The ‘multicultural clinical interaction’ presents itself as a dilemma for the mental health practitioner. Literature describes two problematic areas where this issues emerges - how to make an adequate distinction between religious rituals and the rituals that may be symptomatic of ‘obsessive compulsive disorder’ (OCD), and how to differentiate ‘normative’ religious or spiritual beliefs, behaviours, and experiences from ‘psychotic’ illnesses. When it comes to understanding service user’s ‘idioms of distress’, beliefs about how culture influences behaviour can create considerable confusion and (...) ‘normative uncertainty’ for mental health practitioners. In the absence of clear diagnostic and assessment criteria on distinguishing between ‘culture’ and ‘psychopathology’, practitioners have had to rely on their own intuition and seek out possible ‘strategies’ or ‘procedures’ from a contradictory and cross-disciplinary evidence base. Decontextualisation of service users’ experiences may result in the pathologisation of culturally ‘normative’ phenomenon, ‘category fallacy’ errors, and poor health care experiences and outcomes for service users. This paper situates this dilemma within a wider debate that has concerned both the biomedical and social sciences, namely, the unresolved question of ‘normality’ or ‘abnormality’. Indeed, issues that arise from dilemmas surrounding the question of ‘culture’ or ‘psychopathology’ are intimately tied to wider cultural ideas about what is considered ‘normal’. The disciplines of psychiatry, psychology, and medical anthropology have struggled to establish workable criteria against which to judge behaviour as ‘normal’, ‘abnormal’, or ‘pathological’. Three models for understanding mental ‘abnormality’ are evident in ‘transcultural psychiatry’ (what is now commonly known as ‘cultural psychiatry’), and these models have corresponded closely to the interpretive models used by anthropologists attempting to make sense of the apparent diversity of human societies. The three models of ‘absolutism’, ‘universalism’ and ‘cultural relativism’ have not only important consequences for the nature and conduct of research enquiry, but also have implications for how the dilemma of ‘culture’ or ‘psychopathology’ is attended to in clinical practice. (shrink)

This paper focuses on the most common state policy responses to the opioid crisis, dividing them into six broad categories. Within each category we highlight the rationale behind the group of policies within it, discuss the details and support for individual policies, and explore the research base behind them. The objective is to better understand the most prevalent state responses to the opioid crisis.

The interpretation of the dead donor rule (DDR) has been central to recent debates regarding normothermic regional perfusion with controlled donation after circulatory death (NRP-cDCD). Proponents...

We prove the following surprising property of Heyting's intuitionistic propositional calculus, IpC. Consider the collection of formulas, φ, built up from propositional variables (p,q,r,...) and falsity $(\perp)$ using conjunction $(\wedge)$ , disjunction (∨) and implication (→). Write $\vdash\phi$ to indicate that such a formula is intuitionistically valid. We show that for each variable p and formula φ there exists a formula Apφ (effectively computable from φ), containing only variables not equal to p which occur in φ, and such that for (...) all formulas ψ not involving $p, \vdash \psi \rightarrow A_p\phi$ if and only if $\vdash \psi \rightarrow \phi$ . Consequently quantification over propositional variables can be modelled in IpC, and there is an interpretation of the second order propositional calculus, IpC2, in IpC which restricts to the identity on first order propositions. An immediate corollary is the strengthening of the usual interpolation theorem for IpC to the statement that there are least and greatest interpolant formulas for any given pair of formulas. The result also has a number of interesting consequences for the algebraic counterpart of IpC, the theory of Heyting algebras. In particular we show that a model of IpC2 can be constructed whose algebra of truth-values is equal to any given Heyting algebra. (shrink)

If, as it appears, failure of standardization blocks the rise of general-purpose ideography, then a more precise characterization of “standardization” should help illuminate aspects of the process. Comparison is made with several histories of standardization to outline relevant dimensions and thresholds. This line of inquiry is particularly important for the forward-looking question of whether such ideography can ever arise.

In this article, I focus on internal dimensions of moral responsibility. I argue that if such dimensions are real -- and it seems they are -- then moral responsibility is compatible with determinism.

For good or for ill, we have animal bodies. Through them, we move around, eat and drink, and do many other things besides. We owe much – perhaps our very lives – to these ever-present animals. But how exactly do we relate to our animals? Are we parts of them, or they of us? Do we and these living animals co-inhere or constitute or coincide? Or what? Animalism answers that we are identical to them. There are many objections to animalism, (...) and a dizzying array of rival views. In this article, we do not propose to evaluate those objections and rivals. We will instead present a new argument for that view. The argument begins with the fact that we have emotions. (shrink)

Background: The bioethics literature contains speculation but little data about sociodemographic differences between patients for whom ethics committees (EC) are consulted for conflict about life-sustaining treatment (LST) and the broader hospital population that these committees serve. To provide an empirical context for this discussion, we examined differences in five sociodemographic factors between patients for whom an EC was consulted for conflict over LST and the general inpatient population, hypothesizing that nonwhite patients were most likely to be disproportionately represented. Methods: This (...) was a retrospective cohort study comparing self-reported race/ethnicity, household income, insurance status, primary language, and religious affiliation between patients involved in EC consultations for conflict over LST and the general adult inpatient population at a large academic hospital from January 1, 2007, through December 31, 2013. Results: There were 169 EC consultations involving conflict over LST and 243,197 adult inpatient admissions over the study period. On bivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite, low-income, and to speak a primary language other than English. They were not more likely to be underinsured or to report a religious affiliation. On multivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7–3.7; p <.001). They were also more likely to be low income (OR, 1.8; 95% CI, 1.1–3.0; p =.02). They were not more likely to speak a primary language other than English (OR, 1.4; 95% CI, 0.9–2.1; p =.17). None of the assessed variables were associated with conflict over LST requiring additional meetings beyond the first EC consultation. Conclusions: Nonwhite and low-income status patients are disproportionately represented in EC committee consultation for conflict over LST compared to the general inpatient population. (shrink)

Animalism is the view that we are animals: living, breathing, wholly material beings. Despite its considerable appeal, animalism has come under fire. Other philosophers have had much to say about objections to animalism that stem from reflection on personal identity over time. But one promising objection (the `Elimination Argument') has been overlooked. In this paper, I remedy this situation and examine the Elimination Argument in some detail. I contend that the Elimination Argument is both unsound and unmotivated.

There are predicates and subjects. It is thus tempting to think that there are properties on the one hand, and things that have them on the other. I have no quarrel with this thought; it is a fine place to begin a theory of properties and property-having. But in this paper, I argue that one such theory—bare particularism—is false. I pose a dilemma. Either bare particulars instantiate the properties of their host substances or they do not. If they do not, (...) then bare particularism is both unmotivated and false. If they do, then the view faces a problematic—and, I shall argue, false—crowding consequence. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

Ancient Roman “technical memory” is not (as much of the modern specialist literature would have it) a generative technology of association. Rather it is (as a literal reading of the texts would suggest) a specialized tool for precise serial recall. Modern experimental evidence both confirms the fitness for the purpose of the technique and shows why that purpose is not trivial, as some have suggested. While the mechanism(s) by which the technique operates are not fully understood, a review of the (...) current literature suggests that it would have had the advantage over other mnemonic techniques by virtue of recruiting a variety of cognitive capacities. These likely include spatial/navigational mechanisms and possibly visual/imagery-based ones as well. Finally, small differences between the method as recorded in the ancient texts and similar methods that have been the subject of laboratory experiments are used to suggest possible directions for further experimentation. (shrink)

The Industrial Enlightenment is widely thought to have been a period when “science” and “technology” became intimately intertwined. In his 1791 book on the building of the Eddystone lighthouse (completed in 1759), the English engineer John Smeaton praised the Royal Society for being more than a group of abstract theoreticians. This article looks at the fellows of Smeaton's Royal Society network who contributed knowledge, reports, specimens, and inventions solicited by Smeaton when he was working on this lighthouse project. I show, (...) in line with other recent research on this topic, that the “artisans” of the 18th century did not confine themselves to practical know-how, and that “scholars” were not merely interested in abstract philosophising; instead, the figures I look at in this paper were hybrid knowers who possessed useful knowledge and book learning. I argue that the advice solicited by Smeaton during the building of the lighthouse was characterised not by exchanges between theory and practice, but by a combining of different types of knowledge from separate fields. A second feature of this intellectual co-operation is that it was not centred on a group of practical industrialists or engineers, but rather it was the Royal Society that served as the common denominator, bringing all of the characters in our story into contact with each other. This is reflected in the subject matter involved, which was characteristic of the research focus of the virtuoso tradition in the 18th-century Royal Society. Smeaton's contact with this tradition was influenced by his friendships, his social activities, and, indirectly, by the way that the dissensions that occupied the Royal Society during the early 1780s impacted his retrospective account of the project. (shrink)

A significant increase in the probability of an action resulting from observing that action performed by another agent cannot, on its own, provide persuasive evidence of imitation. Simple models of social influence based on two-person sequential games suggest that both imitation and pseudo-imitation can be explained by a process more fundamental than priming, namely, subjective utility maximization.

C. S. Peirce made the following claim: If science reveals truth, then consensus among scientists can be expected in the limit. This article does not dispute this claim; it simply assumes it. On the basis of this assumption, the following question is asked: Is it possible to extend Peirce's claim to philosophy in a natural way? It is argued that two important differences between science and philosophy strongly militate against such an extension. Does this mean that there is no truth (...) to be found in philosophy? Are there, perhaps, different kinds of truth (scientific, philosophical, religious, and so on)? But such questions, though related to the present investigation, are nevertheless well beyond the scope of this article. (shrink)

Some strange cases have gripped philosophers of mind. They have been deployed against materialism about human persons, functionalism about mentality, the possibility of artificial intelligence, and more. In this paper, I cry “foul”. It’s not hard to think that there’s something wrong with the cases. But what? My proposal: their proponents ignore questions about composition. And ignoring composition is a mistake. Indeed, materialists about human persons, functionalists about mentality, and believers in the possibility of artificial intelligence can plausibly deploy moderate (...) theories of composition in defense of their views. And as it turns out, these strange cases are an interesting source of evidence for moderate theories of composition. (shrink)

I introduce and argue for a Priority Principle, according to which we exemplify certain of our mental properties in the primary or non-derivative sense. I then apply this principle to several debates in the metaphysics and philosophy of mind.

Here's an interesting question: what are we? David Barnett has claimed that reflection on consciousness suggests an answer: we are simple. Barnett argues that the mereological simplicity of conscious beings best explains the Datum: that no pair of persons can itself be conscious. In this paper, I offer two alternative explanations of the Datum. If either is correct, Barnett's argument fails. First, there aren't any such things as pairs of persons. Second, consciousness is maximal; no conscious thing is a proper (...) part of another conscious thing. I conclude by showing how both moves comport with materialist theories of what we are and then apply them to another anti-materialist argument. (shrink)

There is a new objection to the Consequence Argument for incompatibilism. I argue that the objection is more wide-ranging than originally thought. In particular: if it tells against the Consequence Argument, it tells against other arguments for incompatibilism too. I survey a few ways of dealing with this objection and show the costs of each. I then present an argument for incompatibilism that is immune to the objection and that enjoys other advantages.

In this paper, I will examine John Smeaton’s contribution to the vis viva controversy in Britain, focusing on how the hybridization of science, technology, and industry helped to establish vis viva, or mechanic power, as a measure of motive force. Smeaton, embodying the ‘hybrid expert’ who combined theoretical knowledge and practical knowhow, demonstrated that the notion of vis viva possessed a greater explanatory power than momentum, because it could be used to explain the difference in efficiency between overshot and undershot (...) waterwheels. Smeaton’s conclusions were correct since waterwheel efficiency was already measured in terms that were proportional to vis viva, not momentum, as a result of the industrial applications of waterwheel technology, which favored measuring efficiency by the product of mass and vertical displacement. Toward the end of the eighteenth century, the loss of motive force in the inelastic collision driving the undershot wheel began to be seen as equivalent to the expenditure of labor in the manufacture of commodities, further underlining how strictly scientific conclusions about motive force could have their origin in industrial practices. (shrink)

Short interspersed repetitive elements, or SINEs, are tRNA-derived retroposons that are dispersed throughout eukaryotic genomes and can be present in well over 104 total copies. The enormous volume of SINE amplifications per organism makes them important evolutionary agents for shaping the diversity of genomes, and the irreversible, independent nature of their insertion allows them to be used for diagnosing common ancestry among host taxa with extreme confidence. As such, they represent a powerful new tool for systematic biology that can be (...) strategically integrated with other conventional phylogenetic characters, most notably morphology and DNA sequences. This review covers the basic aspects of SINE evolution that are especially relevant to their use as systematic characters and describes the practical methods of characterizing SINEs for cladogram construction. It also discusses the limits of their systematic utility, clarifies some recently published misunderstandings, and illustrates the effective application of SINEs for vertebrate phylogenetics with results from selected case studies. BioEssays 22:148–160, 2000. ©2000 John Wiley & Sons, Inc. (shrink)

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of negative (...) interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods. (shrink)

Many have thought that there is a problem with causal commerce between immaterial souls and material bodies. In Physicalism or Something Near Enough, Jaegwon Kim attempts to spell out that problem. Rather than merely posing a question or raising a mystery for defenders of substance dualism to answer or address, he offers a compelling argument for the conclusion that immaterial souls cannot causally interact with material bodies. We offer a reconstruction of that argument that hinges on two premises: Kim’s Dictum (...) and the Nowhere Man principle. Kim’s Dictum says that causation requires a spatial relation. Nowhere Man says that souls can’t be in space. By our lights, both premises can be called into question. We’ll begin our evaluation of the argument by pointing out some consequences of Kim’s Dictum. For some, these will be costs. We will then present two defeaters for Kim’s Dictum and a critical analysis of Kim’s case for Nowhere Man. The upshot is that Kim’s argument against substance dualism fails. (shrink)

The development of ethical guidelines and regulations regarding human subjects research has focused upon protection of vulnerable populations by relying on a limited typology of vulnerabilities. This results in several challenges: First, Institutional Review Boards struggle to interpret and apply the regulations because they are often vague and inconsistent. Second, applying the regulations to subjects who fit within multiple categories of vulnerability can lead to contradictions and the rejection of research that would be permissible if only one category were applicable. (...) Finally, some potential subjects have social and other context-based vulnerabilities that are not described in the federal regulations... (shrink)

This clear and lively introduction to psychology assumes no prior knowledge of the subject. Extensively revised and updated, this third edition describes psychology as it is taught at universitues. Examples are used throughout to illustrate fundamental ideas, with a self-assessment quiz focusing readers' minds on a number of intriguing psychological problems. The differences betwen psychology, psychiatry and psychoanalysis are explained, and the professions and careers associated with psychology are explored. Suggestions for further reading and useful internet sites are included.

Psychology plays an increasingly important role in today's society. Its influence can be seen all around us - be it in the home, the workplace, the school or our private lives. A uniquely diverse discipline, it ranges from social psychology to biological aspects of behaviour, and from basic research to the applied professions. This _Companion Encyclopedia_ covers all these main branches of psychological research and professional practice. The thematic arrangement is the result of the Editor's extensive research into syllabi, from (...) which he distilled the 13 most frequently taught units. Students can consult and be referred to sections relating to their lecture programme, and can find lucid definitions of frequently used terms in the Glossary. Headings and sub-headings are clearly highlighted at the beginning of each chapter - ideal for quick reference. * Provides authoritative and in-depth reference material on all major branches of psychological research and professional practice * Contributors include many of the world's most eminent psychologists * Written in a lively style without assuming previous knowledge of the subject * Structured according to the core topics appearing most often as discrete modules in contemporary psychology courses * Detailed bibliographies, further reading sections, exhaustive index and glossary of technical terms * Containing 165 supporting illustrations. (shrink)

Andrew Steane reconfigures the public understanding of science, by drawing on a deep knowledge of physics and by bringing in mainstream philosophy of science. Science is a beautiful, multi-lingual network of ideas; it is not a ladder in which ideas at one level make those at another level redundant. In view of this, we can judge that the natural world is not so much a machine as a meeting-place. In particular, people can only be correctly understood by meeting with (...) them at the level of their entire personhood, in a reciprocal, respectful engagement as one person to another. Steane shows that Darwinian evolution does not overturn this but rather is the process whereby such truths came to be discovered and expressed in the world. From here the argument moves towards other aspects of human life. Our sense of value requires from us a response which is not altogether the same as following logical argument. This points us towards what religion in its good forms can express. A reply to a major argument of David Hume, and a related one of Richard Dawkins, is given. The book finishes with some brief chapters setting religion in the context of all human capacities, and showing, in fresh language, what theistic religious response is, or can be, in the modern world. (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...) intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

In Knowledge and Social Construction Andrew Koch asks: how can we know the absolute best path through politics toward a better society? We can't. However, if our claims to social knowledge are more hypothetical in nature than absolute the resultant society will be more open.

My purpose in this article is to defend the goodness of Whitehead's God against two recent critics: Pierfrancesco Basile and Peter Sjöstedt-Hughes. I will both rely on Whitehead's own statements regarding God's goodness and offer a metaphysical interpretation of these statements in relation to his “axianoetic” universe.

In thinking about ontology as the study of being or what fundamentally exists, we can adopt an ontology that either takes substances or processes as primary. There are, however, both commonsense and naturalistic reasons for not fully adopting a substance ontology, which indicate that we ought to suspend judgment with respect to the acceptance of a substance ontology. Doing so allows room to further explore other ontologies. In this book, Andrew M. Winters argues that there are both commonsense and (...) naturalistic reasons for further pursuing a process ontology. Adopting a process ontology allows us to overcome many of the difficulties facing a substance ontology while also accommodating many of the phenomenon that substance ontologies were appealed to for explanation. Given these reasons, we have both commonsense and naturalistic reasons for pursuing and developing a metaphysics without substance. (shrink)

A engaging dialogue with the modern “axionoetic” proposals of A.N. Whitehead, Keith Ward, and John Leslie, arguing for the relational nature of ultimacy wherein Mind and Value, Possibility and Actuality, God and the World are affirmed as ultimate only in virtue of their relationality. This relationship Whitehead calls “mutual immanence.”.

Among your closest associates is a certain human animal – a living, breathing, organism. You see it when you look in the mirror. When it is sick, you don't feel too well. Where it goes, you go. And, one thinks, where you go, it must follow. Indeed, you can make it move through sheer force of will. You bear, in short, an important and intimate relation to this, your animal. So too rest of us with our animals. Animalism says that (...) this relation is nothing short of identity. According to animalists, we do not only coincide with or constitute or inhabit or otherwise hang out with these close associates, our animals: we are them. In this article, I offer an opinionated take on what animalism might be and situate it against contemporary rivals. Then, I outline a simple case for animalism. Finally, I sketch non-standard routes for animalists to take in light of standard challenges. My goal in all of this is to open up some new avenues of animalist thinking. (shrink)

Some have it that wholes are, somehow, identical to their parts. This doctrine is as alluring as it is puzzling. But in this paper, I show that the doctrine is inconsistent with two widely accepted theses. Something has to go.