The main current application of placebo is in clinical research. The term placebo effect refers to diverse non-specific, desired or non-desired effects of substances or procedures and interactions between patient and therapist. Unpredictability of the placebo effect necessitates placebo-controlled designs for most trials. Therapeutic and diagnostic use of placebo is ethically acceptable only in few well-defined cases. While "therapeutic" application of placebo almost invariably implies deception, this is not the case for its use in research. Conflicts may exist between the (...) therapist's Hippocratic and scientific obligations. The authors provide examples in neuropsychiatry, illustrating that objective scientific data and well-considered guidelines may solve the ethical dilemma. Placebo control might even be considered an ethical obligation but some provisos should be kept in mind: (a) no adequate therapy for the disease should exist and/or (presumed) active therapy should have serious side-effects; (b) placebo treatment should not last too long; (c) placebo treatment should not inflict unacceptable risks, and (d) the experimental subject should be adequately informed and informed consent given. (shrink)

In ‘The Politics of Experience’ and the visionary ‘Bird of Paradise’, R.D. Laing shows how the straitjacket of conformity imposed on us all leads to intense feelings of alienation and a tragic waste of human potential. He throws into question the notion of normality, examines schizophrenia and psychotherapy, transcendence and ‘us and them’ thinking, and illustrates his ideas with a remarkable case history of a ten-day psychosis. ‘We are bemused and crazed creatures,’ Laing suggests. This outline of ‘a thoroughly self-conscious (...) and self-critical human account of man’ represents a major attempt to understand our deepest dilemmas and sketch in solutions. ‘Everyone in contemporary psychiatry owes something to R.D. Laing’ Anthony Clare, the Guardian. (shrink)

XLRI, in association with a few Tata Group companies, established the XLRI-JRD Tata Foundation in Business Ethics in 1991 to mark their long-standing commitment and contribution to business ethics in India. The foundation seeks to address this by publicly affirming the urgent need for ethics in business and the need to bring about a conducive culture in which it can thrive.

Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)

Hicks' edition of the De Anima contains valuable commentary from Hicks as well as useful summaries of the views of earlier commentators.

Originally published in 1907, this book contains the ancient Greek text of Aristotle's De Anima, his treatise on the differing souls of living things. An English translation is provided on each facing page, and Hicks supplies a very detailed commentary on each line at the end of the book, as well as a summary of each section. This book will be of value to anyone with an interest in Greek philosophy and the history of classical scholarship.

We show there is only one consistent way to update a probability assignment, that given by Bayes's rule. The price of inconsistent updating is a loss of efficiency. The implications of this for the problem of induction are discussed.

Weber-Fechner Law states that the perceived intensity is proportional to the logarithm of the stimulus. Recent experiments suggest that this law also holds true for perception of numerosity. Therefore, the use of a logarithmic scale for the quantification of the perceived intensity may also depend on how the cognitive apparatus processes information. If Weber-Fechner law is the result of natural selection, then the logarithmic scale should be better, in some sense, than other biologically feasible scales. We consider the minimization of (...) the relative error as the target of natural selection and we provide a formal proof that the logarithmic scale minimizes the maximal relative error. (shrink)

This work is available on its own or as part of the 7 volume set Selected Works of R. D. Laing.

INTRODUCTION! In almost every area of contemporary philosophy the impact of Franz Brentano or his pupils can be detected. ...

Savulescu maintains that our paper, which encourages clinicians to honour requests for "inappropriate treatment" is prejudicial to his atheistic beliefs, and therefore wrong. In this paper we clarify and expand on our ideas, and respond to his assertion that medicine, ethics and atheism are objective, rational and true, while religion is irrational and false.

Open peer commentary on the article “The Autopoiesis of Social Systems and its Criticisms” by Hugo Cadenas & Marcelo Arnold. Upshot: The authors claim that it is justified to extend the concept of autopoiesis from its biological origin to other disciplines, predominately those that have a social character. However, the authors do not lay strong enough conceptual grounds to justify this extension of autopoiesis because it is unclear what concept of autopoiesis it is that would achieve this objective, or why (...) the concept of autopoiesis itself should be crucial to this endeavor. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

: Commitment is the strongest predicator of persistence in an intimate relationship. The aim of this research is to find out the difference about commitment in courtship relationship between high self-monitoring individuals and low self-monitoring individuals. The whole subjects for this research are 127 individuals, which consists of 26 self-monitoring individuals and 21 high self-monitoring individuals. The result indicates that there is not no difference of young adulthood’s commitment between high self-monitoring individuals and low self-monitoring individuals in courtship relationship.  .

Background In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. Objective To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. Method This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided (...) protocol and consent information. Results One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. Conclusions The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask. (shrink)

Open peer commentary on the article “Second-Order Science of Interdisciplinary Research: A Polyocular Framework for Wicked Problems” by Hugo F. Alrøe & Egon Noe. Upshot: The authors propose that a perspective is an autopoietic system. This commentary challenges the feasibility of this claim by pointing out the conceptual difficulties associated with such a proposal. But even granting that a perspective is, or can be, an autopoietic system, what sort of autopoietic system might best ground the authors’ concept of perspective? This (...) last question is also pursued here. (shrink)

We exhibit a finite list of first-order axioms which may be used to define topological spaces. For most separation axioms we discover a first-order equivalent statement.

It is possible to retrieve viable sperm from a dying man or from a recently dead body. This sperm can be frozen for later use by his wife or partner to produce his genetic offspring. But the technical feasibility alone does not morally justify such an endeavour. Posthumous semen retrieval raises questions about consent, the respectful treatment of the dead body, and the welfare of the child to be.We present two cases, discuss these three issues, and conclude that such requests (...) should generally not be honoured unless there is convincing evidence that the dead man would want his widow to carry and bear his child. Even with consent, the welfare of the potential child must be considered. (shrink)