Gilles de la Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterised by the presence of motor and vocal tics. Patients with malignant TS experience severe disease sequelae; risking morbidity and mortality due to tics, self-harm, psychiatric comorbidities and suicide. By definition, those cases termed ‘malignant’ are refractory to all conventional psychiatric and pharmacological regimens. In these instances, deep brain stimulation (DBS) may be efficacious. Current 2015 guidelines recommend a 6-month period absent of suicidal ideation before DBS is offered to (...) patients with TS. We therefore wondered whether it may be ethically justifiable to offer DBS to a minor with malignant TS. We begin with a discussion of non-maleficence and beneficence. New evidence suggests that suicide risk in young patients with TS has been underestimated. In turn, DBS may represent an invaluable opportunity for children with malignant TS to secure future safety, independence and fulfilment. Postponing treatment is associated with additional risks. Ultimately, we assert this unique risk-benefit calculus justifies offering DBS to paediatric patients with malignant TS. A multidisciplinary team of clinicians must determine whether DBS is in the best interest of their individual patients. We conclude with a suggestion for future TS-DBS guidelines regarding suicidal ideation. The importance of informed consent and assent is underscored. (shrink)

Background: COVID-19 pandemic has led to heightened moral distress among healthcare providers. Despite evidence of gendered differences in experiences, there is limited feminist analysis of moral distress. Objectives: To identify types of moral distress among women healthcare providers during the COVID-19 pandemic; to explore how feminist political economy might be integrated into the study of moral distress. Research Design: This research draws on interviews and focus groups, the transcripts of which were analyzed using framework analysis. Research Participants and Context: 88 (...) healthcare providers, based in British Columbia Canada, participated virtually. Ethical Considerations: The study received ethical approval from Simon Fraser University. Findings: Healthcare providers experienced moral dilemmas related to ability to provide quality and compassionate care while maintaining COVID-19 protocols. Moral constraints were exacerbated by staffing shortages and lack of access to PPE. Moral conflicts emerged when women tried to engage decision-makers to improve care, and moral uncertainty resulted from lack of clear and consistent information. At home, women experienced moral constraints related to inability to support children’s education and wellbeing. Moral conflicts related to lack of flexible work environments and moral dilemmas developed between unpaid care responsibilities and COVID-19 risks. Women healthcare providers resisted moral residue and structural constraints by organizing for better working conditions, childcare, and access to PPE, engaging mental health support and drawing on professional pride. Discussion: COVID-19 has led to new and heightened experiences of moral distress among HCP in response to both paid and unpaid care work. While many of the experiences of moral distress at work were not explicitly gendered, implicit gender norms structured moral events. Women HCP had to take it upon themselves to organize, seek out resources, and resist moral residue. Conclusion: A feminist political economy lens illuminates how women healthcare providers faced and resisted a double layering of moral distress during the pandemic. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Most moral philosophers agree that if a moral agent is incapable of performing some act ϕ because of a physical incapacity, then they do not have a reason to ϕ. Most also claim that if an agent is incapable of ϕ-ing due to a psychological incapacity, brought about by, for example, an obsession or phobia, then this does not preclude them from having a reason to ϕ. This is because the 'ought implies can' principle is usually interpreted as a claim (...) about physical, rather than psychological, capacities. In this paper I argue for an opposing view: if we don't have reasons to do things that we are physically incapable of doing, then neither do we have reasons to do things we are psychologically incapable of doing. I also argue that extending the 'ought implies can' principle to psychological capacities makes the principle more attractive. (shrink)

Canada’s Truth and Reconciliation Commission (TRC) is tasked with facing the hundred-year history of Indian Residential Schools. The South African Truth and Reconciliation Commission is frequently invoked in relation to the Canadian TRC, perhaps because this is one of the few TRCs worldwide that Canadians know. Whilst the South African TRC is mainly applauded as an international success, I argue that loose analogizing is often more emotive than concise. Whilst much indeed can be drawn from the South African experience, it (...) is important to specify the Canada–South Africa analogy. In this article, I do so by focussing on the institutional approach to truth and how this relates to issues of settler/White denial. The South African experience teaches that narrow approaches to truth collude with superficial views of reconciliation that deny continuities of violence. Consequently, I argue that Indigenous–settler reconciliation requires a broad truth that locates residential schools on a continuum of violence, linking extraordinary abuses with structural injustices and historic colonization with lived relationships. (shrink)

In this survey of feminist theory, Rosemarie Tong provides coverage of the psychoanalytic, existential and postmodern schools of feminism. The author guides the reader through the complexities of even the most notoriously difficult thinkers. Students will meet and become familiar with many of the essential figures in the feminist tradition, from Wollstonecraft and Engel, on through de Beauvoir, Dinnerstein, and Daly, and up to Mitchell and Cixous. The text treats all views with respect and encourages students to think critically (...) and sympathetically about a wide range of views that have a direct relevance to their own lives. (shrink)

The Descartes Dictionary is an accessible guide to the world of the seventeenth-century philosopher René Descartes. Meticulously researched and extensively cross-referenced, this unique book covers all his major works, ideas and influences, and provides a firm grounding in the central themes of Descartes' thought. The introduction provides a biographical sketch, a brief account of Descartes' philosophical works, and a summary of the current state of Cartesian studies, discussing trends in research over the past four decades. The A-Z entries include clear (...) definitions of the key terms used in Descartes' writings and detailed synopses of his works. Also included are entries noting philosophical influences, of both figures that influenced Descartes and those that he in turn influenced. For anyone reading or studying Descartes, rationalism, or modern philosophy more generally, this original resource provides a wealth of useful information, analysis, and criticism. Including clear explanations of often complex terminology, The Descartes Dictionary covers everything that is essential to a sound understanding of Descartes' philosophy. (shrink)

Rosemary Hennessy confronts some of the impasses in materialist feminist work on rethinking `woman' as a discursively constructed subject. She argues for a theory of discourse as ideology taking into account the work of Kristeva, Foucault and Laclau.

How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book (...) is a compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)

Prologue, invitation to thinking about God In the Hebrew Bible? -- Part I, questions about God? -- Why does God in the Bible have a body? -- What do God's body parts in the Bible mean? -- Why is God angry in the Bible? -- Does God in the Bible have gender or sexuality? -- Part II, questions about God in the world? -- What can creation tell us about God? -- Who-or what-is the Satan? -- Why do people suffer (...) according to the Hebrew Bible? -- Epilogue, God in the Bible and beyond. (shrink)

This title presents a comprehensive guide to interpretative phenomenological analysis (IPA) which is an increasingly popular approach to qualitative inquiry taught to undergraduate and postgraduate students today.

This article suggests evidence for and reasons why prior acquisition may either facilitate or inhibit acquisition of a new construction. It investigates acquisition of the German passive and future constructions which contain a lexical verb with either the auxiliary sein “to be” or werden “to become”, and are related through these to potential supporting constructions. We predicted that a supported construction should be acquired earlier, faster, and unusually rapidly. An inhibited construction should show an extended depressed usage. We analyzed a (...) dense corpus of a German boy between 2;0 and 5;0. He acquired the sein- before the werden-passive. The former was supported by his prior acquisition of the sein copula, whereas the werden-passive itself supported one werden copula construction. He acquired the werden-future extremely slowly due to the hindrance of a semantically identical construction. These results fit with an emergentist approach in which apparently “sudden” acquisition is still due to gradual learning mechanisms. (shrink)

The Japanese scholar Miura Baien (1723-1789) worked throughout his life to produce a philosophical analysis of the natural world. Misinterpretations of his intentions arise from drawing diagrams on his behalf that are inconsistent with his text, or by applying to his text Western academic terms that are quite foreign to his thought. When Baien's text is examined in his own terms we can understand its significant role in the scientific thought of the Edo period.

We ordinarily suppose that there is a difference between having and failing to exercise a rational capacity on the one hand, and lacking a rational capacity altogether on the other. This is crucial for our allocations of responsibility. Someone who has but fails to exercise a capacity is responsible for their failure to exercise their capacity, whereas someone who lacks a capacity altogether is not. However, as Gary Watson pointed out in his seminal essay ’Skepticism about Weakness of Will’, the (...) idea of an unexercised capacity is much more difficult to make sense of than it initially appears. The aim of ’Rational Capacities’ is to provide the needed explication of this idea. (shrink)

WE must first state the subject of our inquiry and the faculty to which it belongs: its subject is demonstration and the faculty that carries it out demonstrative science.

The relationship between international order and justice has long been central to the study and practice of international relations. For most of the twentieth century, states and international society gave priority to a view of order that focused on the minimum conditions for coexistence in a pluralist, conflictual world. Justice was seen either as secondary or sometimes even as a challenge to order. Recent developments have forced a reassessment of this position. This book sets current concerns within a broad historical (...) and theoretical context; explores the depth and scope of this presumed solidarism amidst the difficulties of acting on the basis of a more strongly articulated liberal position; and underscores the complexity and abiding tensions inherent in the relationship between order and justice. Chapters examine a wide range of state and transnational perspectives on order and justice, including those from China, India, Russia, the United States, and the Islamic world. Other chapters investigate how the order-justice relationship is mediated within major international institutions, including the United Nations, the World Trade Organization and the global financial institutions. (shrink)

The purpose of this study was to determine the development of moral judgement in first-year and senior baccalaureate nursing students. These students were enrolled in three separate nursing programmes, each of which differed significantly in ethical content. The sample totalled 180 students enrolled in three New England programmes. Programme A included an ethics course taught by a professor of ethics. Programme B integrated ethical issues into all nursing theory courses. Programme C did not include ethical content in theory courses. The (...) design was of a developmental cross-sectional study. The dependent variable was the development of moral judgement, as measured by Rest’s Defining Issues Test. The independent variable was the amount of ethics taught in the nursing programmes and the level of academic education. The senior nursing students from programme A scored significantly higher than the other senior groups on the Defining Issues Test. The conclusion is that an ethics course with group participation and a decision-making element significantly facilitated nursing students’ development of moral judgement. (shrink)

Demographic differences among consumer groups have become increasingly important to the development of marketing strategies. Marketers depend heavily on the sales force to implement strategies at the consumer level and, not surprisingly, different groups may view the salesperson’s role differently. Unfortunately, unethical sales practices targeted at various consumer groups, and especially at seniors, have been utilized as well. The purpose of this study is to provide initial empirical evidence of the ethical ideological make-up of four age segments outlined by Strauss (...) and Howe (1991, Generations: The History of America’s Future 1584–2069, Morrow, New York) and to examine the propensity for these groups (seniors, in particular) to respond differentially to potentially unethical sales tactics. Data were collected from 179 respondents representing the four generational age groups. MANOVA revealed that the seniors in this study were distinct with respect to ethical ideology and less accepting of unethical sales tactics. Managerial implications are discussed for sales organizations to maximize their effectiveness across consumer groups. (shrink)

What kind of animals are human beings? And how do our visions of the human shape our theories of social action and institutions? In Moral, Believing Animals>, Christian Smith advances a creative theory of human persons and culture that offers innovative, challenging answers to these and other fundamental questions in sociological, cultural, and religious theory. Smith suggests that human beings have a peculiar set of capacities and proclivities that distinguishes them significantly from other animals on this planet. Despite (...) the vast differences in humanity between cultures and across history, no matter how differently people narrate their lives and histories, there remains an underlying structure of human personhood that helps to order human culture, history, and narration. Drawing on important recent insights in moral philosophy, epistemology, and narrative studies, Smith argues that humans are animals who have an inescapable moral and spiritual dimension. They cannot avoid a fundamental moral orientation in life and this, says Smith, has profound consequences for how sociology must study human beings. (shrink)

This book attempts to relate a theory of liberty to the practice of education, and to work out the implications of beliefs about freedom for our schools and classrooms. The author makes a plea for greater respect for children and argues for greater democracy in education.

1. IntroductionA paternalistic act is one in which the protection or promotion of a subject's welfare is the primary reason for attempted or successful coercive interference with an action or state of that person. My aim in this paper is to determine the conditions under which such acts are Justified. The route I take is through the concept of consent, with actual consent providing the foundation for a rather complex condition which I claim is necessary and sufficient for the Justification (...) of paternalism.Because a paternalistic act apparently violates a subject's right to non-interference, it constitutes a problem in the general area of rights. Ideally, then, one should have a developed and convincing theory of rights — that is, a theory which contains an analysis of the concept of a right, and offers solutions to the central problems, e.g. who has rights and why, what considerations override prima facie rights, and how the relative importance of prima facie rights is determined — from which the solutions to various problems about paternalism can be derived. (shrink)

Pure time preference is a preference for something to come at one point in time rather than another merely because of when it occurs in time. In opposition to Sidgwick, Ramsey, Rawls, and Parfit we argue that it is not always irrational to be guided by pure time preferences. We argue that even if the mere difference of location in time is not a rational ground for a preference, time may nevertheless be a normatively neutral ground for a preference, and (...) this makes it plausible to claim that the preference is rationally permitted. (shrink)

Even today entering Neapolis, modern day Kavala, in Greece it is possible to imagine Paul stepping off a ship onto the landing. This is the craft of the author of Luke's Gospel and the Acts of the Apostle to engage the hearer in the narrative he constructs: in Acts, the birth and mission of the church is a story in which the audience have a role. According to Acts, Paul followed a vision, a call from a certain Macedonian to 'Come (...) over to Macedonia and help us'. What would he have expected to find as he set out on a sea voyage from Asia to Macedonia, the home of Alexander the Great? Paul's landing is commemorated on a wall mosaic with ancient stone bollards and pillars slightly inland from the current promenade where the fishing boats line up around the bay. Paul's embarkation on this journey has all the hallmarks of mission. His journey will take him to Philippi and beyond. The focus here is particularly on his encounter with Lydia and the flourishing of this mission in a distinct and different place with new opportunities for the development and growth of leadership and community. In particular I will concentrate on the insights of this narrative for the engagement with new frontiers in our present day. (shrink)

In mainstream analytic epistemology, Reformed theology has made its presence prominently felt in Reformed epistemology, the view of religious belief according to which religious beliefs can be properly basic and warranted when formed by the proper functioning of the sensus divinitatis, an inborn capacity or faculty for belief in God that can be prompted to generate certain religious beliefs when presented with things (e.g., certain majestic aspects of creation). A major competitor to Reformed epistemology is Wittgensteinian quasi-fideism, a position drawn (...) from the epistemology of Wittgenstein’s On Certainty, according to which some foundational religious commitments are not properly basic beliefs but some kind of apodictic, unshakeable certainties that form part of the structure of one’s rationality and worldview. I argue that the Reformed tradition has contained elements of quasi-fideism at least as far back as Calvin’s account of faith from the Institutes of the Christian Religion, book 3, chapter 2. (shrink)

A clearly written, authoritative introduction to Taylor's work.

BackgroundIn this manuscript, we argue that within the context of phase IV, physician-researchers retain their fiduciary obligation to treat the patient-participants.DiscussionWe first clarify why the perspective that research ethics ought to be differentiated from clinical ethics is not applicable in phase IV, and therefore, why therapeutic orientation is most convivial in this phase. Next, assuming that ethics guidelines may be representative of common morality, we show that ethics guidelines see physician-researchers primarily as physicians and only secondarily as researchers. We then (...) elaborate on what a fiduciary obligation is and how some of the obligations are default duties. Lastly, we look at the fiduciary obligation of the physician-researcher in phase IV interventional trials.ConclusionThe fiduciary obligation to treat is not as easily waived as in earlier trials. Assuming the entwinement of research and practice in phase IV, physician-researchers, in collaboration with other researchers, investigators, and research ethics committees, should ensure that in terms of study design, methodology, and research practice, the therapeutic value of the research to the patient-participants is not diminished. (shrink)

"Künstlerische Selbstverletzung - seit den 1960er Jahren international fester Bestandteil der Performance Art - polarisiert, verstört und wirft vor allem Fragen nach Handlungsmotivationen auf. Rosemarie Brucher deutet dieses radikale Phänomen als Bewältigungsversuch bedrohter Autonomie und damit in erster Linie als Ermächtigungsstrategie. In dieser Ambivalenz aus Subjektermächtigung und Naturunterwerfung lässt sich künstlerische Selbstverletzung vor dem Hintergrund von Immanuel Kants Ästhetik des Erhabenen lesen, was die Autorin exemplarisch an VALIE EXPORT und Stelarc darlegt. Eine solche Bezugsetzung eröffnet nicht nur einen innovativen (...) Zugang zu dieser Kunstform, sondern wirft zugleich auch ein neues Licht auf Kants Erhabenheitskonzeption"--Back cover. (shrink)

Abstractabstract:This article examines Harold Ramis’s 2005 noir comedy The Ice Harvest as the critically dystopian counter-panel to his beloved 1993 film Groundhog Day, a film frequently discussed within the paradigm of utopia. While starkly different in genre, tone, and reception, the two films comprise a dialectical dyad that registers the historical transition from the utopian cultural effervescence of the early 1990s to the tragic foreclosure of imaginative horizons and the dystopian transformation of economic, political, and social landscapes in the new (...) millennium. In The Ice Harvest, the author argues, this is achieved through a strategic reactivation of film noir as a variant of the critical dystopia. (shrink)

In the first book of its kind, Garland-Thomson defines staring, explores the factors that motivate it, and considers the targets and the effects of the stare.

We investigate how the perceived uncertainty of a conditional affects a person's choice of conclusion. We use a novel procedure to introduce uncertainty by manipulating the conditional probability of the consequent given the antecedent. In Experiment 1, we show first that subjects reduce their choice of valid conclusions when a conditional is followed by an additional premise that makes the major premise uncertain. In this we replicate Byrne. These subjects choose, instead, a qualified conclusion expressing uncertainty. If subjects are given (...) a third statement that qualifies the likelihood of the additional premise, then the uncertainty of the conclusions they choose is systematically related to the suggested uncertainty. Experiment 2 confirms these observations in problems that omit the additional premise and qualify the first premise directly. Experiment 3 shows that the qualifying statement also affects the perceived probability of the consequent given the antecedent of the conditional. Experiment 4 investigates the effect of suggested uncertainty on the fallacies and shows that increases in uncertainty reduce the number of certain conclusions that are chosen while affirming the consequent but have no effect on denying the antecedent. We discuss our results in terms of rule theories and mental models and conclude that the latter give the most natural account of our results. (shrink)

BackgroundIn research ethics, the most basic question would always be, “which is an ethical issue, which is not?” Interestingly, depending on which ethics guideline we consult, we may have various answers to this question. Though we already have several international ethics guidelines for biomedical research involving human participants, ironically, we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus. In this manuscript, we attempted to do just that.MethodsWe extracted (...) the imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. In doing so, we gathered data on how many guidelines support a specific imperative.ResultsWe found that there is no consensus on the majority of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. Of the 12 clusters, Informed Consent has the highest level of consensus and Research Collaboration and Regulatory Sanctions have the least.ConclusionThere was a lack of consensus in the majority of imperatives from the five internationally-known ethics guidelines. This may be partly explained by the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences. (shrink)

ABSTRACTBusiness actors often act in ways that may harm other parties. While the law aims to restrict harmful behavior and to provide remedies, legal systems do not anticipate all contingencies and legal regulations are not always well-enforced. This article argues that the logic of double effect, which has been developed and deployed in other areas of practical ethics, can be useful in helping business actors decide whether or not to pursue potentially harmful activities in commonplace business activity. The article illustrates (...) how LDE helps to explain the exploitative nature of payday lending, the distinction between permissible and impermissible forms of market competition, and the potential wrong of imposing risk of harm on others. The article also addresses foundational debates about LDE itself. We offer the article as an illustration of the sort of “midlevel” theorizing that can address directly the needs of practitioners. (shrink)

This paper examines what managers ought to do when confronted with apparent moral conflicts between their managerial responsibilities and the general requirements of morality, specifically when those conflicts are driven by the institutional environment. I examine Google’s decision to enter the Chinese search engine market as an example of such a conflict. I consider the view that Google’s managers engaged in justifiable moral compromise in making the choice to engage in self-censorship and show how this view depends on the idea (...) of genuine moral dilemmas or irresolvable moral conflicts. I argue that there are serious reasons to doubt the existence of genuine moral dilemmas both in the abstract, as well as in the context of managerial responsibility. I propose an alternative account for what Google’s managers ought to do, as well as others who face relevantly similar situations. The account contains two conditions for permissibly contributing to another party’s failure to live up to their moral responsibilities. The first condition is that the manager must intend and act in such a way as to minimize the firm’s complicity in the other entity or actor’s failure, which in most cases will imply a duty for the manager to take actions that aim towards changing the institutional context. Under the second condition, managers ought to communicate to the firm’s constituents that they take seriously the importance of the interests at stake. (shrink)