BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors (representing 20% of all Irish registered doctors), which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.ResultsA total of 729 responses were (...) obtained, the majority of which were from young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe (χ2=17.51, p<0.001). Interns being less likely to self-prescribe was not unexpected (χ2=69.55, p<0.001), while general practitioners (GPs) and paediatricians were more likely to self-prescribe (χ2=13.33, p<0.001;χ2=11.35, p<0.001). GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family (χ2=5.19, p<0.05;χ2=8.38, p<0.05;χ2=6.17, p<0.05) and surgeons were more likely to prescribe to friends (χ2=15.87, p<0.001). Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids (χ2=7.82, p<0.01;χ2=7.31, p<0.01;χ2=4.91, p<0.05), while those in hospital medicine were more likely to self-prescribe psychotropic medications (χ2=5.47, p<0.05).ConclusionPrescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it. (shrink)

Replies to commentaries on "Can experiences be rational?", forthcoming in Analytic Philosophy.

In this article we study the development of the mathematical theorem, now known as the T Couple, and discuss the difference between its plane and spherical applications.

We propose that in pictures both the extended limbs of actors and the ground are involved in gestalts for movement. Limbs extend to suggest more motion literally when a dancer is in air and refer to a canonical pose when on the ground. A running pony’s curled limbs off the ground depict fast action literally. A horse’s flying-gallop off the ground suggests speedy motion metaphorically. Cast shadows indicate the actor’s location with respect to the ground. We consider extended and curled (...) limbs, on-ground and off, in literal and metaphoric pictures. (shrink)

What is the role of consciousness in our mental lives? Declan Smithies argues here that consciousness is essential to explaining how we can acquire knowledge and justified belief about ourselves and the world around us. On this view, unconscious beings cannot form justified beliefs and so they cannot know anything at all. Consciousness is the ultimate basis of all knowledge and epistemic justification.

What is involved in making an inference? This chapter argues against what Paul Boghossian calls the Taking Condition: "Inferring necessarily involves the thinker taking his premises to support his conclusion and drawing his conclusion because of that fact" (2014: 5). I won’t argue that the Taking Condition is incoherent: that nothing can coherently play the role that takings are supposed to play in inference. Instead, I’ll argue that it cannot plausibly explain all the inferential knowledge that we ordinarily take ourselves (...) to have. Moreover, I’ll argue that we don’t need it to understand the nature of inference. (shrink)

According to the Rationality Constraint, our concept of belief imposes limits on how much irrationality is compatible with having beliefs at all. We argue that empirical evidence of human irrationality from the psychology of reasoning and the psychopathology of delusion undermines only the most demanding versions of the Rationality Constraint, which require perfect rationality as a condition for having beliefs. The empirical evidence poses no threat to more relaxed versions of the Rationality Constraint, which only require only minimal rationality. Nevertheless, (...) we raise problems for all versions of the Rationality Constraint by appealing to more extreme forms of irrationality that are continuous with actual cases of human irrationality. In particular, we argue that there are conceivable cases of “mad belief” in which populations of Lewisian madmen have beliefs that are not even minimally rational. This undermines Lewis’s claim that our ordinary concept of belief is a theoretical concept that is implicitly defined by its role in folk psychology. We argue that introspection gives us a phenomenal concept of belief that cannot be analyzed by applying Lewis’s semantics for theoretical terms. (shrink)

Does rationality require logical omniscience? Our best formal theories of rationality imply that it does, but our ordinary evaluations of rationality seem to suggest otherwise. This paper aims to resolve the tension by arguing that our ordinary evaluations of rationality are not only consistent with the thesis that rationality requires logical omniscience, but also provide a compelling rationale for accepting this thesis in the first place. This paper also defends an account of apriori justification for logical beliefs that is designed (...) to explain the rational requirement of logical omniscience. On this account, apriori justification for beliefs about logic has its source in logical facts, rather than psychological facts about experience, reasoning, or understanding. This account has important consequences for the epistemic role of experience in the logical domain. In a slogan, the epistemic role of experience in the apriori domain is not a justifying role, but rather an enabling and disabling role. (shrink)

What is the relationship between pleasure and desire? While some philosophers reduce pleasure to desire, this paper explores the prospects for a hedonic theory of desire, which reduces desire to pleasure instead. I argue that desiring that p is best analyzed not as a disposition to feel pleased that p when you believe that p, but rather as a disposition to feel pleasure in what you imagine when you imagine that p. I give three arguments for this hedonic theory of (...) desire, defend it against objections, and consider its broader theoretical implications for current debates in ethics and philosophy of mind. (shrink)

This paper argues that justification is accessible in the sense that one has justification to believe a proposition if and only if one has higher-order justification to believe that one has justification to believe that proposition. I argue that the accessibility of justification is required for explaining what is wrong with believing Moorean conjunctions of the form, ‘p and I do not have justification to believe that p.’.

This chapter argues that attention is a distinctive mode of consciousness, which plays an essential functional role in making information accessible for use in the rational control of thought and action. The main line of argument can be stated quite simply. Attention is what makes information fully accessible for use in the rational control of thought and action. But what makes information fully accessible for use in the rational control of thought and action is a distinctive mode of consciousness. Therefore, (...) attention is a distinctive mode of consciousness. In a slogan: attention is rational-access consciousness. (shrink)

This chapter defends the thesis that feeling conviction is sufficient for belief: if you feel conviction that p, then you believe that p. I begin with a neutral characterization of belief in terms of its normative profile: belief is a state that is subject to certain distinctive norms of rationality. The main argument of the chapter is that feelings of conviction are beliefs because they are subject to the same norms of rationality that govern our beliefs. Functionalists often deny that (...) feelings of conviction constitute beliefs when they play dysfunctional causal roles, as in cases of mad belief or delusion or implicit bias, but this only serves to obscure the kind of irrationality involved in such cases. These are dysfunctional beliefs, rather than non-doxastic states, or "in-between" cases. (shrink)

Questions about the transparency of evidence are central to debates between factive and non-factive versions of mentalism about evidence. If all evidence is transparent, then factive mentalism is false, since no factive mental states are transparent. However, Timothy Williamson has argued that transparency is a myth and that no conditions are transparent except trivial ones. This paper responds by drawing a distinction between doxastic and epistemic notions of transparency. Williamson's argument may show that no conditions are doxastically transparent, but it (...) fails to show that no conditions are epistemically transparent. Moreover, this reinstates the argument from the transparency of evidence against factive mentalism. (shrink)

This chapter is guided by the hypothesis that the point and purpose of using the concept of justification in epistemic evaluation is tied to its role in the practice of critical reflection. In section one, I propose an analysis of justification as the epistemic property in virtue of which a belief has the potential to survive ideal critical reflection. In section two, I use this analysis in arguing for a form of access internalism on which one has justification to believe (...) a proposition if and only if one has higher-order justification to believe that one has justification to believe that proposition. In section three, I distinguish between propositional and doxastic versions of access internalism and argue that the propositional version avoids familiar objections to the doxastic version. In section four, I argue that the propositional version of access internalism also explains and vindicates internalist intuitions about cases. In section five, I conclude with some reflections on the relationship between critical reflection, responsibility and personhood. (shrink)

What is the role of affective experience in explaining how our desires provide us with reasons for action? When we desire that p, we are thereby disposed to feel attracted to the prospect that p, or to feel averse to the prospect that not-p. In this paper, we argue that affective experiences – including feelings of attraction and aversion – provide us with reasons for action in virtue of their phenomenal character. Moreover, we argue that desires provide us with reasons (...) for action only insofar as they are dispositions to have affective experiences. On this account, affective experience has a central role to play in explaining how desires provide reasons for action. (shrink)

Perception enables us to think demonstrative thoughts about the world around us, but what must perception be like in order to play this role? Does perception enable demonstrative thought only if it is conscious? This paper examines three accounts of the role of consciousness in demonstrative thought, which agree that consciousness is essential for demonstrative thought, but disagree about why it is. First, I consider and reject the accounts proposed by Gareth Evans in The Varieties of Reference and by John (...) Campbell in Reference and Consciousness before offering an alternative proposal of my own. My proposal is that consciousness plays an essential epistemic role in explaining the capacity for demonstrative thought about an object by enabling the subject to form immediately justified beliefs about the object. (shrink)

This is the first in a series of two articles that serve as an introduction to recent debates about cognitive phenomenology. Cognitive phenomenology can be defined as the experience that is associated with cognitive activities, such as thinking, reasoning, and understanding. What is at issue in contemporary debates is not the existence of cognitive phenomenology, so defined, but rather its nature and theoretical role. The first article examines questions about the nature of cognitive phenomenology, while the second article explores the (...) philosophical implications of these questions for the role of consciousness in theories of intentionality, introspective self-knowledge, and knowledge of the external world. (shrink)

This chapter develops a simple theory of introspection on which a mental state is introspectively accessible just by virtue of the fact that one is in that mental state. This theory raises two questions: first, a generalization question: which mental states are introspectively accessible; and second, an explanatory question: why are some mental states introspectively accessible, rather than others, or none at all? In response to the generalization question, I argue that a mental state is introspectively accessible if and only (...) if it is phenomenally individuated. And in response to the explanatory question, I argue that a mental state is introspectively accessible if and only if it is among the determinants of justification. This provides the basis of an argument for a phenomenal conception of justification, according to which a mental state is among the determinants of justification if and only if it is phenomenally individuated. (shrink)

What is the normative role of knowledge? I argue that knowledge plays an important role as a norm of assertion and action, which is explained and unified by its more fundamental role as a norm of belief. Moreover, I propose a distinctive account of what this normative role consists in. I argue that knowledge is the aim of belief, which sets a normative standard of correctness and a corresponding normative standard of justification. According to my proposal, it is correct to (...) believe, assert and act on a proposition if and only if one is in a position to know it, but one has justification to believe, assert and act on a proposition if and only if one has justification to believe that one is in a position to know it. (shrink)

In this article, we posit that a cross-scale perspective is valuable for studies of organizational resilience. Existing research in our field primarily focuses on the resilience of organizations, that is, the factors that enhance or detract from an organization’s viability in the face of threat. While this organization level focus makes important contributions to theory, organizational resilience is also intrinsically dependent upon the resilience of broader social-ecological systems in which the firm is embedded. Moreover, long-term organizational resilience cannot be well (...) managed without an understanding of the feedback effects across nested systems. For instance, a narrow focus on optimizing organizational resilience from one firm’s perspective may come at the expense of social-ecological functioning and ultimately undermine managers’ efforts at long-term organizational survival. We suggest that insights from natural science may help organizational scholars to examine cross-scale resilience and conceptualize organizational actions within and across temporal and spatial dynamics. We develop propositions taking a complex adaptive systems perspective to identify issues related to focal scale, slow variables and feedback, and diversity and redundancy. We illustrate our theoretical argument using an example of Unilever and palm oil production in Borneo. (shrink)

In this chapter, I argue for the thesis that phenomenal consciousness is the basis of epistemic justification. More precisely, I argue for the thesis of phenomenal mentalism, according to which epistemic facts about which doxastic attitudes one has justification to hold are determined by non-epistemic facts about one’s phenomenally individuated mental states. I begin by providing intuitive motivations for phenomenal mentalism and then proceed to sketch a more theoretical line of argument according to which phenomenal mentalism provides the best explanation (...) of the independently motivated thesis of access internalism. The result is a theory of epistemic justification that brings intuition and theory into reflective equilibrium. (shrink)

In his book, On Reflection, Hilary Kornblith criticizes what he regards as a chronic tendency in philosophy towards inflating the significance of reflection in ways that manifest a combination of philosophical naiveté and scientific ignorance about how reflection actually works. In these comments, I respond to Kornblith's challenge by sketching an account of the philosophical significance of reflection in the theory of epistemic justification.

The aim of this paper is to argue that what I call the simple theory of introspection can be extended to account for our introspective knowledge of what we believe as well as what we consciously experience. In section one, I present the simple theory of introspection and motivate the extension from experience to belief. In section two, I argue that extending the simple theory provides a solution to Moore’s paradox by explaining why believing Moorean conjunctions always involves some degree (...) of irrationality. In section three, I argue that it also solves the puzzle of transparency by explaining why it’s rational to answer the question whether one believes that p by answering the question whether p. Finally, in section four, I defend the simple theory against objections by arguing that self-knowledge constitutes an ideal of rationality. (shrink)

This is the second in a series of two articles that serve as an introduction to recent debates about cognitive phenomenology. Cognitive phenomenology can be defined as the experience that is associated with cognitive activities, such as thinking, reasoning, and understanding. What is at issue in contemporary debates is not the existence of cognitive phenomenology, so defined, but rather its nature and theoretical role. The first article examines questions about the nature of cognitive phenomenology, while the second article explores the (...) philosophical implications of these questions for the role of consciousness in theories of intentionality, introspective self-knowledge, and knowledge of the external world. (shrink)

This chapter provides a critical overview of several influential proposals about the epistemic function of higher-order evidence. I start by criticizing accounts of higher-order evidence that appeal to evidential defeat (§1), epistemic conflicts (§2), and unreasonable knowledge (§3). Next, I propose an alternative account that appeals to a combination of improper basing (§4) and non-ideal rationality (§5). Finally, I conclude by summarizing my reasons for preferring this account of higher-order evidence to the alternatives (§6).

In order processing, consecutive sequences (e.g., 1‐2‐3) are generally processed faster than nonconsecutive sequences (e.g., 1‐3‐5) (also referred to as the reverse distance effect). A common explanation for this effect is that order processing operates via a memory‐based associative mechanism whereby consecutive sequences are processed faster because they are more familiar and thus more easily retrieved from memory. Conflicting with this proposal, however, is the finding that this effect is often absent. A possible explanation for these absences is that familiarity (...) may vary both within and across sequence types; therefore, not all consecutive sequences are necessarily more familiar than all nonconsecutive sequences. Accordingly, under this familiarity perspective, familiar sequences should always be processed faster than unfamiliar sequences, but consecutive sequences may not always be processed faster than nonconsecutive sequences. To test this hypothesis in an adult population, we used a comparative judgment approach to measure familiarity at the individual sequence level. Using this measure, we found that although not all participants showed a reverse distance effect, all participants displayed a familiarity effect. Notably, this familiarity effect appeared stronger than the reverse distance effect at both the group and individual level; thus, suggesting the reverse distance effect may be better conceptualized as a specific instance of a more general familiarity effect. (shrink)

This is a teaching and learning guide that accompanies "The Nature of Cognitive Phenomenology" and "The Significance of Cognitive Phenomenology".

Theory of mind, the theory that humans attribute mental states to others, has become increasingly influential in the Cognitive Science of Religion in recent years, due to several papers which posit that supernatural agents, like gods, demons, and the dead, are accredited greater than normal knowledge and awareness. Using Old Norse mythology and literary accounts of Old Norse religion, supported by archaeological evidence, I examine the extent to which this modern perspective on religious theory of mind is reflected in religious (...) traditions from the Viking Age. I focus especially on the extent to which superperception and superknowledge were attributed to Old Norse supernatural agents and the impact of this on expressions of religion; how the attribution of theory of mind varied with circumstances and the agents to which it was being attributed; and the extent to which features of religious theory of mind common in other societies were present in the historical North. On this basis, I also evaluate the usefulness of Old Norse historiography to Cognitive Science of Religion and vice versa. (shrink)

The topic of introspection stands at the interface between questions in epistemology about the nature of self-knowledge and questions in the philosophy of mind about the nature of consciousness. What is the nature of introspection such that it provides us with a distinctive way of knowing about our own conscious mental states? And what is the nature of consciousness such that we can know about our own conscious mental states by introspection? How should we understand the relationship between consciousness and (...) introspective self-knowledge? Should we explain consciousness in terms of introspective self-knowledge or vice versa? Until recently, questions in epistemology and the philosophy of mind were pursued largely in isolation from one another. This volume aims to integrate these two lines of research by bringing together fourteen new essays and one reprinted essay on the relationship between introspection, self-knowledge, and consciousness. (shrink)

Why Deleuze and Ricoeur? -- Fields for potential and possible connectors -- Investigative strategies -- Towards the cohesion of a life : chapter outline -- Problematizing the field of the self -- Between rigidification and dehiscence : context and counter-context -- Ancestry for the self in a problematic field -- Conceptual personae and the self -- Aporia of the inscrutability of the self -- Sweeney : philosophical bathyscope -- Critique on the kantian self -- Pretensions of the kantian self -- (...) Divided self still surrounded by the mad and the replicant -- The narrative self -- Oneself as another or onselves as myself -- The narrative self : origins in Kant -- Appearance and exposition of the narrative self -- Working through narrative -- Towards an interrogation of the narrative self -- Questioning the narrative self through its progenitors -- Methodology : questioning back -- The narrative self in retrospect -- The poetic composition of the self : threefold mimesis -- Summary : problems for narrative identity -- Transversals between Ricoeur and Deleuze -- In the land of the larval selves -- Origins in Schelling -- Ontology of productivity -- The dogmatic image of thought -- The narrative self as twin multiplicities -- Dissolving the narrative self -- From multiplicity to the narrative self -- Obscure stammering for a new narrative self -- Between time and the self : a fractured I -- Laws in the germplasm of narrative : the dark precursor -- Narrative persona -- From debt to excess -- Ricoeur's dilemma of the self : substance or illusion? -- Deleuze and Aristotle : a disavowed affinity -- Interzone -- Between dark precursor and narrative self : gelassenheit -- Inhering problems for the becoming-narrative self -- An unguessed axis for narrative selves -- From excess to debt : evolving constraints to narrative identity -- Where to start, three stations : natality, personhood, narrative selfhood -- First constraint : proustian love and lack -- Narrative constraints : implications for the synthesis of the heterogeneous -- The poetic imagination within the evolving constraints of narrative productivity -- Where Deleuze was, there Ricoeur shall be? -- The narrative self : a badly posed question -- Second constraint : imagination within structure and obligation -- A self entombed in a debt to the past. (shrink)

This chapter is organized around four central questions about the role of reasons in the epistemology of perception. The 'whether?' question: does perception provide us with reasons for belief about the external world? The 'how?' question: how does perception provide us with reasons for belief about the external world? The 'when?' question: when does perception provide us with reasons for belief about the external world? The 'what?' question: what are the reasons that perception provides us with for belief about the (...) external world? (shrink)

The Psychic Home: Psychoanalysis of Consciousness and the Human Soul develops, from a number of different viewpoints, the significance of home in our lives. Roger Kennedy puts forward the central role of what he has termed a 'psychic home' as a vital psychic structure, which gathers together a number of different human functions. Kennedy questions what we mean by the powerfully evocative notion of the human soul, which has important links to the notion of home and he suggests (...) that what makes us human is that we allow a home for the soul. As an illustration of this concept he explores how it can help to understand a vital element of William Wordsworth's development as a poet. The word soul is both abstract and yet also powerfully emotive. Kennedy shows that it can be approached from a number of different angles, from psychoanalysis, philosophy, religion, sociology, literature and neuroscience. The Psychic Home, discusses the mysteries and complexities of the soul, and aims to evoke some restoration of its place in our thinking. It illustrates how the word soul and similar key words, such as spirit and inwardness, express so much that is essential for humans, even if we cannot be too precise about their meanings. Insightful, enlightening and broad reaching, The Psychic Home brings the concept of the soul centre stage as an entity that is elemental, an essence, irreducible, and what makes us human as subjects of experience. It will be essential reading for psychoanalysts, psychotherapists, neuroscientists, philosophers and those interested in spirituality and religion. (shrink)

The main goal of this chapter is to argue that accessibilism in epistemology is incompatible with vehicle externalism in philosophy of mind. As we shall see, however, there are strong arguments for both of these positions. On the one hand, there is a compelling argument for vehicle externalism: the parity argument from Clark and Chalmers 1998. On the other hand, there is a compelling argument for accessibilism: the Moorean argument from Smithies 2012. If accessibilism is incompatible with vehicle externalism, then (...) both arguments cannot be sound. I resolve the tension by arguing that while the Moorean argument succeeds, the parity argument fails, and so vehicle externalism should be rejected on broadly epistemological grounds. (shrink)

What is the role of phenomenal consciousness in grounding epistemic justification? This paper explores the prospects for a global version of phenomenal conservatism inspired by the work of Michael Huemer, according to which all epistemic justification is grounded in phenomenal seemings. I’m interested in this view because of its global ambitions: it seeks to explain all epistemic justification in terms of a single epistemic principle, which says that you have epistemic justification to believe whatever seems to you strongly enough on (...) balance to be true. One of the attractions of phenomenal conservatism is that it offers such a simple and unified framework for explaining the epistemic role of phenomenal consciousness. I will argue, however, that the simplicity of phenomenal conservatism is not a theoretical virtue, but a theoretical vice, since it distorts the epistemological phenomena it is supposed to explain. In effect, phenomenal conservatism seeks to explain all epistemic justification on the same model as perception. But this has the predictable effect of distorting the epistemology of other domains, including introspection, inference, and a priori justification. (shrink)