Thesis (PhD)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Autonomy and informed consent are two interrelated concepts given much prominence in contemporary biomedical discourse. The word autonomy, from the Greek autos (self) and nomos (rule), originally referred to the self-governance of independent Hellenic states, but was extended to individuals during the time of the Enlightenment, most notably through the work of Immanuel Kant and John Stuart Mill. In healthcare, the autonomy model is grounded in the idea of the dignity of persons and the claim people have on each other to privacy, self-direction, the establishment of their own values and life plans based on information and reasoning, and the freedom to act on the results of their contemplation. Autonomy thus finds expression in the ethical and legal requirement of informed consent. Feminists and multiculturalists have however argued that since autonomy rests on the Enlightenment ideals of rationality, objectivity and independence, unconstrained by emotional and spiritual qualities, it serves to isolate the individual and thus fails to rectify the dehumanisation and depersonalisation of modern scientific medical practice. It only serves to exacerbate the problematic power-differential between doctor and patient. Medicine is a unique profession since it operates in a space where religion, morality, metaphysics, science and culture come together. It is a privileged space because health care providers assume responsibility for the care of their patients outside the usual moral space defined by equality and autonomy. Patients necessarily relinquish some of their autonomy and power to experts and autonomy thus cannot account for the moral calling that epitomizes and defines medicine. Recognition of the dependence of patients need not be viewed negatively as a lack of autonomy or incompetence, but could rather reinforce the understanding of our shared human vulnerability and that we are all ultimately patients. There is however no need to abandon the concept of autonomy altogether. A world without autonomy is unconceivable. When we recognise how the concept functions in the modern world as a social construct, we can harness its positive properties to create a new form of identity. We can utilise the possibility of self-stylization embedded in autonomy to fashion ourselves into responsible moral agents that are responsive not only to ourselves, but also to others, whether in our own species or in that of another. Responsible agency depends on mature deliberators that are mindful of the necessary diversity of the moral life and the complex nature of the moral subject. I thus argue that the development of modern individualism should not be rejected altogether, since we cannot return to some pre-modern sense of community, or transcend it altogether in some postmodern deconstruction of the self. We also do not need to search for a different word to supplant the concept of autonomy in moral life. What we rather need is a different attitude of being in the world; an attitude that strives for holism, not only of the self, but also of the moral community. We can only be whole if we acknowledge and embrace our interdependence as social and moral beings, as Homo moralis. / AFRIKAANSE OPSOMMING: Outonomie en ingeligte toestemming is twee nou verwante konsepte wat beide prominensie in moderne bioetiese diskoers verwerf het. Die woord outonomie, van die Grieks autos (self) en nomos (reël), het oorspronklik verwys na die selfbestuur van onafhanklike Griekse state, maar is in die tyd van die Verligting uitgebrei om ook na individue te verwys, grotendeels deur die werk van Immanuel Kant en John Stuart Mill. In medisyne is die outonomie model gegrond op die idee van die waardigheid van die persoon en die beroep wat mense op mekaar het tot privaatheid, selfbepaling, die daarstelling van hulle eie waardesisteem en lewensplan, gebasseer op inligting en redenasie, en die vryheid om op die uitkoms van sulke redenasie te reageer. Outonomie word dus vergestalt in die etiese en wetlike bepaling van ingeligte toestemming. Feministe en multikulturele denkers beweer egter dat, siende outonomie gebasseer is op die Verligting ideale van rasionaliteit, objektiwiteit en onafhanklikheid, sonder die nodige begrensing deur emosionele en spirituele kwaliteite, dit die individu noodsaaklik isoleer en dus nie die dehumanisering en depersonalisering van moderne wetenskaplike mediese praktyk teenwerk nie. As sulks, vererger dit dus die problematiese magsverskil tussen die dokter en pasiënt. Die beroep van medisyne is ‘n unieke professie aangesien dit werksaam is in die sfeer waar geloof, moraliteit, metafisika, wetenskap en kultuur bymekaar kom. Dit is ‘n bevoorregde spasie aangesien gesondheidswerkers verantwoordelikheid vir die sorg van hulle pasiënte aanvaar buite die gewone morele spasie wat deur gelykheid en outonomie gedefinieer word. Pasiënte moet noodgedwonge van hulle outonomie en mag aan deskundiges afstaan en outonomie kan dus nie genoegsaam die morele roeping wat medisyne saamvat en definieer, vasvang nie. Bewustheid van die afhanklikheid van pasiënte hoef egter nie in ‘n negatiewe lig, as gebrek aan outonomie of onbevoegtheid, beskou te word nie, maar moet eerder die begrip van ons gedeelde menslike kwesbaarheid en die wete dat ons almal uiteindelik pasiënte is, versterk. Dit is verder nie nodig om die konsep van outonomie heeltemal te verwerp nie. ‘n Wêreld sonder outonomie is ondenkbaar. Wanneer ons bewus word van hoe die konsep in die moderne wêreld as ‘n sosiale konstruk funksioneer, kan ons die positiewe aspekte daarvan inspan om ‘n nuwe identiteit te bewerkstellig. Ons kan die moontlikheid van self-stilering, ingesluit in outonomie, gebruik om onsself in verantwoordelike morele agente te omskep sodat ons nie slegs teenoor onsself verantwoordelik is nie, maar ook teenoor ander, hetsy in ons eie spesie of in ‘n ander. Verantwoordelike agentskap is afhanklik van volwasse denkers wat gedagtig is aan die noodsaaklike diversiteit van die morele lewe en die komplekse aard van die morele subjek. Ek voer dus aan dat die ontwikkeling van moderne individualisme nie volstrek verwerp moet word nie, siende dat ons nie na ‘n tipe premoderne vorm van gemeenskap kan terugkeer, of dit oortref deur ‘n postmoderne dekonstruksie van die self nie. Ons het verder ook nie ‘n nuwe woord nodig om die konsep van outonomie in die morele lewe mee te vervang nie. Ons het eerder ‘n ander instelling van ons menswees in die wêreld nodig; ‘n instelling wat streef na volkomendheid, nie net van onsself nie, maar ook van die morele gemeenskap. Ons kan slegs volkome wees wanneer ons ons interafhanklikheid as sosiale en morele entiteite, as Homo moralis, erken en aangryp.

Abstract The act of knowing is a critical determinant of what is known, yet there are limits and potential violence inherent in all ways of knowing. Social workers have an ethical responsibility to understand our means of knowing and our knowledge claims – both shape the work we do. Conspicuously under-represented as creators of/commentators on how they are represented, people with intellectual disabilities have had little/no control over what or how they are known. These ethical and epistemological concerns were the focus of this arts-informed qualitative study. The purpose was an interrogative encounter with one way of knowing – how public photographic imagery of people with intellectual disabilities influences knowledge about them. It was concerned, however, to come to this knowledge through an inquiry into how labelled people would, themselves, interpret and respond to these representations, and how they might use photography to trouble disabling images and non-disabled (social work) knowing. Theoretically framed by a critical disability lens, the work was influenced, too, by Derrida’s essay on photography, “The Right of Inspection”. The other regarding aspect of the philosophy of Emmanuel Levinas, his concern with our ethical responsibility to the alterity of the Other, most powerfully informs the work. Four adults with intellectual disabilities accepted the invitation to participate in this project. First, they critically engaged with a selection of public photographic images. In a unique methodological turn, they then transformed the images to reflect their critique. Interpretive analysis of the critiques and transformations identified four thematic ideas. Participants’ critiques were insightful and profound; transformations provocative and disruptive. Challenging dominant assumptions – and demanding non-disabled others re-think intellectual disability and people so labeled – the critiques and transformations also respond to the social/political/ideological/psychological ramifications of photographic imagery on the lived experience of intellectual disability. Through the work, participants confront non-disabled responses to public photographs and to labeled people, challenging non-disabled others to question their knowledge, attitudes, and behaviours. The work also raises questions about research and people with intellectual disabilities: the possibilities for voice and empowerment through inclusive research strategies and visual methodologies, and the transformative potential of dialogic encounters between people with and without intellectual disabilities.

This thesis considers the problem of finitely iterated rational secret sharing. We describe how to evaluate this problem using game theory and finitely iterated prisoner’s dilemma. The players each have a private horizon that the other player does not know. The only thing that a player knows about their opponent’s private horizon is a common upper bound. The description of a synchronous and asynchronous finitely iterated secret sharing protocol with private information is followed by a game theoretic proof of the viability of such protocols. / Graduate

Different people can have different cultural interpretations of the person—atomic versus embedded—and these may affect health care decision-making. This study examines both the ethics of variations in personhood as well as their implications for the doctrine of informed consent and the duty to warn of genetic disease risk. It argues that variations in personhood are consistent with the ethics of the Principle of Autonomy and the Canadian stand on informed consent, though autonomy and consent play out differently in practice on the two models. Also as a result of different interpretations of the person, the duty to warn of hereditary risk is found to be relevant to the atomic conception but unnecessary among embedded individuals. / Graduate / 0422 / 0566 / 0326 / pkdheri@uvic.ca

The purpose of this study is to evaluate the effectiveness of an intervention model designed to enhance practitioners’ biological lens when using a biopsychosocial-spiritual model of holistic assessment and planning. The specific intervention utilized is a course curriculum developed to broaden human service professionals’ (including clinical social work professionals) understanding of attachment theory, neuroscience and trauma informed methods of practice. The course teaches professionals how to apply this knowledge to clinical assessment and intervention planning with youth who have experienced significant trauma in their lives and exhibit problems of conduct. Using an experimental design, participants from a large private mental health organization were asked to evaluate the impact of curriculum on their 1) knowledge of attachment theory, trauma informed practice and neurobiology; 2) attitudes concerning the relevance of trauma-informed practice, the biological perspective and consequence focused models of intervention; and 3) assessment and intervention planning strategies. The curriculum focused its application on youth who have experienced significant levels of trauma and display conduct related behavior problems. Group differences for the workshop intervention group and waitlist control group are discussed. Additionally, a preliminary evaluation of differences between two different intervention groups (participants in the Distance Learning version of the course and the Workshop Seminar version of the course) was conducted.

An informed consent of a patient is an institute in the area of medical law, which is still being developed and deals with both private and public legislation. It is one of the legal reasons for interference into physical and mental integrity of a patient, without which every act would be unlawful. This thesis provides an overview of the current legislation of this institute in the light of the new Civil Code, outlines possible application issues between the new legislation and the legislation that is no longer effective. The aim of this thesis is to give a comprehensive review of the criminal aspects of the informed consent, especially its role as a circumstance of justification. The content of this thesis is an analogous legislation in the Federal Republic of Germany, which is being compared to the Czech legislation in the final chapter. The thesis consists of seven chapters. The first one deals with the relationship between the doctor and the patient and its changes in time periods, which are necessary for the new legislation to be well understood. The second chapter gives an overview of the current legislation starting with the constitutional law, including international treatments, statutes, the Code of Ethics, all over to the regulation of the Czech Medical Chamber. It focuses on specific parts...

Subject matter of this thesis is the problem of informed trading on the Prague Stock Exchange. This topic is developed in two directions. First one is empirical analysis of informed trading, which makes use of unique dataset which includes trading in XETRA and SPAD. This dataset enabled the author to compare change in measures of informed trading in respective trading systems. For this comparison models PIN and VPIN are used, the latter for the first time in Czech academic research. Model PIN brings the result that the probability of informed trading has significantly decreased following the transition to XETRA. On the contrary, results of VPIN metric suggest that measure of toxic liquidity has slightly increased. Second one is economic analysis of law. On the basis of economic insight two regulatory issues are identified - the problem of inside information and conflict of interest in case of market makers. Legal analysis has brought two key findings - problem of inside information is the result of incomplete implementation of european legislature and the conflict of interest is attributed to its improper treatment, based on the concept of fiduciary duties, which are hard to enforce in this particular case. Proposal how to fix these problems suggests "chinese wall" as the solution which would...

This dissertation consists of two essays: the first investigates informed trading in the Chinese stock exchanges, and the second examines the persistency of correlation of currency future prices. For the first essay, using a sample of Chinese firms dual-listed in both the China mainland stock exchange and the Hong Kong stock exchange, I investigate the two types of informed trading - insider trading and trading derived from better analysis in the A-and H-share markets. The results suggest that H-shares have relatively more informed trading based on better analysis. In addition, the results from the firm size regression can also be seen as indirect evidence that larger firms tend to have trading with better analysis and less insider trading. These patterns are also confirmed in the sub-period analysis. However, I find no significant relation between informed trading and the relative pricing of A- and H-shares. For the second essay I examine the dynamic correlation between currency futures prices, focusing on the persistency of correlation of currency prices. Using the Dynamic Conditional Correlation model developed by Engle (2002), this study incorporates time-varying correlations into the analysis. The sample includes eight currency futures traded on the Chicago Mercantile Exchange from 1999 to 2008 and the U.S. dollar index future. The study finds that the Canadian dollar has the greater persistency while the Brazilian real has the weakest. No less important, the study finds that the time-varying conditional correlation between currency futures and the U.S. dollar futures is influenced by two types of liquidity: price impacts (Amihud illiquidity) and the logarithm of trading volume.

In the first chapter, we analyze the role of market development, risk premium, and transparency as factors influencing the value of cash in firms listed as American Depository Receipts. Based on the method by Pinkowitz and Williamson (2002), our primary results are as follows. The market value of cash is greater on average for ADR firms than for U.S. firms, and within the ADR sample the value of cash is greater for firms based in less developed countries after 2007 financial crisis but not before. Together, the results suggest that the market development is especially important during more volatile periods. Further, the value of cash is negatively associated with the market risk premium. In addition, the relation between insider trading law execution and the value of cash is statistically insignificant for all periods, but corporate-level transparency as measured by the number of analysts is weakly negatively related to ADR firms’ cash value before 2007 after controlling for the fixed effects. The second chapter attempts to assess the relative importance of superior information and hedging in institutional trading in equity index futures in the Taiwan Futures market for the sample period of January to June 2012. Based on the methodology by Llorente, Michaely, Saar, and Wang (2002), we find that, for the market as a whole, significant informed trading or hedging frequently occur, and the opening minutes tend to be associated with a greater portion of trading motivated by hedging. More important to our purpose, for foreign institutions the absolute value of institutional order imbalance tends to be greater on days when the overall market’s informed trading is greater in the cases of regular contract on Taiwan composite index futures and electronic index futures, but for the dealer and domestic fund groups trading is not correlated with the overall market’s informed trading or hedging. An additional analysis of the relation between past institution trades and current returns provides some evidence implying institutions are informed, but the evidence can also be interpreted as their trades, which account for more than half of the overall trading, having an impact on subsequent trades.

A dor crônica atinge grande parte da população mundial 7% a 8%(FREITAS, 2015b) Estes números mostram a prevalência e necessidade de estudar os mecanismos da dor neuropática a fim de contribuir para a melhora deste quadro no Brasil e no mundo. Lesões de nervo periférico causam, frequentemente, alterações sensoriais crônicas, particularmente, aquelas associadas ao sistema nociceptivo (GAO; JI, 2010). A dor crônica de origem neuropática é uma síndrome incurável que ocorre pela lesão do sistema nervoso central ou periférico e caracteriza-se por alodínea, hiperalgesia, ativação espontânea de nociceptores e expansão da área hipersensibilizada,o tratamento farmacológico para restaurar a função sensorial após a lesão de nervo periférico tem pouco ou nenhum sucesso, tornando fundamental o desenvolvimento de novas estratégias terapêuticas e a identificação de seus mecanismos de ação ((J et al., 2012) NIZARD et al., 2012; (KK., 2008; JIANG, 2010) (J et al., 2012; JAIN, 2008; JIANG, 2010) sabendo que dos benefícios do exercício físico o objetivo deste estudo foi estudar os mecanismos desencadeados pelo exercício (5 sessões de treino, natação, de 20 minutos com intervalo de 48 horas nas intensidades 30, 50 e 75% da MFEL) mudanças fenotípicas, proteicas, do grupo de animais com lesão no nervo e relaciona-las com a melhor resposta nociceptiva. A atividade física será quantificada e monitorada através da MFEL e relacionada com alterações crônicas da sensibilidade somática, a fim de planejar uma estratégia de treinamento que tenha os melhores benefícios provocados pelo exercício. Resultados: a quantificação de treino através da MFEL estipulou a carga de 3.25%, 3.15% e 2.74% do peso corporal respectivamente para os grupos controle, lesão fictícia e lesão. Conclusão: Foi determinada a máxima fase estável do lactato para o modelo de dor neuropática, possibilitando assim a construção do protocolo de exercício físico. A menor carga de exercício,50% da MFEL, promoveu analgesia nos animais que praticaram natação. Não Existem diferenças nas intensidades 50 e 75% da MFEL, em relação a nocicepção ,avaliado pelo teste de sensibilidade mecânica / Chronic pain affects a large part of the world population 7% to 8% (FREITAS, 2015), These figures show the prevalence and necessity of studying the mechanisms of neuropathic pain in order to contribute to the improvement of this situation in Brazil and in the world. Peripheral nerve lesions often cause chronic sensory changes, particularly those associated with the nociceptive system (GAO; JI, 2010). Chronic pain of neuropathic origin is an incurable syndrome that occurs due to injury of the central or peripheral nervous system and is characterized by alodyne, hyperalgesia, spontaneous activation of nociceptors and expansion of the hypersensitized area, pharmacological treatment to restore sensory function after injury of the peripheral nerve has little or no success, making fundamental the development of new therapeutic strategies and the identification of its mechanisms of action (NIZARD et al., 2012; JAIN, 2008; G et al., 2010). The objective of this study was to study the mechanisms triggered by the exercise (5 training sessions, swimming, of 20 minutes with 48 hour intervals in the intensities 30, 50 and 75% of MFEL) phenotypic and protein changes of the group of animals with lesion on the nerve and relates them to the best nociceptive response. Physical activity will be quantified and monitored through MFEL and related to chronic changes in somatic sensitivity in order to plan a training strategy that has the best benefits of exercising. Results: The training quantification through MFEL stipulated the load of 3.25%, 3.15% and 2.74% of body weight respectively for the control, fictitious lesion and injury groups. Conclusion: The maximum stable phase of lactate was determined for the neuropathic pain model, thus enabling the construction of the physical exercise protocol. The lower exercise load, 50% of MFEL, promoted analgesia in the animals that practiced swimming. No There are differences in the intensities 50 and 75% of MFEL, in relation to nociception, evaluated by the mechanical sensitivity test