Volume 24, Issue 7, July 2024, Page 6-12.

In lieu of an abstract, here is a brief excerpt of the content:Excited DeliriumFalsifiability, Causality, and the Importance of AdvocacyArjun Byju, MD (bio) and Phoebe Friesen, PhD (bio)We want to begin by thanking both Kathryn Petrozzo and Paul B. Lieberman for taking the time to read and respond to our article, “Making Up Monsters, Redirecting Blame: An Examination of Excited Delirium,” so thoughtfully. They each offered us an opportunity to consider dimensions of excited delirium that we had not encountered (...) as of yet and encouraged us to think more carefully about them. In our response, we consider each of their commentaries in turn, given that, as a philosopher and a psychiatrist, they each speak to different aspects of our argument.First, we turn to Kathryn Petrozzo’s commentary “Excited Delirium: The Self-Fulfilling Prophecy of Police Brutality.” We are grateful for her generous comments and careful engagement with our arguments. While much of the commentary is supportive of our piece, Petrozzo makes three critical and insightful points that we hope to respond to here.The first point Petrozzo makes is that our assertion that excited delirium is non-falsifiable is not supported. She suggests that those “seeking to exonerate the police/first responders responsible for these deaths, are not accepting this evidence leading them to reject the excited delirium diagnosis, but rather, are crafting an incorrect causal narrative. This is deeply problematic, but it does not necessarily render excited delirium as nonfalsifiable.”Although we are intrigued by this challenge, we would like to hear more about what it would look like to falsify the phenomenon of excited delirium. The way that the causal theories related to it are structured are such that if one causal factor is not present (e.g., drug use), then another causal factor can be located (e.g., mental health), and if that is not found, another may be simply made up (e.g., genetic predisposition), making excited delirium multiply realizable in a seemingly endless fashion. This is precisely what took place in the case of Anthany Dawson, who was initially said to have been experiencing a mental health crisis, but was later said to have died from excited delirium related to a genetic condition never identified before (Hon, 2004; Razack, 2015). [End Page 361]In practice, confirmations of excited delirium are found on the basis of various unrelated factors, such that after a death involving police force, there is almost always the option to reach for excited delirium as an explanation/exoneration. According to proponents, there is no factor that could be present that could rule out the diagnosis of excited delirium as it is currently constructed. Indeed, even in the presence of video evidence showing police officers choking an individual until they stop breathing, these deaths are still attributed to excited delirium. This seems like a clear instance of non-falsifiability.Although Petrozzo might maintain that this is simply “an incorrect causal narrative,” it is a causal narrative that aligns with the current theoretical scaffolding surrounding excited delirium.The second point Petrozzo makes is regarding widespread criticisms of Popper’s demarcation criterion of falsifiability. Indeed, this criterion has been called too inclusive, in that any empirical claim can be called falsifiable in principle—even if it refers to a future apocalypse or a UFO landing. It has also been criticized for being too exclusive, in that it ignores the “remarkable tenacity of scientific theories,” as Lakatos puts it (2009, p. 516). In practice, scientists do not merely abandon a theory if it is not supported by facts; they tend to find other explanations (e.g., the measurement was faulty) rather than accept an instance of falsification.Despite this, we believe it is still worth discussing falsifiability in the context of excited delirium for two reasons. First, while falsifiability may not be successful as a criterion that draws a line between science and pseudoscience, in this case, we argue, it still works well as a signifier of pseudoscience. Recently, many interested in the demarcation question have turned towards pluralism as a way to identify pseudoscientific practices (Pigliucci & Boudry, 2013). And excited delirium offers an excellent example of a phenomenon that bumps up against many of the features that might indicate a pseudoscientific practice... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Excited DeliriumWhat’s Psychiatry Got to do With It?Paul B. Lieberman, MDIf in life we are surrounded by death, so too in the health of our intellect by madness.—WittgensteinDelirium is a medical syndrome defined as “a relatively acute decline in cognition that fluctuates over hours or days” whose primary manifestation is a deficit of attention. It is common, estimated to occur in 10% to more than 50% of hospitalized patients, (...) with higher prevalence rates among people in nursing homes and at the end of life. It is often fatal, with a mortality rate in the hospital estimated to be 25% to 33%. Caused by a wide variety of conditions and frequently difficult to diagnose, it lacks characteristic postmortem pathology (Josephson & Miller 2018)‘Excited delirium,’ as Byju and Friesen forcefully argue (Byju & Friesen, 2023), is, if nothing else, an excuse. The ‘diagnosis’ has not been empirically validated and remains controversial (American Psychiatric Association, 2020). And while delirium is usually treated by internists and emergency medicine physicians, psychiatrists should also be concerned about the misuse of a putative medical diagnosis and join actively in discussion about it. For one thing, patients mis-diagnosed with this condition, as Byju and Friesen’s examples suggest, may actually have another psychiatric condition and, so, be people for whose safety we should advocate. Moreover, the kinds of police interventions which Byju and Friesen document as involving excited delirium also befall patients with other psychiatric problems in whom the issue of delirium does not arise.There are at least two broad ways in which psychiatrists are qualified and obligated to engage with this issue. As physicians, we should join our medical colleagues in carefully but persistently telling the scientific, medical truth. As psychiatrists, we should bring psychiatric knowledge into the discussion, for example, by explaining what can happen when people who do not, apparently, have a diagnosable mental disorder interact under stress with other people who, apparently, do.Delirium is a clinical diagnosis, made when characteristic signs and symptoms are present which should not be made ‘by exclusion’ when, as may happen, other causes are not found. There is no evidence of delirium in any of the three clinical descriptions Byju and Friesen provide. Perhaps such evidence exists which is not in their brief reports, but these three people appear to have had, either, another psychiatric condition, such as psychosis or drug intoxication, or perhaps no [End Page 353] diagnosis at all. Psychiatrists are particularly wellpositioned to make this point since patients with mental health problems are often misdiagnosed when they seek medical attention and are told, and treated as if, “it’s all (“just”!) psychological.”Excited delirium, if it exists, is fatal in 10% of cases (Gonin, Beysard, Hersin, & Carron, 2018) and, although this is lower than the rate for delirium in general, it is still high. Medical personnel must be available to evaluate and ensure the safety of patients in custody.The potential conflict between protecting the patient and protecting the public should not be overstated. Although physical trauma and excessive administration of medications, including ketamine 500 mg IV (Orhurhu, Vashicht, Claus, & Cohen, 2023) can be lethal, mechanical restraint by itself is not (Chieze et al., 2019; Gleerup et al., 2019): something else is necessary, such as asphyxiation (Evans, Wood, & Lambert, 2003). Nor is restraint necessary in many cases in which ‘de-escalation’ techniques can be equally effective (Garriga et al., 2016; Fernández-Costa, 2020). Perhaps these points are best made by law enforcement leaders—and they have been—but psychiatrists can add that safe management of potential violence can be provided for agitated people with psychiatric conditions.Although it is not clear what kind of strength ‘superhuman’ strength might be (certainly not medical), relative imperviousness to pain is clinically described. Its locus classicus is Beecher’s observation, during World War II, that injured soldiers awaiting return home from the front, required lower than usual doses of analgesics (Beecher, 1946). And it’s a common experience, scientifically confirmed, that physical trauma may not become painful until sometime after the injury (Melzack, Wall, & Ty, 1982). But pain is a warning. Its absence is not a license, but a caution... (shrink)

Institutional review boards, tasked with facilitating ethical research, are often pulled in competing directions. In what we call the protection-inclusion dilemma, we acknowledge the tensions IRBs face in aiming to both protect potential research participants from harm and include under-represented populations in research. In this manuscript, we examine the history of protectionism that has dominated research ethics oversight in the United States, as well as two responses to such protectionism: inclusion initiatives and critiques of the term vulnerability. We look at (...) what we know about IRB decision-making in relation to protecting and including “vulnerable” groups in research and examine the lack of regulatory guidance related to this dilemma, which encourages protection over inclusion within IRB practice. Finally, we offer recommendations related to how IRBs might strike a better balance between inclusion and protection in research ethics oversight. (shrink)

This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the (...) debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based on personal responsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individual responsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused on personal responsibility have the potential to lead to increases in medical spending overall. (shrink)

This article reflects on the relevance and applicability of the Belmont Report nearly four decades after its original publication. In an exploration of criticisms that have been raised in response to the report and of significant changes that have occurred within the context of biomedical research, five primary themes arise. These themes include the increasingly vague boundary between research and practice, unique harms to communities that are not addressed by the principle of respect for persons, and how growing complexity and (...) commodification in research have shed light on the importance of transparency. The repercussions of Belmont's emphasis on the protection of vulnerable populations is also explored, as is the relationship between the report's ethical principles and their applications. It is concluded that while the Belmont Report was an impressive response to the ethical issues of its day, the field of research ethics involving human subjects may have outgrown it. (shrink)

As participatory research practices are increasingly taken up in health research, claims related to experiential authority and expertise are frequently made. Here, in an exploration of what grounds such claims, we consider how feminist standpoint theory might apply to the psy sciences (psychiatry, psychology, psychotherapy, psychoanalysis, and so on). Standpoint theory claims that experiences of marginalization and critical engagement can lead to a standpoint that offers an epistemic advantage within a domain of knowledge. We examine experiences of marginalization and critical (...) engagement in the mental health system, as well as evidence for epistemic advantages resulting from these experiences. This evidence, found in the identification of problematic assumptions and the development of new tools and theories in the field, grounds our argument that standpoint theory is indeed relevant to the psy sciences and that many of those who have experienced marginalization and have engaged critically have an epistemic advantage when it comes to knowledge-production. The implications of this argument are significant: those who have attained a standpoint within the psy sciences ought to be included in research and given both tools and funding to develop research programs. However, we must be wary of the risks of tokenization, cooptation, and essentialization that are likely to accompany such a transformation. (shrink)

What is pedagogy, exactly? Merriam-Webster defines it simply as “the art, science, or profession of teaching.” In contemporary academic discourse, however, pedagogy is generally left undefined — with its apparent implicit meanings ranging anywhere from a specific “model for teaching” (e.g., behaviorist or progressivist instruction) to a broadly political philosophy of education in general (most famously, a “pedagogy of the oppressed”). In this paper, Norm Friesen and Hanno Su follow the Continental pedagogical tradition in giving pedagogy a general but (...) explicit definition. They do so by looking at how pedagogy arises both in everyday life and in school as unavoidably ethical activity undertaken primarily for the sake of the young person or child. Such activities, the authors maintain, are structured not so much by processes, methods, and outcomes, but by irresolvable oppositions and the tensions between them. They illustrate this inductively through a series of images and examples — moving gradually from ones involving parenting and early childhood to ones from elementary and secondary schooling. In this way, Friesen and Su show that pedagogy is not so much one or more ideologically focused or evidence-based instructional or psychological approaches to be mastered by a professional or teaching specialist. It is instead an independent but ethically informed practical perspective — one that can (and has) been extended to form a distinctively pedagogical theory and discipline. As such, it is something that is not only a part of our everyday life and culture, but arguably of all human cultures. (shrink)

It is argued here that the practice of medical students performing pelvic exams on women who are under anesthetic and have not consented is immoral and indefensible. This argument begins by laying out the ethical justification for the practice of informed consent, which can be found in autonomy and basic rights. Foregoing the process of consent within medicine can result in violations of both autonomy and basic rights, as well as trust, forming the basis of the wrong of unauthorized pelvic (...) examinations. Several objections to this argument are considered, all of which stem from the idea that this practice constitutes an exception to the general requirement of informed consent. These objections suggest that nonconsensual pelvic examinations on women under anesthetic are ethically acceptable on utilitarian grounds, in that they offer benefits either to the patient or to society, or on the grounds of triviality, in that consent is already presumed, or the practice is insignificant. Each of these objections is rejected and the practice is deemed indefensible. (shrink)

The practice of medically assisted dying has long been contentious, and the question of what to call it has become increasingly contentious as well. Particularly among U.S. proponents of legalizing the practice, there has been a growing push away from calling it “physician‐assisted suicide,” with assertions that medically assisted dying is fundamentally different from suicide. Digging deeper into this claim about difference leads to an examination of the difference between two kinds of suffering—suffering from physical conditions and suffering from psychological (...) conditions—and therefore leads also toward an examination of whether requests for medical assistance in dying by those suffering from psychological conditions and those suffering from physical conditions should be painted with the same brush. In this article, I aim both to illuminate some of the considerations that ought to be included in discussions related to medically assisted dying and to shed light on what the indirect effects of such discussions can be. I consider some of the reasons commonly given for holding that suicide and medically assisted dying differ fundamentally and then whether the conclusion that medically assisted dying should not be called “suicide” follows from the premises. I ask what else might justify the conclusion that the two acts ought to be called by different names, and I examine possible justifications for accepting this premise, as well as what justifications might exist for emphasizing how the acts are alike. Finally, I argue that we should be cautious before concluding that medically assisted dying should not be called “suicide.” We need more evidence either that the two acts are fundamentally different or that emphasizing differences between them is not likely to do more harm than good. (shrink)

This paper offers a critical analysis of several accounts of the placebo effect that have been put forward. While the placebo effect is most often thought of as a control in research and as a deceptive tool in practice, a growing body of research suggests that it ought to be thought of as a powerful phenomenon in its own right. Several accounts that aim to draw boundaries around the placebo effect are evaluated in relation to current evidence and it is (...) argued that none of them adequately capture the variability and potency of the phenomenon. Two accounts, however, that point towards the underlying mechanisms of the placebo effect, are shown to offer promise in terms of developing a more comprehensive account of the placebo effect. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 28-31, January/February 2022.

Many are calling for concrete mechanisms of oversight for health research involving artificial intelligence (AI). In response, institutional review boards (IRBs) are being turned to as a familiar model of governance. Here, we examine the IRB model as a form of ethics oversight for health research that uses AI. We consider the model's origins, analyze the challenges IRBs are facing in the contexts of both industry and academia, and offer concrete recommendations for how these committees might be adapted in order (...) to provide an effective mechanism of oversight for health‐related AI research. (shrink)

While a significant body of bioethical literature considers how the placebo effect might introduce a conflict between autonomy and beneficence, the link between justice and the placebo effect has been neglected. Here, we bring together disparate evidence from the field of placebo studies and research on health inequalities related to race and ethnicity, and argue that, collectively, this evidence may provide the basis for an unacknowledged route by which health disparities are exacerbated. This route is constituted by an uneven distribution (...) of placebo effects, resulting from differences in expressions of physician warmth and empathy, as well as support and patient engagement, across racial and ethnic lines. In a discussion of the ethical implications of this connection, we argue that this contribution to health disparities is a source of injustice, consider ways in which these disparities might be ameliorated and suggest that this conclusion is likely to extend to other realms of inequality as well. (shrink)

In the introduction to a recent anthology of contemporary issues in philosophy of psychiatry, editors Jeffrey Poland and Şerife Tekin declare this to be a moment of crisis within the field. They suggest that the state of psychiatry today reflects Thomas Kuhn's conception of a period of extraordinary science, which occurs when anomalies begin to build up, confidence in the dominant paradigm is shook, competing theories arise, and philosophical questions come to the fore. Although perhaps not all would agree that (...) the field is in crisis, there is certainly an abundance of pessimism. Within the realm of research, a mood of explanatory pessimism has been growing, characterized by a... (shrink)

In their target article, Zamina Mithani, Jane Cooper, and J. Wesley Boyd make a compelling case for the importance of “counter storytelling” in bioethics. They obse...

Why are the fundamentals of education apparently so little changed in our era of digital technology? Is their obstinate persistence evidence of resilience or obsolescence? Such questions can best be answered not by imagining an uncertain high-tech future, but by examining a well-documented past--a history of instruction and media that extends from Gilgamesh to Google. Norm Friesen looks to the combination and reconfiguration of oral, textual, and more recent media forms to understand the longevity of so many educational arrangements (...) and practices. Friesen examines the interrelationship of reading, writing, and pedagogy in the case of the lecture and the textbook--from their premodern to their postmodern incarnations. Over hundreds of years, these two forms have integrated textual, oral, and (more recently) digital media and connected them with changing pedagogical and cultural priorities. The Textbook and the Lecture opens new possibilities for understanding not only mediated pedagogical practices and their reform but also gradual changes in our conceptions of the knowing subject and of knowledge itself. Drawing on wide-ranging scholarship in fields as diverse as media ecology and German-language media studies, Foucauldian historiography, and even archaeological research, The Textbook and the Lecture is a fascinating investigation of educational media. (shrink)

Racial disparities in pain treatment are well documented. Such disparities are explained with reference to factors related to providers, health care structures, and patient behaviors. Racial differences in pain experiences, although well documented, are less well understood. Explanations for such differences usually involve genetic or psychological factors. Here, we argue that racial differences in pain experiences might also be explained by disparities in pain treatment. Based on what we know about the nature of pain, particularly the cognitive and affective aspects (...) of the phenomenon, it is likely that disparities in the treatment of racialized patients can lead to significant racial differences in pain experience that show up at the population level. We argue that the failure of research programs to consider this causal factor is an example of white ignorance. We also consider several implications of the link between racial disparities in pain treatment and racial differences in pain experience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Democratizing Psychiatric ResearchRecognizing the Potential and the Limits of Experiential ExpertiseThe author reports no conflict of interests.First, I want to express my gratitude for such thoughtful and generative responses to the manuscript "Why Democratize Psychiatric Research?," which has been in development for several years and is the product of much reflection that has taken place in academic, advocacy, and interpersonal contexts. I am delighted to see such insightful engagement (...) with the piece and to have a chance to respond to both Drs. David Crepaz-Keay and Sam Fellowes here. Given that the authors raise such different questions within their commentaries, I consider each in turn.In his illuminating commentary, Crepaz-Keay makes three important points in response to the epistemic and ethical reasons I lay out as justifications for democratizing efforts in mental health research. First of all, Crepaz-Keay warns that there is "more subjectivity across much of medicine" than in the picture I've painted, and that we might do better to focus on this shared territory, taking up the goal of democratization across all of medicine, rather than risk "othering" psychiatry as uniquely subjective. In this way, Crepaz-Keay emphasizes, mental health service user researchers might "become leaders in progressive medical thinking."I appreciate this call to emphasize the ways in which the importance of subjective experiences cuts across all of medicine and to learn broad lessons from the pioneering participatory work that has been accomplished in the domain of mental health. I agree that much of medicine suffers from a focus on the objective to the neglect of the subjective, and wonder if this focus can sometimes create a distinct kind of worry in territories in which objective measures are widely available. Consider the focus on reducing the size of a tumor at all costs that can sometimes obscure important considerations related to what a good end of life might look like (Gawande, 2014). Particularly [End Page 143] within the process of determining what is worth measuring within research (and what is worth treating within clinical contexts), patient voices are essential to making an informed and beneficial decision. I agree with Crepaz-Keay here—this point applies to all realms of medicine.In contrast, I think other kinds of risks arise in domains in which objective measures are not widely available and therefore subjective reports of patients make up an essential part of any diagnosis or assessment. Another area I often think about is placebo studies, and in this space, stereotypes related to 'real' suffering and 'real' healing circulate widely (Friesen, 2019b). Largely, these stereotypes tend to support the importance and reality of that which occurs at the level of the physical or biological and take much less seriously suffering or healing which is thought to be located 'all in the head' (Friesen & Dionne, 2022). These biases also cut across medicine, influencing which patients are seen as trustworthy, dramatic, or worthy of one's compassion. I would argue that they show up especially in the setting of mental health care and research, in part because of the lack of objective measures and physiological explanations. A psychiatrized patient often has nothing physical or objective to point to with regard to their suffering, and so may be at the whim of a provider in relation to whether they are likely to be believed or discredited. As such, we must be especially alert to the unique risks that arise when evidence for suffering comes in a subjective form, and how efforts toward democratization might help reduce such risks.Second, Crepaz-Keay offers an essential intervention in relation to the importance of anti-racism within participatory practices in psychiatry. Although I do make mention of the lack of representation of racialized communities in participatory psychiatric research in discussing the important role that values play in the development of psychiatric knowledge, Crepaz-Keay accurately points out that this point related to representation is cross-cutting, and highly relevant to several of the other reasons I offer for why psychiatry research ought to be democratized. I am grateful for this invitation to look more broadly at how the exclusion of some voices from participatory efforts might apply across... (shrink)

The increasing use of online simulations as replacements for animal dissection in the classroom or lab raises important questions about the nature of simulation itself and its relationship to embodied educational experience. This paper addresses these questions first by presenting a comparative hermeneutic-phenomenological investigation of online and offline dissection. It then interprets the results of this study in terms of Borgmann’s (1992) notion of the intentional “transparency” and “pliability” of simulated hyperreality. It makes the case that it is precisely encumbrance (...) and disruption—elements that are by definition excluded from simulations and interfaces—which give dissection its educational value. (shrink)

During the COVID-19 pandemic, several hospitals implemented “birthing alone” policies, banning companions from accompanying individuals giving birth. We offer an ethical analysis of these policies. First, we examine them through a consequentialist framework of risks and benefits. Second, we consider the significance of birth, highlighting the unique ways in which risks, relationships, and rights are understood in the context of obstetrics. We conclude that birthing alone policies are largely unjustified, as the harm they are certain to cause outweighs their possible (...) benefits and because they fail to take into account what matters to mothers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:129 Collisions at the Crossroads: How Place and Mobility Make Race BY GENEVIEVE CARPIO Oakland, California: University of California Press, 2019 REVIEWED BY JARED FRIESEN In Collisions at the Crossroads: How Place and Mobility Make Race, Professor of Chicana and Chicano Studies Genevieve Carpio systematically uncovers several of the insidious forms that power takes in order to construct racial inequality. Settlement, mobility, and immobility have served to draw (...) distinctions between Latino/a, Indigenous, Asian, African Americans and white populations in the inland Southern California region. Carpio produced abundant evidence to bolster these statements through interdisciplinary methodological practices, such as “reinterpreting and recovering history” through archival research, analysis of oral history projects, and the examination of both photographic records and the built environment (14). Collisions at the Crossroads begins with a recent example of how mobility and the social construction of place, or “place making” were used to exclude Latino/a residents from participating in the celebration of the Route 66 heritage of the area. In an effort to protect the authenticity of the event, organizers of the Rendezvous festival implemented a ban on lowriders, thus sanitizing the event of Mexican cruising culture that has been a part of the complex multiracial history of the region. This moment is only one of the latest in the history of inland Southern California reaching back to the arrival of white migrants in the form of the Riverside colony to a region composed of Indigenous and Mexican Book Reviews ENVIRONMENT, SPACE, PLACE / VOLUME 13 / ISSUE 2 / 2021 130 American communities. The book lays bare how “the concept of mobility particularly applies to the everyday channels of movement in a community, especially for Indigenous people and people of color” (3–­4). Mobility is conceptualized as physical movement, the shared meaning of the physical movement, and the policies that enable or constrict movement.Throughthisanalyticlens,Carpio tracesthe “Anglo Fantasy Past” to illuminate how white populations created history that places them at the center and either erases non-­white populations or reduces themtoperpetualoutsiders.Thishistoryincludeswhitesettlement,the rise of the citrus industry, and the role of religion. For example, Indigenous people were immobilized in off-­ reservation boarding schools for AmericanIndianchildren,andcapitalist-­orientedpolicieswereenacted such as the Geary Act (1892) in order to control the mobility of Chinese immigrants. The latter is an excellent example of how race continually shaped the experiences of nonwhite migrants. Mobility is encouraged when a source of low cost labor is needed, but then controlled or even criminalized in order to maintain a racialized hierarchy. Throughout the book, Carpio reinforces the precarious situation of mobilityforpeopleofcolor.“Workersweresupposedtomoveinparticu­ lar ways, at specific times, in and to predetermined spaces” (66). This was deftly accomplished in a way that expresses the subtle processes through which power is used, indeed in ways that appear normative and even natural. Without globalized labor migration, the rise of industries such as large-­ scale citrus agriculture would not have been possible. Alternatively, deterring regional labor migration and desegregated housing were critical to maintaining the white supremacist status quo. Collisions at the Crossroads connects readers to the current turmoil and fear around immigration and racism by looking back at the exploita­ tive incentivizing and coercion of Mexican migrant workers. Mexican immigrants are attracted to work in agricultural communities, then their mobility is pathologized to limit movement through public policy. Ultimately, Mexican immigrants are constructed as “birds of passage” who prefer not to be rooted to a place. Geographer Doreen Massey refers to these processes as “differentiated mobility”: “some people are more in charge of it than others; some initiate flows and movement, others don’t; some are more on the receiving-­end of it than others; some are effectively imprisoned by it.”1 Book Reviews 131 This racialization of labor created a low-­ cost workforce that was immobilized by the threat of arrest but later seen as preferable to Puerto Rican or Filipino migrants who had rights to permanent settlement. The claim was that because Mexicans preferred to migrate to worksites, they should therefore return to Mexico in the ebbs of citrus production in the inland Southern California region. Mexican migrants were considered a natural option for filling the workforce needs of the local citrus industry while... (shrink)

In Transcendent Love: Dostoevsky and the Search for a Global Ethic, Leonard G. Friesen ranges widely across Dostoevsky's stories, novels, journalism, notebooks, and correspondence to demonstrate how Dostoevsky engaged with ethical issues in his times and how those same issues continue to be relevant to today's ethical debates. Friesen contends that the Russian ethical voice, in particular Dostoevsky's voice, deserves careful consideration in an increasingly global discussion of moral philosophy and the ethical life. Friesen challenges the view (...) that contemporary liberalism provides a religiously neutral foundation for a global ethic. He argues instead that Dostoevsky has much to offer when it comes to the search for a global ethic, an ethic that for Dostoevsky was necessarily grounded in a Christian concept of an active, extravagant, and transcendent love. Friesen also investigates Dostoevsky's response to those who claimed that contemporary European trends, most evident in the rising secularization of nineteenth-century society, provided a more viable foundation for a global ethic than one grounded in the One, whom Doestoevsky called simply "the Russian Christ." Throughout, Friesen captures a sense of the depth and sheer loveliness of Dostoevsky's canon. Dostoevsky was, after all, someone who believed that the ethical life was sublimely beautiful, even as it recklessly embraced suffering and unreasonably forgave others. The book will appeal to both students and scholars of Russian literature and history, comparative ethics, global ethics, and cultural studies, and togeneral readers with an interest in Dostoevsky. "Others have written about Dostoevsky's ethics, but I am not aware of any single-authored, sustained attempt to make the case for Dostoevsky's 'transcendent love' as part of a larger discussion of a global ethic. Moreover, Leonard Friesen presents his case in an engaging and highly accessible form. He believes passionately that Dostoevsky is deeply relevant to the discussion; his commitment rings through the pages and draws the reader in. In this way, his essay makes an original contribution to Dostoevsky studies that will appeal to scholars in a variety of disciplines and to educated lay readers with ethical concerns about the path of modernity, as well as to the many fans of Dostoevsky's work." --Russell Hillier, Providence College. (shrink)

Philosophy gives an account of our experience 1. Philosophy does not begin with rational propositions or presuppositions, but rather with our experience. Dooyeweerd begins A New Critique of Theoretical Thought by contrasting the continuity of our pre-theoretical experience with the way that theoretical experience splits apart this continuity.1 He says later, “The apriori structure of reality can only be known by experience. But this is not experience as it is conceived by immanence-philosophy.”2 Human experience is not limited to our temporal (...) functions of consciousness.3 Our experience is not an ‘Erlebnis’ of mere psychical feelings and sensations,4 but rather “a conscious enstatic5 ‘Hineinleben.’” — the experience of our supratemporal selfhood enter ing into and living within all aspects of temporal reality. (shrink)

As we rapidly approach the 50th year of the much‐celebrated ‘cognitive revolution’, it is worth reflecting on its widespread impact on individual disciplines and areas of multidisciplinary endeavour. Of specific concern in this paper is the example of the influence of cognitivism's equation of mind and computer in education. Within education, this paper focuses on a particular area of concern to which both mind and computer are simultaneously central: educational technology. It examines the profound and lasting effect of cognitive science (...) on our understandings of the educational potential of information and communication technologies, and further argues that recent and multiple ‘signs of discontent’, ‘crises’ and even ‘failures’ in cognitive science and psychology should result in changes in these understandings. It concludes by suggesting new directions that educational technology research might take in the light of this crisis of cognitivsm. (shrink)

Historians of Reformational philosophy often claim that Abraham Kuyper obtained the idea of sovereignty in its own sphere from Guillaume Groen van Prinsterer. But very little historical research has been done on Groen’s sources for and development of this idea. The first use of the Dutch phrase souvereiniteit in eigen sfeer is much earlier than previously thought; it was used in 1853 by J.I. Doedes, an associate of the “ethical theologian” Daniël Chantepie de la Saussaye. Groen became aware of the (...) ideas of Franz von Baader through journals founded by them, and by reading and corresponding with them and others, such as J.H. Gunning Jr. and Friedrich Fabri. Groen himself owned some of Baader’s books. He also relied strongly on the work of the jurist Friedrich Julius Stahl, who was 37 years younger than Baader but taught for a while at the same Munich university and shared Baader’s anti-revolutionary ideas. (shrink)

Building on decades of rich discussions of why 'nothing about us without us' matters in the field of psychiatry, this paper aims to illuminate the justifications underlying participatory research in psychiatry, and how these justifications might shape participatory methodologies. This is accomplished through the examination of several epistemic and ethical features of psychiatry that underlie the importance of engaging in participatory research in the field, unpacking their connection to participatory research, and offering suggestions related to their implications for research methodologies. (...) The epistemic features include: the irreducible value of patient experience, the extent of disagreement and uncertainty in the field, and the value-laden nature of knowledge in psychiatry. The ethical features include: the preponderance of harm, denials of agency and epistemic injustice, and the constant struggle for power. These features offer useful touchpoints for thinking through why participation matters in mental health research. (shrink)

While attention has long been a concern in western philosophy and eastern spirituality, technologies (e.g., social media, gaming) and pathologies (e.g., attention deficit disorders) have recently foregrounded the issue specifically in education. Issues of student absorption and diversion have been widely discussed; comparatively less has been said about teachers and the kind of attention that the individuality of each of their students claims. This paper begins by reconstructing the kind of awareness and attention that are implied in Kant’s account of (...) logical tact and Herbart’s lecture on specifically pedagogical tact. Potentially tactful forms of awareness are then explored and delineated in phenomenological, Gestaltist terms – as well as through reference to Freud’s notion of ‘free-floating attention.’ The paper concludes by outlining characteristics of awareness that appear requisite to the demands of tactful decision and action, an attention at once receptive to the world outside yet also modulated by the one attending. (shrink)

The Oxford English Dictionary defines fulfilment as ‘satisfaction or happiness as a result of fully developing one's potential or realizing one's aspirations; self-fulfillment’. Not only has the idea of fulfilment underpinned ‘approximately twenty centuries of philosophy’ as Lefebvre notes, it plays an indispensable role in both popular and scholarly accounts of education and upbringing. Experiences of education, of upbringing and of ‘life lessons’, however, are so often not about the fulfilment of oneself, about the discovery and actualisation of one's full (...) potential. Such experiences instead involve moments of sometimes irreparable failure and loss—a matter that has not received a great deal of attention in educational research and theory. After briefly examining the way that fulfilment is favourably framed both in humanistic psychology and in neo-humanist Bildungstheorie, this paper considers some of the exceptions to the nearly ubiquitous identification of education with fulfilment: Arthur Schopenhauer's view of the irrationality of human (developmental) experience and Ludwig Wittgenstein's use of the term ‘conditioning’ (Abrichtung) in some of his accounts of learning and socialisation. We then focus on failure and loss in education through an overview of the pedagogical theory of O.F. Bollnow. Bollnow, as is gradually being recognised in English-language scholarship, saw moments of uncertainty, disorientation and above all crisis as indispensable in educational experience—for both student and teacher. In this way, we show that instead of being the pursuit of self-fulfilment, education is unavoidably a matter of difficulty, disruption and also failure. It reshapes us, and this reshaping can be seen as being as much about formation as it is about deformation. (shrink)

We are grateful to everyone who took the time to offer such insightful comments with regard to the protection–inclusion dilemma in research oversight. Nearly all respondents agreed that this dilemm...

The following key ideas of the Dutch philosopher Herman Dooyeweerd (1894–1977) can already be found in the nineteenth century German philosopher, Franz von Baader (1765–1841): religious antithesis, the law idea (Wetsidee) contrasted with autonomy of thought, Ground Motives in history, the method of antinomy, the use of Kant’s ideas to criticize Kant’s own Critique, cosmic time, the supratemporal heart, the prism analogy, modalities, sphere sovereignty, sphere universality, analogies of time, anticipation and retrocipation, Christ as the Second Root, pre-theoretical experience, the (...) Subject-Object relation, the Gegenstand relation, theoretical synthesis, and cultural unfolding. A comparison with Baader helps to interpret Dooyeweerd. (shrink)

Although there are many points of continuity, there are also a number of changes in the pedagogical form of the anatomy lecture over the longue durée, over centuries of epistemic change, rather than over years or decades. The article begins with an analysis of the physical and technical arrangements of the early modern anatomy lecture, showing how these present a general underlying similarity compared to those in place today. It then goes on to consider examples of elements of speech and (...) presentation, description and illustration that are used in the biology lecture from the early modern (sixteenth to seventeenth centuries) and late modern (or contemporary) eras. The anatomy lecture thus demonstrates a basic physical and technical continuity in the classroom or theater, whereas the larger epistemic functions in which it is embedded have changed: from a descriptive, discursive function, focusing on individual organs and their physicality, to one that is more integrative, systemic and also performative in both form and content. (shrink)

Current models in finance make strong, self-limiting assumptions about the nature of human utility, human relationships, human flourishing, and human growth. These assumptions facilitate tractable solutions to financial problems but ignore subjective determinants of human well-being and value creation within the firm. The philosophical and theological traditions of Catholic teaching, as well as evidence on human flourishing from model social science, call us beyond these models. This paper focuses on three specific areas where a “disconnect” exists between Catholic teaching and (...) current finance models, highlights the relevance of Catholic teaching, and sketches a framework for more fully integrating human flourishing into finance models. (shrink)

Niebuhr's definitions of "Christ" and "culture" set up a problematic dualism that leads to a misrepresentation of the Christ-against-culture type. The paper proposes that instead of Niebuhr's "idealized" Christ, an embodied Christology locates Christ within culture. The tension, then, is not between Christ and culture, but between different cultural visions. A cultural vision with Christ as norm provides a discriminating ethic of normative practices to engage culture. Many scholars have recognized that Niebuhr not only develops a descriptive typology in Christ (...) and Culture, he also argues that the fifth type, Christ-the-transformer-of-culture, is the most adequate position. Almost everyone identifies with this type. Why is that? The problem is that the variety of meanings of "transformation" is not illuminated by Niebuhr's typology. An alternative typology is proposed which addresses these two problems: a richer development of three types that Niebuhr lumps together in his Christ-against-culture type; and the development of a typology to show that there are four different ways to understand what the church has meant by Christ-the-transformer-of-culture. (shrink)