The issue of how to incorporate the individual's first‐hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces and (...) suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in‐depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions. (shrink)

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)

Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and (...) ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns. (shrink)

ABSTRACTTime-consciousness has long been a focus of research in phenomenology and phenomenological psychology. We advance and extend this tradition of research by focusing on the character of temporal experience under conditions of mania. Symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight-of-ideas, hyperactivity. But what is the underlying structure of temporal experience in manic episodes? We tackle this question using a strategically hybrid approach. We recover and reconstruct three hypotheses (...) regarding manic temporality that were advanced and modeled by two pioneers of clinical phenomenology: Eugène Minkowski and Ludwig Binswanger. We then test, critique, and refine these hypotheses using heterophenomenological methods in an interview-based study of persons with a history of bipolar and a current diagnosis of acute mania. Our conclusions support a central hypothesis due to Minkowski... (shrink)

A book chapter exploring the potential consquences and ethical ramifications of using coercive measures within community mental healthcare. We argue that, althogh the move towards 'care in the community' may have had liberalising motivations, the subsequent reduction in inpatient or other supported residential provision, means that there has been an increasing move towards coercive measures outside of formal inpatient detention. We consider measures such as Community Treatment Orders, inducements, and other forms of leverage, explaining the underlying concepts, aims, and exploring (...) adverse consequences and ethical difficulties. (shrink)

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts (...) to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. (shrink)

Despite extensive evidence for its effectiveness, ECT remains the subject of fierce opposition from those contesting its benefits and claiming extreme harms. Alongside some reflections on my experiences of this treatment, I examine the case against ECT, and find that it appears to rest primarily on unsubstantiated claims about major ethical violations, rather than clinical factors such as effectiveness and risk.

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (shrink)

The novel "Harry Potter" by J.K. Rowling explores the profound impact of various mother and father figures on the protagonist, Harry Potter, who has lost his parents. This paper explores the impact of mother and father figures in Harry Potter's life. Remus Lupin serves as a compassionate guardian, offering support and a sense of belonging. Molly Weasley embodies the maternal figure, providing love and stability. Sirius Black, an absent father figure, symbolizes love and sacrifice. Albus Dumbledore serves as a (...) wise mentor, offering guidance and moral teachings. Collectively, these figures shape Harry's understanding of family, loyalty, power, and responsibility. The paper highlights the transformative power of nurturing relationships and the enduring influence of love, guidance, and mentorship. (shrink)

Revista Intelligence Info este o publicație trimestrială din domeniile intelligence, geopolitică și securitate, și domenii conexe de studiu și practică. -/- Cuprins: -/- EDITORIALE / EDITORIALS -/- Tiberiu TĂNASE Considerații privind necesitatea educării și formării resursei umane pentru intelligence–ul național Considerations regarding the need to educate and train human resources for national intelligence Nicolae SFETCU Epistemologia activității de intelligence Epistemology of intelligence Nicolae SFETCU Rolul serviciilor de informații în război The role of the intelligence agencies in a war Nicolae SFETCU (...) Evoluția inteligenței artificiale în domeniul securității naționale The evolution of artificial intelligence in the field of national security -/- INTELLIGENCE / INTELLIGENCE -/- Ovidiu BOUREANU O scurtă istorie a spionajului: spionajul modern de la Războiul Rece la Războiul împotriva terorii A Brief History of the Spy: Modern Spying from the Cold War to the War on Terror Ioana PĂIUȘ, Tiberiu TĂNASE Securitate și informații într-o lume în schimbare Security and intelligence in a changing world Nicolae SFETCU Activitatea de intelligence - Ciclul intelligence Intelligence Activity – Intelligence Cycle Tiberiu TĂNASE Controlul asupra Intelligence –ului Control over Intelligence Tiberiu TĂNASE Informația și nevoia de gestionare a resurselor informaționale Information and the need to manage information resources Tiberiu TĂNASE Controlul parlamentar al serviciilor de informații Parliamentary control of intelligence services Tiberiu TĂNASE Mecanisme de control democratic al activității serviciilor de informații Mechanisms of democratic control of the activity of intelligence agencies Nicolae SFETCU Analiza informațiilor Intelligence Analysis Bogdan-George RĂDULESCU Cum ar trebui să fie utilizată analiza intelligence pentru a contracara războiul cognitiv? How should intelligence analysis be utilized to counter cognitive warfare? -/- ISTORIE / HISTORY -/- Tiberiu TĂNASE Biroul de Informații al Secției Militare din Transilvania și rolul său în campania pentru apărarea României Mari The Intelligence Office of the Transylvanian Military Section and its role in the campaign for the defense of Greater Romania Stan PETRESCU Pacepa, Kuklinski, Pollard și românii Pacepa, Kuklinski, Pollard and the Romanians Tiberiu TĂNASE Contracararea de către SSI a activităților informative și acțiunilor Serviciilor Germane și Sovietice de Informații implicate în evenimentele din 21 - 23 ianuarie 1941 Countering by the SSI of the informational activities and actions of the German and Soviet Intelligence Services involved in the events of January 21-23, 1941 Tiberiu TĂNASE Alexandru Ioan Cuza, fondatorul Intelligence-lui statului modern românesc Alexandru Ioan Cuza, Founder of the Intelligence of the Modern Romanian State Tiberiu TĂNASE, Bogdan MUSCALU Puncte de vedere privind tradițiile romane în istoria intelligence-lui Viewpoints on Roman traditions in history intelligence Tiberiu TĂNASE Istoria Serviciului Român de Informații – serviciu de intelligence competitiv, și strategiile de intelligence History of the Romanian Intelligence Service – competitive intelligence service, and intelligence strategies Rodica LISEANU Reformele serviciilor secrete de la Mihail Moruzov la Eugen Cristescu, între inovație și decadență Secret service reforms from Mihail Moruzov to Eugen Cristescu Rodica LISEANU Take Ionescu – O biografie vectorială în istoria partidelor politice și în semantica diplomației Take Ionescu - A Vectorial Biography in the History of Political Parties and the Semantics of Diplomacy Remus MACOVEI Trădători și trădători Traitors and traitors -/- GEOPOLITICA / GEOPOLITICS -/- Antoaneta AVRAM Pandemia de COVID-19 și consecințele ei în peisajul anului 2022 The COVID-19 pandemic and its consequences in the landscape of 2022 Darius-Antoniu FERENȚ, Ioan MANCI Analiza conflictului ruso-cecen din perspectivă militară Analysis of the Russian-Chechen conflict from a military perspective Lisa-Maria ACHIMESCU Apusul universalismului european The decline of European universalism Emilian M. DOBRESCU Hegemonia chineză în producția de pământuri rare Chinese Hegemony in the Production of Rare Earths Ionuț-Daniel GORGOVAN ”Descurajarea integrată”. Analiză asupra strategiei SUA în Pacific "Integrated deterrence". Analysis of US Pacific Strategy Tiberiu TĂNASE, Violeta Ioana NAGÂȚ Conflictul arabo-israelian. Percepții privind cauzele și natura conflictului. Repere istorice și actualitate The Arab-Israeli conflict. Perceptions of the causes and nature of conflict. Historical landmarks and current affairs -/- SECURITATE / SECURITY -/- Tănase TIBERIU Minighid de pregătire și protecție contrainformativă Counterintelligence preparation and protection mini-guide Darius-Antoniu FERENȚ ISIS - Jocul morții - Martiri, asasinate și fascinație The Killing Game - Martyrdom, Murder and the Lure of ISIS Traian OSTAHIE Abordări generale ale conceptului de cultură de securitate For a 21st century realism Dalia Elena SILAGHI Terorismul cibernetic: o formă contemporană de terorism Cyber Terrorism: A Contemporary Form of Terrorism Paul Alexandru HELER Conflictul asimetric și consecințele sale în securitatea Asiei Asymmetric Conflict and Its Consequences in Asian Security Daria-Maria TÂRNĂVEAN Confruntarea informațională și repercusiunile sale asupra mediului actual de securitate The Information Confrontation and its Repercussions on the Current Security Environment Darius-Antoniu FERENȚ Analiza atacurilor cibernetice, precum APT (Advanced Persistent Threat) și ransomware Analysis of cyber attacks such as APT (Advanced Persistent Threat) and ransomware Daniela Georgiana GOLEA, Oana Ștefania COȘA Nevoia de adaptare managerială a noilor probleme de securitate modernă The need for managerial adaptation to new modern security issues Darius-Antoniu FERENȚ, Corneliu PREJA Implicarea NATO în domeniul apărării cibernetice NATO's involvement in cyber defence Alexandru CRISTIAN Paradigme în mediul internațional de securitate Paradigms in the international security environment Alexandru CRISTIAN Schimbarea paradigmelor în mediul internațional de securitate Changing paradigms in the international security environment Dan D. FARCAȘ Adevăr și dezinformare în fenomenul OZN Truth and disinformation in the UFO phenomenon Alexandru CRISTIAN Un nou mediu de securitate A new security environment -/- ȘTIINȚA INFORMAȚIEI / INFORMATION SCIENCE -/- Oana Ștefania COȘA Rolul structurilor de intelligence medical în atingerea obiectivul de consolidare a sistemului de sănătate The role of medical intelligence structures in achieving the objective of strengthening the health system Nicolae SFETCU Preocupări legislative în mineritul datelor Legislative concerns in data mining Nicolae SFETCU Utilizarea analiticii rețelelor sociale în intelligence Using social network analytics in intelligence Nicolae SFETCU Ingineria cunoașterii în colectarea informațiilor Knowledge Engineering in Intelligence Gathering -/- ISSN 2971 – 9089 ISSN-L 2821 – 8159, DOI: 10.58679/II26972. (shrink)