We develop the concept of a volitional disability as an aid in understanding those patients who behave in ways that are harmful to themselves in spite of their desire to do otherwise. Using this concept enables us to describe their behavior as intentional but ‘unvoluntary’. We demonstrate the clinical reality of such behavior by giving clinical examples of the behavior of those with phobic, compulsive, and addictive disorders. We then attempt to show how some kinds of self-harming behavior of noncompliant (...) patients are similar to phobic and compulsive behavior. We propose use of the concept of volitional disability to make it easier for physicians to work with these noncompliant patients and thus to improve their ability to provide better care for them. (shrink)

This article presents the new German law on advance directives from 1 September 2009. The history of the parliamentary process of this law is described, the present regulations are explained, their relevance for medical practice discussed and shortcomings are identified. Finally, the new law is compared with other regulations in the international context. Previously established legal practice in Germany has now become largely confirmed by the new law: An advanced directive must be respected in any decision concerning medical treatment, regardless (...) of the stage of the illness. It can be informally revoked at any time, even with limited decision-making capacity. Nobody may be obliged to issue a directive in any way. Advance directives do not need notarisation or routine updating after certain time intervals. Provided that the patient, who is no longer mentally competent, has issued a lasting power of attorney, or provided that the patient has been appointed a healthcare proxy by the courts, this authorised surrogate must assert the patient's will. The role of the guardianship court is clarified: it only needs to be involved in cases of disagreement as to the patient's will. The new German law thus combines more legal certainty with a liberal emphasis on patient autonomy and flexible, adaptable regulations. (shrink)

R. J. Hankinson traces the history of ancient Greek thinking about causation and explanation, from its earliest beginnings through more than a thousand years to the middle of the first millennium of the Christian era. He examines ways in which the Ancient Greeks dealt with questions about how and why things happen as and when they do, about the basic constitution and structure of things, about function and purpose, laws of nature, chance, coincidence, and responsibility.

Generalized anxiety disorder (GAD) and social phobia (SP) are major anxiety disorders identified by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). They are comorbid, overlap in symptoms, yet present with distinct features (worry in GAD and fear of embarrassment in SP). Both have also been explained in terms of conditioning-based models. However, there is little reasoning currently to believe that GAD in adulthood reflects heightened conditionability or heightened threat processing—though patients with SP may show heightened processing (...) of social threat stimuli. Moreover, the computational architectures that maintain these disorders in adulthood are different. For GAD this may reflect the development of an inefficient “worrying” strategy of emotional regulation. For SP this appears to reflect the atypical processing of self-referential information. (shrink)

Psychopaths continue to be demonised by the media and estimates suggest that a disturbing percentage of the population has psychopathic tendencies. This timely and controversial new book summarises what we already know about psychopathy and antisocial behavior and puts forward a new case for its cause - with far-reaching implications. Presents the scientific facts of psychopathy and antisocial behavior. Addresses key questions, such as: What is psychopathy? Are there psychopaths amongst us? What is wrong with psychopaths? Is psychopathy due to (...) nature or nurture? And can we treat psychopaths? Reveals the authors' ground-breaking research into whether an underlying abnormality in brain development leaves psychopaths with an inability to feel emotion or fear. The resulting theory could lead to early diagnosis and revolutionize the way society, the media and the state both views and contends with the psychopaths in our midst. (shrink)

Empathy is a lay term that is becoming increasingly viewed as a unitary function within the field of cognitive neuroscience. In this paper, a selective review of the empathy literature is provided. It is argued from this literature that empathy is not a unitary system but rather a loose collection of partially dissociable neurocognitive systems. In particular, three main divisions can be made: cognitive empathy , motor empathy, and emotional empathy. The two main psychiatric disorders associated with empathic dysfunction are (...) considered: autism and psychopathy. It is argued that individuals with autism show difficulties with cognitive and motor empathy but less clear difficulties with respect to emotional empathy. In contrast, individuals with psychopathy show clear difficulties with a specific form of emotional empathy but no indications of impairment with cognitive and motor empathy. (shrink)

Recent interest in emotion as the basis for moral development began with work involving individuals with psychopathic tendencies, and a recent paper with this population has allowed fresh insights (Glenn, Iyer, Graham, Koleva, & Haidt, 2009). Two main conclusions suggested by this paper are: (i) that systems involved in different forms of morality can be differentiated; and (ii) that systems involved in justice reasoning likely include amygdala and/or ventromedial prefrontal cortex, even if the specifics of their functional contribution to justice (...) development remain unidentified. (shrink)

One method for investigating the neurobiology of consciousness is to experimentally manipulate consciousness as a variable and then visualize the resultant functional brain changes with advanced imaging techniques. To begin investigation into this area, healthy volunteers underwent positron emission tomography scanning while listening to randomized word lists in both conscious and unconscious conditions. Following anaesthesia, subjects had no explicit memories. Nonetheless, subjects demonstrated implicit memory on a forced-choice test . These subsequent memory scores were correlated with regional brain metabolism measured (...) during encoding. Conscious recall and unconscious recognition memory demonstrated considerable anatomic overlap in correlating significantly with relative glucose metabolism in auditory verbal memory areas. However, only conscious recall correlated with mediodorsal thalamic nucleus activity; unconscious recognition memory did not. These findings suggest that conscious versus unconscious memory distinctions may depend on the presence or absence of correlated thalamic activity, and directly implicate the thalamus in the neurobiology of consciousness. (shrink)

Through case studies that highlight the type of information that is seldom reported in the news, Faces of Environmental Racism exposes the type and magnitude of environmental racism, both domestic and international. The essays explore the justice of current environmental practices, asking such questions as whether cost-benefit analysis is an appropriate analytic technique and whether there are alternate routes to sustainable development in the South.

In Coming to Our Senses, Michael Devitt insists that if we are going to argue about what meanings are, we should know why we care. He reasonably observes that unless we agree about this, we are likely to be arguing past one another. The meanings Devitt discusses are token meanings of individual thoughts and utterances. He holds that these meanings are properties, and that we have two purposes for attributing them to thoughts and utterances: to predict and explain a subject’s (...) behavior, and to learn about the world. If a property attributed to a thought by means of a t-clause serves either of these purposes then that property plays a semantic role. A meaning is any property that plays a semantic role. (shrink)

In §50 of Philosophical Investigations Wittgenstein wrote the sentence, “There is one thing of which one can say neither that it is one metre long, nor that it is not one metre long, and that is the standard metre in Paris.” Although some interpreters have claimed that Wittgenstein’s statement is mistaken, while others have proposed various explanations showing that this must be correct, none have questioned the fact that he intended to assert that it is impossible to describe the standard (...) meter as being a meter long. Given that Wittgenstein introduces this sentence as analogous to the claim that “existence cannot be attributed to an element,” and that the preceding passages discuss a language-game the simples of which can be described by their own names, there is good reason to think that Wittgenstein did not intend to assert this infamous sentence. (shrink)

Among young liberal Catholic intellectuals, Lonergan is held in extremely high esteem. His philosophic treatise, Insight, is considered to be the important philosophic book where Thomism genuinely encounters contemporary secular philosophy. But outside this circle of Catholic intellectuals Lonergan's thought is barely known. This collection of articles does reflect the comprehensiveness and depth of his thought. Papers range over intricate theological discussions of the Assumption, Christ, marriage, the role of a Catholic university in the modern world, and technical philosophic issues (...) such as the form of inference and geometric possibility. Because the papers are short and have been written for a variety of audiences, it is difficult to discern any overreaching continuity and perspective. Many of the discussions demand a more thorough and critical analysis than is exhibited here. The introduction by Crowe is helpful for reconstructing Lonergan's intellectual development and supplying a broader context for appreciating the papers, although the tone is more reverential than critical.—R. J. B. (shrink)

In his Preface, Vendler acknowledges the influence of Ziff, who taught him philosophy; Harris, who taught him linguistics; and Austin, who made him see the connection of the two. The influence of these three is manifest in both the philosophical style and content of this book. The opening chapter reviews the dispute between the staunch defenders of ordinary language analysis and the champions of the new transformational linguistics. Vendler sensitively reviews the claims and counterclaims concluding that linguistics is helpful in (...) analytic philosophy "and its empirical source need not sully the transcendental purity of philosophical thought." The chapters that follow set out to show just how linguistics and a sensitive ear for English can help us through the tangle of issues in getting clear about singular terms; quantifiers; verbs and time; facts and events; effects, results, and consequences; and the grammar of goodness. Vendler's inquiries, which may appear oblique, are always directed at those concepts that have been central to philosophy. And in the course of his analyses, even the unsympathetic will probably be provoked and illuminated.—R. J. B. (shrink)