Dementia undermines all of our philosophical assumptions about the coherence of the self. But that might be a good thing
By Charles Leadbeater
Aeon
Originally published March 26, 2015
Here are two excerpts:
The memory-based account of identity is powerful, deeply rooted and dangerously partial. It will direct us to potential memory cures – a mixture of implants and drugs – that will almost certainly disappoint as much as they excite. Memory is not created in a little box in the brain, but by diffuse and dispersed circuits of neurons firing in concert. Someone with dementia would need more than an implant: they would need their brain refreshed and rewired. And still the nagging question would remain: are they the same person?
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The notion of an embedded identity takes us into much more fertile territory when it comes to considering meaningful care for dementia sufferers. It implies that the main challenge is to work imaginatively and empathetically to find common ground, creating conversational topics and cues that help make connections with people, despite their failing memory. As the British psychologist Oliver James explains in Contented Dementia (2008), this requires more skill and persistence than most conversations demand, precisely because its pre-suppositions cannot be taken for granted. My 85-year-old mother-in-law, for example, cannot always remember that she has a preserving pan, but that does not stop her enjoying making (and, even more, talking about making) marmalade.
The entire article is here.
Wednesday, April 15, 2015
Measuring the Return on Character
Harvard Business Review
April 2015
Here is an excerpt:
Character is a subjective trait that might seem to defy quantification. To measure it, KRW cofounder Fred Kiel and his colleagues began by sifting through the anthropologist Donald Brown’s classic inventory of about 500 behaviors and characteristics that are recognized and displayed in all human societies. Drawing on that list, they identified four moral principles—integrity, responsibility, forgiveness, and compassion—as universal. Then they sent anonymous surveys to employees at 84 U.S. companies and nonprofits, asking, among other things, how consistently their CEOs and management teams embodied the four principles. They also interviewed many of the executives and analyzed the organizations’ financial results. When financial data was unavailable, leaders’ results were excluded.
The entire article is here.
April 2015
Here is an excerpt:
Character is a subjective trait that might seem to defy quantification. To measure it, KRW cofounder Fred Kiel and his colleagues began by sifting through the anthropologist Donald Brown’s classic inventory of about 500 behaviors and characteristics that are recognized and displayed in all human societies. Drawing on that list, they identified four moral principles—integrity, responsibility, forgiveness, and compassion—as universal. Then they sent anonymous surveys to employees at 84 U.S. companies and nonprofits, asking, among other things, how consistently their CEOs and management teams embodied the four principles. They also interviewed many of the executives and analyzed the organizations’ financial results. When financial data was unavailable, leaders’ results were excluded.
The entire article is here.
Tuesday, April 14, 2015
Hannah Arendt: thinking versus evil
By Jon Nixon
The Times of Higher Education
Originally posted February 26, 2015
Here are two excerpts:
That is why the notion of “thinking” played such an important part in Arendt’s analysis of totalitarianism, from her 1951 The Origins of Totalitarianism to her highly controversial coverage of the Adolf Eichmann trial, the latter culminating in her 1963 book Eichmann in Jerusalem. In this, she famously employed the phrase “the banality of evil” to describe what she saw as Eichmann’s unquestioning adherence to the norms of the Nazi regime. In concluding from the occasional lies and inconsistencies in his courtroom testimony that Eichmann was a liar, the prosecution had missed the moral and legal challenge of the case: “Their case rested on the assumption that the defendant, like all ‘normal persons’, must have been aware of the criminal nature of his acts” – but, she added, Eichmann was normal only in so far as he was “no exception within the Nazi regime”. The prosecution had, according to Arendt’s analysis, failed to grasp the moral and political significance of Eichmann’s “abnormality”: namely, his adherence to the norms of the regime he had served and therefore his lack of awareness of the criminal nature of his acts.
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In Arendt’s view, Eichmann’s “banality” left him no less culpable – and rendered the death sentence no less justifiable – but it shifted the basis of the argument against him: if he was a monster, then his monstrosity arose from an all too human propensity towards thoughtlessness. If Heidegger had represented the unworldliness of “pure thought”, then Eichmann represented the unworldliness of “thoughtlessness”. Neither connected with the plurality of the world as Arendt understood it. A world devoid of thinking, willing and judging would, she argued, be a world inhabited by automatons such as Eichmann who lacked freedom of will and any capacity for independent judgement.
The entire article is here.
The Times of Higher Education
Originally posted February 26, 2015
Here are two excerpts:
That is why the notion of “thinking” played such an important part in Arendt’s analysis of totalitarianism, from her 1951 The Origins of Totalitarianism to her highly controversial coverage of the Adolf Eichmann trial, the latter culminating in her 1963 book Eichmann in Jerusalem. In this, she famously employed the phrase “the banality of evil” to describe what she saw as Eichmann’s unquestioning adherence to the norms of the Nazi regime. In concluding from the occasional lies and inconsistencies in his courtroom testimony that Eichmann was a liar, the prosecution had missed the moral and legal challenge of the case: “Their case rested on the assumption that the defendant, like all ‘normal persons’, must have been aware of the criminal nature of his acts” – but, she added, Eichmann was normal only in so far as he was “no exception within the Nazi regime”. The prosecution had, according to Arendt’s analysis, failed to grasp the moral and political significance of Eichmann’s “abnormality”: namely, his adherence to the norms of the regime he had served and therefore his lack of awareness of the criminal nature of his acts.
(cut)
In Arendt’s view, Eichmann’s “banality” left him no less culpable – and rendered the death sentence no less justifiable – but it shifted the basis of the argument against him: if he was a monster, then his monstrosity arose from an all too human propensity towards thoughtlessness. If Heidegger had represented the unworldliness of “pure thought”, then Eichmann represented the unworldliness of “thoughtlessness”. Neither connected with the plurality of the world as Arendt understood it. A world devoid of thinking, willing and judging would, she argued, be a world inhabited by automatons such as Eichmann who lacked freedom of will and any capacity for independent judgement.
The entire article is here.
The Ethics of Physicians’ Web Searches for Patients’ Information
Nicholas Genes and Jacob Appel
The Journal of Clinical Ethics
Volume 26, Number 1, Spring 2015
When physicians search the web for personal information about their patients, others have argued that this undermines patients’ trust, and the physician-patient relationship in general. We add that this practice also places other relationships at risk, and could jeopardize a physician’s career.
Yet there are also reports of web searches that have unambiguously helped in the care of patients, suggesting circumstances in which a routine search of the web could be beneficial. We advance the notion that, just as nonverbal cues and unsolicited information can be useful in clinical decision making, so too can online information from patients. As electronic records grow more voluminous and span more types of data, searching these resources will become a clinical skill, to be used judiciously and with care—just as evaluating the literature is, today.
But to proscribe web searches of patients’ information altogether is as nonsensical as disregarding findings from physical exams—instead, what’s needed are guidelines for when to look and how to evaluate what’s uncovered, online.
The entire article is here.
The Journal of Clinical Ethics
Volume 26, Number 1, Spring 2015
When physicians search the web for personal information about their patients, others have argued that this undermines patients’ trust, and the physician-patient relationship in general. We add that this practice also places other relationships at risk, and could jeopardize a physician’s career.
Yet there are also reports of web searches that have unambiguously helped in the care of patients, suggesting circumstances in which a routine search of the web could be beneficial. We advance the notion that, just as nonverbal cues and unsolicited information can be useful in clinical decision making, so too can online information from patients. As electronic records grow more voluminous and span more types of data, searching these resources will become a clinical skill, to be used judiciously and with care—just as evaluating the literature is, today.
But to proscribe web searches of patients’ information altogether is as nonsensical as disregarding findings from physical exams—instead, what’s needed are guidelines for when to look and how to evaluate what’s uncovered, online.
The entire article is here.
Monday, April 13, 2015
Steps to Strengthen Ethics in Organizations: Research Findings, Ethics Placebos, and What Works
By Ken Pope
Journal of Trauma & Dissociation
Volume 16, Issue 2, 2015
Abstract
Research shows that many organizations overlook needs and opportunities to strengthen ethics. Barriers can make it hard to see the need for stronger ethics and even harder to take effective action. These barriers include the organization’s misleading use of language, misuse of an ethics code, culture of silence, strategies of justification, institutional betrayal, and ethical fallacies. Ethics placebos tend to take the place of steps to see, solve, and prevent problems. This article reviews relevant research and specific steps that create change.
The entire article is here.
Journal of Trauma & Dissociation
Volume 16, Issue 2, 2015
Abstract
Research shows that many organizations overlook needs and opportunities to strengthen ethics. Barriers can make it hard to see the need for stronger ethics and even harder to take effective action. These barriers include the organization’s misleading use of language, misuse of an ethics code, culture of silence, strategies of justification, institutional betrayal, and ethical fallacies. Ethics placebos tend to take the place of steps to see, solve, and prevent problems. This article reviews relevant research and specific steps that create change.
The entire article is here.
Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia
Maust DT, Kim H, Seyfried LS, et al.
Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia: Number Needed to Harm.
JAMA Psychiatry. Published online March 18, 2015.
doi:10.1001/jamapsychiatry.2014.3018.
Importance
Antipsychotic medications are associated with increased mortality in older adults with dementia, yet their absolute effect on risk relative to no treatment or an alternative psychotropic is unclear.
Objective
To determine the absolute mortality risk increase and number needed to harm (NNH) (ie, number of patients who receive treatment that would be associated with 1 death) of antipsychotic, valproic acid and its derivatives, and antidepressant use in patients with dementia relative to either no treatment or antidepressant treatment.
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Conclusions and Relevance
The absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose.
The research article is here.
Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia: Number Needed to Harm.
JAMA Psychiatry. Published online March 18, 2015.
doi:10.1001/jamapsychiatry.2014.3018.
Importance
Antipsychotic medications are associated with increased mortality in older adults with dementia, yet their absolute effect on risk relative to no treatment or an alternative psychotropic is unclear.
Objective
To determine the absolute mortality risk increase and number needed to harm (NNH) (ie, number of patients who receive treatment that would be associated with 1 death) of antipsychotic, valproic acid and its derivatives, and antidepressant use in patients with dementia relative to either no treatment or antidepressant treatment.
(cut)
Conclusions and Relevance
The absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose.
The research article is here.
Sunday, April 12, 2015
Human, All Too Human: 3-Part Documentary Profiles Nietzsche, Heidegger & Sartre
From Open Culture
Originally published in April 8, 2014
Certainly three of the most radical thinkers of the last 150 years, Nietzsche, Heidegger, and Sartre were also three of the most controversial, and at times politically toxic, for their perceived links to totalitarian regimes. In Nietzsche’s case, the connection to Nazism was wholly spurious, concocted after his death by his anti-Semitic sister. Nevertheless, Nietzsche’s philosophy is far from sympathetic to equality, his politics, such as they are, highly undemocratic. The case of Heidegger is much more disturbing—a member of the Nazi party, the author of Being and Time notoriously held fascist views, made all the more clear by the recent publication of his infamous “black notebooks.” And Sartre, author of Being and Nothingness, has long been accused of supporting Stalinism—a charge that may be oversimplified, but is not without some merit.
The three 50 minute videos are here.
Originally published in April 8, 2014
Certainly three of the most radical thinkers of the last 150 years, Nietzsche, Heidegger, and Sartre were also three of the most controversial, and at times politically toxic, for their perceived links to totalitarian regimes. In Nietzsche’s case, the connection to Nazism was wholly spurious, concocted after his death by his anti-Semitic sister. Nevertheless, Nietzsche’s philosophy is far from sympathetic to equality, his politics, such as they are, highly undemocratic. The case of Heidegger is much more disturbing—a member of the Nazi party, the author of Being and Time notoriously held fascist views, made all the more clear by the recent publication of his infamous “black notebooks.” And Sartre, author of Being and Nothingness, has long been accused of supporting Stalinism—a charge that may be oversimplified, but is not without some merit.
The three 50 minute videos are here.
Saturday, April 11, 2015
Amid a Sea of False Findings, the NIH Tries Reform; Science needs to get its house in order, says Francis Collins, director of the NIH
By Paul Voosen
Chronicle of Higher Education
Originally published March 16, 2015
How do you change an entire scientific culture?
It may sound grandiose, but that is the loaded question now facing the National Institutes of Health, the federal agency that oversees and finances U.S. biomedical research.
While the public remains relatively unaware of the problem, it is now a truism in the scientific establishment that many preclinical biomedical studies, when subjected to additional scrutiny, turn out to be false.
Many researchers believe that if scientists set out to reproduce preclinical work published over the past decade, a majority would fail.
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The NIH, if it was at first reluctant to consider the problem, is now taking it seriously. Just over a year ago, the agency's director, Francis S. Collins, and his chief deputy, Lawrence A. Tabak, announced actions the agency would take to improve the research it finances.
Science needs to get its house in order, Dr. Collins said in a recent interview with The Chronicle.
The entire article is here.
Chronicle of Higher Education
Originally published March 16, 2015
How do you change an entire scientific culture?
It may sound grandiose, but that is the loaded question now facing the National Institutes of Health, the federal agency that oversees and finances U.S. biomedical research.
While the public remains relatively unaware of the problem, it is now a truism in the scientific establishment that many preclinical biomedical studies, when subjected to additional scrutiny, turn out to be false.
Many researchers believe that if scientists set out to reproduce preclinical work published over the past decade, a majority would fail.
(cut)
The NIH, if it was at first reluctant to consider the problem, is now taking it seriously. Just over a year ago, the agency's director, Francis S. Collins, and his chief deputy, Lawrence A. Tabak, announced actions the agency would take to improve the research it finances.
Science needs to get its house in order, Dr. Collins said in a recent interview with The Chronicle.
The entire article is here.
Telepsychology, Telehealth, & Internet-Based Therapy
From Ken Pope's site
I gathered the following resources to help therapists, counselors, and other clinicians to keep abreast of the rapidly evolving professional guidelines, research, treatments, innovations, and practices in the areas of telepsychology, telehealth, internet-based therapy.
I've divided the resources into 3 sections:
1) Links to 24 sets of professional guidelines that focus on telepsychology, online counseling, internet-based therapy, etc.
2) Citations for 51 recent (i.e., published in 2013-2015) articles
3) State Psychology Board Telepsychology Laws, Regulations, Policies, & Opinions--This third section was generously compiled by psychologist Kenneth R. Drude, and I am indebted to him for his kind offer to post it here.
The resource page is here.
I will link it in the Guides and Guidelines section of this site.
I gathered the following resources to help therapists, counselors, and other clinicians to keep abreast of the rapidly evolving professional guidelines, research, treatments, innovations, and practices in the areas of telepsychology, telehealth, internet-based therapy.
I've divided the resources into 3 sections:
1) Links to 24 sets of professional guidelines that focus on telepsychology, online counseling, internet-based therapy, etc.
2) Citations for 51 recent (i.e., published in 2013-2015) articles
3) State Psychology Board Telepsychology Laws, Regulations, Policies, & Opinions--This third section was generously compiled by psychologist Kenneth R. Drude, and I am indebted to him for his kind offer to post it here.
The resource page is here.
I will link it in the Guides and Guidelines section of this site.
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