Results of salt intake restriction monitored with the new sodium control biosensor

Adherence to a low sodium (Na) diet is crucial in patients under hemodialysis, as it improves cardiovascular outcomes and reduces thirst and interdialytic weight gain. Recommended salt intake is lower than 5 g/day. The new 6008 CareSystem monitors incorporate a Na module that offers the advantage of estimating patients' salt intake. The objective of this study was to evaluate the effect of dietary Na restriction for 1 week, monitored with the Na biosensor.A prospective study was conducted in 48 patients who maintained their usual dialysis parameters and were dialyzed with a 6008 CareSystem monitor with activation of the Na module. Total Na balance, pre/postdialysis weight, serum Na (sNa), changes in pre- to post-dialysis sNa (ΔsNa), diffusive balance, and systolic and diastolic blood pressure were compared twice, once after 1 week of patients' usual Na diet and again after another week with more restricted Na intake.Restricted Na intake increased the percentage of patients on a low-sodium diet (<85 Na mmol/day) from 8% to 44%. Average daily Na intake decreased from 149 ± 54 to 95 ± 49 mmol and interdialytic weight gain was reduced by 460 ± 484 g per session. More restricted Na intake also decreased pre-dialysis sNa and increased both intradialytic diffusive balance and ΔsNa. In hypertensive patients, reducing daily sodium by more than 3 g Na/day lowered their systolic blood pressure.The new Na module allowed objective monitoring of Na intake, which in turn could permit more precise personalized dietary recommendations in patients under hemodialysis.S. Karger AG, Basel

The Moral Duty of Self-Preservation

UIDB/00183/2020 UIDP/00183/2020This chapter provides an in-depth examination of Kant’s view of suicide. After a contextualization of Kant’s prohibition of suicide (§2.1), seven different arguments against the moral permissibility of suicide are identified: three from the Lectures on Ethics (§2.2) and four from the published writings (§2.3). Each argument is presented (with possible variations) and explained. Strengths and flaws are pointed out, and possible objections and counter-objections are discussed, taking into consideration the abundant bibliography on the subject. The conclusion is that, against a recent trend in secondary literature, which tends to read Kant as justifying not only a right, but even a duty to suicide, Kant does not allow for any exception to his strict prohibition of suicide.authorsversionpublishe

Why Moral Expertise Needs Moral Theory

Discussions of the nature or possibility of moral expertise have largely proceeded in atheoretical terms, with little attention paid to whether moral expertise depends on theoretical knowledge of morality. Here I argue that moral expertise is more theory-dependent than is commonly recognized: Moral expertise consists, at least in part, in knowledge of the correct or best moral theory, and second, that knowledge of moral theory is essential to moral experts dispensing expert counsel to non-experts. Moral experts would not be moral experts absent knowledge of moral theory, nor could they play the testimonial role we would expect them to play in moral inquiry and deliberation absent such knowledg

Depression and Motivation

Among the characteristic features of depression is a diminishment in or lack of action and motivation. In this paper, I consider a dominant philosophical account which purports to explain this lack of action or motivation. This approach comes in different versions but a common theme is, I argue, an over reliance on psychologistic assumptions about action–explanation and the nature of motivation. As a corrective I consider an alternative view that gives a prominent place to the body in motivation. Central to the experience of depression are changes to how a person is motivated to act and, also as central, are changes to bodily feelings and capacities. I argue that broadly characterizing motivation in terms of bodily capacities can, in particular, provide a more compelling account of depressive motivational pathology

Penal Disenfranchisement

This paper considers the justifiability of removing the right to vote from those convicted of crimes. Firstly, I consider the claim that the removal of the right to vote from prisoners (or serious offenders) is necessary as a practical matter to protect the democratic process from those who have shown themselves to be untrustworthy. Secondly, I look at the claim that offenders have broken the social contract and forfeited rights to participate in making law. And thirdly, I look at the claim that the voting ban is essential part of the justified punishment of serious offenders. These arguments have in common the feature that they attempt to articulate the sense in which rights imply responsibilities, particularly that voting rights should be conditional on one's having met one's civic responsibilities. I argue that the only interpretation of this view that could justify prisoner disenfranchisement is that which thinks of disenfranchisement as fair and deserved retributive punishment for crime. Against widespread opposition to, and confusion about, the importance of retributive punishment, I offer a brief defence. However, I conclude that even if legitimate retributive purposes could in principle justify prisoner disenfranchisement, the significance of disenfranchisement is such that it should be reserved for the most serious crimes. © 2014 Springer Science+Business Media Dordrecht

Parenting the Parents: The Ethics of Parent-Targeted Paternalism in the Context of Anti-poverty Policies

Governments often aim to improve children’s wellbeing by targeting the decision-making of their parents. In this paper, I explore this phenomenon, providing an ethical evaluation of the ways in which governments target parental decision-making in the context of anti-poverty policies. I first introduce and motivate the concept of parent-targeted paternalism to categorize such policies. I then investigate whether parent-targeted paternalism is ever pro tanto wrong, arguing that it is when directed at parents who meet a threshold of parental competency. I next explore the factors that affect the degree of pro tanto wrongness of paternalistic anti-poverty policies targeting parents, and provide an account of the conditions under which such policies are on balance permissible, and when they are not. Finally, I illustrate the plausibility and usefulness of my framework by considering a case

Self‐manslaughter and the forensic classification of self‐inflicted death

By emphasising the intentions underlying suicidal behaviour, suicidal death is distinguished from accidental death in standard philosophical accounts on the nature of suicide. A crucial third class of self‐produced deaths, deaths in which agents act neither intentionally nor accidentally to produce their own deaths, is left out by such accounts. Based on findings from psychiatry, many life‐threatening behaviours, if and when they lead to the agent's death, are suggested to be neither intentional nor accidental, with many apparently suicidal behaviours being of this sort, especially the so‐called “cries for help”. This category may be usefully analogised to the existing legal category of manslaughter