Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)

In his 1963 response to an open letter from eight white religious leaders chastising his involvement in Birmingham, Martin Luther King, Jr. explained that civil rights activists’ blatant breaking of some laws while obeying others was the result of two types of laws: just laws and unjust laws. Civil rights activists believed they had a legal responsibility to obey just laws and a moral responsibility to disobey unjust laws. Today, new civil rights struggles continue to challenge unjust laws that shred (...) the fabric of democracy that America espouses. Drawing upon both the Civil Rights Movement and the contemporary Movement for Black Lives, this article argues that unjust laws and practices must be broken and challenged before a just society is established. It identifies four ethical strategies for social activism: collective work and responsibility, strategic timing and economic disconnection, political mobilization, and faithful perseverance. (shrink)

What is man? “The feather of an angel was brought and tied to a donkey's tail that the donkey perhaps might turn into an angel”.Thus writes the greatest of all Persian-writing mystical poets of Islam, Maulânâ Jalâladdân Rûmî (1207-1273) in his conversations, Fîhi mâ fîhi, when pointing to the mystery of man's existence : man is able to attain a rank superior to that of the angels (who have no free will and are eternally good) provided he develops his God-given (...) faculties of reason and love; but he can sink lower than a beast if he neglects his spiritual powers and falls a prey to sensual pleasures and crimes owing to the misuse of his rational faculties. (shrink)

Disease-mongering, or the medicalisation of aspects of daily life in an attempt to generate commercial profit for a party other than the person whose complaint is medicalised, is a newly recognized and legitimate source of concern for both consumers and deliverers of health care. The interest brought to this area by the academy has the potential to acknowledge and address the consequences of the practice. However, before disease-mongering can establish itself firmly as an area of scholarly concern, researchers must understand (...) that the critique is not just about identifying commercial intent, but also about naming the mechanism through which discourses of health, cure and self-management are positioned. In this paper, I argue that a critical reflection on the construction of disease concepts and the mongering of their cure must include discussions of the foundations of health and the clinical encounter. I identify a number of pivotal issues within these themes that should be explored in order to ensure an unambiguous and productive discussion of disease-mongering and its correlates. (shrink)

Children themselves place a high value on their own spiritual care when in hospital. However, the spiritual care of children in hospital is often overlooked. Hospitalisation and medical procedures can be traumatic and overwhelming for children, they often see hospitalisation as punishment for something they did wrong and they can even experience spiritual distress during illness and suffering. The spiritual care of hospitalised children should thus be a priority to help these children making sense of pain and suffering, and assisting (...) them to connect with a loving and forgiving God. Spirituality namely influences a diverse range of human concerns such as beliefs about illness and health, fears, relationships with family and friends and the experience of pain and suffering. Unfortunately, children often harbour misconceptions precisely in these areas. This article will draw directly on the given that children are concrete thinkers, yet able to have an understanding of holiness and God as the Holy One, if they receive the right guidance. The study will explore children’s spirituality and the way in which they experience holiness in the healthcare environment from a nursing science perspective. (shrink)

Centering Women of Color in Academic Counterspaces offers a rich multidimensional account of teaching, learning, and classroom dynamics among diverse students in a classroom counterspace centered on women of color. This book provides insights into learning outcomes, the process of transformational learning, and some of the challenges related to covering social justice topics like oppression, intersectionality, identity, beauty, body image, and inclusive leadership in a college classroom.

A large body of information and opinion related to COVID-19 is being shared via social media platforms. Recent reports have raised concerns about the reliability and verifiability of said information being disseminated and the way systems, processes and design of the platforms facilitates such spread. This, alongside other areas of concern, has resulted in several social media platforms taking steps towards tackling the spread of mis- and dis-information. Here we discuss approaches to online public health messaging from a range of (...) sources during COVID-19, with a focus on official and non-official sources in the United Kingdom. We highlight issues for ongoing public health decisions, and the potential impact for the future course of the pandemic. (shrink)

In part 1 of Enquiry 12, Hume presents a skeptical argument against belief in external existence. The argument involves a perceptual relativity argument that seems to conclude straightaway the double existence of objects and perceptions, where objects cause and resemble perceptions. In Treatise 1.4.2, Hume claimed that the belief in double existence arises from imaginative invention, not reasoning about perceptual relativity. I dissolve this tension by distinguishing the effects of natural instinct and showing that some ofthese effects supplement the Enquiry’s (...) perceptual relativity argument. The Enquiry’s skeptical argument thus reveals the fundamental involvement of natural instinct in any belief in external existence. (shrink)

Even the simplest narratives combine multiple strands of information, integrating different characters and their actions by expressing multiple perspectives of events. We examined the emergence of referential shift devices, which indicate changes among these perspectives, in Nicaraguan Sign Language (NSL). Sign languages, like spoken languages, mark referential shift grammatically with a shift in deictic perspective. In addition, sign languages can mark the shift with a point or a movement of the body to a specified spatial location in the three-dimensional space (...) in front of the signer, capitalizing on the spatial affordances of the manual modality. We asked whether the use of space to mark referential shift emerges early in a new sign language by comparing the first two age cohorts of deaf signers of NSL. Eight first-cohort signers and 10 second-cohort signers watched video vignettes and described them in NSL. Narratives were coded for lexical (use of words) and spatial (use of signing space) devices. Although the cohorts did not differ significantly in the number of perspectives represented, second-cohort signers used referential shift devices to explicitly mark a shift in perspective in more of their narratives. Furthermore, while there was no significant difference between cohorts in the use of non-spatial, lexical devices, there was a difference in spatial devices, with second-cohort signers using them in significantly more of their narratives. This suggests that spatial devices have only recently increased as systematic markers of referential shift. Spatial referential shift devices may have emerged more slowly because they depend on the establishment of fundamental spatial conventions in the language. While the modality of sign languages can ultimately engender the syntactic use of three-dimensional space, we propose that a language must first develop systematic spatial distinctions before harnessing space for grammatical functions. (shrink)

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed (...) participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values. (shrink)

This article focuses on both daily forms of weakness of will as discussed in the philosophical debate and psychopathological phenomena as impairments of decision making. We argue that both descriptions of dysfunctional decision making can be organized within a common theoretical framework that divides the decision making process in three different stages: option generation, option selection, and action initiation. We first discuss our theoretical framework, focusing on option generation as an aspect that has been neglected by previous models. In the (...) main body of this article, we review how both philosophy and neuropsychiatry have provided accounts of dysfunction in each decision-making stage, as well as where these accounts can be integrated. Also, the neural underpinnings of dysfunction in the three different stages are discussed. We conclude by discussing advantages and limitations of our integrative approach. (shrink)

Recent studies of scientific interaction based on agent-based models suggest that a crucial factor conducive to efficient inquiry is what Zollman has dubbed ‘transient diversity’. It signifies a process in which a community engages in parallel exploration of rivaling theories lasting sufficiently long for the community to identify the best theory and to converge on it. But what exactly generates transient diversity? And is transient diversity a decisive factor when it comes to the efficiency of inquiry? In this paper we (...) examine the impact of different conditions on the efficiency of inquiry, as well as the relation between diversity and efficiency. This includes certain diversity-generating mechanisms previously proposed in the literature, as well as some factors that have so far been neglected. This study is obtained via an argumentation-based ABM. Our results suggest that cautious decision-making does not always have a significant impact on the efficiency of inquiry while different evaluations underlying theory-choice and different social networks do. Moreover, we find a correlation between diversity and a successful performance of agents only under specific conditions, which indicates that transient diversity is sometimes not the primary factor responsible for efficiency. Altogether, when comparing our results to those obtained by structurally different ABMs based on Zollman’s work, the impact of specific factors on efficiency of inquiry, as well as the role of transient diversity in achieving efficiency, appear to be highly dependent on the underlying model. (shrink)

Much of the time, human beings seem to rely on habits. Habits are learned behaviours directly elicited by context cues, and insensitive to short-term changes in goals: therefore they are sometimes irrational. But even where habitual responses are rational, it can seem as if they are nevertheless not done for reasons. For, on a common understanding of habitual behaviour, agents’ intentions do not play any role in the coming about of such responses. This paper discusses under what conditions we can (...) say that habitual responses are, after all, done for reasons. We show how the idea that habitual behaviour cannot be understood as ‘acting for reasons’ stems from a widely but often implicitly held theoretical framework: the causal theory of action. We then propose an alternative, Anscombean understanding of intentional action, which can account for habitual responses being done for reasons. (shrink)

Donald C. Ainslie's Hume's True Scepticism is a wonderful book—clearly written and forcefully argued—and was deservedly honored with Journal of the History of Philosophy's Book Prize for 2016. The focus of the book is part four of the first Book of Hume's Treatise, "Of the sceptical and other systems of philosophy." Ainslie develops an interpretation that takes seriously Hume's psychological claims, using them to solve puzzles in Hume scholarship, including the extent of Hume's scepticism, the nature of his sceptical crisis, (...) and the basis for his second thoughts on personal identity.I would encourage Ainslie to go further in tracing Hume's psychological explanations. In what follows, I will... (shrink)

Obwohl die Substitutionsbehandlung nachweislich den Gesundheitszustand opiatabhängiger Patienten verbessern und die Beschaffungskriminalität reduzieren kann, bestehen enge gesetzliche Regelungen, die die Therapiefreiheit der behandelnden Ärzte stark begrenzen: So werden durch das Betäubungsmittelgesetz und die zugehörigen Verordnungen nicht nur das Behandlungsziel (Abstinenz) sondern auch notwendige Therapiebausteine definiert, die darauf ausgerichtet sind, die Therapietreue des Patienten zu kontrollieren. Deutsche Ärzte, die die strengen Auflagen nicht strikt befolgten, wurden zu Gefängnisstrafen verurteilt. Wie der Artikel zeigt, fördern die bestehenden Gesetze eine „kontrollierende“ statt einer motivierenden (...) ärztlichen Behandlung, ohne wichtige Ziele, wie den Schutz der Allgemeinheit vor einer illegalen Verbreitung illegaler Opioide, vollständig zu erreichen. Zusammenfassend zeigt der Artikel, dass eine stärker am Wohl der Patienten ausgerichtete Substitutionsbehandlung (einschließlich notwendiger Kontrolluntersuchungen) mit hoher Wahrscheinlichkeit auch die Öffentlichkeit wirksamer vor den potenziellen Gefahren einer illegalen Verbreitung von gefährlichen Opioiden schützt als die Befolgung abstrakter, restriktiver gesetzlichen Normen. (shrink)

It would be hard to imagine medical care without diagnosis, so pivotal is it to how Western medicine is practiced. Diagnosis is one of medicine’s principle tools, bringing with it as it does an explanation for what ails the sick person, an idea of what the treatment options might be, a prognosis, and much more. It assigns responsibility for illness, within medicine and outside. It will determine which specialty or sub-specialty can take care of which disorders. It also explains causation, (...) pointing the finger variably at the patient for what she ought to have done, or to the gene for what one can do little about. Diagnosis structures and explains relationships as it provides the impetus for the sick.. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic is associated with various painful symptoms and could potentially lead to a significant increase in patients experiencing chronic pain. While churches had to close their doors during the pandemic, emerging scientific data suggest that, when our spiritual needs are not met, our well-being can be in jeopardy, and it could also increase the experience of physical pain. The aim of this article is, therefore, to explore the role that spirituality and religion could play in (...) addressing physical pain. An interdisciplinary approach is used with the goal of integrating different insights so as to construct a more comprehensive understanding of the problem. Literature in the disciplines of humanities, health sciences, as well as social sciences is explored to identify the concepts of physical, social and spiritual pain and to explore the link between the different dimensions of pain. It became clear that physical, social, and spiritual pain can influence one another, and addressing one kind of pain can also improve pain in another dimension. Several spiritual and religious interventions were found in the literature and confirmed to be valuable in helping patients cope with physical pain, such as accepting and giving meaning to pain, prayer, meditation, scripture, music, support from the religious community and helping others.Contribution: This article highlights the importance of an interdisciplinary approach that incorporates religion and/or spirituality to address physical pain during and after the COVID-19 pandemic. (shrink)

Journal Name: Cognitive Linguistics Issue: Ahead of print.

A well‐known typological observation is the dominance of subject‐initial word orders, SOV and SVO, across the world's languages. Recent findings from gestural language creation paradigms offer possible explanations for the prevalence of SOV. When asked to gesture transitive events with an animate agent and inanimate patient, gesturers tend to produce SOV order, regardless of their native language biases. Interestingly, when the patient is animate, gesturers shift away from SOV to use of other orders, like SVO and OSV. Two competing hypotheses (...) have been proposed for this switch: the noisy channel account (Gibson et al., 2013) and the role conflict account (Hall, Mayberry, & Ferreira, 2013). We set out to distinguish between these two hypotheses, disentangling event reversibility and patient animacy, by looking at gestural sequences for events with two inanimate participants (inanimate‐inanimate, reversible). We replicated the previous findings of a preference for SOV order when describing animate‐inanimate, irreversible events as well as a decrease in the use of SOV when presented with animate‐animate, reversible events. Accompanying the drop in SOV, in a novel condition we observed an increase in the use of SVO and OSV orders when describing events involving two animate entities. In sum, we find that the observed avoidance of SOV order in gestural language creation paradigms when the event includes an animate agent and patient is driven by the animacy of the participants rather than the reversibility of the event. We suggest that findings from gestural creation paradigms are not automatically linkable to spoken language typology. (shrink)

This book explores classic philosophical questions regarding the phenomenon of weakness of will or ‘akrasia’: doing A, even though all things considered, you judge it best to do B. Does this phenomenon really exist and if so, how should it be explained? Nacht van Descartes -/- The author provides a historical overview of some traditional answers to these questions and addresses the main question: how does the phenomenon of 'going against your own judgment' relate to the idea that we are (...) rational beings? She elaborates on the notion of rational agency and shows how different types of behaviour express or fail to express our rational agency. This leads to the speculation of what is needed for akratic action to be free action. -/- A novel position is developed, stating that certain widespread philosophical accounts of free action must conclude that 'going against your own judgment' is necessarily unfree. This also requires a reflection on possible implications for moral responsibility. Would it mean that people cannot be held accountable for irrational behaviour? -/- Kalis offers insight on whether everyday irrational behaviour differs from irrational behaviour occurring in the context of psychiatric dysfunction, and develops a view on how we should understand ourselves when we do something other than what we judge best. -/- Written for philosophers, psychologists and psychiatrists interested in issues of irrationality and philosophy of action, this is an indispensable book for both professionals and students interested in interdisciplinary endeavours in the science of mind and behaviour. (shrink)

Classification shapes medicine and guides its practice. As clinicians classify symptoms and illnesses, they trigger a range of actions and consequences. The assignment of particular disease labels is linked to both therapeutic and social responses. However, the classifications of medicine, natural though they may seem, contain significant social content, and are arrived at via a number of cultural framing devices (Aronowitz 2008). This article will explore the social intent and construction of classification and their embodiment in medical diagnosis.Effective classification recognizes (...) difference as well as similarity. By classifying, we are putting items together that have more in common with one another than they .. (shrink)

We may be at the brink of a Kuhnian paradigm shift when it comes to the categorical classification system of mental disorders. Reviewing more than 30 years of critical literature on the categorical classification of personality disorders, Kueger, Hopwood, Wright, and Markon conclude that the Diagnostic and Statistical Manual of Mental Disorders is "fundamentally broken". Just before, the director of the National Institute of Mental Health declared that the institute will no longer support research that is based on DSM categories.The (...) critique on the categorical system of mental disorders consists of several arguments that are briefly mentioned as they have been... (shrink)

Recently, two apparent truisms about self‐control have been questioned in both the philosophical and the psychological literature: the idea that exercising self‐control involves an agent doing something, and the idea that self‐control is a good thing. Both assumptions have come under threat because self‐control is increasingly understood as a mental mechanism, and mechanisms cannot possibly be good or active in the required sense. However, I will argue that it is not evident that self‐control should be understood as a mechanism, suggesting (...) that we might also argue the other way around: if we have independent reason to hold onto the idea that self‐control is inherently good and active, the conclusion might be that self‐control cannot be a mechanism. I will show that Aristotle's original analysis of self‐control actually offers grounds for both assumptions: he took there to be conceptual connections between self‐control and goodness/activity. By examining these connections, I argue that an Aristotelian approach could offer promising leads for a contemporary non‐mechanistic understanding of self‐control as a normative capacity. (shrink)

Die Behandlung von einwilligungsunfähigen psychisch kranken Menschen mit neuen Therapiemethoden ist insbesondere im Kontext des „individuellen Heilversuchs“, der als Anwendung wenig erprobter Therapieansätze im Rahmen von „ultima ratio“-Entscheidungen charakterisiert ist, mit ethischen Abwägungsproblemen verbunden. Diese bestehen aufgrund von Einschränkungen in der Handlungs- und Entscheidungsautonomie der betroffenen Patienten und, aufgrund eigen- oder fremdgefährdender Symptome der psychischen Krankheit selbst, insbesondere in der praktischen Umsetzung ethisch akzeptierter Modelle stellvertretender Entscheidung sowie in der Wahl des Bezugspunkts der Nutzen-Risiko-Analyse des intendierten Therapieverfahrens. Der Artikel untersucht (...) den ethischen Konflikt zwischen gerechtfertigter Hilfeleistung und Instrumentalisierungsrisiko psychisch kranker Menschen zu Fremdzwecken am historischen Beispiel der „Rindenexcisionen“ des Psychiaters Gottlieb Burckhardt (1836–1907). Als Lösungsmöglichkeit dieses ethischen Konflikts wird das „Konzept des kontrollierten individuellen Heilversuchs“ diskutiert. (shrink)