BackgroundThe assessment of patients’ decision-making capacity is ubiquitous in contemporary healthcare. This paper examines the ethics of undisclosed probing of capacity by psychiatrists. The discussion will refer to the law in England and Wales, though the highlighted issues are likely to be relevant in similar jurisdictions.Main textDecision-making capacity is a private attribute, and patients may not necessarily be aware that one of their personal abilities is being explored. Routine exploration of capacity has not historically been a part of psychiatric examination, (...) but it is now difficult to avoid during psychiatric interview.Ethical practice and shared decision-making require patients to be aware that their decision-making may be evaluated by the doctor at some point, and the potential implications of an objective professional conclusion of incapacity. Case law directs that patients should be informed about any assessment of their decision-making ability, though the extent to which this has translated into practice is unclear. However, explanation about the assessment may cause a patient to react negatively, which may impede therapeutic engagement and constitute an ethical dilemma. It is argued that in the absence of systemic measures, professionals should retain the discretion to decide whether a particular patient should be informed about the impending probe into their decision-making ability, or not. In the latter instance, concealment of information about the assessment or its purpose should be subject to the caveats and safeguards associated with any recourse to therapeutic exception.ConclusionThe necessity to mandatorily inform patients about assessment of their capacity introduces a novel ethical dilemma for psychiatrists. The negotiation of this dilemma should not be the prerogative of the clinician, and requires systemic initiatives to ensure universal awareness of patients about the possibility of their capacity being assessed during their journeys through healthcare systems. (shrink)

Pancreatic beta cells secrete insulin in response to elevated plasma glucose levels in a Ca2+‐dependent fashion. Released insulin may act on the beta cell itself to promote further insulin synthesis and release. Recent studies by Johnson and Misler,1 Masgrau et al.2 and Mitchell et al.3 provide strong evidence (1) for the existence of intracellular Ca2+ stores sensitive to NAADP, a potent Ca2+‐mobilizing messenger, and (2) that these Ca2+ stores are involved in both glucose‐ and insulin‐mediated signal transduction. NAADP may therefore (...) play an important role in controling secretion of insulin from pancreatic beta cells. BioEssays 25:430–433, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

The 2015 UK Supreme Court judgment in Montgomery v Lanarkshire reinforces the importance of informed consent to medical treatment. This paper suggests that Montgomery recognises the challenge faced by vulnerable individuals in choosing between treatment options and making decisions with appreciation of information about material risks. The judgment endorses a form of weak paternalism to safeguard such persons, which is not disrespectful of the aggregate principles of the Mental Capacity Act 2005. But ethical practice requires professionals to tread carefully between (...) weak and hard paternalism in the context of therapeutic interactions with vulnerable patients, while ensuring their awareness of material risks. (shrink)

And in this book the distinguished scholar Amartya Sen offers a powerful critique of the theory of social justice that, in its grip on social and political ...

Gary Becker and others have done important work to broaden the content of self interest, but have not departed from seeing rationality in terms of the exclusive pursuit of self-interest. One reason why committed behavior is important is that a person can have good reason to pursue objectives other than self interest maximization (no matter how broadly it is construed). Indeed, one can also follow rules of behavior that go beyond the pursuit of one's own goals, even if the goals (...) include non-self-interested concerns. By living in a society, one develops possible reasons for considering other people's goals as well, which takes one beyond an exclusive concentration on one's own goals, not to mention the single-minded pursuit of one's own self interest. The recognition of other people's goals may be a part of rational thought. If rational behavior may depart from the relentless pursuit of one's own goals, commitment has to be important in a theory of rationality. Furthermore, seeing the role of commitment in human behavior can have explanatory importance in allowing us to understand behavior patterns that are hard to fit into the narrow format of contemporary rational choice theory. Commitment is, thus, important both for practical reason and for causal explanation. (shrink)

I am embarrassed at being placed in the dizzying company of one of the truly great thinkers in the world. The similarities between Mill's ideas and mine partly reflect, of course, his influence on my thinking. But I also discuss some difficulties in taking Mill's whole theory without modification, since there are internal tensions within it. In a paper I published in 1967, I tried to discuss how Mill's willingness to hold on to some contrary positions depended on the nature (...) of his empirical reading of the world. I draw on that diagnosis in commenting on some of the articles here. There are some serious issues of misinterpretation in one of the articles, which I try to clarify. I also comment on Arrow's interpretation of what is involved in the idea of autonomy and on his own way of assessing freedom, and acknowledge the seriousness of the questions he raises about the value of freedom in normative political philosophy. (shrink)

Colloquially, episodic memory is described as “the memory of personally experienced events”. Even though episodic memory has been studied in psychology and neuroscience for about six decades, there is still great uncertainty as to what episodic memory is. Here we ask how episodic memory should be characterized in order to be validated as a natural kind. We propose to conceive of episodic memory as a knowledge-like state that is identified with an experientially based mnemonic representation of an episode that allows (...) for a mnemonic simulation thereof. We call our analysis the Sequence Analysis of Episodic Memory since episodes will be analyzed in terms of sequences of events. Our philosophical analysis of episodic memory is driven and supported by experimental results from psychology and neuroscience. We discuss selected experimental results that provide exemplary evidence for uniform causal mechanisms underlying the properties of episodic memory and argue that episodic memory is a natural kind. The argumentation proceeds along three cornerstones: First, psychological evidence suggests that a violation of any of the proposed conditions for episodic memory amounts to a deficiency of episodic memory and no form of memory or cognitive process but episodic memory fulfills them. Second, empirical results support a claim that the principal anatomical substrate of episodic memory is the hippocampus. Finally, we can pin down causal mechanisms onto neural activities in the hippocampus to explain the psychological states and processes constituting episodic memory. (shrink)

In this volume, Peter Burke, a prominent "Western" historian, offers ten hypotheses that attempt to constitute specifically "Western Historical Thinking".

In an interesting letter to Anna George, the daughter of Henry George, Bernard Shaw wrote: “Your father found me a literary dilettante and militant rationalist in religion, and a barren rascal at that. By turning my mind to economics he made a man of me”. I am not able to determine what making a man of Bernard Shaw would exactly consist of, but it is clear that the kind of moral and social problems with which Shaw was deeply concerned could (...) not be sensibly pursued without examining their economic aspects. For example, the claims of property rights, which some would defend and some would dispute, are not just matters of basic moral belief that could not possibly be influenced one way or the other by any empirical arguments. They call for sensitive moral analysis responsive to empirical realities, including economic ones. (shrink)

We live in a world in which the idea of human rights is persistently invoked. However, despite the tremendous appeal of the idea of human rights, it is also seen by many as lacking in foundation. I have argued, particularly in my book The Idea of Justice, that human rights are best seen as articulations of commitments in social ethics, comparable to — but very different from — accepting utilitarian reasoning. Like other ethical tenets, human rights can, of course, be (...) disputed, but the claim is that they will survive open and informed scrutiny.This view contrasts with seeing human rights in primarily legal terms, either as consequences of humane legislation, or as precursors of legal rights, or as pointing towards what should ideally be legal rights. Human rights may well be reflected in legislation, may inspire legislation, and may even serve, in many circumstances, as ideals that demand legislative attention. However, these are ‘further facts’— not the defining characteristics of human rights. (shrink)

This book develops some of the most important themes of Sen's works over the last decade. He argues in a rich and subtle approach that we should be concerned with people's capabilities rather than their resources or welfare.

Commodities and Capabilities presents a set of inter-related theses concerning the foundations of welfare economics, and in particular about the assessment of personal well-being and advantage. The argument presented focuses on the capability to function, i.e. what a person can do or can be, questioning in the process the more standard emphasis on opulence or on utility. In fact, a person's motivation behind choice is treated here as a parametric variable which may or may not coincide with the pursuit of (...) self-interest. Given the large number of practical problems arising from the roles and limitations of different concepts of interest and the judgement of advantage and well-being, this scholarly investigation is both of theoretical interest and practical import. (shrink)

Enthält: "Historisches Denken als Trauerarbeit - Jacob Burckhardts Antwort auf eine Frage unserer Zeit" (S. 73-95).

We propose that rapid eye movement (REM) and slow-wave sleep contribute differently to the formation of episodic memories. REM sleep is important for building up invariant object representations that eventually recur to gamma-band oscillations in the neocortex. In contrast, slow-wave sleep is more directly involved in the consolidation of episodic memories through replay of sequential neural activity in hippocampal place cells.

This book develops some of the most important themes of Sen's works over the last decade. He argues in a rich and subtle approach that we should be concerned with people's capabilities rather than their resources or welfare.

Based on the 1972 Radcliffe Lectures, this book presents a systematic treatment of the conceptual framework as well as the practical problems of measurement of inequality.

One approach to the analysis of ethical dilemmas in medical practice uses the “four principles plus scope” approach. These principles are: respect for autonomy, beneficence, non-maleficence and justice, along with concern for their scope of application. However, conflicts between the different principles are commonplace in psychiatric practice, especially in forensic psychiatry, where duties to patients often conflict with duties to third parties such as the public. This article seeks to highlight some of the specific ethical dilemmas encountered in forensic psychiatry: (...) the excessive use of segregation for the protection of others, the ethics of using mechanical restraint when clinically beneficial and the use of physical treatment without consent. We argue that justice, as a principle, should be paramount in forensic psychiatry, and that there is a need for a more specific code of ethics to cover specialised areas of medicine like forensic psychiatry. This code should specify that in cases of conflict between different principles, justice should gain precedence over the other principles. (shrink)

This paper is about three distinct but interrelated problems: (1) the role 0f rights in moral theory, (2) thc characterization 0f agent relative values and their admissibility in consequ<—:ncc—bascd evaluation, and ( 3) the nature 0f moral evaluation 0f states 0f aihirs.

Aphoristic work on the fundamentals of Nyaya philosophy with classical Sanskrit commentaries; critical edition with exhaustive introduction.

Die in diesem Band vereinigten Beiträge stellen einen interdisziplinären Zusammenhang her, der eine komplexe Perspektive auf das Thema "Geschichtsbewusstsein" eröffnet. Es geht hier um das Ensemble mentaler Operationen, die das Geschichtsbewusstsein als zentrales Phänomen menschlicher Subjektivität ausmachen. Im Mittelpunkt stehen seine kulturellen Funktionen zur Orientierung der menschlichen Lebenspraxis. Psychologische, linguistische und geschichtliche Analysen verbinden sich mit theoretischen Entwürfen, die die Leistung der Zeitdeutung und Identitätsbildung umfassend explizieren. Die theoretischen Analysen des Bewusstseins von Geschichte stehen jedoch nicht allein, sondern werden auf (...) konkrete Phänomene und auf systematisch angelegte empirische Untersuchungen bezogen. (shrink)

This series aims at bridging the gap between historical theory and the study of historical memory as well as western and non-western concepts, for which this ...

Without denying the importance of the postmodernist approach to the narrative form and rhetorical strategies of historiography, the author, one of Germany's ...

Contributed articles presented in an international conference on self-knowledge and agency, organized and held at Centre for Philosophy, School of Social Sciences, Jawaharlal Nehru University, New Delhi in January 2007.

Leśniewski is known for his pedantry and idiosyncratic notation, which make it extremely difficult to read and follow. As reading comes before understanding, this paper therefore attempts only one...

Amartya Sen; XII*—Plural Utility, Proceedings of the Aristotelian Society, Volume 81, Issue 1, 1 June 1981, Pages 193–216, https://doi.org/10.1093/aristotelian/.

In the summer of 1997, I was asked by a leading Japanese newspaper what I thought was the most important thing that had happened in the twentieth century. I found this to be an unusually thought-provoking question, since so many things of gravity have happened over the last hundred years. The European empires, especially the British and French ones that had so dominated the nineteenth century, came to an end. We witnessed two world wars. We saw the rise and fall (...) of fascism and Nazism. The century witnessed the rise of communism, and its fall (as in the former Soviet bloc) or radical transformation (as in China). We also saw a shift from the economic dominance of the West to a new economic balance much more dominated by Japan and East and Southeast Asia. Even though that region is going through some financial and economic problems right now, this is not going to nullify the shift in the balance of the world economy that has occurred over many decades (in the case of Japan, through nearly the entire century). The past hundred years are not lacking in important events. (shrink)