Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

There are three questions associated with Simpson’s Paradox (SP): (i) Why is SP paradoxical? (ii) What conditions generate SP?, and (iii) What should be done about SP? By developing a logic-based account of SP, it is argued that (i) and (ii) must be divorced from (iii). This account shows that (i) and (ii) have nothing to do with causality, which plays a role only in addressing (iii). A counterexample is also presented against the causal account. Finally, the causal and logic-based (...) approaches are compared by means of an experiment to show that SP is not basically causal. (shrink)

There are three questions associated with Simpson’s paradox (SP): (i) Why is SP paradoxical? (ii) What conditions generate SP? and (iii) How to proceed when confronted with SP? An adequate analysis of the paradox starts by distinguishing these three questions. Then, by developing a formal account of SP, and substantiating it with a counterexample to causal accounts, we argue that there are no causal factors at play in answering questions (i) and (ii). Causality enters only in connection with action.

In the Bṛhadāraṇyaka Upaniṣad, one of the principal Upaniṣads, we find a venerable and famous story where the god Prajāpati separately instructs three groups of people (gods, humans, and demons) simply by uttering the syllable “Da.” In this paper, our concern is not with ethics but theories of meaning and interpretation: How can all divergent interpretations of a single expression be correct, and, indeed, endorsed by the speaker? As an exercise in cross-cultural philosophical reflection, we consider some of the leading (...) modern theories of meaning—those of Grice, Quine, and Davidson—in order to see if the Upaniṣadic story receives a natural home in any of them. We conclude that the story is best understood through Grice’s theory of meaning rather than Quine’s or Davidson’s. (shrink)

ABSTRACT -/- Ayurveda is science of living being with an aim to live healthy life and curing of ailments. Arogyata (healthy life) is root to achieve the purushartha chatushtaya which are dharma(religious rituals), artha, kama and moksha. Kama in society is taken in sexual lust but Vatsayan has described kama as the enjoyment of appropriate objects by the five senses of hear- ing, feeling, seeing, tasting, and smelling, assisted by the mind together with the soul. The ingre- dient in this (...) is a peculiar contact between the organ of sense and its object, and the consciousness of pleasure which arises from that contact is called Kama. A well organised, controlled form of kama comes under brahmacharya. Acharya Charaka has specified brahmacharya among three subpillars which assists in healthy living being. Brahmacharya leads to conservation of shukra dhatu which is essence of ahara. This shukra dhatu is responsible for bala, virya, yash, dhairya, preeti. Development of these qualities assists higher faculty buddhi or pragya not to indulge in pragyaparadh leading to correct decisionary power and patience. Healthy state of mind is achieved with this brahmacharya. Through this paper a review over various parameters of brah- macharya have been discussed and concluded. -/- Keywords: Kama, dhairya, pragyaparadh, health, shukra dhatu. (shrink)

The Journal of Oriental Research was started in 1927 by Prof. S Kuppuswami Sastri, who was also the founder of the Kuppuswami Sastri Research Institute. Originally an annual journal, its regularity has been disturbed due to financial difficulties. Th e present issue comprises volumes eighty-three to eighty-four and has been funded by the Dr V Raghavan Memorial Endowment.

Book review of 'Srimad Bhagavata—Condensed in the Poet's Words' by A M Srinivasachariar. In this book, the Sanskrit Bhagavata verses have been condensed without using any words other those of the original. This has been translated into English by V Raghavan. This book enables one to have an idea of the main content of the lengthier original text.