Mental health research and care in the twenty first century faces a series of conceptual and ethical challenges arising from unprecedented advances in the neurosciences, combined with radical cultural and organisational change. The Oxford Textbook of Philosophy of Psychiatry is aimed at all those responding to these challenges, from professionals in health and social care, managers, lawyers and policy makers; service users, informal carers and others in the voluntary sector; through to philosophers, neuroscientists and clinical researchers. Organised around a series (...) of case studies in five key topic areas - concepts of disorder, the philosophical history of psychopathology, philosophy of science, ethics and philosophical value theory, and philosophy of mind - the book provides a detailed introduction to the field and a framework for study and skill development. Each case study is supported by selected readings from both philosophy and mental health, thinking skills exercises, self-test questions, key learning points and detailed guides to further reading. There is an introduction for philosophers to classification and descriptive psychopathology, and for practitioners to philosophical methods (including logic). The philosophical topics covered include philosophical methods (analytic and Continental); phenomenology, hermeneutics and existentialism, logical empiricism and its successors; idealism and realism; reasons and causes; and modern theories of mind and brain, free will and personal identity. Topics from mental health include psychiatry and 'anti-psychiatry'; Jaspers' psychopathology and the new neurosciences; the future of psychiatric classifications; strengths-based approaches, recovery practice, social inclusion and diversity; and key topics in psychopathology, such as delusion, autism, disorders of volition, thought insertion and other experiences in schizophrenia. The Oxford Textbook of Philosophy of Psychiatry aims to secure the skills-base of the discipline by bringing philosophers closer to the realities of practice in mental health, and mental health practitioners closer to the resources of philosophy as a partner to the sciences in responding to the challenges of twenty-first century mental health and social care. (shrink)

This chapter identifies and explores a series of challenges raised by the clinical concept of delusion for theories which conceive autonomy as an agency rather than a status concept. The first challenge is to address the autonomy-impairing nature of delusions consistently with their role as grounds for full legal and ethical excuse, on the one hand, and psychopathological significance as key symptoms of psychoses, on the other. The second challenge is to take into account the full logical range of delusions, (...) which may take the form of true or false factual beliefs, positive or negative evaluations, as well as the paradoxical delusion of mental illness. The third and final challenge is to make room for non-pathological or, autonomy-preserving delusions and to offer a credible way of distinguishing between these and pathological or, autonomy-impairing delusions. By setting out these challenges, we are able to, firstly, distinguish between two separate conceptions of objectivity that may be at work in existing accounts of delusions and, secondly, to put a spotlight on an elusive yet inescapable notion of agential success that underlies our thinking about autonomy as well as mental disorder. (shrink)

Usually, modular construction involves the off-site manufacturing of standard building components in a factory before the components are assembled on the construction site. It is common to use terms like "prefabrication," "off-site construction," and "modular construction" interchangeably. The construction of modular constructions nowadays is flourishing all over the globe. The roots of the Albanian prefabricated constructions are extended for the first time around the 1970s. This paper will indeed analyze some recently built modular construction in Albania, considering and comparing it (...) with international case studies. The demand for new construction in Albania is rising rapidly. Currently, the most common structures are cast-in-place beam-column designs, driven by both traditional mindsets and industrial capabilities. However, with Albania's economic growth, there is an increasing need for affordable, quickly built, and technologically advanced buildings. Modular construction, which assembles prefabricated modules on-site, offers a solution. This method aligns with bioclimatic design principles, reducing environmental impact and optimizing resources, marking a shift toward sustainability in the construction industry. The purpose of this article is to explore the potential integration of “modular construction techniques” with “bioclimatic design concepts” to create buildings that are environmentally friendly, energy-efficient, and multipurpose by function. This study explores the use of modular construction techniques in conjunction with bioclimatic techniques to increase “building sustainability”. Combining these tactics encourages energy efficiency and a reduced environmental effect, making people far more resilient and weather-adaptable. The synergy between the two of them is necessary. (shrink)

This short work sets out to argue that the set of simple expressions comprising the lexicon of a given individual and the lexis of a given community are not just contingently but necessarily finite at any given moment in time. Where the lexicon is concerned, this is done by adapting a very simple argument presented by Fred Dretske (1965) concerning whether an individual can count to infinity. This is extended to the more challenging case of the lexis of a community (...) by introducing lexicalization as a condition, which facilitates the same sort of argument as presented for the lexicon. Though the lexicon and lexis are often implicitly assumed to be finite, with little need for further argumentation, there does appear to be grounds for the stronger and more interesting claim that they are necessarily finite at any given moment in time. (shrink)

The aim of this essay is to describe and reflect upon the concrete particulars of one academician's work as an expert ethics witness. The commentary on my practices and the narrative descriptions of three cases are offered as evidence for the thesis that it is possible to act honorably within a role that some have considered to be inherently illicit. Practical measures are described for avoiding some of the best known pitfalls. The discussion concludes with a listing of the distinctive (...) competencies and understandings that are useful in serving as an expert ethics witness. (shrink)

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined (...) for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy. (shrink)

This volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organized around the main stages of the clinical encounter from the patient's perspective. They run from staying well and 'first contact' through to either recovery or to long-term illness, death and dying.

A study found that women participating in mammography screening were content with the programme and the paternalistic invitations that directly encourage participation and include a pre-specified time of appointment. We argue that this merely reflects that the information presented to the invited women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. This short-circuits informed decision-making and the (...) legislation on informed consent, and violates the autonomy of the women. Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility for the screening programmes must be separated from the responsibility for the information material. (shrink)

OBJECTIVES: To study the resources available and resources needed for ethics teaching to medical students in UK medical schools as required by the new GMC core curriculum. DESIGN: A structured questionnaire was piloted and then circulated to deans of medical schools. SETTING: All UK medical schools. RESULTS: Eighteen out of 28 schools completed the questionnaire, the remainder either indicating that their arrangements were "under review" (4) or not responding (6). Among those responding: 1) library resources, including video and information technology (...) were found to be fairly well developed; 2) many schools had a good supply of handouts and sample cases for teaching; 3) most had a written syllabus, and 4) two-thirds examined in the subject. However, many schools indicated that there was an urgent need for: 1) full-time teachers (most ethics teaching is still by part-time and voluntary staff); funding for books and journals, and 3) additional teaching materials (including further case vignettes, handouts and sample exam questions). CONCLUSIONS: There has been a considerable overall improvement in resources for medical ethics teaching since the time of the last national survey (The Pond Report). However, provision varies widely from medical school to medical school. The particular needs identified were for full-time teachers, library resources and teaching materials. Wider use of existing organisations concerned with medical ethics could help to meet these needs. (shrink)

Most of the economic models on basic income account just for pecuniary forms of work, i. e. “time spent making money”, in employment. This restriction is a drawback of these analyses and of the standard economic labor supply model itself. If one wants to understand the potential effects of basic income on individual and social welfare, one should not restrict observation to the pecuniary uses of time. The objective of this contribution is to rethink the meaning of work usually applied (...) in economic models, based on contributions of other social scientists. This reassessment is undertaken through the development of a microeconomic model, which discusses the effects of basic income on time use and interprets work not just as a source of income, but also of non-pecuniary benefits. Further, we disentangle the usual work-leisure dichotomy in two other ones. (shrink)

Given Lewis’s views about recombination and spatial relations, there are possible worlds in which space is discrete and yet the Pythagorean theorem is true – contrary to the so-called Weyl-Tile argument that concluded that the Pythagorean theorem must fail if space is discrete.

This collection examines prevalent assumptions in moral reasoning which are often accepted uncritically in medical ethics. It introduces a range of perspectives from philosophy and medicine on the nature of moral reasoning and relates these to illustrative problems, such as New Reproductive Technologies, the treatment of sick children, the assessment of quality of life, genetics, involuntary psychiatric treatment and abortion. In each case, the contributors address the nature and worth of the moral theories involved in discussions of the relevant issues, (...) and focus on the types of reasoning which are employed. 'Medical ethics is in danger of becoming a subject kept afloat by a series of platitudes about respect for persons or the importance of autonomy. This book is a bold and imaginative attempt to break away from such rhetoric into genuine informative dialogue between philosophers and doctors, with no search after consensus.' Mary Warnock. (shrink)

In the current climate of dramatic advances in the neurosciences, it has been widely assumed that the diagnosis of mental disorder is a matter exclusively for value-free science. Starting from a detailed case history, this paper describes how, to the contrary, values come into the diagnosis of mental disorders, directly through the criteria at the heart of psychiatry's most scientifically grounded classification, the American Psychiatric Association's DSM (Diagnostic and Statistical Manual). Various possible interpretations of the prominence of values in psychiatric (...) diagnosis are outlined. Drawing on work in the Oxford analytic tradition of philosophy, it is shown that, properly understood, the prominence of psychiatric diagnostic values reflects the necessary engagement of psychiatry with the diversity of individual human values. This interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values (also derived from analytic philosophy) called 'values-based practice.' Developments in values-based practice in training, policy and research in mental health are briefly outlined. The paper concludes with an indication of how the integration of values-based with evidence-based approaches provides the basis for psychiatric practice in the twenty-first century that is both science-based and person-centred. (shrink)

Nature and Narrative is the launch volume in a new series of books entitled International Perspectives in Philosophy and Psychiatry. Nature(representing interest in the causes of a problem) and Narrative (for understanding its meanings) will introduce the field and the series, by touching on a range of issue relevant to this interdisciplinary 'border country'.

Two of the staunchest critics of astrology presented their case in an article published in this journal that has since become a standard reference. The authors argue that the astrological experience is more likely to work by 'hidden persuaders' than by either objective or psychic criteria, yet their argument provides no evidence of this. The authors demand careful testing yet their own examples and claims against astrology are not careful. The metaanalysis claim mixes studies with widely disparate data types. The (...) parental tampering argument against Michel Gauquelin's planetary eminence findings lacks supportive evidence. The 'definitive' time twins test fails to define the criteria of resemblance. The test of predicting psychological test profiles does not discriminate between permanent personality dimensions and psychological states as astrology requires. The blind chart matching studies evaluated skills on the wrong parties where they would not be expected by either astrology or psychology. The authors fail to mention the most interesting and promising peer-reviewed astrological research studies that were available to them. Improved discourse with astrological subject matter experts is recommended. (shrink)

It is well known that successive observations of the instantaneous state of a decaying system lead to a modified decay law. In the limit of infinitely frequent observations, the modified lifetime becomes infinite (“Zeno's paradox”). We study here the behavior of decaying systems under continuous rather than successive observations. Such continuous observation is achieved by a permanent coupling of the decaying system to a counter, which is sufficiently sensitive to the presence of the decay products. For two explicitly soluble models (...) we obtain a result very similar to Zeno's paradox: The observation again strongly modifies the decay law, and prevents the decay completely in the limit of a perfect (i.e., infinitely sensitive) counter. Like Zeno's paradox, however, this “watchdog effect” is not very likely to be detected in actual experiments, e.g., with radioactive nuclei. (shrink)

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)

This edited volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organised around the main stages of the clinical encounter from the patient's perspective. This introductory chapter opens up crucial issues of methodology and of practical application in this highly innovative approach to the role of ethics in healthcare.

Complementarity is not only a feature of quantum mechanical systems but occurs also in the context of finite automata.

Inasmuch as physical theories are formalizable, set theory provides a framework for theoretical physics. Four speculations about the relevance of set theoretical modeling for physics are presented: the role of transcendental set theory (i) in chaos theory, (ii) for paradoxical decompositions of solid three-dimensional objects, (iii) in the theory of effective computability (Church-Turing thesis) related to the possible “solution of supertasks,” and (iv) for weak solutions. Several approaches to set theory and their advantages and disadvatages for physical applications are discussed: (...) Canlorian “naive” (i.e., nonaxiomatic) set theory, contructivism, and operationalism. In the author's opinion, an attitude of “suspended attention” (a term borrowed from psychoanalysis) seems most promising for progress. Physical and set theoretical entities must be operationalized wherever possible. At the same time, physicists should be open to “bizarre” or “mindboggling” new formalisms, which need not be operationalizable or testable at the lime of their creation, but which may successfully lead to novel fields of phenomenology and technology. (shrink)

A review of Dretske's Naturalizing the Mind.

In this paper we examine the theoretical foundations underlying the testing of quantum electrodynamics. We show that for the photon propagator (together with the contiguous vertices) it is not necessary to introduce ad hoc modifications in sufficiently accurate scattering experiments. Energy, momentum transfer, and accuracy determine the tested length in a model-independent way. The situation is quite different with the electron propagator. If gauge invariance is taken for granted, the electron propagator cannot be tested with processes where diagrams with open (...) electron lines are important in the lowest order of perturbation theory. These processes can only give limits for anomalous moment and multiphoton parts of the vertices. On the other hand, processes with closed electron loops (vacuum polarization), such as photon-photon and Delbrück scattering, as well as photon splitting or corresponding low-energy, high-precision experiments can give limits also for the electron propagator. But in these cases only less accurate limits can be obtained, which depend on the modification model. Hence testing of the electron propagator, i.e., roughly speaking, the Dirac equation, is much more difficult than testing of the photon propagator, i.e, Maxwell's equations. (shrink)

The paper considers Ernst' Cassirer's standpoint with reference to Euclidean geometry and the complementarity principle of quantum theory, interpreted as a choice between a causal description and a space — time description. The acceptance of the complementarity principle by Cassirer not only lands him off the Kantian path slightly, but it also leads him to some contradictions and incompatibilities within his own system of thought. 1. Accepting complementarity, Cassirer cannot still hold that there is an infinite hierarchy of objective levels (...) as he does towards the end of hisDeterminismus; and 2. accepting complementarity, Cassirer cannot still hold on to the observability principle of Leibniz. (shrink)