This paper stems from an ethnographic, multidisciplinary study that explored the views and experiences of practitioners and scientists on social, ethical and clinical dilemmas encountered when working in the area of pre-implantation genetic diagnosis for serious genetic disorders. We focus here on staff perceptions and experiences of working with embryos and helping women/couples to make choices that will result in selecting embryos for transfer and disposal of 'affected' embryos, compared to the termination of affected pregnancies following prenatal diagnosis. Analysis and (...) discussion of our data led us to consider the possible advantages of pre-implantation genetic diagnosis and whether a gradualist account of the embryo's and fetus's moral status can account for all of these, particularly since a gradualist account concentrates on the significance of time (developmental stage) and makes no comment as to the significance of place (in vitro, in utero). (shrink)

We propose that the pragmatic factors that mediate everyday deduction, such as alternative and disabling conditions (e.g. Cummins et al., 1991) and additional requirements (Byrne, 1989) exert their effects on specific inferences because of their perceived relevance to more general principles, which we term SuperPs. Support for this proposal was found first in two causal inference experiments, in which it was shown that specific inferences were mediated by factors that are relevant to a more general principle, while the same inferences (...) were unaffected by factors not relevant to the general principle. These results were extended to deontic inferences in two further experiments. Taken together, these findings show that unstated superordinate principles play a significant role in certain types of reasoning. Questions raised by the findings for the main theoretical approaches are discussed. (shrink)

Objective: Population based cohort studies involving genetic research have been initiated in several countries. However, research published to date provides little information on the willingness of the general population to participate in such studies. Furthermore, there is a need to discover the optimal methods for acquiring fully informed consent from the general population. We therefore examined the results of a population based genetic cohort study to identify the factors affecting the participation rate by members of the general public and also (...) specifically to examine the impact of different consent procedures on the rate of participation by prospective candidates and their subsequent withdrawal rate from the study.Design: Descriptive analyses.Setting and participants: The study evaluated two non-genetic subcohorts comprising 3166 people attending for a health checkup during 2002, and two genetic subcohorts comprising 2195 people who underwent a checkup during 2003.Main outcome measurements: Analysis endpoints were differences in participation rates between the non-genetic and genetic subcohorts, differences between providing non-extensive and extensive preliminary information, and changes in participation status between baseline and at 6 months.Results: Participation rates in the genetic subcohorts were 4·7–9·3% lower than those in the non-genetic subcohorts. The odds ratios of participation in genetic research were between 0·60 and 0·77, and the OR for withdrawal from the research was over 7·70; providing preliminary extensive information about genetic research reduced the withdrawal risks but worsened participation rates .Conclusions: The general population responded sceptically towards genetic research. It is crucial that genetic researchers utilise an informative and educational consent process worthy of public trust. (shrink)

I argue that there is a version of (quasi-Armstrongian) weak illusionism that intelligibly relates phenomenal concepts and introspective opacity, accounts for the (hard) problem intuitions Chalmers highlights (modal, epistemic, explanatory, and metaphysical), and undermines the most important arguments Chalmers deploys against type-B and type-C materialisms. If this is successful, we can satisfactorily account for the meta-problem of consciousness, mollify our hard problem intuitions, and remain genuine realists about phenomenal experience.

Against Barnett (2012), I argue that the theory I advance in DeRose 2010 is best construed as one on which ‘"were"ed-up’ future-directed conditionals like ‘If the house were not to be painted, it would soon look quite shabby’ are, in ways important to how they function in deliberation, different in literal content from their ‘straightforward’ counterparts like ‘If the house is not painted, it will soon look quite shabby’. I also defend my way of classifying future-directed conditionals against an attack (...) by Barnett by defending a standard (among philosophers) approach to the basic structure of some conditionals. Finally, I counter Barnett’s charge that by using the concept of deliberation in my account of the meaning of future-directed conditionals, I put an implausibly demanding constraint on what it takes to understand such sentences. (shrink)

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)

Background: Theoretically, the principle of justice is strong in healthcare priorities both nationally and internationally. Research, however, has indicated that questions can be raised as to how this principle is dealt with in clinical intensive care. Objective: The objective of this article is to examine how significant others may affect the principle of justice in the medical treatment and nursing care of intensive care patients. Method: Field observations and in-depth interviews with physicians and nurses in intensive care units (ICU). Emphasis (...) was placed on eliciting the underlying rationale for prioritisations in clinical intensive care with particular focus on clinicians’ considerations when limiting ICU treatment. Results: Significant others could induce an unintentional discrimination of ICU patients. Family members who were demanding received more time and attention for both the patient and themselves. Patients’ and families’ status and position and/or an interesting medical diagnosis seemed to govern the clinicians’ priorities of patients and families—consciously as well as unconsciously. The clinicians emphasised that patient information given through families was important. However, patients’ preferences and values conveyed to clinicians through their families were not always taken seriously. This even applied in cases with very serious prognoses and an explicit patient wish to forego life-prolonging treatment. Conclusion: The principle of justice was violated when qualified attention was given to significant others, and through this also to patients. Attention given to significant others was influenced by the healthcare workers’ professional and personal values, attitudes and interests. (shrink)

This chapter introduces the edited volume, The Oxford Handbook of Philosophy and Psychiatry. Published in 2013, the centenary of Karl Jaspers' General Psychopathology, the chapter draws lessons from the last hundred years for the coming century. No predictions are made. Instead, five 'conditions for flourishing' are set out: 1) Particular Problems - the importance of focussing on well-defined particular problems rather than general theory building, 2) Product- orientation - remaining always responsibly product oriented in the specific sense that both sides (...) put in the work necessary to 'go deep' with each other's fields, 3) Partnership - working in partnerships of one kind or another, 4) Process - constant reflection on process based on peer review but leaving scope for the occasional rogue voice to cut innovatively against the grain, and 5) Q - a condition of a different kind, Q is an empirically derived measure of the balance between in-group cohesion and out-group openness required to support creativity. Illustrations are given of how these five conditions for flourishing have underpinned the rapid expansion of philosophy and psychiatry in the closing decades of the twentieth century, and, correspondingly, are also reflected in the Handbook as a whole. Overviews and commentaries on individual contributions to the Handbook are given in extended editorial introductions to each of its eight sections. (shrink)

This book provides a defence of epistemological relativism against its most powerful opponents.

Index to the Mahaniddesa. L. S. Cousins. Pali Text Society, Oxford 1995. £13. ISBN 0-86013-310-9.

Back in Ancient India, Shankaracharya postulated a philosophy which is now known as Advaita. According to Advaita philosophy, the ‘jivãtma’ (individual soul) and ‘Brahmãtma’ (universal soul) are one and the same and these are the only ‘real’ things that exist. Everything else is an illusion. To challenge this almost unshakeable viewpoint, I bring to the fore a book authored by a Nobel Laureate. In 1935, Alexis Carrel’s revolutionary book entitled “Man the Unknown” was published. Though controversial in terms of its (...) content, it delineates the unexplored aspects of the human being – the understanding of mental processes and consciousness, which he claims humans have not mastered. Throughout the book, Carrel suggests that there is something that is unknown in the homo sapiens and hence he titles his work “Man the Unknown.” Based on this, I argue that both the esoteric East and the pragmatic West have not uncovered something “hidden” –the unknown factor/element. Substantial evidence exists for this contention in the scientific community. For example, questions such as among identical twins diagnosed with depression, why does one medication cure depression for one twin and have no effect on the other twin? Ceteris paribus, why does therapy work for one client but not for another client with the same disorder? These questions do not have clear, crystallized answers. Perhaps, if such a thing like an unknown element exists, it would pave the way for the postulation of the Grand Theory of the behavioural sciences. (shrink)

The lepidopteral imaginary that animates Nabokov's relationship to translation can be understood in light of Deleuze and Guattari's notions of ‘apparatus of capture’ and ‘rhizomatic becomings’. On the one hand, Nabokov's scientific fascination with butterflies frames his radically literal approach to translation. The scientific dissection of texts and butterflies ‘captures’ an original and singular content as it flutters, reducing it to the homogenised content of a target source. On the other hand, in Speak, Memory's engagement with ‘multiple metamorphoses, familiar to (...) butterflies’, Nabokov as both literary artist and autobiographical personage becomes-butterfly with translation itself, entering into affective intensities with butterflies that include lepidopteral relations of movement and rest, speed and slowness. (shrink)

Journal of the Pali Text Society, Volume XXVI. Edited by O. von Hinüber and R.F. Gombrich. Pali Text Society, Oxford 2000. 234 pp. £15.00. ISBN 0 86013 391 5.

Linguistic Approach to Buddhist Thought. Genjun H. Sasaki. Motilal Banarsidass, Delhi 1986. x, 194 pp. Rs. 125.

The Casket of Medicine. Trans. Jinadasa Liyanaratne. Pali Text Society, Oxford 2002. xviii, 197 pp. £12.10. ISBN 0 86013 4003 2.

The History of the Buddha's Religion (Sasanavamsa). Translated by Bimala Churn Law, Bibliotheca Indo-Buddhica No. 29. Sri Satguru Publications, Delhi 1986. xvii, 174 pp. Rs 120.

The Mahasudarsanavadana and The Mahasudarsanasutra. Hisashi Matsumura. Bibliotheca Indo-Buddhica 47, Indian Books Centre, Delhi 1988. lvii, 142 pp. Rs.350.

Therigatha-atthakatha. W. Pruitt. Pali Text Society, Oxford 1998. vii, 414 pp. £17.00 ISBN 0 86013 352 5.

Summary Some case studies in elementary particle physics are presented in this work, that can be used for the critical appraisal of specific criteria which were proposed to account for the development of Heisenberg's work. It is attempted to define the philosophical problems associated with and emerging from the structures of theories, rather than analyse the philosophical aspects of concepts used in elementary particle physics. This necessitates the discussion of the relationship between theory and experiment, and the role of the (...) mathematical framework being used. The question of elementarity is studied in this connection. Popper's tetradic schema and his concept of world three are modified, and it is shown that the new schema can accommodate the development of certain research programs in a much more satisfactory manner. As a result of the systematic treatment of specific research programs, the principle of contextual re-interpretation is expanded by specifying the different kinds of interpretations at the various stages of development of theories. It is also shown that principles such as those of simplicity and beauty can be understood in terms of the mathematical structure of the theories, and their methodological importance is emphasized. (shrink)

The debate about the moral status of the embryo has gained new impetus because of the advances in reproductive technology that have made early human embryo experimentation a possibility, and because of the public concern that this arouses. Several philosophical arguments claiming that fertilisation is the event that accords moral status to the embryo were initially formulated in the context of the abortion debate. Were they formulated with sufficient precision to account for the scientific facts as we now understand them? (...) Or do these arguments need modification? Aspects of three arguments for moral status being acquired at fertilisation are examined in relation to current scientific knowledge, highlighting the reasons why such arguments, at present, seem to provide an inadequate basis for the determination of moral status. (shrink)

In this paper some of the general issues surrounding recently published guidelines for the practice of research ethics committees are outlined, concentrating in particular on the difficulties raised by research with psychiatric patients. Research is distinguished from ordinary clinical practice by the intention to advance knowledge. So defined, research with psychiatric patients should be governed by the same four principles as research with any other group--knowledge, necessity, benefit and consent. In applying these principles, however, particularly the principle of consent, many (...) acute difficulties are raised by psychiatric patients. A number of proposals for addressing these difficulties are discussed. It is suggested that, notwithstanding the value of published guidelines, and the help that may be available from research ethics committees, the primary responsibility for maintaining high standards of practice in research rests with research workers themselves. (shrink)

My mother is losing her mother to Alzheimer's disease. Although my mother feels loss, I am connecting through my grandmother to our ancestors, including a deceased father and paternal grandmother. I am also connecting to a daughter who has lost her mother, through a grandmother who, through her loss of memory, is more open to kin networks than my mother. Through deepening connections to my maternal grandmother and to my daughter, I feel I am losing my mother. I look to (...) revolutionary mothering as a way to reconnect shattered bonds and find lost mothers. This article honors the important work of Saidiya Hartman, Dorothy Roberts, and countless revolutionary mothers. (shrink)

Purpose: This paper is a brief introduction to enactive cognitive science: a description of some of the main research concerns; some examples of how such concerns have been realized in actual research; some of its research methods and proposed explanatory mechanisms and models; some of the potential as both a theoretical and applied science; and several of the major open research questions. Findings: Enactive cognitive science is an approach to the study of mind that seeks to explain how the structures (...) and mechanisms of autonomous cognitive systems can arise and participate in the generation and maintenance of viable perceiver-dependent worlds -- rather than more conventional cognitivist efforts, such as the attempt to explain cognition in terms of the ``recovery'' of (pre-given, timeless) features of The (objectively-existing and accessible) World. As such, enactive cognitive science is resonant with radical constructivism. Research implications: As with other scientific efforts conducted within a constructivist orientation, enactive cognitive science is broadly ``conventional'' in its scientific methodology. That is, there is a strong emphasis on testable hypotheses, empirical observation, supportable mechanisms and models, rigorous experimental methods, acceptable criteria of validation, and the like. Nonetheless, this approach to cognitive science does also raise a number of specific questions about the scope of amenable phenomena (e.g., meaning, consciousness, etc.) -- and it also raises questions of whether such a perspective requires an expansion of what is typically considered within the purview of scientific method (e.g., the role of the observer/scientist). (shrink)