The Future of Psychopharmacological Enhancements: Expectations and Policies

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed

Flowcharts for the management of biliary tract and ampullary carcinomas

No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated type of PBM is a risk factor for gallbladder carcinoma. Symptoms that may indicate biliary tract carcinoma are jaundice and pain in the upper right area of the abdomen. The first step of diagnosis is to carry out blood biochemistry tests and ultrasonography (US) of the abdomen. The second step of diagnosis is to find the local extension of the carcinoma by means of computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP). Because resection is the only way to completely cure biliary tract carcinoma, the indications for resection are determined first. In patients with resectable disease, the indications for biliary drainage or portal vein embolization (PVE) are checked. In those with nonresectable disease, biliary stenting, chemotherapy, radiotherapy, and/or best supportive care is selected

Libertarian paternalism: Policy and everyday translations of the rational and the affective

Following the financial collapse in 2008 many commentators went onto pronounce the end of neoliberalism as a credible system for managing welfare state capitalism. The narrow economic belief in individuals as rational utility maximizers (the linchpin of neoliberal governance) was proved to be uncomfortably inaccurate. In light of these claims, British governments and think tanks have published various research and pol-icy documents promoting the use of soft forms of state power to ‘nudge’ citizens into behaving responsibly and rationally. Through an analysis of key policy documents and academic texts, I examine the repertoires and formulations informing this emerging governmental rationality (‘libertarian paternalism’) and draw together these perspectives to explore their effects in terms of framing policy understandings of the rational and the emotional. I conclude the article by utilizing a discursive psychology approach with the aim to problematize existing policy (mis)understandings of emotion as automated and unreflexive

Visuospatial attention and the split brain

In callosotomy patients, the right hemisphere attends to the entire visual field, whereas the left hemisphere attends to the right field only. The occurence of rightward attentional biases, simulating a hemineglect from right hemisphere damage, suggests that in these patients visuospatial attention tends to be controlled by the left hemisphere

The neural correlates of language production

This chapter reviews the findings of 58 word production experiments using different tasks and neuroimaging techniques. The reported cerebral activation sites are coded in a common anatomic reference system. Based on a functional model of language production, the different word production tasks are analyzed in terms of their processing components. This approach allows a distinction between the core process of word production and preceding taks-specific processes (lead-in processes) such as visual or auditory stimulus recognition. The core process of word production is subserved by a left-lateralized perisylvian/thalamic language production network. Within this network there seems to be functional specialization for the processing stages of word production. In addition, this chapter includes a discussion of the available evidence on syntactic production, self-monitoring, and the time course of word production

The neural correlates of language production

This chapter reviews the findings of 58 word production experiments using different tasks and neuroimaging techniques. The reported cerebral activation sites are coded in a common anatomic reference system. Based on a functional model of language production, the different word production tasks are analyzed in terms of their processing components. This approach allows a distinction between the core process of word production and preceding taks-specific processes (lead-in processes) such as visual or auditory stimulus recognition. The core process of word production is subserved by a left-lateralized perisylvian/thalamic language production network. Within this network there seems to be functional specialization for the processing stages of word production. In addition, this chapter includes a discussion of the available evidence on syntactic production, self-monitoring, and the time course of word production