In the last decade, the cases of breast and cervical cancer have been positioned at the top rank of cancer statistics worldwide. Consequently, many husbands become family caregivers (FCGs) and get the burden of cancer caregiving. Being blind and incompetent, they need supportive care from healthcare professionals (HCPs). To support them, HCPs provide various healthcare information to meet their needs. Further, their demand for a specific type of healthcare information may reflect their need for emotional support from the HCPs (...) to reduce the burden. This study aims to examine the predictors of the need for emotional support among FCGs of female cancer patients by analyzing the demanded healthcare information. The mindsponge theory was used in conceptual development and interpretation. Bayesian Mindsponge Framework (BMF) analytics were used for statistical analysis on a dataset of 48 husbands and 12 significant others in five congested communities of Surabaya, Indonesia. Results showed that among the six types of healthcare information, the demanded cancer-specific information and information on cancer physical needs significantly predict the need for emotional support among respondents. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need emotional support. Other types of information have ambiguous effects on the need for emotional support. This study reveals that the demanded cancer-specific information, e.g., cancer prognosis or likely outcome, and information on cancer physical needs must be prioritized in information disclosure to meet the needs for emotional support among FCGs of female cancer patients. (shrink)

In this paper, we apply the perspective of intra-organismal ecology by investigating a family of ecological models suitable to describe a gene therapy to a particular metabolic disorder, the adenosine deaminase deficiency (ADA-SCID). The gene therapy is modeled as the prospective ecological invasion of an organ (here, bone marrow) by genetically modified stem cells, which then operate niche construction in the cellular environment by releasing an enzyme they synthesize. We show that depending on the chosen order (a (...) choice that cannot be made on \textit{a priori} assumptions), different kinds of dynamics are expected, possibly leading to different therapeutic strategies. This drives us to discuss several features of the extension of ecology to intra-organismal ecology. (shrink)

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect the (...) FCG’s role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)

In this paper, we discuss the perspective of intra-organismal ecology by investigating a family of ecological models. We consider two types of models. First order models describe the population dynamics as being directly affected by ecological factors (here understood as nutrients, space, etc). They might be thought of as analogous to Aristotelian physics. Second order models describe the population dynamics as being indirectly affected, the ecological factors now affecting the derivative of the growth rate (that is, the population acceleration), (...) possibly through an impact on non-genetically inherited factors. Second order models might be thought of as analogous to Galilean physics. In the joint paper, we apply these ideas to a situation of gene therapy. (shrink)

Traditionally, the key features of the family system of Eating Disorders have been considered those originally outlined by Minuchin in his description of the "psychosomatic" family patterns of interaction. This controlled study tests two of the principal characteristics of Minuchin's model, namely enmeshment and rigidity, operationalised as extreme cohesion and low adaptability. Perceived and desired cohesion and adaptability, measured with the FACES III, were compared between 30 clinical families and 30 non-clinical families. Differences across ED family members (...) were also considered, as well as differences between ED symptomatological subgroups . High cohesion scores were found in ED families, but similar findings were also reported in control families. Cohesion scores were significantly higher in restricting anorectics than in patients with bulimic symptoms. Adaptability was normal in both ED and control families. This study does not support Minuchin's observations on family enmeshment and rigidity. Although high levels of cohesion were found in ED families, the same relational pattern was found in the control families, suggesting that a tendency to a hyper-involvement of family members might be "normal" in some sociocultural contexts. (shrink)

This dissertation is an investigation into how scientific values may influence the kinds of theories which are investigated, and in turn which theories become ‘mainstream’. I have focussed on psychedelic therapy as a family of theories, and I identified three main reasons as to why psychedelic therapy is somewhat incompatible with the current psychiatric paradigm: (1) the inability to conduct double-blind trials, (2) The inability to isolate one explanatory variable, and (3) The mystical and spiritual dimensions of (...) the mechanisms of action of psychedelic drugs. Because double-blind randomised controlled trials, isolating one explanatory variable, and neurobiological- style explanations of mechanisms of action are seen as an integral part of good psychiatric research, this means that psychedelic therapy is inherently disadvantaged as a research avenue in the current paradigm. These three things also arguably embody scientific values proposed by Kuhn (1977), such as accuracy, simplicity, and consistency. Helen Longino (1995) argues that Kuhn’s values do not simply increase the likelihood of a theory being true, but in some instances serve to perpetuate discriminatory ideologies. She proposes her own list of values as a route to a more equitable science, and by extension, a more equitable society. Interestingly, psychedelic therapy as a theory embodies many, if not all of the values proposed by Longino. This led me to my conclusion that if the psychiatric paradigm were more feminist according to Longino’s criteria, then psychedelic therapy would be considered a “better” theory. It would therefore be easier to conduct research in this area, and psychedelic therapy would have a better chance at becoming a mainstream treatment. (shrink)

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over (...) half (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

Psoriatic arthritis is a chronic, systemic inflammatory disorder. It has been classified in spondyloarthropathies group which shares clinical, radiologic, serologic features, familial and genetic relationship. Up to 5-30% of patients with psoriasis may go on to develop psoriatic arthritis, usually within 5-10 years. Adalimumab (ADA) is the first human monoclonal antibody against TNF-α. ADA is a biologic agent effective in both skin lesions and joint signs. Anti-TNF agents are powerful immunmodulating drugs with potentially side effects. Our case is 38 years (...) old woman complaining about swelling and pain in hand joints. In physical examination she has asymmetrical arthritis in wrist, proximal (PIP) and distal interphalangeal (DIP) hand joints and right knee joint. In laboratory; sedimentation rate: 80 mm/h, C-reactive protein: 17 mg/l, rheumatoid factor (RF): 8.7 IU/ml and HLA B27 was positive. Radiologically, erosions and narrowing were determined in PIP and DIP hand joints and grade 3 sacroiliitis bilaterally. In clinical monitoring, psoriaform lesions progressed in her scalp, so we diagnosed psoriatic artritis. We started ADA therapy 40 mg subcutaneously every two weeks. She developed periorbital infection in left-sided in tertiary month following. Streptococcal proliferation was seen in lesion culture, so we began amoxicillin-clavulanate therapy. She benefit antibiotic therapy, infectious signs regressed. ADA therapy discontinued, instead of it, etanercept 50 mg twice weekly subcutaneous and methylprednisolone 12 mg/daily oral therapy is started. We purposed to declare our case with literature selection. (shrink)

Among all aspects, the unmet needs of healthcare information from the healthcare and illness-related domains have the potency to predict the unmet needs of emotional support from the emotional and relational domains in this population. The current study aims to examine the predictors of the needs for emotional support among FCGs of cancer patients by analyzing the demanded healthcare information, i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support (...) services. (shrink)

The current study aims to examine how types of demanded healthcare information affect the FCG’s role in reducing the fear of female cancer patients (i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services).

The current study aims to examine how types of demanded healthcare information affect the FCG’s role in catalyzing the adaptation of female cancer patients (i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services).

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how (...) clinicians use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

In this chapter, I describe my “post-diagnosis” experiences as the parent of an autistic child, those years in which I tried, but failed, to make sense of the overwhelming and often nonsensical information I received about autism. I argue that immediately after being given an autism diagnosis, parents are pressured into making what amounts to a life-long commitment to a therapy program that (they are told) will not only dramatically change their child, but their family’s financial situation and (...) even their entire mode of existence. Moreover, despite information overload, many treatment programs for autism rely on empty jargon and make completely unrealistic promises, so parents are left feeling overwhelmed and panicked. Even well respected therapy programs encourage parents to spend liberally. Indeed, autistic therapists, who help construct what I refer to as the Culture of Autism, advise parents to commit to a minimum of 35 to 45 hours of intensive therapy every week. The implications are clear: for a parent who works full-time, their autistic child becomes a second full-time job. Autism is big business right now, and therapists are pushing parents to the brink of desperation. So it is not too surprising that there is a desperate cry for a more permanent solution—which is why researchers seek to cure autism. But there are two ways to conceptualize cure. A Therapeutic Cure model (TC) conceives of a cure as a beneficial treatment for the patient that eliminates or ameliorates the harms of the disease or condition. But the notion of a therapeutic cure for autism is highly implausible, given the complexities of autism. Indeed, at this point, the vast majority of researchers have come to the conclusion that the idea of a therapeutic cure for autism is simply a non-starter. Therefore the bulk of research seeking a cure for autism focuses instead on a second approach, which I refer to as the Negative Eugenics Cure model (NEC). With this model, the intention is to eliminate the disease or condition without regard for the health or well-being of the organism carrying the disease or condition. So, with regard to autism, researchers are focusing on identifying genetic markers for autism that can be detected in utero, or in embryos, so that autistic fetuses can be eliminated and autism eradicated by preventing the existence of autistic individuals. I review both models and argue that both fail to provide convincing arguments that the “solution” either offers is desirable. Both rest on the assumption that autism renders a life not worth living which, all things considered, is false. Instead of pushing to cure autism, an idea pervasive in this Culture of Autism, I contend that autistics are individuals with lives worth living. Moreover, rather than expend millions on research to search for the means to eliminate autism, we should instead expend our resources to ensure autistic individuals have access to support they may need. If the phenomenology of autism were better understood and appreciated, the panicked demand for a cure for autism might abate and perhaps autism could be seen as having value in and of its own right. (shrink)

Currently, documentation on the effects of psychedelics on psychosis appears scarce. In the present case, a higher-dose LSD experience during acute paranoid psychosis before the initiation of antipsychotics induced feelings of love, which resolved the majority of the symptoms of the paranoid psychosis in one session, leading the person to reconnect with his family and seek treatment in a psychiatric hospital. The session did not resolve schizoaffective disorder, however. More than a decade later, while using the antipsychotic aripiprazole, concurrent (...) self-administration of ketamine induced psychedelic effects that appeared to allow for practicing 'grounding' of psychotic thoughts. Immediately afterwards, daily self-administration of psycholytic doses of LSD for four weeks caused a mood-enhancing effect that enabled the patient to successfully discontinue aripiprazole without the return of psychotic symptoms. No psychotic or other noticeable symptoms could be observed during two interviews conducted in the two months following the discontinuation of the antipsychotic. -/- The mechanisms of action remain unexplored, and their possible generalizability to other cases remains unclear, but the observations may serve as a basis for further research. It may, for example, be that chronic use of LSD induces a tolerance to its psychedelic effects but not to its anti-inflammatory or other possibly unknown effects, which may be related to the observed mood-enhancing effect. A preclinical study from 1971 appeared consistent with the claimed effect. -/- In the present case, paranoia, i.e., the hypersensitivity to potential threats, was partly due to childhood trauma, partly intentionally induced by military training, and partly accentuated by war experiences. It could not be 'turned off'. Fear related to the uncertainty of survival formed the core of psychosis; without the fear, psychosis would likely not have existed. Paranoid psychosis presented itself as a biased estimation of probabilities of possible adverse outcomes, as a mismatch between the past and the present. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Abstract: Lung cancer is the top reason of cancer-associated deaths globally. Surgery is the typical treatment for early-stage non-small cell lung cancer (NSCLC). Advancement in the knowledge of the biology of non-small cell lung cancer has shown molecular evidence used for systemic cancer therapy aiming metastatic disease, with a significant impact on patients’ overall survival (OS) and eminence of life. Though, a biopsy of overt metastases is an invasive technique restricted to assured positions and not effortlessly satisfactory in the (...) clinic. The examination of peripheral blood samples of cancer patients embodies a new basis of cancer-derived material, recognized as liquid biopsy, and its constituents (circulating tumour cells (CTCS), circulating free DNA (cfDNA), exosomes, and tumour-educated platelets (TEP)) may be gotten from nearly any body liquids. These constituents have shown to imitate features of the status of both the primary and metastatic diseases, aiding the clinicians to go towards a tailored medicine. In this paper, the reasons of lung cancer will be recognized and the risk elements that initiated the increase of infection, for instance Smoking, Disclosure to secondhand smoke, Disclosure to radon gas, Disclosure to asbestos and other compounds, Family past history of lung cancer, and decrease of the spread of disease and approaches of handling and prevention of lung cancer. (shrink)

The public health crisis is started with emergence of new coronavirus on 11 February 2020 which triggered as coronavirus disease-2019 (COVID-19) pandemics. The causative agent in COVID-19 is made up of positively wrapped single-stranded RNA viruses ~ 30 kb in size. The epidemiology, clinical features, pathophysiology, and mode of transmission have been documented well in many studies, with additional clinical trials are running for several antiviral agents. The spreading potential of COVID-19 is faster than its two previous families, the severe (...) acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Apart from clinical manifestation, comorbid status is playing key role for prevalence of COVID-19 infection and mortalities. The comorbid effects associated with COVID-19 are diabetes, cardiovascular, digestive, hepatitis-B, cerebrovascular, hypertension, liver injury, coronary heart disease, cancer, rheumatoid arthritis, and neurological impairment. Antimalarial drugs (chloroquine and hydroxychloroquine), remdesivir, Tocilizumab, clopinavir/ritonavir, convalescent plasma therapy, spike protein-angiotensin-converting enzyme 2 (ACE2) inhibitors, human monoclonal antibodies, mRNA-1273, mesenchymal stem cells, Indian and Chinese traditional medicine, small molecules antioxidant, natural products and dietary supplements, high doses of vitamin-E, -C, -D, minerals, flavonoids,and IFN-beta are therapeutic intervention running to develop treatment against COVID-19. Although clinical usage of these therapeutic agents against COVID-19 is well documented, cytokine storms, absence of appropriate animal model have limited its therapeutic use. This review explores the clinical information currently available on COVID-19 on the mechanisms of infection, prevention, management, comorbid status, and current drug treatment options. (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)

The articles presents my journey with "Live Poetry" a participatory poetry methods created by Luis Enrique Amaya in Perù. This journey is marked by three encounters I had, that convinced me of the depth of the beauty and healing this journey can bring. The first occurs in Cali, Colombia, in a vast set of working-class neighbourhoods called Distrito de Agua Blanca. This area is dominated by drug trafficking and invisible borders between rival gangs. Teenagers experience a daily life of violence (...) and neglect. In this neighbourhood, I meet Luis Enrique Amaya, poet and social activist from Lima, Peru. Today, Luis will lead a poetry workshop with teenagers in the neighbourhood. It is based on a community poetry method he created years before with his collaborators. The workshop today will have two phases. In the first phase, the poet interviews a passer-by, a member of the community, and asks them to talk about someone important to her or him (a family member, a friend, a lover). In the second phase, the poet asks the interviewee to wait for few minutes. Then the poet sits alone for about ten minutes and composes a poem dedicated to the person chosen by the interviewee. When he has finished, the poet gives the poem to the interviewee as a gift saying: “After listening to you, I composed this poem and I give it to you as a gift. But beware: it is not for you. It is to invite you give it as a gift to the person you told me about”. (shrink)

An important strand of current experimental philosophy promotes a new kind of methodological naturalism. This chapter argues that this new ‘metaphilosophical naturalism’ is fundamentally consistent with key tenets of Wittgenstein’s metaphilosophy, and can provide empirical foundations for therapeutic conceptions of philosophy. Metaphilosophical naturalism invites us to contribute to the resolution of philosophical problems about X by turning to scientific findings about the way we think about X – in general or when doing philosophy. This new naturalism encourages us to use (...) resources from psychology that can empirically vindicate precisely some of the most controversial aspects of Wittgenstein’s conception of philosophy: They can establish the need, and provide key tools, for something worth calling ‘therapy’, in philosophy. As ‘pudding proof’ this chapter shows how methods and findings from psycholinguistics motivate and facilitate a therapeutic approach to a characteristically philosophical problem: ‘the problem of perception’. (shrink)

In Paris in August 1839, the French government revealed a gift free of charge that would change the world forever. This gift was the daguerreotype process which had been invented by artist Louis Daguerre who used an iodine-sensitised silvered plate and mercury vapour to create some of the world’s earliest photographs and soon afterwards commercial photography was born. The trend of taking photographs spread quickly across the English Channel, but competition was fierce over the next several decades to develop new (...) methods of creating clearer images for less expense and with reduced exposure times. Victorian society embraced the technology of photography and much of the work conducted by family historians today revolves around identifying relatives in nineteenth and early twentieth century photographs. This article explores the history of portrait photography followed by an analysis of the ambrotype, tintype, cartes de visite and cartes postale found in the collection of the Moon/Prescott family from Lancashire which will provide a practical guide to dating and interpreting antique photographs. (shrink)

Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the case (...) of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied. (shrink)

A recent attitudinal change towards animals has led many people to recognize their family structures as multispecies families, that is, a family composed of human members and animals of other species, united by affective ties, and solidarity, in a horizontal relationship, and even where there is mutual recognition. This social phenomenon requires that the legal concept of family, which today more than ever accepts the plurality of family structures, also includes multispecies families. The protection of multispecies (...) families is necessary and possible if one considers that in Latin America today, a post-positivist legal system prevails that is aimed at protecting fundamental rights and freedoms. This legal system allows for a broad interpretation of rights such as the right to free development of personality and the right to family integrity, rights that already serve as foundational for the recognition and protection of multispecies families in Latin America. (shrink)

An introductory text describing the author’s approach to epistemology in terms of self-referential argumentation and self-validating proofs. The text emphasizes a skill-based, rather than content-based, approach to the study of epistemology. The book is a simply stated, basic text whose purpose is to introduce students to the technical approach to epistemology developed by the author in other publications. ●●●●● -/- 2022 UPDATE: The approach of this book has been updated and developed further in the author’s 2021 book _Critique of Impure (...) Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). (shrink)

The paper clarifies therapeutic ideas about philosophical method which Wittgenstein puts forward in his "Big Typescript". It does so by analysing how Wittgenstein treats the question 'What is meaning?', in that part of the same work from which the opening sections of his "Philosophical Investigations" derive. On this basis, the paper explains why Wittgenstein set himself a therapeutic goal, why this is reasonable, and how he sought to attain that goal without 'pronouncing new truths about the subject of the investigation', (...) viz. meaning. (shrink)

In this opinion piece we propose the investigation of psychedelic-assisted psychotherapy for the treatment of body dysmorphic disorder (BDD). BDD is a psychiatric disorder characterised by appearance-based preoccupations and accompanying compulsions. While safe and effective treatments for BDD exist, non-response and relapse rates remain high. Therefore, there is a need to investigate promising new treatment options for this highly debilitating condition. Preliminary evidence suggests safety, feasibility, and potential efficacy of psychedelic treatments in disorders that share similar psychopathological mechanisms with BDD. (...) Drawing on this evidence, as well as on relevant qualitative reports and theoretical proposals, we argue that it would be worthwhile to conduct a phase 2a study aimed at assessing the safety and feasibility of psychedelic-assisted psychotherapy in BDD. We also offer some suggestions for how future research ought to proceed. (shrink)

The Confucian family, not only in its historical manifestations but also in the imagination of the Confucian founders, was the locus of misogynist norms and practices that have subjugated women in varying degrees. Therefore, advancing women’s well-being and equality in East Asia may seem to require radically transforming the Confucian family to approximate alternative ideal conceptions of the family in the West. This article opposes such a stance by arguing that (1) Western conceptions of the family (...) may be neither plausible nor feasible in traditionally Confucian societies and (2) the Confucian family, once reconstructed in line with Confucianism’s core ideas and values, can be conducive to a feminist future in East Asia that is uniquely Confucian. In order to support my position, not only influential contemporary Western ideal conceptions of the family from the justice perspective and care ethics, but also different interpretations of the Confucian family will be carefully examined. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

Desire is an important philosophical topic that deeply impacts everyday life. Philosophical practice is an emerging trend that uses philosophical theories and methods as a guide to living a eu‐ daimonic life. In this paper, we define desire philosophically and compare different theories of desire in specific Eastern and Western traditions. Based on the Lacanian conceptual–terminological triad of “Need‐Demand‐Desire”, the research of desire is further divided into three dimensions, namely, the subject of desire, the object of desire, and the desire (...) itself. The concept of desire is then an‐ alyzed from this triad and these three dimensions through different philosophical theories. This paper selects Buddhism as the representative of Eastern tradition, and Stoicism as the representative of the West, paying special attention to Stoicism’s “spiritual exercises” following Pierre Hadot. By exploring and comparing the Buddhist paths to liberation from suffering (i.e., the Four Noble Truths and the Noble Eightfold Path) and the two theoretical pillars in Stoicism (i.e., the notions of “living according to nature” and “the dichotomy of control”), practical guidance is then provided for un‐ derstanding and regulating desire in times of crisis. This understanding and regulation of desire constitutes a philosophical therapy for today’s troubles, particularly those caused by excessive or irrational desires. (shrink)

The family poses problems for liberal understandings of social justice, because of the ways in which it bestows unearned privileges. This is particularly stark when we consider inter-generational inequality, or ‘class fate’ – the ways in which inequality is transmitted from one generation to the next, with the family unit ostensibly a key conduit. There is a recognized tension between the assumption that families should as far as possible be autonomous spheres of decision-making, and the assumption that we (...) should as far as possible equalize the life chances of all children, regardless of background. In this article I address this tension by way of recent liberal egalitarian literature, and consideration of the different dimensions of class fate. I argue, firstly, that the tension may not be of the a priori nature which liberals have tended to identify – and secondly, that as well as distributive and recognition-based aspects, the notion of contributive justice provides a particularly illuminating way of analyzing what is wrong about class fate, and the role of the family in promoting it. (shrink)

The concept of work–family balance was introduced in the 1970s in the United Kingdom based on a work–leisure dichotomy, which was invented in the mid-1800s. It is usually related to the act of balancing of inter-role pressures between the work and family domains that leads to role conflict. The conflict is driven by the organizations’ views of the “ideal worker” as well as gender disparities and stereotypes that ignore or discount the time spent in the unpaid work of (...) family and community. Solutions for balance include legislation, flexible workplace arrangements, and the market care services. (shrink)

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

The case of Andrew Gobea, the first child to receive experimental gene therapy for SCID, and a reflection on the associated ethical implications of gene therapy research.

In his article Banicki proposes a universal model for all forms of philosophical therapy. He is guided by works of Martha Nussbaum, who in turn makes recourse to Aristotle. As compared to Nussbaum’s approach, Banicki’s model is more medical and less based on ethical argument. He mentions Foucault’s vision to apply the same theoretical analysis for the ailments of the body and the soul and to use the same kind of approach in treating and curing them. In his interpretation (...) of philosophical therapy, there are, however, some controversial issues, to which we would like to call attention: -/- Is restoring health by a philosophical method of treatment – health understood as a person’s ability to reach his/her vital goals – a convincing explication of philosophical therapy in general? In order to answer this question, it may be useful to look at Plato. It is not only Platonism (and especially Neo-platonism since Plotinus) that questions the idea that therapy is necessarily connected with „vital goals“. Buddhist and Gnostic philosophies are questioning „the vital“ in general. The immense effort in the history of philosophy to liberate the mind from the body casts doubt on the project to explain philosophical therapy solely in analogy to medical therapy. -/- According to Banicki a therapeutic philosophy has to identify the diseases it attempts at curing. There are, however, reasons for associating the term therapy with suffering/risk rather than disease. If a therapy aims at reducing the fear of death, as for example many classical philosophical therapies do, then there is no disease to be cured. A model based on chances and risks also has the advantage that the Buddhist and Stoic reinterpretation of desires/emotions as “diseases” can be dropped in contemporary philosophical therapy. -/- Banicki mentions the comparison of therapies as one of the primary goals of modelling. Methods should be verified by a statistical correlation between method and therapeutic success and/or by a theory which justifies the method. Some forms of therapies, however, avoid theory-specific terms and concepts in favor of an unprejudiced interpretation of the patient’s statements. Others share the (Nietzschean) aspiration to explore and change measures of value. If the therapeutic process is seen as a unique phenomenon, then there can be no theory and no statistics with co-occurrences. -/- According to Banicki philosophical therapy has to describe techniques which qualify as genuinely philosophical. Techniques like maieutics and hermeneutics, however, are antique philosophical “inventions”, which were later adopted by psychotherapy. If meditation is accepted as a therapeutic tool – as it was in ancient times – then there is not only a methodical but also an emotional relation to religion. If finally, the Socratic search for a good life is seen as one of the characteristics of philosophical therapy, then delimitation even turns into a criterion for non-philosophical therapies. The search for a good life requires an interdisciplinary approach. -/- For the concretization of the formal structure, we suggest a typology of therapies, which is based on chances and risks. Such a typology has the advantage, that it can model conflicting (and even opposing) forms of therapies. The variety of therapeutic goals and methods is a consequence of the historical development towards conceptual freedom. (shrink)

Contemporary research offers a more compelling account on the complex emotion of envy than the traditional view of envy as simply something bad. This essay explains how Logic-Based Therapy can use this account to coach individuals struggling with negative species of envy. Given that jealousy and envy are often equated, the essay differentiates the two; explains the conditions that make the four species of envy possible; identifies cardinal fallacies associated with negative species of envy; proposes counteractive virtues, and describes (...) ways to help people struggling with negative species of envy acquire these virtues. (shrink)

Internationally, there is considerable inconsistency in the recognition and regulation of children's genetic connections outside the family. In the context of gamete and embryo donation, challenges for regulation seem endless. In this paper, I review some of the paths that have been taken to manage children' being closely genetically related to people outside their families. I do so against the background of recognising the importance of children's interests as moral status holders. I look at recent qualitative research involving donor-conceived (...) people and borrow their own words to make sense of a purported interest to know (of) their close genetic ties. I also review ways in which gamete donation may have facilitated new kinds of kinship, which are at the same time genetic and chosen. In short, in this paper, I explore what meaning there could be in genetic connections that is not about parenthood. Further, I argue that the focus on parenthood in previous work in this area may be detrimental to appreciating some of the goods that can be derived from close genetic connections. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation (...) wishes. Second, families can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Therapists and related theorists and practitioners of mental health tend to hold one of two broad views about how to help patients. On the one hand, some maintain that, or at least act as though, the basic point of therapy is to help patients become clear about what they want deep down and to enable them to achieve it by overcoming mental blockages. On the other hand, there are those who contend that the aim of therapy should instead (...) be to psychologically enable patients to live objectively desirable lives, say, ones that involve developing their inherent talents or exhibiting an authentic/strong/integrated self. In this chapter, I argue that neither of these prominent approaches is complete. Contra the former, sometimes what patients want deep down is not something to promote, and, against the latter, it can sometimes be reasonable for patients to want to sacrifice their own objective interests and for therapists to assist them in this regard. I argue that the category of meaningfulness does well at accounting for these counterexamples to the two dominant approaches, while capturing the kernels of truth in them. The proper aim of therapy, I suggest, is to enable patients to live meaningfully. (shrink)

There are many different interpretations of what the family should be – its desired member composition, its primary purpose, and its cultural significance – and many different examples of what families actually look like across the globe. I examine the most paradigmatic conceptions of the family that are based upon the supposed primary purpose that the family serves for its members and for the state. I then suggest that we ought to reconceptualize how we understand and define (...) the family in an effort to move away from these paradigmatic conceptions. This approach requires that we examine the way(s) in which the family has been defined descriptively – that is, how families have been defined historically – in an effort to determine what a normative theory of the family might look like. The goal of this inquiry is to define a family in terms of what it ought to be – a goal that moves our understanding of the family to a new conceptual landscape. I then present my own account of familial relations that aims to capture a normative understanding of the unique primary purpose that the family serves for its members. (shrink)

The so-called ‘‘species problem’’ has plagued evolution- ary biology since before Darwin’s publication of the aptly titled Origin of Species. Many biologists think the problem is just a matter of semantics; others complain that it will not be solved until we have more empirical data. Yet, we don’t seem to be able to escape discussing it and teaching seminars about it. In this paper, I briefly examine the main themes of the biological and philosophical liter- atures on the species problem, (...) focusing on identifying common threads as well as relevant differences. I then argue two fundamental points. First, the species problem is not primarily an empirical one, but it is rather fraught with philosophical questions that require—but cannot be settled by—empirical evidence. Second, the (dis-)solution lies in explicitly adopting Wittgenstein’s idea of ‘‘family resemblance’’ or cluster concepts, and to consider spe- cies as an example of such concepts. This solution has several attractive features, including bringing together apparently diverging themes of discussion among bio- logists and philosophers. The current proposal is con- ceptually independent (though not incompatible) with the pluralist approach to the species problem advocated by Mishler, Donoghue, Kitcher and Dupre ́, which implies that distinct aspects of the species question need to be emphasized depending on the goals of the researcher. From the biological literature, the concept of species that most closely matches the philosophical discussion pre- sented here is Templeton’s cohesion idea. (shrink)

What would the institution of the family look like, if it were reformed according to republican desiderata? Would it even survive such re-shaping?

The most common approach to the problem of requests for futile treatment – the hospital futility policy – rests on the assumption that demands for futile treatment are both intractable and irrational. But there is another approach to the futility problem, an approach that would be dialogic, piecemeal, and case-by-case. This is the only approach that attempts to deal with both the hospital’s problem and the patient’s or family’s problem that motivates the request/demand for futile treatments. As such, it (...) holds the promise of resolving the problem of demands for futile treatment in a way that does not generate anger and ill will at the hospital staff for what will inevitably strike patients and their families as a blatant assertion of the hospital’s power. (shrink)

I shall argue that, with a proper realignment of core Confucian values, an explicitly feminist reading of Confucianism—a conception of Confucian feminism—could be constructed to promote the feminist goal of gender equality in contemporary Confucian societies. My paper proceeds in the following order: first, I shall identify two aspects of Confucianism implicated in the Confucian subjugation of women: li and family. Given the centrality of both li and family in Confucianism, it may seem that Confucianism is inherently antagonistic (...) to the feminist goal of gender equality. In order to determine whether this is the case, I shall reconstruct the valuational system of Confucianism and examine the proper locations of li and family within it. I shall argue that Confucian ethics promotes women’s self-cultivation on a par with men’s and that Confucian emphases on li and family do not necessitate the subjugation of women. However, some may worry that the importance of family in Confucianism may require the undivided attention of at least one parent, which in reality would be mostly the mother. To alleviate this worry, I shall argue that a democratic Confucian welfare state, entailed by the Confucian thought system, ought to pick up the responsibility of providing comprehensive assistance to families so that families can thrive in the Confucian polity. (shrink)

2022 UPDATE: The approach of this paper has been updated and developed further in the author’s 2021 book _Critique of Impure Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). ●●●●● The author distinguishes between the “information-oriented” approach of conservative, traditional philosophy, and an approach to (...) philosophy as “conceptual therapy.” The former emphasizes scholarship, textual explication and criticism, and, in general, a knowledge of the views of traditional thinkers. Philosophy as conceptual therapy, on the other hand, seeks an improvement of intellectual skills, and fosters a therapy for concepts and, by inference, a therapy for thinkers. The major concern of the paper is to argue that the traditional information-oriented approach to philosophy does not help its students effectively to develop intellectual skills, and that a conception of philosophy as conceptual therapy can provide a valuable contribution to the teaching and to the subject-matter of philosophy. (shrink)

The notion that the family is the unit of care for family doctors has been enigmatic and controversial. Yet systems theory and the biopsychosocial model that results when it is imported into medicine make the family system an indispensable and important component of family medicine. The challenge, therefore, is to provide a coherent, plausible account of the role of the family in family practice. Through an extended case presentation and commentary, we elaborate two views (...) of the family in family medicine — treating the patient in the family and treating the family in the patient — and defend both as appropriate foci for care by family doctors. The practical problem that arises when the family is introduced into health care is deciding when to concentrate on the family system. The moral problems that arise concern how extensively doctors may become involved in the personal lives of their patients and families. The patient-centered clinical method provides a strategy for handling both problems. Thus, making the family a focus of care in family medicine can be justified on theoretical, practical, and moral grounds. (shrink)

This paper develops the implications of Spinoza’s invocation in chapter 6 of the traditional analogy between the oikos and the polis. Careful attention to this analogy reveals a number of interesting features of Spinoza’s political theory. Spinoza challenges the perception that absolute monarchy offers greater respite from the intolerable anxiety of the state of nature than does democracy. He acknowledges that people associate monarchical rule with peace and stability, but asserts that it can too easily deform its subjects. Unchallenged monarchy (...) may be credited with a certain order, “but if slavery, barbarism, and desolation are to be called peace, there can be nothing more wretched for mankind than peace.” This is all familiar to friends of Spinoza, but what kind of democracy is the alternative to those monarchies that tend toward despotism? It is a form of association that, he suggests, resembles a bitterly quarrelsome but nevertheless virtuous family. Thus, he admits that democratic, or popular, rule is typically turbulent and disorderly, but urges his reader to view contentions and disputes as a kind of salutary discord that preserves rather than threatens virtue. (shrink)

This study evaluated the impact of fuel subsidy removal on family income and sustainability in Ondo City. The study adopted a descriptive survey research design. Three (3) research questions guided the study. The study population was comprised of all household members in Ondo Metropolis. The total population of the study is two hundred and fifty-three thousand, four hundred and sixty-two (253,462). The sample size was one hundred and eighty-five (185) and was randomly selected using a simple random technique. A (...) structured questionnaire was the research instrument used to elicit responses from the respondents. Split-half reliability was used to determine the instrument's consistency, and a correlation coefficient of 0.76 was obtained. Data collected were analysed using descriptive statistics. The findings revealed that the fluctuation of oil prices in the international market necessitated subsidy removal, and the higher cost of transportation increases the cost of food items. The study concluded that the factors that necessitate fuel subsidy removal have a significant relationship with the possible challenges encountered by households in family sustenance. It was therefore recommended that the government's actions, such as increasing civil servants' wages and providing incentives for business owners, could enable them to cope with the increasing prices of commodities, offering a hopeful outlook for the future. (shrink)