink)

BackgroundAlthough the number of reporting guidelines has grown rapidly, few have gone through an updating process. The STARD statement (Standards for Reporting Diagnostic Accuracy), published in 2003 to help improve the transparency and completeness of reporting of diagnostic accuracy studies, was recently updated in a systematic way. Here, we describe the steps taken and a justification for the changes made.ResultsA 4-member Project Team coordinated the updating process; a 14-member Steering Committee was regularly solicited by the Project Team when making critical (...) decisions. First, a review of the literature was performed to identify topics and items potentially relevant to the STARD updating process. After this, the 85 members of the STARD Group were invited to participate in two online surveys to identify items that needed to be modified, removed from, or added to the STARD checklist. Based on the results of the literature review process, 33 items were presented to the STARD Group in the online survey: 25 original items and 8 new items; 73 STARD Group members (86 %) completed the first survey, and 79 STARD Group members (93 %) completed the second survey.Then, an in-person consensus meeting was organized among the members of the Project Team and Steering Committee to develop a consensual draft version of STARD 2015. This version was piloted in three rounds among a total of 32 expert and non-expert users. Piloting mostly led to rewording of items. After this, the update was finalized. The updated STARD 2015 list now consists of 30 items. Compared to the previous version of STARD, three original items were each converted into two new items, four original items were incorporated into other items, and seven new items were added.ConclusionsAfter a systematic updating process, STARD 2015 provides an updated list of 30 essential items for reporting diagnostic accuracy studies. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of (...) the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)

This study was designed to investigate the trust relationship between parents and teachers in first grade. Additional research questions were whether trust was related to ethnicity and reading performance. The five facets of trust; benevolence, reliability, competence, honesty and openness, were measured on a 4-point Likert scale. Reading performance was measured by the three-minute test. Parents were found to have more trust in the reliability, competence and honesty of teachers than teachers in parents. Native-Dutch and immigrant parents have the same (...) trust level towards their children?s teacher. However, teachers reported lower trust levels on all five facets of trust for immigrant parents. Our findings indicated that ethnicity has no influence on parents trust in teachers, but ethnicity may explain teachers? trust in parents. Some support was found for the assumption that teachers? trust plays a role in reading performance. Children were found to have higher reading performance when teachers reported higher trust in the benevolence and openness of parents. (shrink)

Research has demonstrated that two types of affect have an influence on judgment and decision making: incidental affect (affect unrelated to a judgment or decision such as a mood) and integral affect (affect that is part of the perceiver’s internal representation of the option or target under consideration). So far, these two lines of research have seldom crossed so that knowledge concerning their combined effects is largely missing. To fill this gap, the present review highlights differences and similarities between integral (...) and incidental affect. Further, common and unique mechanisms that enable these two types of affect to influence judgment and choices are identified. Finally, some basic principles for affect integration when the two sources co-occur are outlined. These principles are discussed in relation to existing work that has focused on incidental or integral affect but not both. (shrink)

This book is a survey of the range of apparently miraculous accidents of nature that have enabled the universe to evolve its familiar structures (atoms, stars, galaxies, and life itself) concludes with an investigation of the so-called anthropic principle.