Self-medication of antibiotics is an irrational use of drugs, contributing to microbial resistance, increasing healthcare costs and higher mortality and morbidity. This study aimed to assess self-medication with antibiotics without a medical prescription in the community of Libya. This is a cross-sectional study conducted from June to December 2022 and the total number of participants was 200. The design of the study and sample size were modified according to the proficiency of pharmacists and the medical and (...) non-medical population of Libya. The questionnaire was developed in English and Arabic language and was distributed through social media platforms. The questions were used after a thorough literature search and assessing the validity and reliability. The significant signs regarding reasons for the treatment by self-medication drugs of antibiotics, because of its various drugs of antibiotic by pharmacist (n=80, 40.0%) and family (n=90, 45.0%) compared with experience and physicians by used prescription was 13 (6.50%) and significant sings regarding by nasal congestion self-medication of various antibiotics (n=100, 50.0%). This sign must be practiced based on a previous physician’s prescription. The antibiotics are often self-administered as patients feel that they will save money and time but this can lead to substantial adverse drug reactions, antibiotic resistance, treatment failure and drug-related toxicity. This study respondent's medical and non-medical public of Libya who should be relatively informed and educated about the risk of treatment by self-medication of antibiotics with the development of resistance. (shrink)

Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human health care. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should prescribe antibiotics. It also does not explore the ethical significance of (...) public views or their sensitivity to awareness of AMR risks or the standpoint (self-interested or impartial) taken by participants. Methods: An online survey was conducted with a sample of the U.S. public (n = 158). Participants were asked to indicate what relative priority should be given to individual patients and society-at-large from various standpoints and in various contexts, including antibiotic prescription. Results: Of the participants, 50.3% thought that doctors should generally prioritize individual patients over society, whereas 32.0% prioritized society over individual patients. When asked in the context of AMR, 39.2% prioritized individuals whereas 45.5% prioritized society. Participants were significantly less willing to prioritize society over individuals when they themselves were the patient, both in general (p = .001) and in relation to AMR specifically (p = .006). Conclusions: Participants’ attitudes were more oriented to society and sensitive to collective responsibility when informed about the social costs of antibiotic use and when considered from a third-person rather than first-person perspective. That is, as participants came closer to taking the perspective of an informed and impartial “ideal observer,” their support for prioritizing society increased. Our findings suggest that, insofar as antibiotic policies and practices should be informed by attitudes that are impartial and well-informed, there is significant support for prioritizing society. (shrink)

The Unified Theory of Free Will: The Three Universal Laws, Systemic Imbalance, and Nature’s Self-Correction -/- By Angelito Malicse -/- Introduction -/- For centuries, the concept of free will has been debated, with perspectives ranging from determinism to compatibilism and libertarianism. However, these traditional views fail to acknowledge the natural laws that govern human decision-making. By synthesizing the Universal Law of Balance in Nature, the Universal Feedback Loop Mechanism, and the Error-Free System, we establish a unified theory of free (...) will—a structured approach to human choices within the constraints of natural order. -/- Additionally, it is crucial to recognize the tolerance limits of hierarchical systems—both natural and man-made. When human decisions exceed these limits and imbalances persist, nature will automatically step in to restore equilibrium. This natural correction often manifests in disruptive ways, such as natural disasters, economic collapses, or social upheavals. Understanding these dynamics is essential to ensuring stability across all systems. -/- Furthermore, human emotions, which have evolved as essential survival mechanisms, play a dual role in maintaining or disrupting balance. Emotions influence decision-making, motivation, and social interactions. When properly regulated, they help individuals and societies adapt to challenges and maintain systemic harmony. However, when emotions exceed their tolerance limits—such as excessive fear leading to panic or unchecked anger causing conflict—they contribute to systemic imbalance and dysfunction. -/- The Three Universal Laws and Their Role in Decision-Making -/- 1. Universal Law of Balance in Nature -/- Every system—biological, social, and technological—operates within specific tolerance limits. Decisions that align with natural balance maintain stability, while those that exceed these limits lead to disruption. If humans fail to correct imbalances, nature will forcefully restore equilibrium, often through unpredictable and catastrophic means. -/- Examples of Balance, Systemic Imbalance, and Natural Correction: -/- Personal Health: A balanced diet sustains physical well-being, while excessive consumption leads to obesity and related diseases. If ignored, the body self-corrects through metabolic disorders and immune system responses. -/- Economic Stability: A balanced economy fosters growth, while financial mismanagement leads to economic crashes. Recessions and inflation serve as corrective mechanisms for financial excesses. -/- Environmental Sustainability: Responsible resource management ensures long-term survival, whereas overexploitation leads to climate change and natural disasters such as droughts and hurricanes, which force societies to adapt. -/- Ecosystem Regulation: Overfishing disrupts marine populations, but nature counters with species migration and ecological shifts that eventually restore stability. -/- Energy Consumption: Overuse of fossil fuels accelerates climate change, prompting extreme weather events and necessitating the shift to renewable energy sources. -/- 2. Universal Feedback Loop Mechanism -/- Decision-making must incorporate continuous feedback to ensure adaptation and refinement. Ignoring or distorting feedback results in inefficiencies and systemic collapse. -/- Examples of Feedback, Systemic Imbalance, and Nature’s Response: -/- Business Adaptation: Companies that respond to consumer feedback thrive, while those that ignore it collapse due to declining market relevance. -/- Political Governance: Leaders who suppress public concerns foster unrest, often leading to revolutions or government overhauls. -/- Technological Development: AI systems trained on biased or incomplete data develop flawed decision-making patterns, necessitating retraining and regulation. -/- 3. Error-Free System -/- Every decision has consequences, and ensuring 100 percent correct information is essential to maintaining systemic balance. Errors in data, assumptions, or implementation can trigger unintended disruptions. -/- Examples of Cause and Effect, Misinformation, and Systemic Collapse: -/- Academic Success: Proper study methods enhance learning, while reliance on ineffective strategies results in poor educational outcomes. -/- Industrialization and Environmental Impact: Sustainable practices protect ecosystems, while reliance on false environmental data accelerates degradation. -/- Global Resource Consumption: Inaccurate assessments of resource availability lead to economic and geopolitical instability. -/- The Evolution and Purpose of the Duality of Human Emotions -/- Human emotions have evolved as critical mechanisms for survival, adaptation, and social cohesion. They function as regulatory signals that guide decision-making, helping individuals and societies maintain equilibrium. However, emotions also possess a dual nature, where their misalignment or overexpression can lead to instability and dysfunction. -/- Positive Role of Emotions in Systemic Balance: -/- Empathy and Cooperation: Emotions such as compassion and trust foster social cohesion, strengthening communities and enhancing cooperation. -/- Fear and Caution: A moderate level of fear helps individuals assess risks and avoid dangerous situations, ensuring personal and collective safety. -/- Motivation and Ambition: Positive emotions such as enthusiasm and joy drive personal growth, innovation, and societal progress. -/- Negative Role of Emotions in Systemic Imbalance: -/- Excessive Fear and Panic: When fear surpasses a system’s tolerance limit, it leads to irrational decision-making, paranoia, and social instability. -/- Unchecked Anger and Conflict: Intense anger without regulation contributes to violence, political unrest, and societal fragmentation. -/- Despair and Apathy: Chronic negative emotions, such as depression and hopelessness, reduce individual productivity and can weaken societal resilience. -/- Examples of Emotional Duality in Decision-Making: -/- Public Health Responses: Balanced fear leads to precautionary health measures, while excessive panic results in chaos (e.g., misinformation-fueled reactions during pandemics). -/- Leadership and Governance: A compassionate leader fosters unity, while an authoritarian leader driven by anger and paranoia destabilizes societies. -/- Market Behavior: Optimistic investors drive economic growth, while fear-driven panic selling causes financial crashes. -/- Effects of Systemic Imbalances and Nature’s Automatic Correction -/- When human decisions disrupt equilibrium and corrective actions are not taken, nature enforces balance through forceful interventions. -/- Examples of Human-Induced Imbalances and Nature’s Response: -/- Healthcare Systems: Overuse of antibiotics results in drug-resistant bacteria, increasing disease severity and forcing new medical advancements. -/- Economic Systems: Financial bubbles burst, leading to recessions that correct speculative excesses. -/- Political Systems: Corrupt governance leads to revolutions, shifts in power, and societal restructuring. -/- Environmental Systems: Deforestation causes soil erosion and desertification, forcing human migrations and altering agriculture. -/- Overpopulation: Excessive growth strains resources, leading to food shortages, pandemics, and natural events that regulate population levels. -/- Urban Expansion: Overcrowding leads to declining infrastructure, pollution, and social conflicts, often prompting mass relocations and policy reforms. -/- Conclusion -/- Free will is not an arbitrary concept but a structured system governed by natural laws. By understanding the Universal Law of Balance in Nature, the Universal Feedback Loop Mechanism, and the Error-Free System, we can align human decisions with nature’s equilibrium. -/- Additionally, recognizing the evolution and duality of human emotions is essential for maintaining stability in personal and societal decision-making. If humanity fails to correct imbalances, nature will automatically restore equilibrium, often in ways that are catastrophic and beyond human control. -/- By integrating these principles into education, governance, and AI development, we pave the way for a rational, ethical, and self-correcting society. -/- . (shrink)

Prescribing drugs for elderly patients is not an easy task since elderly patients frequently have comorbid conditions. In Libya, there are no guidelines for the management of medications used in elderly patients and no specialized geriatric health institutions. This study aims to assess the pattern of medication use among hospitalized elderly patients in Sebha Medical Centre and the drug-related problems associated with these patterns. This report is a descriptive and retrospective cross-sectional study conducted at Sebha Medical Center in 2021. (...) Potential drug-related problems were assessed based on the classification of Hepler and Strand. In this study, out of 195 participants, most patients have been given antibiotics (92.0%). The majority of patients have been prescribed anti-gastric agents, vitamins and anti-thrombotic agents which accounted for 75.0%, 62.0% and 55.0%, respectively. To a lesser extent, anti-hypertensive agents, analgesics and antihyperlipidemic were reported by 45.0%, 43.0% and 38.0%, respectively. Almost all the patients have at least one event of drug-related problem and more than three-quarters of the patients had more than one event of drug-related problems. The highest rate was untreated indications which were reported for 77.0% then followed by drug use without indication in nearly half of the events 48.0%. To fewer extent rates were reported: “in improper drug selection”, “drug interaction” and “adverse effects” which were reported for 25.0%, 23.0% and 18.0% of the total events, respectively. Almost all elderly patients have been prescribed antibiotics, analgesics and vitamins. Drug-related problems are predominantly prevalent in the clinical practice at the center. This study highlights the importance of activation of clinical pharmacist interventions at hospitals which can contribute to reducing the chance of risk of drug-related problems events among hospitalized elderly patients and ensuring rational drug prescribing in the geriatric clinical settings. (shrink)

Prescription drug misuse has emerged as a significant problem over the past decade, particularly topical corticosteroids for skin lightening. This study aimed to assess the misuse of topical corticosteroids among the female population in southern Libya; to determine prevalence, awareness, attitude, and practice regarding this drug misuse. A descriptive, cross-sectional questionnaire was distributed on January 2022 to females aged between 16-45 years old in southern Libya. Out of 200 distributed questionnaires, 155 were returned with a response rate of 77.5%. The (...) majority of the participants were aged 16-25 years (n=138, 89.0%) and over two-thirds of participants, said they obtained lightening products containing cortisone from pharmacies (n=107, 69.0%) while 36 participants indicated they obtained these products from cosmetic shops (23.2%). More than three-quarters of the participants said they were aware that they should read product ingredients (n=120, 77.4%). Just over one-quarter of respondents indicated they used the product on their face almost daily (n=41, 26.5%) while 28 participants denied using it (18.1%). The most common source of information about topical corticosteroids among participants was the Internet (n=51, 32.9%), followed by dermatologists (n=41, 26.5%), and pharmacists (n=31, 20.0%). Almost half of respondents were aware that topical corticosteroids can cause harmful effects (n=75, 48.4%). The most common indications reported for using topical corticosteroids were whitening (23.3%), and acne treatment (54.2%). Over two-thirds of participants, declared they would not use topical lightening products if they contained corticosteroids (n=107, 69.0%). In a similar attitude, nearly a third of participants stated that they would never use corticosteroid medications again if they knew about the negative effects of whitening (n=51, 32.9%). The majority of females, (87.7%), concur that only pharmacies should be able to sell and prescribe topical corticosteroid medications. The study's findings indicate that topical corticosteroids are frequently misused and that to lessen contraindications, especially for prolonged use, it is imperative to provide basic care to females who continue using topical corticosteroids in public or unlicensed marketing settings. (shrink)

Monkeypox, an infectious disease caused by the Orthopoxvirus, was identified in humans in 1970. It has recently emerged as a global health concern due to outbreaks beyond its endemic regions in Central and West Africa. This review examines the current state of medical treatments for monkeypox as of 2024, focusing on antiviral agents, immunotherapies, and supportive care measures. Monkeypox manifests with symptoms including fever, rash, and lymphadenopathy, with severe cases more common in immunocompromised individuals. Antiviral therapies such as tecovirimat and (...) brincidofovir are central to treatment strategies, with tecovirimat demonstrating efficacy in alleviating symptoms and reducing viral shedding. Emerging treatment strategies involve novel lipid-based formulations and combination therapies that integrate antivirals with immune-modulating agents. Supportive care remains essential, involving analgesics and antibiotics for secondary infections, while the MVA-BN vaccine plays a critical role in prevention. Research emphasizes the need for a deeper understanding of viral pathogenesis and host immune responses to improve therapeutic and preventive measures. Despite significant advancements, challenges remain, including potential antiviral resistance, disparities in healthcare access, and the necessity for enhanced diagnostic and surveillance capabilities. This review highlights the imperative for ongoing research, international collaboration, and investment in healthcare infrastructure to advance the management and prevention of monkeypox and to prepare for future outbreaks. (shrink)

Antibiotic-resistant bacteria pose a serious threat to our health. Our ability to destroy deadly bacteria by using antibiotics have not only improved our lives by curing infections, it also allows us to undertake otherwise dangerous treatments from chemotherapies to invasive surgeries. The emergence of antibiotic resistance, I argue, is a consequence of various iterations of prisoner’s dilemmas. To wit, each participant (from patients to nations) has rational self-interest to pursue a course of action that is suboptimal for (...) all of us. The standard solutions to prisoner’s dilemma look to realign cost-benefit such that individuals’ interests match those of the collective. However, the lack of a global organization to enforce an effective carrot-and-stick system makes it unlikely that we can solve the antibiotic resistance problem this way. I argue that our best chance might be an attempt to teach altruism and convince individuals to act not out of their self-interests. (shrink)

Creativity and Intelligence: Emergent Properties of the Brain as a Balancing Mechanism for Overpopulation, Natural Disasters, and Diseases -/- The human brain is an extraordinary organ, capable of producing creativity and intelligence as emergent properties that allow humanity to address complex challenges. These traits are not merely tools for individual survival; they function as collective mechanisms to adapt to large-scale issues that threaten humanity’s balance with the environment. Overpopulation, natural disasters, and the prevalence of diseases and illnesses represent some of (...) the most significant pressures on human societies. Through the brain’s capacity for problem-solving and innovation, humanity has developed strategies to mitigate these challenges and maintain equilibrium within the universal law of balance. -/- The Brain as a Balancing Mechanism -/- At its essence, the brain operates as a dynamic system that processes external stimuli and generates adaptive responses. Creativity and intelligence arise from this system as tools to predict, analyze, and address challenges that disrupt balance. Overpopulation, natural disasters, and diseases disrupt human life on social, economic, and environmental levels, testing the brain’s ability to create solutions. -/- Creativity in Addressing Overpopulation -/- Overpopulation places immense strain on resources, ecosystems, and social structures, often leading to food shortages, environmental degradation, and urban overcrowding. The brain’s creative capacity has allowed humans to develop innovations to address these issues. Urban agriculture, such as vertical farming, is an example of how creativity has transformed food production in densely populated areas, reducing dependence on traditional farmland and conserving resources. Similarly, advancements in renewable energy technologies, such as solar and wind power, reduce the ecological footprint of growing populations, providing sustainable solutions to energy needs. -/- Creativity also plays a critical role in social policies and education. Family planning programs and reproductive health education have empowered individuals, particularly women, to make informed decisions, reducing population growth rates in many regions. These initiatives reflect the brain’s ability to create holistic solutions that align societal needs with the preservation of natural balance. -/- Intelligence in Managing Natural Disasters -/- Natural disasters, unpredictable and often catastrophic, require intelligent strategies to mitigate their impact. Intelligence enables humans to analyze data, predict disasters, and prepare for their consequences. Early warning systems for tsunamis, hurricanes, and earthquakes exemplify this, providing communities with critical time to evacuate and take protective measures. -/- Furthermore, intelligence drives the design of resilient infrastructure that can withstand disasters. For instance, earthquake-resistant buildings and flood mitigation systems demonstrate the brain’s capacity to transform scientific knowledge into practical solutions. These innovations save lives, reduce economic losses, and facilitate faster recovery after disasters, ensuring that human societies maintain their balance despite nature’s unpredictability. -/- Creativity and Intelligence in Combating Diseases and Illnesses -/- Diseases and illnesses have long been among humanity’s greatest challenges, especially in the context of overpopulation, which facilitates the rapid spread of infectious diseases. The brain’s emergent properties of creativity and intelligence have been critical in combating these threats through advancements in medicine, public health, and technology. -/- The development of vaccines, antibiotics, and antiviral drugs highlights humanity’s creative response to disease. For example, the eradication of smallpox and the near-elimination of polio are milestones achieved through creative and intelligent applications of medical science. During the COVID-19 pandemic, intelligence and creativity led to the rapid development of vaccines using mRNA technology, showcasing the brain’s ability to adapt to new challenges at an unprecedented pace. -/- Public health strategies, such as sanitation systems, clean water initiatives, and disease surveillance networks, also reflect the brain’s ability to create systemic solutions. These measures have significantly reduced the burden of communicable diseases, particularly in densely populated areas. Moreover, advancements in artificial intelligence and biotechnology continue to enhance humanity’s ability to detect, prevent, and treat illnesses. -/- The Interplay of Creativity, Intelligence, and Feedback Mechanisms -/- Creativity and intelligence act as feedback mechanisms that enable humans to respond to disruptions while maintaining balance within the universal law of nature. Overpopulation, natural disasters, and diseases disrupt this balance, prompting the brain to generate solutions that restore harmony. -/- For instance, urban planning that incorporates green spaces and sustainable infrastructure addresses the environmental strain caused by overpopulation. Similarly, the integration of traditional knowledge with modern technologies enhances disaster resilience. In the context of diseases, the collaboration of global institutions and local communities reflects the brain’s capacity to balance innovation with cultural and social considerations. -/- Challenges and Ethical Considerations -/- While creativity and intelligence empower humanity to address these challenges, they also carry significant ethical responsibilities. Technological advancements must align with principles of sustainability and equity. For example, while vaccines have saved millions of lives, unequal access to these innovations highlights the need for ethical distribution systems. Similarly, urban development projects must prioritize environmental conservation and community well-being to avoid exacerbating existing imbalances. -/- Additionally, the misuse of intelligence and creativity—such as the development of biological weapons or unsustainable industrial practices—can worsen the effects of overpopulation, natural disasters, and diseases. Ensuring that human ingenuity aligns with the principles of balance and harmony is essential to avoid unintended consequences. -/- Conclusion -/- Creativity and intelligence are emergent properties of the human brain that have enabled humanity to adapt to and mitigate the negative effects of overpopulation, natural disasters, and diseases. These traits function as balancing mechanisms, allowing humans to innovate and maintain harmony within the framework of natural laws. However, the application of these capabilities must be guided by ethical considerations and a commitment to sustainability. By aligning human creativity and intelligence with the universal law of balance, humanity can navigate its most pressing challenges and build a more resilient and equitable future. -/- . (shrink)

Abstract: To improve the countries’ pharmaceutical situation and to monitor the progress, the World Health Organization (WHO) and member states developed a system of indicators to measure the respective important aspects as a prerequisite step. Level I indicators to assess the country’s pharmaceutical situation include the national drug policy; legislation and regulations; drug accessibility and affordability; essential drug list; quality control; pharmacovigilance; storage and distribution; information and rational use. This study is aimed to document the professional opinion of 20 pharmacy (...) practice professionals on Libya’s current pharmaceutical situation, utilizing WHO indicator-based approach. The core indicators measure the most important information needed to understand the pharmaceutical situation in a country. A closed-end questionnaire was distributed to ten practicing pharmacists and ten pharmacy teaching staff members who practice pharmacy. The questionnaires were handed over personally and collected on the same day. The responses were analyzed using simple statistics. The results were argued in the light of the first author’s observation and view, being expert in this field, with reference to the other experts’ views, relevant publications’ findings and WHO reports’ conclusions on these indicators. Suggestions and recommendations for a proper situation assessment, planning and action taking are presented. Primarily, government’s commitment towards appropriate restructuring, management and monitoring of the pharmaceutical sector is crucial. That is to enhance the country’s pharmaceutical situation, to provide and sustain efficient pharmaceutical services and to improve the overall health care system’s performance. (shrink)

Newer antidepressant drugs are frequently cited as having reduced side effect profiles to that of their older counterparts. However, recent studies have begun to dispute this claim, citing selective sampling, short clinical trials, and clinical trial environments as influencing reported outcomes. At present, little research on antidepressant side effects draws on RWD (Real-World Data). Despite this, interest in examining RWD samples for antidepressant drug side effects is increasing as of 2020. The reported study asked a random sample of 300+ individuals (...) taking a variety of different antidepressant medications to complete online drug side effect self-report scales with previously high validity. Newer antidepressants belonging to the atypical antidepressant drug class were reported as having only slightly reduced side effects of weight gain compared with older SSRI-class medications. No reduced side effects of increased depression, anxiety, sexual dysfunction (SD), sleepiness, or suicidal ideation (SI) were found for the newer atypical-class medications vs older SSRI-class agents. Medication adherence did not differ significantly between SSRI and atypical classes. No evidence for reduced side effects was found for newer SSRI and atypical antidepressants vs older same-class drugs when comparing six new and old medications drawn from atypical and SSRI classes. However, atypical antidepressants were associated with increased use of adjunct medications to bolster primary treatment. (shrink)

The purpose of this study was to determine the attitudes, expectations, experiences, and barriers that physicians in Tripoli hospitals experienced when working alongside Clinical Pharmacists (CPs). A descriptive self-administered questionnaire was used for the study, and participants were selected from several Tripoli hospitals. Most of the respondents agreed that CPs are an essential part of patient care teams and that they have the legal authority to review a patient's medication regimen and response. More than half of respondents believe (...) CPs must be responsible for the medications they prescribe to patients. Half of the respondents agreed that CPs should be encouraged to play a more active role in hospitals and other healthcare facilities. The majority of participants agreed that CPs should participate in managing drug side effects and almost half agreed that CPs can contribute to decisions about drug interactions. By a low agreement rate, 42.7% of respondents thought CPs were specially qualified to counsel patients on drug therapy. A similar low trend was observed, with 40.9% agreeing to provide pharmacists with additional responsibility and authority in clinical departments, in contrast, 54.5% expressed their concern about the clinical responsibility of CPs in clinical practice. A minority of physicians agreed that Physicians should consult pharmacists in selecting the best pharmacological treatment. At the same time, the majority think that pharmacists lack clinical skills and 61.8% feel that physicians are unable to communicate effectively with CPs. 43.6% acknowledged that the traditional opposition between the two professions was a barrier to interprofessional collaboration while the absence of pharmacy space in clinical settings was cited by 39.1%. A majority of respondents agreed that physicians and pharmacists may improve their interprofessional collaboration by raising their awareness about it. A minority of respondents thought that laws and regulations governing physician collaboration should be put in place to promote effective collaboration between physicians and CPs. The study discovered that although most physicians endorse the introduction of clinical pharmacy services in hospitals and believe that physicians and pharmacists can collaborate on many tasks, respondents were not as impressed with the CPs' performance and believed that they lacked the professionalism required to carry out clinical responsibilities successfully. To facilitate the growth of clinical pharmacy services, laws and regulations must be put in place. (shrink)

Midazolam, a benzodiazepine medication, is used for sedation during diagnostic and therapeutic medical procedures. Insufficient doses of sedatives, including midazolam, can result in patient anxiety and awareness during the procedure. Several brands of midazolam are available in the Libyan market. This study aims to identify and estimate the medication content of intravenous midazolam in various marketed products using different analytical methods. Product identity was confirmed using Infrared methods (IR) and retention times of High-Performance Liquid Chromatographic methods (HPLC). Quantification (...) was performed using a rapid reverse-phase HPLC method. Chromatographic analysis was conducted on a C18 column (250 mm×3.3 mm I.D., 5.0 μm particle size) with a mobile phase comprising acetonitrile, methanol, and 0.065 M ammonium acetate buffer (50: 20: 30, v/v/v), adjusted to a pH of 5.5±0.02 with orthophosphoric acid, at a flow rate of 1.0 ml/min. Ultraviolet (UV) detection was set at 220 nm. The identification results met British Pharmacopeia (BP) standards. However, the midazolam content in the Tunisian brand was shallow compared to the products from Germany and Switzerland. Thus, post-marketing testing is essential to assess the quality of critical drugs like midazolam, and further investigations, including clinical evaluations and regulatory follow-up, are necessary. (shrink)

Vaccination effectively reduces morbidity and mortality from infectious diseases. Several countries allow pharmacists to administer vaccines, and community pharmacists are considered as accessible providers of these services. In Libya, however, pharmacists lack the authority to administer vaccines, unlike their counterparts elsewhere. Involving pharmacists in vaccination efforts could enhance the healthcare system. This observational study aimed to evaluate the readiness and willingness of community pharmacists, supported by pharmacy technicians, to provide vaccination services and to identify barriers and supportive factors for implementation (...) in Libya. A descriptive, self-administered online questionnaire was distributed via social media, specifically in pharmacy-focused closed groups. Participants were recruited from various community pharmacies in Tripoli, Libya. The questionnaire was completed by 130 respondents. Most respondents (88.0%) recognized the important role of the community pharmacist in advertising and promotion of vaccination and 79.0% recognized the accessibility of community pharmacies. Major barriers included a lack of training (85.0%) and increased workloads (75.0%). Cooperation between pharmacists and health professionals and support of medical and nursing associations were highlighted, with 93.0% of respondents agreeing on the importance of these initiatives, followed by the need for improved education and ongoing training workshops on vaccination administration (92.0%). In conclusion, most respondents expressed readiness to initiate pharmacy-based vaccination services. Those willing to participate are open to the necessary training and believe that vaccinations in community pharmacies would be safe. To enhance pharmacists' readiness for vaccination services, regulators must emphasize the significance of training and its impact on patient safety and satisfaction. Appropriate laws and regulations are also essential to support the development of community pharmacy services. (shrink)

Stimulants have been shown to be safe and effective for reduction of the symptoms of attention deficit hyperactivity disorder. Despite much debate, however, there has been little empirical evidence as to whether stimulants affect authenticity and moral agency in children. Singh presents evidence that stimulants do not undercut children's' sense of self and increase their experience of agency. These findings are consistent with laboratory evidence that stimulant drugs in therapeutic doses improve cognitive control over thought and behavior.

Postpartum depression is a major maternal health problem after childbirth. It can start at any time within the first year after delivery and continue for several years. It is characterized by an inability to experience pleasure, anxiety symptoms, panic attacks, spontaneous crying and depressed mood. Some women with postpartum depression even have thoughts of harming their child and self-harm. This study aims to find out the status of postpartum depression and the associated factors among postnatal mothers at the first, (...) fourth and sixth month. This study is a prospective descriptive study, carried out in three major health facilities in Misurata. This study consists of a three-part questionnaire. Part 1 covers the demographic characteristics of the participants, while Part 2 explores the associated risk factors according to the variables used. Part 3 consists of the psychological evaluation of the participants. A hundred mothers (ages between 15 and 43 years) were enrolled in this study. The findings revealed that the prevalence of depression is 60.0% and 22.0% are suffering from borderline depression. Development of depression was strongly correlated with sleeping disturbances, the state of the neonate after birth, excess consumption of stimulants, less weight acceptance by mothers during pregnancy and infant illness. There was a weak relation between depression and delivery state, maternal admission to the hospital during the current pregnancy, and infant gender dissatisfaction. No correlation was found with the development of depression regarding miscarriage, maternal medical problems after delivery, previous child sex, maternal age, education, parity or neonate weight. Thus, this study shows that the chance of having a miscarriage and an unhealthy neonate increases with advanced maternal age. It also shows that caesarean section is associated with bad neonatal outcomes, more weight gain and having gestational diabetes or preeclampsia during pregnancy. Maternal sleeping problems are more pronounced in the first month, attributed to the baby's care, compared with the fourth and sixth months. The study indicates that depression is a common state of psychiatric disorders among Libyan women and should have appropriate attention by physicians and gynecologists. (shrink)

Postpartum depression is a major maternal health problem after childbirth. It can start at any time within the first year after delivery and continue for several years. It is characterized by an inability to experience pleasure, anxiety symptoms, panic attacks, spontaneous crying and depressed mood. Some women with postpartum depression even have thoughts of harming their child and self-harm. This study aims to find out the status of postpartum depression and the associated factors among postnatal mothers at the first, (...) fourth and sixth month. This study is a prospective descriptive study, carried out in three major health facilities in Misurata. This study consists of a three-part questionnaire. Part 1 covers the demographic characteristics of the participants, while Part 2 explores the associated risk factors according to the variables used. Part 3 consists of the psychological evaluation of the participants. A hundred mothers (ages between 15 and 43 years) were enrolled in this study. The findings revealed that the prevalence of depression is 60.0% and 22.0% are suffering from borderline depression. Development of depression was strongly correlated with sleeping disturbances, the state of the neonate after birth, excess consumption of stimulants, less weight acceptance by mothers during pregnancy and infant illness. There was a weak relation between depression and delivery state, maternal admission to the hospital during the current pregnancy, and infant gender dissatisfaction. No correlation was found with the development of depression regarding miscarriage, maternal medical problems after delivery, previous child sex, maternal age, education, parity or neonate weight. Thus, this study shows that the chance of having a miscarriage and an unhealthy neonate increases with advanced maternal age. It also shows that caesarean section is associated with bad neonatal outcomes, more weight gain and having gestational diabetes or preeclampsia during pregnancy. Maternal sleeping problems are more pronounced in the first month, attributed to the baby's care, compared with the fourth and sixth months. The study indicates that depression is a common state of psychiatric disorders among Libyan women and should have appropriate attention by physicians and gynecologists. (shrink)

My dissertation develops a defense of a right to self-defense against the state. I set aside anarchist theories and grant for the sake of argument that the state has legitimate political authority. My goal is to convince non-anarchists that the right to self-defense extends to individuals against the state and the state’s agents. I argue that the right to self-defense is a fundamental, negative, claim right. The right to self-defense has these characteristics: (1) it is fundamental, (...) meaning that it is not derivative of any other right—it doesn’t appeal to any other right for its justification (2) it is negative, meaning that it simply requires others to refrain from certain action, and (3) it is a claim right, rather than a permission right, which means that it logically entails correlative duties on others. I also challenge some basic tenets of the orthodox account of justified defensive force, including the imminence, necessity, and proportionality conditions. My argument is a controversial one; many will resist the idea that an individual could be justified in self-defense against the state for a variety of reasons, ranging from thinking the idea is absurd or dangerous, to thinking that even if it is morally permissible, it is impractical. I aim to rebut these objections and to provide strong moral reasons to show why individuals do in fact have this right. -/- This research explores the relationship between one of our most basic rights—the right to self-defense—with our most basic political relationship—the relationship between the individual and the state. Part of my aim is to convince non-anarchist readers of philosophical claims that are usually only supported by anarchists. The reason this is important, beyond being academically interesting, is that if I am successful, it could allow a great majority of individuals to rethink their relationship with the state; not just at a basic level, but also in other applied areas such as gun rights, drug laws, and issues surrounding punishment and imprisonment. (shrink)

Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in (...) reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics. (shrink)

"Why are there 'transsexuals' but not 'transracials'?" "Why is there an accepted way to change sex, but not to change race?" I have repeatedly heard these questions from theorists puzzled by the phenomenon of transsexuality. Feminist thinkers, in particular, often seem taken aback that in the case of category switching the possibilities appear to be so different. Behind the question is sometimes an implicit concern: Does not the (hypothetical or real) example of individual “transracialism” seem politically troubling? And, if it (...) is, does not the case of transsexuality merit equivalent critique? Or, conversely, if one accepts transsexuals as people with legitimate demands (e.g., on medical resources or single-sex spaces), then would one not also be committed to accepting the putative transracial in analogous ways? Understanding the ontological constraints and possibilities with regard to transforming one’s identity is, I suggest, a project that should accompany ethical evaluation of those transformations. Under what circumstances is it (un)ethical to leave behind a gender or racial group with which one has once been affiliated? This question is, again, especially pressing for radical thinkers who endorse the claims that race and gender taxonomies are internally hierarchical and constituted through relations of oppression, domination, and normalization. Changing one’s identity under these circumstances will surely always be linked, however tenuously, to consideration of the larger political and cultural milieu in which such changes are advantageous or disadvantageous, complicit with oppressive norms and/or resistant to them. To illuminate these larger questions, in this paper, I first provide three examples of the analogy thesis in feminist thinking about race and sex change, each of which draws ethical conclusions about individual motivation, political strategy, or public policy, premised on the assumption that race and sex change are equivalent phenomena. None of these accounts consider the genealogy of each category as significant to contemporary possibilities. I next offer a descriptive analysis that highlights different norms at play in contemporary North American understandings: Sex–gender, I argue, is essentialized as a property of the individual’s body, while race is essentialized with reference to both the body and ancestry. This analysis, I conclude, shows politically significant disanalogies between the categories, and reveals the importance of genealogical accounts of race and sex in thinking ethically about changing ourselves. (shrink)

The Consequences of Human Overpopulation: Nature’s Automatic Balancing Mechanism -/- Introduction -/- Throughout history, civilizations have risen and fallen due to their ability—or failure—to manage resources and population growth. In today’s world, human overpopulation has reached an unprecedented scale, straining ecosystems, depleting resources, and accelerating climate change. If population growth remains unchecked, nature will impose its own form of balance through disease, war, famine, and environmental collapse. This essay explores how overpopulation mirrors invasive species behavior and how nature’s corrective mechanisms (...) will inevitably restore equilibrium if humans fail to act. -/- Human Overpopulation as an Invasive Species Phenomenon -/- In ecology, an invasive species is one that spreads uncontrollably, outcompeting native species and destabilizing ecosystems. Humans fit this description in many ways. Over the past centuries, human populations have expanded across the planet, altering environments, driving species to extinction, and consuming resources at an unsustainable rate. -/- Characteristics of an Invasive Species in Human Behavior: -/- 1. Uncontrolled Growth – The human population has increased exponentially, surpassing eight billion and continuing to rise. -/- 2. Resource Overconsumption – Forests are cleared, water sources are depleted, and fossil fuels are burned at unsustainable rates. -/- 3. Disruption of Ecosystems – Pollution, habitat destruction, and climate change have permanently altered natural cycles. -/- 4. Lack of Natural Population Control – Unlike other species, humans have eliminated most natural predators and diseases through medicine and technology. -/- When any species exceeds the carrying capacity of its environment, nature enforces balance through survival pressures. Humanity is not exempt from this rule. -/- Nature’s Methods of Population Control -/- If humans fail to regulate their own numbers, natural forces will intervene. The following mechanisms have historically served as population checks and will continue to do so: -/- 1. Disease and Pandemics -/- Throughout history, pandemics have significantly reduced human populations. The Black Death in the 14th century wiped out nearly 50% of Europe’s population, and more recently, COVID-19 caused millions of deaths worldwide. Overpopulation leads to dense urban areas where diseases spread rapidly. Additionally, antibiotic resistance and new viruses could emerge as unintended consequences of human activity, leading to more devastating outbreaks. -/- 2. War and Conflict -/- As resources become scarce, competition intensifies. Wars often arise from disputes over land, water, food, and energy. In modern times, conflicts in regions suffering from overpopulation and resource depletion—such as the Middle East and parts of Africa—demonstrate this pattern. Future conflicts over freshwater, fertile land, and energy resources are highly likely. -/- 3. Famine and Food Shortages -/- The global food supply is under strain as agricultural land becomes exhausted and climate change disrupts weather patterns. As the population grows, the demand for food increases, but overfarming leads to soil degradation, making it harder to produce enough food. Countries already facing food insecurity will suffer the most, leading to malnutrition, starvation, and potential mass migrations. -/- 4. Environmental Collapse -/- Unchecked human activity is leading to deforestation, biodiversity loss, and pollution. Climate change, fueled by overpopulation and industrialization, is causing more frequent and severe natural disasters, including hurricanes, droughts, and wildfires. These environmental catastrophes will destroy infrastructure, displace millions, and further strain already limited resources. -/- 5. Social Breakdown and Crime -/- Overpopulation leads to overcrowded cities, economic inequality, and competition for jobs and resources. In societies where basic needs cannot be met, crime rates rise, and social unrest becomes more frequent. Countries with high population densities and weak governance structures are already experiencing increased violence, civil conflicts, and failing economies. -/- Can Humanity Avoid Nature’s Harsh Correction? -/- Unlike other species, humans have the ability to recognize and mitigate the consequences of their actions. There are two possible paths: -/- 1. Self-Regulation Through Sustainable Policies -/- Governments and organizations can promote family planning, education, and birth control to stabilize population growth. -/- Shifting toward sustainable agriculture, renewable energy, and resource conservation can help prevent environmental collapse. -/- Strengthening international cooperation to manage resource distribution and prevent conflicts can reduce the risks of war and famine. -/- 2. Ignoring the Problem and Facing Natural Consequences -/- If humanity refuses to control its population, disease, war, famine, and environmental collapse will enforce balance. -/- The poorest regions will suffer first, but wealthier nations will also experience economic decline, migration crises, and societal breakdown. -/- Conclusion -/- Human overpopulation follows the pattern of an invasive species, consuming resources at an unsustainable rate and destabilizing ecosystems. While humans have the intelligence and technology to regulate their own numbers, history suggests that if we fail to act, nature will impose balance through suffering and destruction. Whether through pandemics, war, famine, or climate disasters, population control will occur—either by human intervention or by nature’s unforgiving hand. -/- The choice is clear: Will humanity take responsibility for its future, or will we wait for nature to correct our mistakes in the most brutal way possible? -/- . (shrink)

The labeling of medications includes the provision of information and instructions as well as a unique identity for the medical product. It is one of the most important sources of information for patients. Good labeling practice is critical to ensuring patients' safe and effective use of products. Misreading the label, insufficient data on the label, inappropriate labeling font, writing style, and placement on the dosage form can all have disastrous consequences. The objective of this study was to assess medication (...) labeling practices among community pharmacists in Libya. A simulated client method (SCM) was used, and the study was carried out in the City of Zawia, where 146 local pharmacies were visited over three months for the investigation (January to March 2023). These visits were made at random, without the pharmacist's knowledge. The findings revealed that all dispensed drugs were not labeled, and none of the practicing pharmacists in any pharmacies visited displayed any drug label, printed or handwritten. The majority of pharmacists did not address or explain significant information to the patient in an effective manner, which led to inappropriate and harmful consumption of medications. The absence of dispensed drug labels reduces the patient's knowledge of the necessary information about the medicine, resulting in a treatment deficit or unsuccessful therapy. Thus, more effort should be made by health authorities to instruct pharmacists to use and work according to international labeling standards or to establish local labeling specifications. (shrink)

Psychedelics are currently being studied intensively for the treatment of various psychiatric disorders. Ayahuasca, a plant-based extract originating from the Amazonian area, is traditionally consumed in ritualistic group events. The related indigenous traditions date back hundreds of years and have amassed vast amounts of knowledge on the therapeutic use of psychedelic and non-psychedelic plant-based substances. -/- These traditions require a prospective ceremony facilitator to undergo years of intensive training to acquire knowledge, mental power or self-confidence, stability, sensitivity, intuitive treatment (...) outcome prediction skills, musical skills, and sufficient physical strength. These qualities of a facilitator, in the presence of integrity and love, largely determine treatment outcomes. -/- In Europe, predominantly in the first decade of the 2000s and in the early 2010s, some individuals began building connections with diverse indigenous groups and syncretic churches of the Amazonia in an attempt to find cures for their treatment-resistant psychiatric conditions. Small circles of other patients in need of similar treatment formed around them. This led to the formation of decentralized, diverse local ceremony cultures that either followed the principles of the traditional lineages of their origin or synthesized various influences. -/- These unofficial ceremony contexts appeared to complement official healthcare systems, offering efficient methods unavailable in the medical context and correcting the consequences of medical malpractice and neglect. These ceremony contexts appeared highly communal, were largely based on volunteering, and contained mechanisms for self-correcting possible emerging issues. They seemed to function as systems for collecting, preserving, storing, and distributing knowledge of psychedelic therapy methods; in other words, systems for knowledge base building and innovation. -/- doi: 10.13140/RG.2.2.27385.85602. (shrink)

Multiple drug resistant strains of HIV and continuing difficulties with vaccine development highlight the importance of psychologi- cal interventions which aim to in uence the psychosocial and emo- tional factors empirically demonstrated to be significant predictors of immunity, illness progression and AIDS mortality in seropositive persons. Such data have profound implications for psychological interventions designed to modify psychosocial factors predictive of enhanced risk of exposure to HIV as well as the neuroendocrine and immune mechanisms mediating the impact of such factors (...) on disease progression. Many of these factors can be construed as unconscious mental ones, and psychoanalytic self-psychology may be a useful framework for conceptualizing psychic and immune de- fence as well as bodily and self-integration in HIV infection. Al- though further prospective studies and cross-cultural validation of research are necessary, existing data suggest that psychoanalytic insights may be useful both in therapeutic interventions and evaluative research which would require an underlying epistemology of the complementarity of mind and matter. (shrink)

Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done antimicrobial susceptibility (...) testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight. (shrink)

This chapter explores the question of whether or not individual agents are under a moral obligation to reduce their ‘antimicrobial footprint’. An agent’s antimicrobial footprint measures the extent to which her actions are causally linked to the use of antibiotics. As such, it is not necessarily a measure of her contribution to antimicrobial resistance. Talking about people’s antimicrobial footprint in a way we talk about our carbon footprint may be helpful for drawing attention to the global effects of individual behaviour (...) and for highlighting that our choices can collectively make a real difference. But can we be morally obligated to make a contribution to resolving a collective action problem when our individual contributions by themselves make no discernible difference? I will focus on two lines of argument in favour of such obligations: whether a failure to reduce one’s antimicrobial footprint is unfair and whether it constitutes wrongdoing because it is harmful. I conclude by suggesting that the argument from collective harm is ultimately more successful. (shrink)

Diabetes mellitus is a major global health concern, which has worse mental health outcomes such as suicide, however, suicide is one of the top public health priorities worldwide. The World Health Organization's objectives for suicide prevention emphasize the identification of high-risk groups especially people with comorbidity. This study aims to determine the prevalence of suicidal ideation and its associated factors among diabetic patients and correlate it with socio-demographic, lifestyle, and clinical characteristics. A cross-sectional study including diabetic Libyan patients attending diabetes (...) outpatient clinic health centers in Tripoli, Libya from January to August 2024, using a questionnaire consisting of two parts. Part I contains data about the socio-demographic, lifestyle, and medical data and Part II uses a single item of the 9-item version of the Patient Health Questionnaire-9. Data was analyzed by Chi-square test, and logistic regression was used to identify factors. Odds ratio with 95% CI was used and variables with a p<0.05 in multivariable logistic regression were significant. A total of 395 participants was responding using systematic sampling, 62.8% of them where female, mean age of the patient was 52.98±9.30 years, 85.8% were non-smokers, mean duration of diabetic illness was 10.96±8.02, 59.0% insulin-dependent, 77.7% often committed to their drug, 61.8% had diabetes complication. The highest complication was in the eye 33.9%, 48.9% had comorbidity, 90.4% had no diet commitment, 21.8% had regular physical activity and 63.3% had difficulty to dealing ordinary life, and 26.8% of the patients had reported suicidal ideation. Female was 1.83 times (AOR=1.832 CI95%:1.26, 2.982) more likely to have suicidal ideation than males. The risk of suicidal ideation in age >50 years was 1.04 times that age ≤50 years (AOR=1.042 CI95%: 0.640, 1.698). The diabetic patients who used insulin therapy, the odds of risk higher than participants who used oral antidiabetic was 1.34 times (AOR=1.345 CI95%: 0.849, 2.131). The odds of having suicidal ideation among participants with poor glycemic control was 3.60 times higher when compared with good control diabetes participants (AOR=3.614 CI95%: 1.924, 6.783). The prevalence of suicidal ideation was 26.8% in type II diabetic patients attending Primary Healthcare Centers. There was a significant association between suicidal ideation and female gender, age, and poor glycemic control. (shrink)

There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists (...) of the kappa opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED. (shrink)

Addicts sometimes engage in such spectacularly self-destructive behavior that they seem to act under compulsion. I briefly review the claim that addiction is not compulsive at all. I then consider recent accounts of addiction by Holton and Schroeder, which characterize addiction in terms of abnormally strong motivations. However, this account can only explain the apparent compulsivity of addiction if we assume—contrary to what we know about addicts—that the desires are so strong as to be irresistible. I then consider accounts (...) that invoke the phenomenon of “ego depletion,” according to which a person can resist temptation for a while, but not indefinitely. Implicit in this account is the assumption that addiction-related desires persist long enough to deplete the addict’s willpower. The balance of the paper argues that the persistence of the desire to consume drugs is a significant form of dysfunction in its own right, and that it makes an important and independent contribution to the compulsivity of addiction. I argue that addiction involves dysfunction in a mechanism that normally prevents a person from being tempted to do something that would invite disaster. (shrink)

The problem of self-knowledge has been thoroughly discussed in the context of traditional epistemology. In parallel to the traditional approach to epistemology, Radically Embodied Cognitive Science (RECS) has emerged in the last 30 years as a genuine contender in its field. According to RECS, the unity of analysis of cognitive processes is the dynamics between brain, body and environment. In this paper, I advance a RECS approach to self-knowledge, which immediately suggests that knowing oneself is a matter of (...) knowing what one’s body can do. I then turn to resistance training, particularly weightlifting, and argue that it offers a paradigmatic case of self-knowledge in RECS’s terms. More precisely, resistance training allows the trainee to achieve knowledge of themselves in a fundamentally practical manner—and doing so is transformative of the kind of actions they are capable of. (shrink)

Euthanasia or mercy killing is, now a day, a major problem widely discussed in medical field. Medical professionals are facing dilemma to take decision regarding their incompetent patient while tend to do euthanasia. The dilemma is by nature moral i.e. whether it is morally permissible or not. In some countries of Europe and in some provinces of USA euthanasia is legally permitted fulfilling some conditions. It is claimed by Rachels that in our practical medical practice we do euthanasia by forbidding (...) patients from taking drugs. He concludes that if that type of euthanasia can be practiced in our society without any hesitation then why assisting euthanasia will not be permitted1. There are so many arguments both pro and con of euthanasia. But it is not the function of the current paper to discuss all the arguments. Philippa Foot in her article „Euthanasia‟ and J Velleman in his article titled as „A Right to Self-termination‟ discussed about the permissibility of euthanasia. The objective of the paper is to justify their arguments and then come to a conclusion regarding the permissibility of euthanasia. The focus will be given mainly on non- voluntary active and non-voluntary passive euthanasia. The method of discussion will be that an example will be given from Bangladesh and then the arguments provided by Foot and Velleman in their above mentioned papers will be discussed to justify the act of euthanasia on concerned patient. In the last section of the paper the situation of Bangladesh will also be considered for the permissibility of euthanasia i.e. whether the act of euthanasia can be permitted in our country considering the existing socio-cultural-religious practice. (shrink)

In critical medical emergencies, timely and accurate drug recommendation is essential for saving lives and reducing complications. This project proposes a Drug Recommendation System utilizing Machine Learning (ML) techniques to assist healthcare professionals in making quick and accurate drug selections based on patient symptoms, medical history, and emergency condition. The system integrates data from diverse medical databases, including symptoms, diseases, patient demographics, and prior medical records, to recommend the most appropriate drugs or treatments in real-time. The ML model is trained (...) on historical medical data, utilizing algorithms such as Decision Trees, Random Forests, and Neural Networks to predict optimal drug choices for different emergency situations. The system not only considers the immediate medical needs but also factors in contraindications, potential drug interactions, and patient-specific conditions, ensuring safer drug administration. This approach aims to reduce human errors in emergency drug prescriptions, enhance the speed of medical response, and improve the overall quality of care during emergencies. By leveraging data-driven insights, the system supports healthcare professionals in making well-informed decisions, even in high-pressure situations. Ultimately, the Drug Recommendation System serves as a valuable tool in healthcare, enhancing emergency medical care and optimizing treatment outcomes. (shrink)

Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study aimed to perform a comparative assessment of the methanol extracts of the fruit and the leaf of Solanum melongena against multi-drug-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The crude extracts were obtained from the leaves and fruits of the plant using methanol. The plant extracts were tested for the presence of various phytochemical constituents qualitatively. The antibacterial assay and minimum inhibitory concentration for the crude extracts were carried (...) out using the agar well diffusion and agar dilution methods, respectively. Phytochemical analysis of methanol extracts of Solanum melongena revealed the presence of various phytoconstituents. Antibacterial assay of methanol extracts of Staphylococcus melongena against multi-drug-resistant Staphylococcus aureus isolates with ciprofloxacin as a reference control revealed inhibition zone diameter ranging from 04.0±0.0 to 11.0±0.0 mm; in contrast that of multi-drug-resistant Pseudomonas aeruginosa isolates revealed inhibition zone diameter, with ciprofloxacin showing no inhibition. The minimum inhibitory concentration of the methanol extracts on Pseudomonas aeruginosa isolates ranges from 25.0 to 50.0 mg/ml and 25.0->50.0 mg/ml, respectively, in comparison, the minimum inhibitory concentration of the methanol extracts on Staphylococcus aureus isolates ranges from 6.25 to 50.0 mg/ml and 6.25->50.0 mg/ml respectively. Thus, the fruit extract had better activity against test multi-drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus than the leaf extract of Solanum melongena. (shrink)

Attaining Nirvana Using the Universal Formula: Eliminating Imbalances in the Body, Emotions, Mind, and Spirituality -/- By Angelito Malicse -/- Introduction -/- Nirvana, the state of ultimate peace and liberation, can only be attained by eliminating all imbalances in the body, emotions, mind, and spirituality. My universal formula, which follows the law of balance in nature, the law of karma as a systemic principle, and feedback mechanisms, provides an exact path to achieving this state. -/- Imbalances in human life arise (...) due to physical illnesses, negative emotions, irrational thinking, and spiritual confusion. These imbalances cause suffering, preventing people from achieving inner peace. By applying my universal formula, one can correct these defects and align with the natural laws that govern life, leading to a harmonious existence and the attainment of Nirvana. -/- This essay will provide real-world examples of how imbalances arise in each aspect of human existence and how applying my universal formula eliminates them. It will also highlight the importance of medicine, positive emotions, deep faith in God or Divine Essence, and how they contribute to balance and enlightenment. -/- 1. The Role of the Body in Creating Imbalance and the Solution -/- Example of Physical Imbalance: Chronic Illness Due to an Unhealthy Lifestyle -/- Scenario: A person consumes excessive processed foods, avoids exercise, and does not get enough sleep. Over time, they develop obesity, diabetes, and heart disease. These physical imbalances create suffering by limiting mobility, causing chronic pain, and shortening lifespan. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The body requires proper nutrition, movement, and rest to function optimally. A balanced diet, regular exercise, and sufficient sleep restore equilibrium. -/- Apply the Law of Karma as a Systemic Principle: The body operates as a biological system, and like any system, it must be free of defects to function correctly. Eliminating unhealthy habits and seeking medical care corrects these defects, restoring proper function. -/- Use Feedback Mechanisms for Self-Correction: Pain, fatigue, and illness are signals from the body indicating an imbalance. Instead of ignoring these warnings, one should adjust lifestyle choices, preventing further suffering. -/- Example of Physical Imbalance: Addiction (Alcoholism, Drug Use, Smoking) -/- Scenario: A person suffers from alcohol addiction, which damages their liver, distorts their judgment, and causes conflict in relationships. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The human body cannot function well when it is poisoned by harmful substances. Eliminating alcohol and drugs and replacing them with healthy habits restores physical and mental balance. -/- Apply the Law of Karma as a Systemic Principle: Addiction is a defect in the nervous system—it alters brain chemistry, leading to dependency. Medical treatment, rehabilitation, and psychological support correct this defect, helping the person regain control. -/- Use Feedback Mechanisms for Self-Correction: Withdrawal symptoms, declining health, and damaged relationships are signals of imbalance. Recognizing these signs motivates change, leading to recovery. -/- The Importance of Medicine -/- Medicine plays a crucial role in restoring physical balance. When the body suffers from illness, medical intervention corrects internal imbalances. However, medicine must be combined with lifestyle changes and emotional stability for long-term health. -/- 2. The Role of Emotions in Creating Imbalance and the Solution -/- Example of Emotional Imbalance: Uncontrolled Anger and Hatred -/- Scenario: A man is always angry at his coworkers, leading to stress, conflicts, and isolation. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: Anger disrupts inner peace and must be regulated through emotional awareness and self-discipline. -/- Apply the Law of Karma as a Systemic Principle: Uncontrolled anger is a defect in the emotional system. Practicing patience, forgiveness, and communication corrects this defect, leading to healthier interactions. -/- Use Feedback Mechanisms for Self-Correction: Frequent stress, tension, and failed relationships indicate emotional imbalance. Recognizing these effects motivates change toward emotional stability. -/- The Importance of Positive Emotions in Human Relationships -/- Positive emotions such as love, compassion, and gratitude create harmony in relationships. Expressing kindness and understanding balances social interactions, reducing conflicts and strengthening bonds. This balance is necessary for personal peace and the path to Nirvana. -/- 3. The Role of Spirituality in Creating Imbalance and the Solution -/- Causes of Spiritual Imbalance -/- Spiritual imbalances occur when a person lacks connection, purpose, or faith. The main causes include: -/- 1. Materialism and Excessive Focus on the Physical World – Prioritizing wealth, power, or pleasure over inner peace and wisdom leads to dissatisfaction. -/- 2. Religious Dogma and Fear-Based Beliefs – When spirituality is based on fear, guilt, or rigid doctrines, it creates psychological distress rather than enlightenment. -/- 3. Loss of Faith or Meaning in Life – When people lose trust in God, Divine Essence, or Higher Purpose, they experience emptiness and existential suffering. -/- 4. Isolation and Lack of Spiritual Practice – A lack of meditation, prayer, or reflection disconnects people from inner wisdom. -/- Example of Spiritual Imbalance: Loss of Faith and Meaning -/- Scenario: A person feels lost, purposeless, and disconnected from life. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The soul craves connection to something greater. Engaging in spiritual practices like prayer, meditation, or service restores spiritual balance. -/- Apply the Law of Karma as a Systemic Principle: A loss of faith is a defect in the spiritual system. Deepening one’s connection to God, Divine Essence, or Higher Guidance corrects this defect, bringing fulfillment. -/- Use Feedback Mechanisms for Self-Correction: Depression and existential dread indicate spiritual emptiness. Seeking meaning through faith and selfless service restores harmony. -/- The Importance of Deep Faith in God or Divine Essence -/- Faith provides inner stability, helping people endure suffering and maintain hope and resilience. A deep connection with the Divine or Universal Truth aligns human existence with higher wisdom, guiding one toward Nirvana. -/- Conclusion -/- Attaining Nirvana requires eliminating imbalances in the body, emotions, mind, and spirituality. My universal formula provides the exact method to restore balance by aligning with natural laws, correcting systemic defects, and using feedback mechanisms for self-correction. -/- By embracing health, positive emotions, wisdom, and spiritual faith, one can transcend suffering and achieve ultimate peace. This is the path to Nirvana—the state of complete harmony with the universe. -/- . (shrink)

This is an attempt to investigate the causal relationship existing between the psychedelic literary genre in fiction and the application of trauma theory in the study of One Flew over the Cuckoo's Nest. Trauma theory, which is a psychological theory in essence; has been widely linked to the study of literature since traumatic responses take narrative forms. Scientifically, many studies have proven that the psychedelic trip leads to a deepened exploration of the unconscious tracing latent emotional traumas. Henceforth, I am (...) going to explore this novel as a psychedelic example of science fiction through a generic analysis due to the numerous parallels I have noticed with the effects of drug administration on real life patients. I will base my claim on a medical theory known as Psychedelic Information Theory which investigates psychedelic hallucinations, expanded consciousness and their impact on the metaphysical aspects of self-exploration. Consequently, I shall presuppose that psychedelics act metaphorically on the text of One Flew over the Cuckoo's Nest inducing character-based hallucinatory narratives. Hallucinations are caused by an eruption of a psychedelic consciousness that is the antithesis of the normal state of a mind. Hallucinations range from happy enjoyable experiences laden with kaleidoscopic colourful streams of visions to painful manifestations of latent trauma. I endeavour to analyze this novel as a traumatic example of psychedelic fiction through establishing a cause-result relationship between information theory and trauma theory as a fluid encounter between literature and science within science fiction framework. Finally, I attempt to link the cultural integration of psychedelics to the shift of the traumatic experience from cultural to structural. This paper explores primarily the manifestations of Chief Bromden’s historic trauma. It traces secondarily the psychedelic characteristics of the novel. Lastly, it studies the effects of Bromden’s psychedelic journey on his traumatic recovery. (shrink)

This article explores the utility of Nietzsche’s ethical thought for philosophical counselling. Central to the philosophical counseling process is philosophical counsellors applying the work of philosophers to inspire, educate, and guide their counselees in dealing with life problems. For example, Logic-Based Therapy (LBT), a method of philosophical counselling developed by Elliot Cohen, provides a rational framework for confronting problems of living, where the counselor helps the counselee find an uplifting philosophy that promotes a guiding virtue that acts as an antidote (...) to unrealistic and often self-defeating conclusions derived from irrational premises. I present the argument that Nietzsche’s moral philosophy, and more specifically his analysis of suffering, is one such uplifting philosophy which can be of utility to philosophical counselors to help their counselees with confronting problems of living. According to Bernard Reginster, suffering forms the bedrock of Nietzsche's life-affirming concept of the will to power. Nietzsche’s notion of the will to power radically alters our conception and significance of suffering – and that the will to power is best understood as man’s desire for the activity of overcoming resistance. Nietzsche's analysis implies that the fundamental human impulse is not to avoid suffering, but instead to will nothing less than suffering itself. To find meaning in suffering is tantamount to affirming life itself. (shrink)

Why Does Poverty Still Exist in Many Countries? -/- Despite advances in technology, economic growth, and globalization, poverty remains a significant issue in many countries. While some nations have successfully reduced poverty levels, millions of people still struggle with hunger, lack of education, and inadequate living conditions. The persistence of poverty is not simply due to a lack of resources; rather, it is the result of complex systemic, economic, political, and social factors that continue to hinder progress. Understanding these factors (...) is crucial to developing effective solutions for a more equitable world. -/- Economic Inequality and Wealth Concentration -/- One of the primary reasons poverty remains widespread is economic inequality. In many countries, wealth is concentrated in the hands of a few, leaving a large portion of the population with little access to resources and opportunities. Many economies prioritize profit and market growth over ensuring basic needs for all, resulting in low wages, high living costs, and limited social mobility. As the rich get richer, the poor struggle to survive, creating a cycle that is difficult to break. Without policies that promote fair wealth distribution, poverty will continue to persist. -/- Corruption and Poor Governance -/- Corruption is a major barrier to poverty reduction. In many nations, public funds that should be used for education, healthcare, and social services are instead diverted by corrupt officials. Weak governance leads to mismanagement of resources, ineffective policies, and a lack of accountability. When governments fail to prioritize poverty reduction, citizens are left without essential services and economic opportunities. Fighting corruption and ensuring transparent governance is essential in addressing poverty. -/- Flawed Economic Systems -/- Many economic systems rely on exploitative labor practices, where wages are too low to lift workers out of poverty. Global trade structures also favor wealthier nations, keeping poorer countries dependent on foreign aid and limited economic opportunities. In some regions, industries are controlled by multinational corporations that extract resources without fairly compensating local workers or investing in community development. To reduce poverty, economies must shift towards fair wages, job creation, and sustainable development. -/- Lack of Access to Quality Education -/- Education is one of the most powerful tools for escaping poverty. However, in many countries, access to quality education is limited due to underfunded schools, lack of qualified teachers, and high costs of schooling. Without proper education, people struggle to secure stable employment and improve their living conditions. Investing in education, particularly for marginalized communities, is crucial for breaking the cycle of poverty and creating a more skilled and self-sufficient workforce. -/- Overpopulation and Resource Strain -/- Rapid population growth can strain a country’s resources, making it difficult for governments to provide adequate jobs, housing, and social services. In many developing nations, population growth outpaces economic opportunities, leading to high unemployment rates and increased poverty. Effective family planning, education on sustainable living, and policies that promote economic development alongside population growth can help address this issue. -/- Political and Social Instability -/- Wars, conflicts, and political unrest disrupt economies and displace millions of people, making poverty worse. When a country is in crisis, resources are diverted toward military spending rather than social welfare, and businesses collapse, leaving many unemployed. Additionally, social discrimination based on class, race, or gender often limits access to education, jobs, and healthcare, keeping certain groups in poverty. Peace, stability, and equal opportunities for all citizens are necessary to create an environment where people can thrive. -/- Environmental and Climate Factors -/- Climate change and natural disasters disproportionately affect poorer communities. Droughts, floods, and hurricanes destroy homes, disrupt food supplies, and push already vulnerable populations deeper into poverty. Many developing nations lack the resources to recover from these environmental crises. Implementing sustainable agricultural practices, investing in disaster preparedness, and providing financial assistance to affected communities can help reduce the impact of climate-related poverty. -/- Debt and Economic Dependence -/- Many developing countries are trapped in a cycle of debt, owing large sums to wealthier nations and international financial institutions. High-interest payments on these debts limit the ability of governments to invest in poverty reduction programs, infrastructure, and social services. Additionally, foreign aid often comes with conditions that do not always align with the needs of the poorest populations. Reducing debt burdens and restructuring international financial systems can help countries allocate more resources toward development and poverty alleviation. -/- Inadequate Social Safety Nets -/- In many countries, there are few protections for people who lose their jobs, face medical emergencies, or experience financial hardships. Without social safety nets such as universal healthcare, housing support, and unemployment benefits, people remain vulnerable to economic shocks. Stronger social welfare systems can help lift people out of poverty and prevent them from falling back into it. -/- Cultural and Structural Barriers -/- Traditional power structures and cultural beliefs can also contribute to poverty. In some societies, reforms such as land redistribution or labor rights improvements are resisted by those in power. Additionally, discrimination and systemic inequalities prevent marginalized groups from accessing economic and social opportunities. Changing these deeply rooted structures requires education, advocacy, and policy changes that promote fairness and inclusion. -/- Can Poverty Be Solved? -/- Poverty is not an unsolvable problem, but addressing it requires systemic change. Strong governance, fair economic policies, and investment in education, healthcare, and social services are essential. Global cooperation is also necessary to reduce unfair trade practices, restructure debt, and ensure that developing countries have the resources they need to grow sustainably. If governments, businesses, and individuals work together to prioritize social and economic equity, poverty can be significantly reduced, creating a better future for all. -/- Conclusion -/- The persistence of poverty is not due to a lack of resources but rather the result of economic inequality, corruption, poor governance, flawed economic systems, and structural barriers. While many organizations and governments work toward poverty reduction, true progress requires systemic reforms and global cooperation. By addressing these root causes and ensuring fair opportunities for all, the world can move closer to eradicating poverty and building a more just society. -/- . (shrink)

Solanum melongena (Eggplant) is a medicinal plant belonging to the family Solanaceae. This study aimed to perform a comparative assessment of the methanol extracts of the fruit and the leaf of Solanum melongena against multi-drug-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The crude extracts were obtained from the leaves and fruits of the plant using methanol. The plant extracts were tested for the presence of various phytochemical constituents qualitatively. The antibacterial assay and minimum inhibitory concentration for the crude extracts were carried (...) out using the agar well diffusion and agar dilution methods, respectively. Phytochemical analysis of methanol extracts of Solanum melongena revealed the presence of various phytoconstituents. Antibacterial assay of methanol extracts of Staphylococcus melongena against multi-drug-resistant Staphylococcus aureus isolates with ciprofloxacin as a reference control revealed inhibition zone diameter ranging from 04.0±0.0 to 11.0±0.0 mm; in contrast that of multi-drug-resistant Pseudomonas aeruginosa isolates revealed inhibition zone diameter, with ciprofloxacin showing no inhibition. The minimum inhibitory concentration of the methanol extracts on Pseudomonas aeruginosa isolates ranges from 25.0 to 50.0 mg/ml and 25.0->50.0 mg/ml, respectively, in comparison, the minimum inhibitory concentration of the methanol extracts on Staphylococcus aureus isolates ranges from 6.25 to 50.0 mg/ml and 6.25->50.0 mg/ml respectively. Thus, the fruit extract had better activity against test multi-drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus than the leaf extract of Solanum melongena. (shrink)

John Harris recently argues that the moral bioenhancement proposed by Persson and Savulescu can damage moral agency by depriving the recipients of their freedom to fall (freedom to make wrongful choices) and therefore should not be pursued. The link Harris makes between moral agency and the freedom to fall, however, implies that all forms of moral enhancement, including moral education, that aim to make the enhancement recipients less likely to “fall” are detrimental to moral agency. In this paper, I present (...) a new moral agency-based critique against the moral bioenhancement program envisaged by Persson and Savulescu. I argue that the irresistible influences exerted by the bioenhancement program harms our capabilities for conducting accurate self-reflection and forming decisions that truly express our will, which subsequently undermine our moral agency. (shrink)

Background: Increasing resistance of Pseudomonas aeruginosa to ciprofloxacin in ICU/burn units has created a problem in the treatment of infections caused by this microorganism. -/- Methods: Fifty P. aeruginosa strains were isolated from burn patients hospitalized in the Kerman Hospital during May 1999-April 2000 and were tested for in-vitro sensitivity to different antibiotics by disc diffusion breakpoint assay. The isolates were subjected to minimum inhibitory concentration (MIC) test by agar dilution method. Existence of the plasmids was also investigated in the (...) isolates. -/- Results: Thirty-four patients infected with ciprofloxacin strains showed MIC of 8 mg/ml [p<0.001]. Sixteen patients were infected with sensitive strains exhibiting MIC range of 0.0125-0.125 ± 0.033 mg/ml. The isolates were also also resistant to other antibiotics [p<0.001]. Plasmid isolation and agarose gel electrophoresis (0.7%) revealed three plasmid bands in strains 8 and 16, and one band in strain 35. -/- Conclusion: The emergence of ciprofloxacin resistance of P. aeruginosa in burn patients is alarming since this antibiotic has only recently been introduced onto the market in Iran. One important observation was that some isolates exhibited cross resistance to other antibiotics. Furthermore, some strains were carriers of plasmids which might have acted as the potential source of acquired resistance in the hospital setting. -/- . (shrink)

Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...) lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)

When talking about personal identity in the context of medical ethics, ethicists tend to borrow haphazardly from different philosophical notions of personal identity, or to abjure these abstract metaphysical concerns as having nothing to do with practical questions in medical ethics. In fact, however, part of the moral authority for respecting a patient’s self-regarding decisions can only be made sense of if we make certain assumptions that are central to a particular, psychological picture of personal identity, namely, that patients (...) will remain psychologically connected to a certain degree with their future selves. I draw this out, show problems with approaches in medical ethics based on alternate theories of personal identity that do not recognise this, and explore some important implications. Namely, I show how this recognition can better explain the circumstances under which we should respect advance directives and why, and how it can better make sense of patient fears that they will not "survive" personality-altering deep brain stimulation procedures, and provide guidance on approaching patient decisions concerning this type of procedure in a manner that captures and addresses such concerns. (shrink)

See "What's Wrong with Factory Farming?" (2015) for an updated treatment of these issues.

Despite their centrality to medicine, drugs are not easily defined. We introduce two desiderata for a basic definition of medical drugs. It should: (a) capture everything considered to be a drug in medical contexts and (b) rule out anything that is not considered to be a drug. After canvassing a range of options, we find that no single definition of drugs can satisfy both desiderata. We conclude with three responses to our exploration of the drug concept: maintain a monistic concept, (...) or choose one of two pluralistic outcomes. Notably, the distinction between drugs and other substances is placed under pressure by the most plausible of the options available. (shrink)

Gender dysphoria is better understood within the right to morphological self-determination than as a medical condition.

Users of psychedelic drugs often report that their sense of being a self or ‘I’ distinct from the rest of the world has diminished or altogether dissolved. Neuroscientific study of such ‘ego dissolution’ experiences offers a window onto the nature of self-awareness. We argue that ego dissolution is best explained by an account that explains self-awareness as resulting from the integrated functioning of hierarchical predictive models which posit the existence of a stable and unchanging entity to which (...) representations are bound. Combining recent work on the ‘integrative self' and the phenomenon of self-binding with predictive processing principles yields an explanation of ego dissolution according to which self-representation is a useful Cartesian fiction: an ultimately false representation of a simple and enduring substance to which attributes are bound which serves to integrate and unify cognitive processing across levels and domains. The self-model is not a mere narrative posit, as some have suggested; it has a more robust and ubiquitous cognitive function than that. But this does not mean, as others have claimed, that the self-model has the right attributes to qualify as a self. It performs some of the right kinds of functions, but it is not the right kind of entity. Ego dissolution experiences reveal that the self-model plays an important binding function in cognitive processing, but the self does not exist. (shrink)

According to the Self-Location Thesis, certain types of visual experiences have self-locating and so first-person, spatial contents. Such self-locating contents are typically specified in relational egocentric terms. So understood, visual experiences provide support for the claim that there is a kind of self-consciousness found in experiential states. This paper critically examines the Self-Location Thesis with respect to dynamic-reflexive visual experiences, which involve the movement of an object toward the location of the perceiving subject. The main (...) aim of this paper is to offer an alternative interpretation of these cases which resists attributing them self-locating content, arguing for a replacement of the de se component with a non-conceptual equivalent of the indexical ‘here’. In its final section, the paper also considers an extension of the h-replacement account to cases of visual kinesthesis. (shrink)