Rather than approaching the question of the constructive or therapeutic character of Hegel’s Logic through a global consideration of its argument and its relation to the rest of Hegel’s system, I want to come at the question by considering a specific thread that runs through the argument of the Logic, namely the question of the proper understanding of power or control. What I want to try to show is that there is a close connection between therapeutic and constructive (...) elements in Hegel’s treatment of power. To do so I will make use of two deep criticisms of Hegel’s treatment from Michael Theunissen. First comes Theunissen’s claim that in Hegel’s logical scheme, reality is necessarily dominated by the concept rather than truly reciprocally related to it. Then I will consider Theunissen’s structurally analogous claim that for Hegel, the power of the concept is the management of the suppression of the other. Both of these claims are essentially claims about the way in which elements of the logic of reflection are modified and yet continue to play a role in the logic of the concept. (shrink)

The few people familiar with the pseudo-Platonic dialogue Axiochus generally have a low opinion of it. It's easy to see why: the dialogue is a mish-mash of Platonic, Epicurean and Cynic arguments against the fear of death, seemingly tossed together with no regard whatsoever for their consistency. As Furley notes, the Axiochus appears to be horribly confused. Whereas in the Apology Socrates argues that death is either annihilation or a relocation of the soul, and is a blessing either way, "the (...) Socrates of the Axiochus wants to have it both ways": death is both annihilation and a release of the soul from the body into a better realm. This may be used to construct a valid argument for the conclusion that death is not evil, but at the expense of having a contradiction as one of its premises. But D. S. Hutchinson has recently proposed that these inconsistencies shouldn't surprise us if we view the Axiochus as "an unconventional version of a very conventional genre--the consolation letter." In this paper I expand on Hutchinson's brief suggestion and argue that the Axiochus can be rehabilitated by paying attention to its genre. Although the Axiochus does display many similarities to the consolation letter, the shift from letter to dialogue does--pace Hutchinson--significantly affect what's going on. Within the dialogue, Socrates behaves toward Axiochus in a way similar to the way the author of a consolation letter behaves towards the letter's reader: he is willing to use inconsistent arguments, borrowed from any source, in order to soothe the patient. However, in depicting this type of consolatory relationship between Socrates and Axiochus, the dialogue itself is not aiming at consoling its readers. Instead, it should be seen as displaying for the reader's consideration a certain type of consolatory argumentative practice. -/- Socrates notes that Axiochus is "very much in need of consolation" (365a), and he uses any means necessary to accomplish this task. Socrates exhibits many ways in which he is willing to sacrifice argumentative hygiene for the sake of therapeutic effectiveness. These include: -/- * Use of arguments with inconsistent premises, presented in propria persona. * Appeals to emotion * Tailoring arguments to the audience. * Presenting invalid arguments so as to induce unjustified but comforting beliefs. * Evasion. In these respects, I think that Socrates' argumentative practice is best compared to PH III 280-1, where Sextus Empiricus says that the skeptic will deliberately use logically weak arguments as long as they work. Dorothy Tarrant claims that what links the Socrates of the Axiochus to Socrates as he appears elsewhere in the Platonic corpus is his evident care for the welfare of his interlocutor's psyche. But this concern takes a quite different form in the Axiochus than it usually does. As with Sextus, psychic therapy in the Axiochus involves relief from pain. The primary difference between them is that Socrates, unlike Sextus, is not aiming at producing epochê in his patient. (shrink)

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar ethical concerns (...) as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (shrink)

The fight to find effective, long-lasting treatments for cancer has led many researchers to consider protein degrading entities. Recent developments in PROteolysis TArgeting Chimeras (PROTACs) have signified their potential as possible cancer therapies. PROTACs are small molecule, protein degraders that function by hijacking the built-in Ubiquitin-Proteasome pathway. This review mainly focuses on the general design and functioning of PROTACs as well as current advancements in the development of PROTACs as anticancer therapies. Particular emphasis is given to PROTACs designed against various (...) types of Leukemia/Blood malignancies. (shrink)

Hundreds of evaluative studies of psychotherapy still leave the issue of its effectiveness unsettled. The author argues that such studies have ignored the major determinant of therapeutic effectiveness, the role of a patient’s belief in the successful outcome in therapy. Psychiatrist Thomas Szasz, one of the foremost critics of psychiatry, wrote of this paper: "It is one of the best, if not the best, that I have read on this subject.” It makes little sense to claim that (...) a certain therapy is effective or ineffective in itself; rather, there is a relation of mutual interaction among three terms: a patient’s ability to learn in a psychological context, a therapist’s ability to teach, and the capacity of an approach to therapy to engender in the patient the necessary belief in its effectiveness. -/- The paper is followed by a 4-page 2014 Afterword. (shrink)

Objective: Vascular disorders severely impair the psycho-social status of individuals. Various laser and light systems, which have advantages and disadvantages, including the pro-yellow laser are used for the therapy of these disorders. Aim: The goal of the present study was to investigate the effectiveness and feasibility of the 577 nm pro-yellow laser for a broad range of indications including erythematelangiectatic rosacea, facial erythema, post-acne erythema, facial telangiectasis, hemangioma, genital angiokeratoma, and port wine stain nevus. Methods: A total of 98 (...) patients (25 male, 73 female) older than 15 years who were treated with the pro-yellow laser for vascular disorders at the cosmetology unit between 2017 and 2019 were retrospectively included in the study. Results: The mean rate of recovery was 100% in genital angiokeratoma, 94.4% in spider angioma, 83.3% in facial telangiectasis, 74.8% in erythematotelangiectatic rosacea, 72% in facial erythema + facial telangiectasis, and 68.3% in facial erythema. Over 60% of improvement was observed in most patients with vascular disorders. There was no significant link between the Fitzpatrick skin type and treatment success. Treatment success was significantly low in cases with nasal involvement. Conclusion: The current study concluded that pro-yellow laser is an efficient and safe laser modality that may yield satisfactory outcomes regardless of the different skin types. (shrink)

Introduction: Multiple sclerosis (MS) is an autoimmune disease that causes scar tissue in the nervous system and seriously affects the quality of life of people. Muscle weakness, spasticity and coordination problems are seen primarily in the lower extremities. Strengthening exercises improve muscle strength in people with multiple sclerosis, but there is no consensus on their effect on walking capacity. -/- Methods: To determine the relationship between gluteus maximus muscle strength, ataxia, balance and walking capacity in Multiple Sclerosis. An experimental study (...) design was applied. Gluteus maximus muscle strength was measured using a dynamometer. Walking capacity was determined by the 6-minute walk test (6MWT) and dynamic gait index (DGI). Balance was evaluated with the one-leg standing test (SLS). The severity of ataxia was measured with the International Ataxia Rating Scale (ICARS). Fatigue was evaluated with VAS and quality of life of all patients with SF36 short form. -/- Results: EDSS mean of the study = 3.39 ± 1.4; 2 men and 16 women with mean age = 37.17 ± 9.16 years were included. 6MWT, DGI, ALS, ICARS, VAS were different before and after treatment (p<0.05). There was no significant difference other than physical function and general health among the sub-parameters of SF36 (p>0.05). Correlation of muscle strength with ataxia, gait and balance was not significant (p>0.05) -/- Conclusion: In individuals with MS, the fact that the treatment program consists of modalities that include balance and sensory exercises as well as muscle strengthening exercises increases the success of rehabilitation. (shrink)

Introduction: Metabolic syndrome (MetS) is an endocrinopathy with a combination of cardiovascular and metabolic compounds. In our study, it is expected to obtain results showing that mortality rate, loss of workforce, and treatment costs due to disorders caused by MetS can be reduced by physical exercise. The study analyses the effect of moderate exercise training on this Apolipoprotein E (ApoE), Apolipoprotein CIII (ApoCIII), adiponectin, resistin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) which are thought to have a role in the (...) deterioration of glucose and lipid metabolism in MetS. -/- Methods: This clinical experimental study consists of 3 groups. The MetS+E (n=24) group, which included the participants who agreed to participate in the exercise program in addition to their medical treatment, the MetS (n=23) group who received medical treatment but did not exercise, and the Control+E (n=25) group, which included healthy volunteers who had the same protocol as MetS+E ApoE, ApoCIII, adiponectin, resistin, IL-6, and TNF-α plasma levels of all participants were measured both at the beginning of the study and at the end of the protocol. -/- Results: At the end of the study we reached the following findings; insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) levels decreased in exercise groups (p=0,03). ApoCIII levels increased in all the groups after the study (p<0,01). IL-6 levels decreased in MetS+E (p<0,01) and Control+E (p=0,037). ApoE (p=0,01) and TNF-α (p=0,037) levels decreased only in the Control+E group. -/- Conclusion: Training showed metabolic, anti-inflammatory, and physical improvements independent of ApoE and ApoCIII in those with MetS. (shrink)

Objective: The purpose of our study is to show how the relationship between marital adjustment and satisfaction will change in cases of chronic disease in either or both spouses of married couples using a multivariate statistical analysis method. -/- Methods: Marriage adjustment ve marriage satisfaction scales were used. A structural equation modeling - multiple group analysis method was used in the study, which was designed as a relational screening model. -/- Results: In the study, which included 898 participants, 56.6% of (...) the participants were female and 43.4% were male. The mean age of the participants was 36.94 ± 8.72 standard deviations. First, the relationship between marital adjustment and satisfaction was analyzed using structural equation modeling, and the relationship between the scales was found to be statistically significant (p=0.001). In the model, which was significant and sufficient, the variable of chronic disease was coded on the arrow representing the regression coefficient between the scales, and multiple group analysis was applied. The relationship between marital adjustment and satisfaction was found to be weak among individuals with chronic diseases. The rate of marriage satisfaction explaining marriage adjustment was lower in individuals without chronic disease (R2=0.16) than in those without chronic disease (R2=0.10). While ego scores were not significant in individuals without chronic disease (p=0.237), they were statistically significant in individuals with chronic disease (p=0.017). -/- Conclusion: Chronic diseases has been found to have a significant impact on the relationship between spouses. Many studies have examined the effects of chronic diseases on marriage. However, our study differs from other studies because of the analytical methods used. In the scales, it was determined whether the chronic disease showed a change in the relationship between the scales, not the scores in the chronic disease state. (shrink)

A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral (...) effects of three widely used drugs or drug types: propranolol, selective serotonin reuptake inhibitors, and drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis. (shrink)

1: Placebo effect sometimes plausibly has powerful effects. 2: Buddhism philosophy holds that every living animal is sentient, and has a consciousness and killing them is bad for the killer and freeing them is good somehow. Consciousness may involve some aspects of quantum mechanism as Roger Penrose’s Orch OR' theory of consciousness pointed out. -/- 3: Although previous studies show that there is no “demonstrable effects of distant intercessory prayer. Anecdotal cases of a special kind of Buddhist activity of freeing (...) captive animals in huge amount seem to have powerful therapeutic effects on severe and terminal patients. We want test it experimentally. 4: The cunning point that exceeds previous stuies is, it’s reasonable to consider there may be collective and superpositional effects of this activity due to the likely quantum mechanism of consciousness, and it may play as a sort of magnifying glass that shows a discernible placebo effect. -/- 5:We recruit a considerable number of patients that are terminally ill and the doctors said they can not help them anymore and have double-blind experiments of the above idea.The statistics may show some anomalous distribution. Ethical concerns shall take into consideration. (shrink)

Objective: The study was conducted to determine predictive effect of anxiety and burnout levels related to the COVID-19 Pandemic and organizational commitment on their ıntention to leave the organization of the healthcare professionals. -/- Methods: The sample of study consisted of 251 healthcare professionals who actively worked during the pandemic process. Data were collected by applying the "Coronavirus Anxiety Scale", "COVID-19 Burnout Scale", "Organizational Commitment Scale", and "Intention to Leave the Organization Scale". The data was analysed in the SPSS 22 (...) package program. -/- Results: 66.5% of all participants worked in the pandemic units during the pandemic process, 57.4% of them had COVID-19, 75.3% of them had COVID-19 vaccine, and 32.3% of them lost a relative due to COVID-19. 42.2% of the healthcare professionals had dysfunctional anxiety and they experienced a very high level of burnout, their continuance commitment, which is one of the subscales of organizational commitment, was high, their affective and normative commitment was moderate, and their intention to leave the organization was moderate. The anxiety level of healthcare professionals explained 7.7% of the change in their intention to leave the organization. The anxiety (p<0.05) and burnout levels (p>0.05) together explained 8.5% o the change in intention to leave the organization. The Anxiety and burnout levels and organizational commitment levels together explained 25.9% of the change in intention to leave the organization (p˂0.05). -/- Conclusions: The anxiety levels and the levels of affective organizational commitment of healthcare professionals during the pandemic process are significant predictors of intention to leave the organization. (shrink)

Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about (...) the connections between mechanistic processes and more fundamental reasons for medical interventions, particularly moral, ethical, religious, and political concerns about health, agency, and power. This paper uses debates over the controversial morning-after pill to gain insight into the deeper reasons for the production and use of mechanistic knowledge throughout biomedical research, clinical practice, and governmental regulation. To practice socially relevant philosophy of science, I argue that we need to account for mechanistic knowledge beyond immediate effectiveness, such as how it can also provide moral guidance, aid ethical categorization in the clinic, and function as a political instrument. Such insights have implications for medical epistemology, including the value-laden dimensions of mechanistic reasoning and the “epistemic friction” of values. Furthermore, there are broader impacts for teaching research ethics and understanding the role of science advisors as political advocates. (shrink)

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire (...) medication-like effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated. (shrink)

Objective: Lung cancer is the most common cause of morbidity and mortality. Platinum-based chemotherapy, which is the primary line of treatment, offers limited benefit due to drug resistance and side effects. Berberine (BBR), which is characterised by its potent and safe anticancer activity, represents a promising combination option in chemotherapy. To overcome the limitations in lung cancer chemotherapy, we investigated whether BBR and cisplatin (CIS) exert synergistic effects on non-small cell lung cancer cell line (A549) based on cytotoxicity and apoptotic (...) response markers. -/- Methods: The potential cytotoxic effects of the combination treatment were evaluated using the MTT and Chou-Talalay methods. Elisa assays were also performed to measure the levels of the pro-apoptotic protein Bax and the effector protein caspase (Cas)-3. -/- Results: The results showed that BBR alone reduced A549 cell viability in a dose-dependent manner and synergized with CIS (CI =0.34±0.05 at IC50 concentrations). Elisa results showed that the combined treatment (both at IC50 concentrations) modulated apoptotic signalling pathways in A549 cells. Bax and Cas3 protein levels were dramatically enhanced in A549 cells treated with CIS +BBR compared to control (0.5% DMSO) (p < 0.001). -/- Conclusion: Our results suggest that BBR can synergistically enhance the therapeutic effect of CIS in A549 cells. The potential therapeutic efficacy of BBR as part of a combination in current chemotherapy should be supported by in-depth research and clinical studies on the molecular mechanisms associated with cancer. (shrink)

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics and exercise (...) scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

Resonance can trigger of a series of quantum events and therefore induce several changes related to consciousness at micro as well as macro level within a living system. Therapeutic effects have been observed in several religious meditative and healing practices, which use resonance in the form of chanting and prayers. A living system may have many resonant frequencies due to their degrees of freedom, where each can vibrate as a harmonic oscillator supporting the progression of vibrations as waves that (...) moves as a ripple within the whole system. A cell as an organism or cells in multicellular organisms act as resonating bodies that trigger of oscillation of oscillatory proteins of the cytoskeletal network. The resulting protein conformational changes generate a conscious moment that is regulated via electron tunneling, delocalization and superposition in space time geometry. Consciousness or sentience are phenomenal characteristics of every cell and even though we don’t know the “why” we surely can predict and hypothesize the “how” of consciousness to be quantum computed, which enables the cell to understand and judge perceptions giving it a prospect to behave as per will. (shrink)

Philosophy is deeply rooted in human nature. On the one hand, thinking of an infinite essence of the universe may actualize an infinite essence of humans themselves and thus root them in the Cosmos infinity. On the other hand, to think of infinity is to acquire the power of infinity, i.e., an infinite power. In short, thinking in terms of infinity fills us with infinity. Philosophy allows individuals to overstep the limits of the lived experience, transcends their Selves beyond daily (...) occurrence. Obviously, just this human transcendence into metaphysical reality, into the world of essential relationships ensures a therapeutic effect of philosophy. (shrink)

Mind-body therapies have been shown to be effective in clinical treatment of disorders such as high blood pressure and stress. Significant differences in the effectiveness of mind–body therapies have been shown and a common link among the therapies has yet to be defined. This article overviews the role of slow rhythmic breathing in physiological as well as therapeutic effects of mind-body therapies. Slow deep breathing practice has important implications as it may underlie the basic mechanism that synchronizes the (...) brain with the autonomic response. This article reviews studies that include the effect of deep slow breathing with or without mind-body therapy exercises. In utero studies that monitor patterns of fetal breathing reveal sympathetic activation with irregular, shallow fast breathing movements compared to slow deep breathing. Recognition of respiratory mechanisms in mind-body therapies can lead to development of more effective relaxation exercises that may incorporate deep slow breathing in clinical applications. (shrink)

Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and assessing (...) technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, in providing justification for health technologies. (shrink)

The number of police departments carrying Narcan keeps increasing at a fast pace throughout the U.S., as it is considered an effective measure to fight the opioid epidemic. However, there have been strong oppositions to the idea of the police Narcan use. Still, in 2018, the nation is debating about it. Though not clearly visible to the public, there are important ethical arguments against the police Narcan use which necessarily involve understanding of the ethical roles and responsibilities of police as (...) the law enforcement agency and apprehension of the moral status of a non-therapeutic opioid use. The authors of the paper investigate, primarily, the existing ethical controversies surrounding the police Narcan use while touching upon the issue of the decriminalizing drug policy in the U.S. The authors conclude that the police can carry and administer Narcan without self-contradiction and that the policymakers’ investigation on the drug decriminalization policy should begin with the understanding of the “common morality” of the American public, the ethical view shared and practiced by the greatest number of people. (shrink)

Health and disease are prime focus in the field of Indian medicine and exploration of cause as primary thirst in human being. Cause and effect in Ayurveda is discussed throughout Ayurvedic texts. A critical appraisal of karana(cause) from different point of view was done and it has been concluded that effect conceived in form of sign/symptoms in healthy or diseased must have certain cause. No individual cause can bring an effect until there is an interrelationship, inter-contact and interaction among causes. (...) Causes in Ayurveda has been explored in different contexts in form of causative factors for disease, dhatusamyata (health), cause for origin of shrishti (universe), purusha (human), garbha(foetus), karyadravya(existing matter), one cause for many effect, use of different synonyms like hetu, nidana, ayatana, nimitta, role of cause in therapeutics, cause as one important examination tool of dasha parikshya vishaya, cause as primary focus for research etc. were intervened. What is this cause? In which form has cause been described in Ayurveda? What are different names for these causes in Ayurveda? What are the different effects produced by causes? Analysis of karana from different point of view has been objective of this paper.. (shrink)

In “Flourish,” the psychologist Martin Seligman proposed that psychological well-being consists of “PERMA: positive emotion, engagement, relationships, meaning, and accomplishment.” Although the question of what constitutes flourishing or psychological well-being has been long debated among scholars, the recent literature has suggested that a paradigmatic or prototypical case of psychological well-being would manifest most or all of the aforementioned PERMA factors. The recent literature on poetry therapy has also suggested that poetry practice may be utilized as “an effective therapeutic tool” (...) for patients suffering from a variety of ailments so it seems plausible that practicing poetry can positively contribute to one flourishing with greater psychological well-being. However, recent studies on poetry therapy have not yet been reviewed and integrated under the PERMA framework from positive psychology to further explore and explicate this possibility. This article therefore contributes to extant work by reviewing recent research on poetry therapy and psychological well-being and offering support for the claim that practicing poetry can positively contribute to one flourishing with greater psychological well-being by positively influencing their emotions, engagement or “flow” experiences, social relationships, sense of meaning or purpose in life, and personal accomplishments. (shrink)

A RELATIVISTIC THEORY OF PHENOMENOLOCICAL CONSTITUTION: A SELF-REFERENTIAL, TRANSCENDENTAL APPROACH TO CONCEPTUAL PATHOLOGY. (Vol. I: French; Vol. II: English) -/- Steven James Bartlett -/- Doctoral dissertation director: Paul Ricoeur, Université de Paris Other doctoral committee members: Jean Ladrière and Alphonse de Waehlens, Université Catholique de Louvain Defended publically at the Université Catholique de Louvain, January, 1971. -/- Universite de Paris X (France), 1971. 797pp. -/- The principal objective of the work is to construct an analytically precise methodology which can serve (...) to identify, eliminate, and avoid a certain widespread _conceptual fault_ or _misconstruction_, called a "projective misconstruction" or "projection" by the author. It is argued that this variety of error in our thinking (i) infects a great number of our everyday, scientific, and philosophical concepts, claims, and theories, (ii) has largely been undetected, and (iii), when remedied, leads to a less controversial and more rigorous elucidation of the transcendental preconditions of human knowledge than has traditionally been possible. The dissertation identifies, perhaps for the first time, a _projective_ variety of self-referential inconsistency, and proposes an innovative, self-reflexive approach to transcendental argument in a logical and phenomenological context. The strength of the approach lies, it is claimed, in the fact that a rejection of the approach is possible only on pain of self-referential inconsistency. The argument is developed in the following stages: A general introduction identifies the central theme of the work, defines the scope of applicability of the results reached, and sketches the direction of the studies that follow. The preliminary discussion culminates in a recognition of the need for a _critique of impure reason_. The body of the work is divided into two parts: Section I seeks to develop a methodology, on a purely formal basis, which is, on the one hand, capable of being used to study the transcendental foundations of the special sciences, including its own proper transcendental foundation. On the other hand, the methodology proposed is intended as a diagnostic and therapeutic tool for dealing with _projective_ uses of concepts. The approach initiates an analysis of concepts from a perspective which views _knowledge as coordination_. Section I describes formal structures that possess the status of preconditions in such a coordinative account of knowledge. Special attention is given to the preconditions of _identifying reference_ to logical particulars. The first section attempts, then, to provide a self-referential, transcendental methodology which is essentially revisionary in that it is motivated by a concern for conceptual error-elimination. Phenomenology, considered in its unique capacity as a self-referential, transcendental discipline, is of special relevance to the study. Section II accordingly examines a group of concepts which come into question in connection with the central theme of _phenomenological constitution_. The "_de-projective methodology_" developed in Section I is applied to these concepts that have a foundational importance in transcendental phenomenology. A translation is, in effect, proposed from the language of consciousness to a language in which preconditions of referring are investigated. The result achieved is the elimination of self-defeating, projective concepts from a rigorous, phenomenological study of the constitutive foundations of science. The dissertation was presented in a two volume, double-language format for the convenience of French and English researchers. Each volume contains an analytical index. (shrink)

This paper focuses on invasive therapeutic procedures, defined as procedures requiring the introduction of hands, instruments, or devices into the body via incisions or punctures of the skin or mucous membranes performed with the intent of changing the natural history of a human disease or condition for the better. Ethical and methodological concerns have been expressed about studies designed to evaluate the effects of invasive therapeutic procedures. Can such studies meet the same standards demanded of those, for example, (...) evaluating pharmaceutical agents? This paper describes a research project aimed at examining the interplay and sometimes apparent conflict between ethical standards for human research and standards for methodological rigor in trials of invasive procedures. The paper discusses how the authors plan to develop a set of consensus standards that, if met, would result in substantial and much-needed improvements in the methodological and ethical quality of such trials. (shrink)

Excerpt: 1. Introduction This chapter provides insight into the diverse ethical debates on genetics and epigenetics. Much controversy surrounds debates about intervening into the germline genome of human embryos, with catchwords such as genome editing, designer baby, and CRISPR/Cas. The idea that it is possible to design a child according to one’s personal preferences is, however, a quite distorted view of what is actually possible with new gene technologies and gene therapies. These are much more limited than the editing and (...) design metaphors suggest. Such metaphors are therefore highly problematic phrases in the context of new gene technologies, for two reasons. On one hand, to design a child of choice by modifying the genome would require modifying any gene of choice, which is more than can be done with current gene technologies, such as CRISPR/Cas. On the other hand, a modification of genes would need to be enough to create any characteristic of choice in the future child. The latter presupposes the assumption of genetic determinism. Moreover, the CRISPR/Cas technology can not only be used in a potentially therapeutic manner at the germline level. In addition, there is the (more likely) scenario of a future clinical therapeutic use of these new gene technologies for modifying the DNA sequence of other cells of the body (somatic genome editing). There is also the option of modifying the epigenome, that is, the spatial configuration of DNA (epigenome editing) (see table 1). Like genetics and genome editing, epigenetics has been at the center of recent popular scientific and ethical discourse as well as scientific debates. The concept of epigenetics has given rise to very different notions of inheritability and responsibility for health, which, however, are oftentimes based on scientifically controversial basic assumptions. That there continues to be covert genetic determinism in the form of epigenetic determinism (see table 2) in debates about epigenetics has been pointed out in ethical analyses of epigenetics. Neither genetic determinism nor epigenetic determinism has been confirmed scientifically. It is therefore important to recognize the concepts that are discussed (and sometimes harshly criticized) in debates about genome editing and epigenetics—for example, concepts about the causal role of DNA for our own life course. This importance is based on the fact that if we understand such controversial concepts, we will be able to remain critical when evaluating scientific knowledge and ethical arguments about genome editing and epigenetics. This chapter, therefore, explains some of these concepts. For an ethical analysis of epigenetics as well as of genome editing, it is necessary to understand and critically reflect upon the underlying concepts of genetic determinism and other, related -isms. The following section offers a detailed introduction to these -isms (section 2; see also table 2). Section 3 provides an ethical analysis of genome editing and epigenetics based on the explanations in section 2. Section 3 focuses on inheritability and responsibility, justice, safety, the problem of consent, and the effects of genome editing and epigenetics on embryos and future generations. This section does not discuss in detail further points that can be found in ethical debates about epigenetics as well as in ethical debates about genome editing. These points include (among others): • fear that the findings of epigenetics and that the methods of genome editing are misused—this also with respect to eugenics and enhancement; • naturalness—an issue we mention in passing a few times in the following analysis; • a possible connection between the genome/epigenome and the concept of human dignity, and the derived danger of instrumentalization and infringement of autonomy when intervening in the genome or epigenome. Since current discourse about ethical issues associated with genome editing focuses mainly on germline interventions, which are, for instance, interventions into a human embryo’s genome, we mainly focus on germline interventions when comparing the debates on genome editing and on epigenetics in section 3. (shrink)

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI (...) systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called “general” or “human-like” AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. (shrink)

This was written for the Archdiocese of Calcutta's mouthpiece, The Herald in 2009 and published there. The audience is chiefly popular and not the usual academic audience both within Catholicism or in the academe in general. This essay makes a case for us in understanding and empathizing with the essential loneliness of the Catholic Religious (as understood by a married Hindu man). Further, literature is shown hear as effective therapy for resisting loneliness and as a therapeutic tool for self-help (...) by Catholic Religious. The author is not in possession of the published article but has been informed that copies of The Herald, Kolkata are kept at Goethals's Library, St. Xavier's College, Kolkata. (shrink)

This is Vol. I in French. Vol. II in English is available separately from this website. -/- The principal objective of the work is to construct an analytically precise methodology which can serve to identify, eliminate, and avoid a certain widespread conceptual fault or misconstruction, called a "projective misconstruction" or "projection" by the author. -/- It is argued that this variety of error in our thinking (i) infects a great number of our everyday, scientific, and philosophical concepts, claims, and theories, (...) (ii) has largely been undetected, and (iii), when remedied, leads to a less controversial and more rigorous elucidation of the transcendental preconditions of human knowledge than has traditionally been possible. -/- The dissertation identifies, perhaps for the first time, a projective variety of self-referential inconsistency, and proposes an innovative, self-reflexive approach to transcendental argument in a logical and phenomenological context. The strength of the approach lies, it is claimed, in the fact that a rejection of the approach is possible only on pain of self-referential inconsistency. The argument is developed in the following stages: -/- A general introduction identifies the central theme of the work, defines the scope of applicability of the results reached, and sketches the direction of the studies that follow. The preliminary discussion culminates in a recognition of the need for a critique of impure reason. -/- The body of the work is divided into two parts: Section I seeks to develop a methodology, on a purely formal basis, which is, on the one hand, capable of being used to study the transcendental foundations of the special sciences, including its own proper transcendental foundation. On the other hand, the methodology proposed is intended as a diagnostic and therapeutic tool for dealing with projective uses of concepts. -/- The approach initiates an analysis of concepts from a perspective which views knowledge as coordination. Section I describes formal structures that possess the status of preconditions in such a coordinative account of knowledge. Special attention is given to the preconditions of identifying reference to logical particulars. The first section attempts, then, to provide a self-referential, transcendental methodology which is essentially revisionary in that it is motivated by a concern for conceptual error-elimination. -/- Phenomenology, considered in its unique capacity as a self-referential, transcendental discipline, is of special relevance to the study. Section II accordingly examines a group of concepts which come into question in connection with the central theme of phenomenological constitution. The "de-projective methodology" developed in Section I is applied to these concepts that have a foundational importance in transcendental phenomenology. A translation is, in effect, proposed from the language of consciousness to a language in which preconditions of referring are investigated. The result achieved is the elimination of self-defeating, projective concepts from a rigorous, phenomenological study of the constitutive foundations of science. -/- The dissertation was presented in a two volume, double-language format for the convenience of French and English researchers. Each volume contains an analytical index. (shrink)

Research in infection biology aims to understand the complex nature of host–pathogen interactions. While this knowledge facilitates strategies for preventing and treating diseases, it can also be intentionally misused to cause harm. Such dual-use risk is potentially high for highly pathogenic microbes such as Risk Group-3 (RG3) bacteria and RG4 viruses, which could be used in bioterrorism attacks. However, other pathogens such as influenza virus (IV) and enterohemorrhagic Escherichia coli (EHEC), usually classified as RG2 pathogens, also demonstrate high dual-use risk. (...) As the currently approved therapeutics against these pathogens are not satisfactorily effective, previous outbreaks of these pathogens caused enormous public fear, media attention and economic burden. In this interdisciplinary review, we summarize the current perspectives of dual-use research on IV and EHEC, and further highlight the dual-use risk associated with evolutionary experiments with these infectious pathogens. We support the need to carry out experiments pertaining to pathogen evolution, including to gain predictive insights on their evolutionary trajectories, which cannot be otherwise achieved with stand-alone theoretical models and epidemiological data. However, we also advocate for increased awareness and assessment strategies to better quantify the risks-versus-benefits associated with such evolutionary experiments. In addition to building public trust in dual-use research, we propose that these approaches can be extended to other pathogens currently classified as low risk, but bearing high dual-use potential, given the particular pressing nature of their rapid evolutionary potential. (shrink)

Memory modification technologies (MMTs)—interventions within the memory affecting its functions and contents in specific ways—raise great therapeutic hopes but also great fears. Ethicists have expressed concerns that developing and using MMTs may endanger the very fabric of who we are—our personal identity. This threat has been mainly considered in relation to two interrelated concerns: truthfulness and narrative self‐constitution. In this article, we propose that although this perspective brings up important matters concerning the potential aftermaths of MMT utilization, it fails (...) to tell the whole story. We suggest that capturing more tangible potential consequences of MMT use, namely, its psychological ramifications is crucial both in ethical considerations and in making decisions regarding the permissibility of such interventions. To this end, we first examine what current MMTs are capable of and what are the prospects of emerging MMTs. Subsequently, we outline the relationship between memory and personal identity; specifically, we indicate that concepts of self‐defining memories and narrative identity are crucial to considering how MMTs may influence one's psychological functioning. On this basis, we analyze potential consequences of narrative disruption that may be the result of the use of MMTs; more precisely, we consider its potential effects on mental health, well‐being, and personal agency, and outline the ethical dilemmas that decision‐makers face in this context. We conclude by considering the broader cultural context that may have influence on policymaking regarding permissibility of memory modification interventions. (shrink)

Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of psychotherapy (...) have a duty to ‘go open’ to patients about the role of common factors in therapy ; to not ‘go open’ is supposed to unjustly restrict patients’ autonomy. This paper makes two related arguments against the ‘go open’ claim. While therapies ought to provide patients with sufficient information to make informed treatment decisions, informed consent does not require that practitioners ‘go open’ about therapeutic common factors in psychotherapy, and clarity about the mechanisms of change in psychotherapy shows us that the common-factors findings are consistent with, rather than undermining of, the truth of many theory-specific forms of psychotherapy; psychotherapy, as it is commonly practiced, is not deceptive and is not a placebo. The call to ‘go open’ should be resisted and may have serious detrimental effects on patients via the dissemination of a false view about how therapy works. (shrink)

Moralising accounts of depression include the idea that depression is a sin or the result of sin, and/or that it is the result of demonic possession which has occurred because of moral or spiritual failure. Increasingly some Christian communities, understandably concerned about the debilitating effects these views have on people with depression, have adopted secular folk psychiatry’s ‘medicalising’ campaign, emphasising that depression is an illness for which, like (so-called) physical illnesses, experients should not be held responsible. This paper argues that (...) both moralising and medicalising models of depression are intellectually and practically (pastorally and therapeutically) problematic, gesturing towards more promising emphases. (shrink)

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness (...) of belief revision in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

Mindfulness exercises are presented as being compatible with almost any spiritual, religious or philosophical beliefs. In this paper, we argue that they in fact involve imagining and conceptualising rather striking and controversial claims about the self, and the self’s relationship to thoughts and feelings. For this reason, practising mindfulness exercises is likely to be in tension with many people’s core beliefs and values, a tension that should be treated as a downside of therapeutic interventions involving mindfulness exercises, not unlike (...) a side effect. Clients ought to be informed of these metaphysical aspects of the exercises, and mental health providers ought to take them into account in assessing which course of treatment to recommend. Given these concerns, the casual way in which mindfulness exercises are presently distributed by mental health providers to the general public is inappropriate. (shrink)

The present narrative review seeks to unravel where we are now, and where we need to go to delineate the active ingredients in psychotherapy delivered by conversational agents (e.g., chatbots). While psychotherapy delivered by conversational agents has shown promising effectiveness for depression, anxiety, and psychological distress across several randomized controlled trials, little emphasis has been placed on the therapeutic processes in these interventions. The theoretical framework of this narrative review is grounded in prominent perspectives on the active ingredients (...) in psychotherapy. Based on search terms derived from various theoretical perspectives, we conducted a systematic literature search of four scientific databases and identified 17 studies. Across the selected studies, three themes emerged: relationship variables, emotional venting, and cognitive factors. While methodological issues compromise the epistemic value of this evidence base, core questions also remain to be answered. Such questions include, but are not limited to, whether humans can form affectionate bonds to inanimate beings and whether these kind of mental health treatments should be understood as psychotherapy or something else. Researchers should therefore be cautious when applying theories of psychotherapy in the realm of conversational agents. We conclude the paper by introducing recommendations for future research, which we hope will help instigate methodologically sound studies in this field. (shrink)

Abstract: The study aimed to determine the quality of services and its role in enhancing strategic flexibility, from the point of view of the internal beneficiary in non-governmental hospitals in Gaza Strip. The study relied on the descriptive and analytical approach, and the questionnaire was designed as a tool to collect data and consisted of (39) items, and the researchers used the comprehensive survey method, and the number of the study population was (536) individuals, where (434) questionnaires were retrieved, and (...) the recovery rate was (80.97%). The study revealed many results, the most important of which were: the existence of a high degree of approval by the study sample regarding the quality of services, as it was evident through the field of service quality obtaining a relative weight (79.90%), and the results of the study indicated that there is a moderate degree of approval by the members of the study sample. On the strategic flexibility, as it was evident by obtaining the area of strategic flexibility as a whole on a relative weight (60.44%). The results of the study revealed a statistically significant relationship between the quality of services and the strategic flexibility in non-governmental hospitals in Gaza Strip, with a correlation coefficient of 0.490). The results of the study also revealed a statistically significant effect of the quality of services on the strategic flexibility in non-governmental hospitals in Gaza Strip. The study reached many recommendations, the most important of which were: Establishing an effective system to receive patients' complaints in a manner that ensures rapid response and treatment, to achieve continuous communication between patients and the hospital administration, to notify patients of dealing with the complaints they submit, and to work to provide all medical and health specialties in hospitals in place. The study, by making use of medical delegations visiting Gaza Strip, involving them in therapeutic operations, bringing in doctors and specialists from abroad, updating the criteria for measuring services provided to patients on an ongoing basis, based on patients' suggestions and complaints, developing facilities in hospitals, as well as updating medical devices and equipment Used in hospitals periodically and the need to work on appointing young people and people of energy, for vacancies in the hospitals under study, and the need to seek the help of an administrative staff that is distinguished by scientific and practical qualifications, and to work on updating information systems, archiving and networks through which data and information are transferred between departments, and finding mechanisms to be done from During which the information stored can be used to enhance the decision-making process. (shrink)

Deep Brain Stimulation (DBS) is an invasive therapeutic method involving the implantation of electrodes and the electrical stimulation of specific areas of the brain to modulate their activity. DBS brings therapeutic benefits, but can also have adverse side effects. Recently, neuroethicists have recognized that DBS poses a threat to the very fabric of human existence, namely, to the selves of patients. This article provides a review of the neuroethical literature examining this issue, and identifies the crucial dimensions related (...) to the self which DBS may endanger—personal identity, authenticity, and autonomy. The most influential theories accounting for these dimensions are analyzed herein, and it is argued that most of these theories require further refinement. This paper also demonstrates the interrelation between personal identity, authenticity, and autonomy, and concludes that one can only fully understand the impact of DBS on the self when all of these factors are taken into account. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits (...) of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

ABSTRACT Nietzsche sometimes offers the elusive suggestion that his psychology is not just original, but inaugural: a “first” in the field of philosophy. This article argues that a clue to his inaugural ambitions is discovered in his novel use of sublimation as a concept that engages in both a genealogical critique and a therapeutic reassessment of the basic prejudices of value dualism that he claims constitute the evaluative core of the Western tradition. Genealogically, sublimation provides Nietzsche with a new (...) structure of naturalistic narrative that explains how traditionally opposed values actually share a common natural origin. Therapeutically, Nietzsche's various sublimation narratives serve to qualify the effects of his own naturalistic critique by revealing how and why our animal bodies and drives can now be practically affirmed as a new source of human dignity. (shrink)

Starting from the importance of the figure of the parrhesiastes — the political and therapeutic truth- teller— for Foucault’s understanding of the care of the self, this paper traces the political figuration of the analogy between philosophers and physicians on the one hand, and rhetors and disease on the other in Plato’s Gorgias. I show how rhetoric, in the form of ventriloquism, infects the text itself, and then ask how we account for the effect of the “ contaminated ” (...) philosophical dialogue on our readerly health. Is the text placebo, vaccine, or virus? All of these options, I argue, complicate Foucault’s prescription for parrhesia, requiring us to think anew the continuing political ramifications of the metaphor of care. (shrink)

5-MeO-DMT is a psychedelic substance with a short duration of action and intensive effects. Its therapeutic efficacy and practicality may significantly surpass those of classical psychedelics such as ayahuasca and LSD. -/- This retrospective ethnographic inquiry features a woman in her mid-thirties who witnessed her mother's violent suicide and its bloody aftermath at the age of three. Before and after that, her childhood was characterized by domestic violence and sexual abuse perpetrated by several members of her family and extended (...) family. In her twenties and thirties, she dated a member of the local mafia with the intention of asking him to kill her father, who had been the main perpetrator of the sexual abuse and violence. This plan was eventually not carried out, but it reflected her deep bitterness and wrath. -/- A process initiated in her early thirties involving four 5-MeO-DMT sessions and a few additional sessions with psilocybin and ayahuasca in the course of two years completely resolved her symptoms related to the abuses, to the extent that she could rebuild a functional relationship with her father and feel love and compassion towards him. This outcome, i.e., the complete reversal of her attitude and emotions towards her father, appeared highly unusual. For the last three years, the outcome had remained stable. -/- The article also presents the perspective of a female facilitator of this treatment process. The article contributes to a better understanding of the use of 5-MeO-DMT in severe traumatization as well as exemplifies the possible positive contributions of actors who are not medical professionals in resolving deep collective traumatization in societies. (shrink)

In ‘Psychotherapy, Placebos and Informed Consent’, I argued that the minimal standard for informed consent in psychotherapy requires that ‘patients understand that there is currently no consensus about the mechanisms of change in psychotherapy, and that the therapy on offer…is based on disputed theoretical foundations’, and that the dissemination of this information is compatible with the delivery of many theory-specific forms of psychotherapy (including cognitive behavioural therapy [CBT]). I also argued that the minimal requirements for informed consent do not include (...) information about the role of therapeutic common factors in healing (e.g., expectancy effects and therapist effects); practitioners may discuss the common factors with patients, but they are not part of the ‘core set’ of information necessary to obtain informed consent. In a recent reply, Charlotte Blease criticises these two arguments by claiming they are not supported by empirical findings about the therapeutic common factors. Blease’s response is based on serious misunderstandings of both CBT and what the common factor findings actually find. Nevertheless, addressing the reasons for these misunderstandings is instructive and gives us an opportunity to clarify what, exactly, needs to be explained to patients in order to obtain informed consent for psychotherapy. (shrink)

The CRISPR system for gene editing can break, repair, and replace targeted sections of DNA. Although CRISPR gene editing has important therapeutic potential, it raises several ethical concerns. Some bioethicists worry CRISPR is a prelude to a dystopian future, while others maintain it should not be feared because it is analogous to past biotechnologies. In the scientific literature, CRISPR is often discussed as a revolutionary technology. In this paper we unpack the framing of CRISPR as a revolutionary technology and (...) contrast it with framing it as a value-threatening biotechnology or business-as-usual. By drawing on a comparison between CRISPR and the Ford Model T, we argue CRISPR is revolutionary as a product, process, and as a force for social change. This characterization of CRISPR offers important conceptual clarity to the existing debates surrounding CRISPR. In particular, conceptualizing CRISPR as a revolutionary technology structures regulatory goals with respect to this new technology. Revolutionary technologies have characteristic patterns of implementation, entrenchment, and social impact. As such, early identification of technologies as revolutionary may help construct more nuanced and effective ethical frameworks for public policy. (shrink)

In response to the COVID-19 pandemic, large-scale research and pharmaceutical regulatory processes have proceeded at a dramatically increased pace with new and effective, evidence-based COVID-19 interventions rapidly making their way into the clinic. However, the swift generation of high-quality evidence and the efficient processing of regulatory authorisation have given rise to more specific and complex versions of well-known research ethics issues. In this paper, we identify three such issues by focusing on the authorisation of Molnupiravir, a novel antiviral medicine aimed (...) at reducing the ability of SARS-CoV-2 to multiply in the body, for clinical use by the National Health Service in England and the concomitant testing of Molnupiravir through the large-scale PANORAMIC randomised control trial. By analysing the ways in which the authorisation and clinical use of Molnupiravir complicate standard approaches to clinical equipoise, standard of care, and participant consent in the PANORAMIC randomised control trial we will explain some of ethical implications for clinical trials that aim to study the efficacy and safety of new COVID-19 and other therapeutics when conditional authorisation has already been granted and when such treatments have already been made available to patients by national health providers. (shrink)

This article describes a case of a teenager with early complex trauma due to chronic domestic violence. Cannabis use triggered auditory hallucinations, after which the teenager was diagnosed with an acute schizophrenia-like psychotic disorder. Antipsychotic medication did not fully resolve symptoms. Eventually the teenager chose to self-medicate with LSD in order to resolve a suicidal condition. The teenager carried out six unsupervised LSD sessions, followed by an extended period of almost daily use of inhaled low-dose DMT. Psychotic symptoms were mostly (...) resolved after approximately one year. Subsequent cannabis use caused a transient relapse. -/- While his psychosis may have been due to cannabis use in the presence of a genetic predisposition, LSD and DMT did not promote psychotic symptoms in this case, and resolved the suicidal condition in one session. Additional high-dose LSD sessions and low-dose DMT sessions appeared to resolve the symptoms related to the early complex trauma. Alternatively, if psychosis is understood as a massive defense system resulting from early complex trauma, and if his psychotic symptoms were partially due to such trauma, psychedelics appeared to transcend this defense system, providing access to traumatic memories in order to allow for an integrative treatment effect. -/- Information was acquired from medical record excerpts provided by the patient, a semi-structured retrospective video interview, and follow-up interviews a year later. The present case suggests a need for further studies on the relationship between psychedelics and psychotic disorders, the feasibility of supervised vs unsupervised settings for various situations, and alternative therapeutic models for utilizing the hyperaware-hypersensitive state induced by psychedelics. With regard to self-treatment, a harm reduction approach should be adopted. Low-risk psycholytic self-treatment protocols could be developed for future use in public health care systems. (shrink)

Within dramatherapy and psychodrama, the term ‘de-roling’ indicates a set of activities that assist the subjects of therapy in ‘disrobing’ themselves from their fictional characters. Starting from the psychological needs and the therapeutic goals that ‘de-roling’ techniques address in dramatherapy and psychodrama, this text provides a broader understanding of procedures and exercises that define and ease transitional experiences across cultural practices such as religious rituals and spatial design. After this introductory section, we propose a tentative answer as to why (...) game studies and virtual world research largely ignored processes of ‘roling’ and ‘de-roling’ that separate the lived experience of role-play from our everyday sense of the self. The concluding sections argue that de-roling techniques are likely to become more relevant, both academically and in terms of their practical applications, with the growing diffusion of virtual technologies in social practices. The relationships we can establish with ourselves and with our surroundings in digital virtual worlds are, we argue, only partially comparable with similar occurrences in pre-digital practices of subjectification. We propose a perspective according to which the accessibility and immersive phenomenological richness of virtual reality technologies are likely to exacerbate the potentially dissociative effects of virtual reality applications. This text constitutes an initial step towards framing specific socio-technical concerns and starting a timely conversation that binds together dramatherapy, psychodrama, game studies, and the design of digital virtual worlds. (shrink)

Worldwide populations are aging with economic development as a result of public health initiatives and advances in therapeutic discoveries. Since 1850, life expectancy has advanced by 1 year for every four. Accompanying this change is the rapid development of anti‐aging science. There are three schools of thought in the field of aging science. One perspective is the life course approach, which considers that aging is a good and natural process to be embraced as a necessary and positive aspect of (...) life, where the aim is to improve the quality of existing lifespan and “compress” morbidity. Another view is that aging is undesirable, and that rejuvenation and indeed immortality are possible since the biological basis of aging is understood, and therefore, strategies are possible for engineering negligible senescence. Finally, a hybrid approach is that life span can be extended by anti‐aging medicines but with uncertain effects on health. While these advances offer much promise, the ethical perspectives are seldom discussed in cross‐disciplinary settings. This article discusses some of the key ethical issues arising from recent advances in biogerontology. (shrink)

It seems certain that one day we will allow the genetic technology which will enhance our offspring. A highly effective new tool, called CRISPR, which allows for carving out genes, is already being used to edit the genomes of animals. In July 2017, the FDA legalized that germline drugs for therapeutic purposes could be sold in the market. It is a high time, now, that we need engage in discussions about the ethics of germline intervention. To contribute to the (...) discussion by showing our thought and to educate the public, we write this paper. (shrink)

In this article I use Maurice Merleau-Ponty’s existential phenomenology as a method for presenting a disclosing critique of aphonia as the loss of a political voice of one’s own. I claim that aphonia is a phenomenon that is qualitatively different from a lack of opportunities for democratic participation and a lack of the communicative capabilities required for effective political participation. I give examples from sociological literature on social exclusion and political apathy, and then diagnose them using Merleau-Ponty’s concepts of operative (...) intentionality and the lived body. A picture emerges of aphonia as the diminishing of the expressive modality of the lived body. This can lead to the inability to perceive oneself as a capable public speaker and the public realm as a welcoming field of possibilities for political engagement. I propose that democratic theory should consider the way that the negative social experiences of social marginalization can diminish, or even completely take away, the capability to authentically give a voice to one’s experiences in public on one’s own terms. I conclude with a call for grass-roots alternatives towards engendering political participation among marginalized groups through a “therapeutic” approach to political inclusion. (shrink)