IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

This paper traces the unspoken, implicit white racial logic of the brain disease model of addiction, which is based on seemingly universal, disembodied brains devoid of social or environmental influences. In the United States, this implicit white logic led to “context-free” neuroscience that made the social hierarchies of addiction and its consequences invisible to, and thus exacerbated by, national policies on opioids. The brain disease model of addiction was selectively deployed among the white middle-class population that had long accessed narcotics (...) and pharmaceutical treatments for narcotics disorders from biomedical clinics, as opposed to from illegal sources subject to law enforcement. In turn, new treatments for opioid addiction were racially marketed to the same white clientele to which newly patented opioid analgesics were marketed, tapping into a circumscribed but highly lucrative consumer base that has long benefited from a legally protected, racially segregated safe space for white narcotics consumption. The connecting thread for the contemporary white opioid “crisis,” therefore, is white race as a ghost variable in addiction neuroscience and in its pharmaceutical and biotechnological translation. (shrink)

As social media becomes increasingly popular, human subjects researchers are able to use these platforms to locate, track, and communicate with study participants, thereby increasing participant retention and the generalizability and validity of research. The use of social media; however, raises novel ethical and regulatory issues that have received limited attention in the literature and federal regulations. We review research ethics and regulations and outline the implications for maintaining participant privacy, respecting participant autonomy, and promoting researcher transparency when using social (...) media to locate and track participants. We offer a rubric that can be used in future studies to determine ethical and regulation-consistent use of social media platforms and illustrate the rubric using our study team’s experience with Facebook. We also offer recommendations for both researchers and institutional review boards that emphasize the importance of well-described procedures for social media use as... (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

A probability distribution is regular if it does not assign probability zero to any possible event. While some hold that probabilities should always be regular, three counter-arguments have been posed based on examples where, if regularity holds, then perfectly similar events must have different probabilities. Howson and Benci et al. have raised technical objections to these symmetry arguments, but we see here that their objections fail. Howson says that Williamson’s “isomorphic” events are not in fact isomorphic, but Howson is speaking (...) of set-theoretic representations of events in a probability model. While those sets are not isomorphic, Williamson’s physical events are, in the relevant sense. Benci et al. claim that all three arguments rest on a conflation of different models, but they do not. They are founded on the premise that similar events should have the same probability in the same model, or in one case, on the assumption that a single rotation-invariant distribution is possible. Having failed to refute the symmetry arguments on such technical grounds, one could deny their implicit premises, which is a heavy cost, or adopt varying degrees of instrumentalism or pluralism about regularity, but that would not serve the project of accurately modelling chances. (shrink)

Engineers encounter difficult ethical problems in their practice and in research. In many ways, these problems are like design problems: they are complex, often ill-defined; resolving them involves an iterative process of analysis and synthesis; and there can be more than one acceptable solution. This book offers a real-world, problem-centered approach to engineering ethics, using a rich collection of open-ended scenarios and case studies to develop skill in recognizing and addressing ethical issues.

Recent work has defended “Euclidean” theories of set size, in which Cantor’s Principle (two sets have equally many elements if and only if there is a one-to-one correspondence between them) is abandoned in favor of the Part-Whole Principle (if A is a proper subset of B then A is smaller than B). It has also been suggested that Gödel’s argument for the unique correctness of Cantor’s Principle is inadequate. Here we see from simple examples, not that Euclidean theories of set (...) size are wrong, but that they must be either very weak and narrow or largely arbitrary and misleading. (shrink)

Le livre de Caroline Petit, Galien de Pergame ou la rhétorique de la Providence, constitue la première étude d’ensemble du rôle de la rhétorique dans l’œuvre de Galien, aux sources du discours médical et scientifique, et de l’autobiographie intellectuelle. Caroline Petit’s Galien de Pergame ou la rhétorique de la Providence is the first comprehensive study of the role of rhetoric in Galen’s oeuvre, a cornerstone of medical and scientific discourse and of intellectual autobiography in the West.

Retraçant sont itinéraire philosophique dans Beau Voyage, quelques mois avant sa mort, Maurice Pradines (1874-1958) résume sa philosophie de la sensation par cet adage: "Nihil est in sensu quod non prius fuerit in intellectu". Pour l'auteur de la Philosophie de la sensation, la sensation est, en effet, originairement intelligente: elle n'a de légitimité biologique qu'en tant qu'elle donne quelque chose à comprendre. Renvoyant dos-à-dos le sensualisme (qui construit l'intelligence sur une sensation denué d'esprit) et le rationalisme (qui prétend trouver l'esprit (...) dans une raison transcendante), Pradines inscrit l'intentionalité au cœur de la physiologie de la sensation. Percevoir, pour un vivant, c'est d'abord percevoir quelque chose qui intéresse la vie, à savoir un danger à écarter ou un objet à conquérir. Aussi n'est-il guère surprenant que le sens ultime de la sensation soit l'espace: elle est le signe d'une distance à déployer ou, au contraire, à réduire. Les phénomènes psychiques ne peuvent être des données immédiates puisqu'ils font sens dans la stricte mesure où l'espace les élabore en même temps qu'il se construit. Les fondements d'une psychologie conséquente peuvent, dès lors, être posés. Elle consistera à saisir la genèse de l'esprit à partir du sens biologique de la sensation, c'est-à-dire d'une spatialité pensée elle-même comme "genèse première". (shrink)

Inspired by Voltaire's advice that a text needs to be concise to have real influence, this anthology contains fiery extracts by forty eighteenth-century authors, from the most famous philosophers of the age to those whose brilliant writings are less well-known. These passages are immensely diverse in style and topic, but all have in common a passionate commitment to equality, freedom, and tolerance. Each text resonates powerfully with the issues our world faces today. Tolerance was first published by the Société française (...) d'étude du dix-huitième siècle (the French Society for Eighteenth-Century Studies) in the wake of the Charlie Hebdo assassinations in January 2015 as an act of solidarity and as a response to the surge of interest in Enlightenment values. With the support of the British Society for Eighteenth-Century Studies, it has now been translated by over 100 students and tutors of French at Oxford University."--Publisher's website. (shrink)

The puzzle of petitionary prayer: if we ask for the best thing, God was already going to do it, and if we ask for something that's not the best, God's not going to grant our request. In this paper, we give a new solution to the puzzle.

Newton published his deduction of universal gravity in Principia (first ed., 1687). To establish the universality (the particle-to-particle nature) of gravity, Newton must establish the additivity of mass. I call ‘additivity’ the property a body's quantity of matter has just in case, if gravitational force is proportional to that quantity, the force can be taken to be the sum of forces proportional to each particle's quantity of matter. Newton's argument for additivity is obscure. I analyze and assess manuscript versions of (...) Newton's initial argument within his initial deduction, dating from early 1685. Newton's strategy depends on distinguishing two quantities of matter, which I call ‘active’ and ‘passive’, by how they are measured. These measurement procedures frame conditions on the additivity of each quantity so measured. While Newton has direct evidence for the additivity of passive quantity of matter, he does not for that of the active quantity. Instead, he tries to infer the latter from the former via conceptual analyses of the third law of motion grounded largely on analogies to magnetic attractions. The conditions needed to establish passive additivity frustrate Newton's attempted inference to active additivity. (shrink)

Ethics and Organizations provides a rich and valuable overview of an increasingly important issue for management and organizations in contemporary society. Debates about equal opportunities, environmental responsibility, consumer redress, and corporate governance have given ethics a prominent place in the study of organizations in their social and natural environments. Within the organization, new management styles that seek to energize employees by manipulating their beliefs have highlighted the moral-ethical principles at issue in contemporary management. At the same time, debates around postmodernism (...) and relativism have moved ethics to a new centrality in contemporary social theory. This volume addresses the questions that these and other developments raise for the study of management and organizations, from a multidisciplinary perspective. Ethics and Organizations will be invaluable to advanced-level students and academics engaged in analyzing the moral, political, and ethical dimensions of organization theory and organizational practice. (shrink)

Schopenhauer’s pessimistic philosophy is a depressing read. He writes many pages about how suffering is the norm, and any happiness we feel is merely a temporary alleviation of suffering. Even so, his account of suffering rings true to many readers. What are we to do with our lives if Schopenhauer is right, and we are doomed to suffer? In this paper, I use William James’ pragmatic method to find practical implications of Schopenhauer’s pessimism. I provide a model for how we (...) are to live our lives in a suffering world, a model that provides means to reduce suffering. (shrink)

Le « Bulletin bibliographique de philosophie politique et sociale » est réalisé pour la revue Philosophique par une équipe de rédactrices et de rédacteurs. Il est coordonné par Caroline Guibet Lafaye (CNRS) et Fabien Ferri (université de Franche-Comté) au sein du Centre de Documentation et de Bibliographie Philosophiques de l’université de Franche-Comté (UR 2274 CDBP – Logiques de l’agir), et propose de brèves recensions d’ouvrages récemment parus, réparties dans diverses rubriques thématique...

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

Up Against Foucault offers both a feminist critique of Foucauldian theories as well as an attempt to reconcile these seemingly irreconcilable perspectives. Feminists are often "up against Foucault" because he questions key conclusions in feminism regarding the nature of gender relations, and men's possession of power. This book, however, fills the gap in literature about Foucault by showing how his theories of sexuality and power relations are often applicable to the everyday realities of women's lives. Drawing upon their diverse backgrounds (...) in social theory and philosophy, the contributors discuss the ways in which Foucault provokes feminists into questioning their grasp of power relations, and examines the implications of his decision to overlook categories of gender in his discussion of sexuality and power relations. They also show that in spite of his lack of interest in gender, Foucault's ways of understanding the control of women and female sexuality ultimately have much to offer feminism. (shrink)

If, as many suppose, pornography changes people, a question arises as to how.1 One answer to this question offers a grand and noble vision. Inspired by the idea that pornography is speech, and inspired by a certain liberal ideal about the point of speech in political life, some theorists say that pornography contributes to that liberal ideal: pornography, even at its most violent and misogynistic, and even at its most harmful, is political speech that aims to express certain views about (...) the good life, 2aims to persuade its consumers of a certain political point of view—and to some extent succeeds in persuading them. Ronald Dworkin suggests that the pornographer contributes to the ‘moral environment, by expressing his political or social convictions or tastes or prejudices informally’, that pornography ‘seeks to deliver’ a ‘message’ , that it reflects the ‘opinion’ that ‘women are submissive, or enjoy being dominated, or should be treated as if they did’, that it is comparable to speech ‘advocating that women occupy inferior roles’.3 Pornography on this view is political speech that aims to persuade its listeners of the truth of certain ideas about women, and of course ‘the government must leave to the people the evaluation of ideas’.4 Another answer offers a vision that is not grand and noble, but thoroughly reductive. Pornography is not politically persuasive speech, but speech that works by a process of psychological conditioning. This view seems common enough in the social science literature. Consider, for example, this description of an early experiment, from a time that pre-dates contemporary political debate. (shrink)

This primer on authentic education explores how mind and heart can work together in the learning process. Moving beyond the bankruptcy of our current model of education, Parker Palmer finds the soul of education through a lifelong cultivation of the wisdom each of us possesses and can share to benefit others.

Le « Bulletin bibliographique de philosophie politique et sociale » est réalisé pour la revue Philosophique par une équipe de rédactrices et de rédacteurs. Il est coordonné par Caroline Guibet Lafaye (CNRS) et Fabien Ferri (Université de Franche-Comté) au sein de Centre de Documentation et de Bibliographie Philosophiques de l’Université de Franche-Comté (UR 2274 CDBP–Logiques de l’Agir), et propose de brèves recensions d’ouvrages récemment parus, réparties dans diverses rubriques thématiques....

This book offers a fresh framework for the historical understanding of revolutions and ideas about revolution.

Burnout among health professionals is at epidemic proportions. In response, many health institutions have emphasised the importance of self-care, relying particularly on the idea that doctors who are burned out provide worse care for their patients. Although not made explicit, this suggests that doctors might have a responsibility to their patients (and perhaps others) to practice self-care. This chapter explores the potential grounds for such an obligation. We suggest that while there is potential for a limited obligation of self-care, institutional (...) emphasis on this risks instrumentalising doctors' well-being, minimising institutional responsibilities and workers' rights, and being excessively demanding for individuals. (shrink)

This book takes the discursive and postmodern turn in psychotherapy a significant step forward and will be of interest to all those working in mental health who want to work wiht clients in ways that will facilitate challenges to oppression and processes of emancipation. It achieves this by: · reflecting on the role of psychotherapy in contemporary culture · developing critiques of language in psychotherapy that unravel its claims to personal truth · the reworking of a place in the transforative (...) therapeutic practice Deconstruction is brought to bear on the key conceptual and pragmatic issues that therapists and clinical psychologists face, and the project of therapy is opened up to critical attention and reconstruction. The book provides clear reviews of different viewpoints and will help readers to orient themselves on the complex terrain of debates. (shrink)

Arguments in environmental ethics often appeal to information from environmental science, such as information about the causes of environmental problems. Contemporary work in philosophy of science can shed light on the practice of environmental science as well as some of the challenges it faces. This chapter surveys some of this work, focusing on three interrelated topics: the nature of scientific evidence, including connections with uncertainty and consensus; the use and evaluation of scientific models; and values and objectivity in scientific practice. (...) A better understanding of these topics can help to ensure that scientific information is used appropriately and effectively in ethical argumentation. (shrink)

What is citizenship? -- What are choices? -- Choosing to think for yourself -- Choosing to say no -- Choosing to be friendly -- Choosing to be fair -- Choosing what to eat -- Choosing to spend or save money -- Choosing entertainment -- Choosing to be active -- Choosing to follow the rules -- Choosing to tell the truth -- Making choices and happiness.

A passage in Eunapius (476–7, pp. 440–2 Loeb) draws an interesting contrast between the attitudes to divination of the two sophists Maximus and Chrysanthius: Maximus, who manipulates the omens until they say what he wants, and Chrysanthius, who scrupulously obeys their apparent meaning. But a passage a little later (500–1, pp. 542–4 Loeb) apparently ascribes to Chrysanthius the opposite attitude. This article suggests a transposition to restore coherence to the text. Even if the transposition is wrong, the contrast drawn in (...) the first passage between two attitudes to divination, one rigorous and literalist, one manipulative, is important. (shrink)

Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making. First, the genetic essentialism that is commonly associated with the genomics (...) revolution in health care might inadvertently exacerbate stigma towards people with mental disorders. Secondly, the promises of genomic medicine advance a narrative of individual empowerment. This narrative could promote a fatalism towards patients' biology in ways that function in practice to undermine patients' agency and autonomy, or, alternatively, a heightened sense of subjective genetic responsibility could become embedded within mental health services that leads to psychosocial therapeutic approaches and the clinician-patient therapeutic alliance being undermined. Finally, adopting a genomics-focused approach to public mental health risks shifting attention away from the complex causal relationships between inequitable socio-economic, political, and cultural structures and negative mental health outcomes. The article concludes by outlining a number of potential pathways for future ethics research that emphasizes the importance of examining appropriate translation mechanisms, the complementarity between genetic and psychosocial models of mental disorder, the implications of genomic information for the clinician-patient relationship, and funding priorities and resource allocation decision making in mental health. (shrink)

Julian Savulescu argues for two principles of reproductive ethics: reproductive autonomy and procreative beneficence, where the principle of procreative beneficence is conceptualised in terms of a duty to have the child, of the possible children that could be had, who will have the best opportunity of the best life. Were it to be accepted, this principle would have significant implications for the ethics of reproductive choice and, in particular, for the use of prenatal testing and other reproductive technologies for the (...) avoidance of disability, and for enhancement. In this paper, it is argued that this principle should be rejected, and it is concluded that while potential parents do have important obligations in relation to the foreseeable lives of their future children, these obligations are not best captured in terms of a duty to have the child with the best opportunity of the best life. (shrink)

On a basic level, "cyberpsychology" refers to the comparison of the mind with different kinds of machines. This multidisciplinary collection brings together essays by leading psychologists and cultural theorists working in the spheres of technology and psychology to explore links between popular culture, technoscience, feminism and politics. Tracing historical and contemporary lines of argument around the fascination between different forms of psychological and machine culture, contributors articulate "cyberpsychological" reflections on contemporary crises in psychology with emerging technologies of the self. The (...) volume offers challenging perspectives and insights to anyone interested in the connections between psychology and technological developments in the information age. (shrink)

This accessible text introduces social theory as a set of flexible and practical concepts that can be used to reflect on and make sense of social behavior. It encourages the reader to critically assess social explanations and to construct their own as active theorists in their own right. Drawing on examples chosen to appeal to a wide, international student readership, it offers a resolutely straightforward, practical and student-centered approach to theory, avoiding the heavy emphasis on individual theorists and the often (...) difficult language of many existing texts. (shrink)

The ‘Ordinary Language’ philosophy of the early 20th century is widely thought to have failed. It is identified with the broader so-called ‘linguistic turn’, a common criticism of which is captured by Devitt and Sterelny (1999), who quip: “When the naturalistic philosopher points his finger at reality, the linguistic philosopher discusses the finger.” (p 280) The implication is that according to ‘linguistic’ philosophy, we are not to study reality or truth or morality etc, but the meaning of the words ‘reality’, (...) ‘truth’, ‘morality’ etc. Ordinary Language philosophy has fallen so thoroughly into disrepute because it is supposed to advocate that not only are we to study words and meanings rather than the phenomena themselves (which is apparently bad enough), but we must restrict that study to words and meanings as they occur in the language used by the ordinary speaker. A number of preposterous corollaries have been taken to follow from this view. Most seriously, perhaps, and irritatingly, is that any theory which contains ‘non-ordinary’ uses of expressions is thereby ‘meaningless’ or simply false – which is clearly absurd. In this paper I show that this is a completely inaccurate picture of Ordinary Language philosophy. My aim is to correct these persistent misinterpretations, and make possible a more sensible reassessment of the philosophy. (shrink)

The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

This book explores the thinking of philosophers and theologians about controversies concerning animal consciousness and animal rights. The special contribution of the book is a presentation of Bernard Lonergan's theory about consciousness and the operations of the mind. The author tests this theory against present-day research with apes.