When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

In this study, we explore the relationship between perceived CEO greed and workplace safety. Drawing on insights from the social psychology literature, we theorize that CEOs are cognizant that their perceived greed has implications for how observers respond to failures in workplace safety. Our theorizing points to a somewhat counterintuitive positive relationship between perceived CEO greed and workplace safety. Consistent with our theorizing, we find that the relationship is attenuated when the CEO is insulated from how observers respond to firm (...) conduct and is amplified when the CEO’s characteristics have a larger impact on how observers respond to adverse firm-level events. We contribute to business ethics research on executive greed, on the relationship between CEO traits and (ir)responsible corporate conduct, and on the antecedents of workplace safety. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004; Pomerantz & Segrist, 2006) indicates that when psychologists consider a client with symptoms of depression or anxiety, payment method significantly influences diagnostic decisions. This study extends the scope of the previous research to consider clients with symptoms of social phobia and attention deficit hyperactivity disorder (ADHD). Psychologists in independent practice responded to vignettes of clients whose descriptions deliberately included subclinical impairment. Half of the participants were told that the clients would pay (...) via managed care; the other half were told that the clients would pay out-of-pocket. Confirming previous studies, payment method had a highly significant impact on diagnosis such that compared to out-of-pocket clients, managed care clients were much more likely to be assigned Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses. Ethical implications relate to informed consent, accuracy and truthfulness in diagnosis, and psychologists' integrity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Insightlessness, the Deflationary TurnJennifer Radden (bio)Keywordsinsightlessness, deflationary turn, Harry Stack Sullivan, open placebos, space of reasonsMarga Reimer argues that treatment compliance in patients who are without any, or complete, insight into psychotic symptoms may be neither particularly abnormal nor entirely unreasonable. In broad sympathy with these conclusions, I wish only to add a couple of ancillary observations and some historical context.Reimer's discussion can be placed alongside other research (...) on aspects of psychosis putting forward what have been called "deflationary" accounts, accounts that depict psychotic symptoms as differing from normal states, traits, and responses in degree rather than kind. Such accounts have been offered about auditory hallucinations or "hearing voices" (Leudar and Thomas 2000; Romme and Escher 1989; Smith 2007), about delusional thinking (Bentall 2003; Bentall et al. 1989; Bracken and Thomas 2005; Hamilton 2007; Kinderman and Bentall 2007), and spiritual experiences (Jackson 1997; Jackson and Fulford 1997); in the introduction of the notion of "benign psychosis" (Jackson 2007), and even in recognition that insight is a complex, dimensional attribute (Amador and David 1998). Harkening back to the middle years of the twentieth century, and associated with Adolph Meyer's influence in the United States, as well as the influence of psychodynamic (and psychoanalytic) ideas, this deflationary turn challenges the neo-Kraepelinian presuppositions of our contemporary biomedical psychiatry. Rather than sharply separating psychotic states and symptoms from normal experience, the deflationary approach emphasizes the continuities and similarities linking them.Reimer proceeds in two separate steps. To the extent that treatment compliance among patients suffering psychotic states occurs in the absence of any or full insight, it is shown, this seems not dissimilar from other more ordinary cases where treatment compliant behavior occurs either without—or without regard for—a recognition that one is ill. (The term insightlessness is here used to indicate the absence of full and complete insight. This recognizes the dimensional and complex nature of insight, which has been shown to involve a range of beliefs over one's disorder, those about its presence, about the need for treatment, and about the social consequences of suffering it.)Had her discussion stopped here, Reimer would have completed the first "deflationary" step. By showing that this sort of insightless treatment compliance also occurs in the absence of mental disorder, she encourages us to see psychotic patients' lack of insight into their disorder as at least akin to more benign and commonplace responses. In doing so, she would have shifted something of the burden of proof within discussions of insight. Those insisting insightlessness is an irresoluble obstacle to positive treatment outcomes would [End Page 81] now be required to explain why this should be so. And those denying the analogy between the insightless compliance of the psychotic patient and more everyday cases such as those Reimer describes, might be called upon to show why these cases were disanalogous.Reimer does not leave matters there. She goes on to establish that none of the instances of insightless treatment compliance that she discusses can be judged to be entirely unreasonable. Treatment compliance without full insight is not only quite normal, it may not even be particularly irrational. As she explains, the patients in each case anticipate benefits from the treatment, even though such benefits are not understood in terms suggestive of pathology. Unfailingly, they conform to a general human tendency: [T]o act in accordance with what we perceive, rightly or wrongly, to be in our best interests.Reimer locates the error in more traditional thinking about lack of insight at the immodest assumption that there is but a single way to accurately characterize the patient's condition—medically. This view, which she attributes to contemporary psychiatry, she finds mistaken—and mistaken, I agree it is. Rather than one, there seem likely to be several accurate ways to frame things. And although the medical framing will best fit the interests and purposes of clinicians, other framings may better suit the interests of their patients.When the possibility of alternative, non-medical perspectives is granted, and our goal is to assess insightless compliance vis à vis rationality norms, a number of considerations gain salience. The insightless patient, Reimer shows, may... (shrink)

ChatGPT has taken the academic community by storm (Cotton, Cotton, and Shipway 2023; Cox and Tzoc 2023; Sullivan, Kelly, and McLaughlan 2023). Since its release in November 2022, chatGPT has predic...

In Moody Minds Distempered philosopher Jennifer Radden assembles several decades of her research on melancholy and depression. The chapters are ordered into three categories: those about intellectual and medical history of melancholy and depression; those that emphasize aspects of the moral, psychological and medical features of these concepts; and finally, those that explore the sad and apprehensive mood states long associated with melancholy and depressive subjectivity. A newly written introduction maps the conceptual landscape, and draws out the analytic and (...) thematic interconnections between the chapters. Radden emphasizes and develops several new themes: the implications, theoretical phenomenological and moral, of recognizing melancholy and depressive states as mood states; questions of method, as they affect how we understand and characterize claims about melancholy and depression; and the persistence and force of cultural tropes linking such states to brilliance, creativity, and sagacity. Insights from literature and the history of medicine, psychology, and psychiatry are woven together with those from the more recent disciplines of feminist theory and cultural studies. This is interdisciplinary writing at its best-part analytic philosophy, and part history of ideas. (shrink)

We study the Johansen–Ledoit–Sornette model of financial market crashes :219–255, 2000). On our view, the JLS model is a curious case from the perspective of the recent philosophy of science literature, as it is naturally construed as a “minimal model” in the sense of Batterman and Rice :349–376, 2014) that nonetheless provides a causal explanation of market crashes, in the sense of Woodward’s interventionist account of causation.

There is reason for genuine puzzlement about Hume's aim in ‘The Natural History of Religion’. Some commentators take the work to be merely a causal investigation into the psychological processes and environmental conditions that are likely to give rise to the first religions, an investigation that has no significant or straightforward implications for the rationality or justification of religious belief. Others take the work to constitute an attack on the rationality and justification of religious belief in general. In contrast to (...) these views, I argue that Hume aims to establish two important claims in ‘The Natural History of Religion’. First, almost all popular religions, including popular monotheism, are deeply superstitious. Second, superstitious monotheism is incompatible with the variety of theism supported by the argument from design. This incompatibility puts significant pressure on the rational acceptability of popular religions. (shrink)

Most words in English are ambiguous between different interpretations; words can mean different things in different contexts. We investigate the implications of different types of semantic ambiguity for connectionist models of word recognition. We present a model in which there is competition to activate distributed semantic representations. The model performs well on the task of retrieving the different meanings of ambiguous words, and is able to simulate data reported by Rodd, Gaskell, and Marslen‐Wilson [J. Mem. Lang. 46 (2002) 245] on (...) how semantic ambiguity affects lexical decision performance. In particular, the network shows a disadvantage forwords with multiple unrelated meanings (e.g., bark) that coexists with a benefit for words with multiple related word senses (e.g., twist). The ambiguity disadvantage arises because of interference between the different meanings, while the sense benefit arises because of differences in the structure of the attractor basins formed during learning. Words with few senses develop deep, narrow attractor basins, while words with many senses develop shallow, broad basins. We conclude that the mental representations of word meanings can be modelled as stable states within a high‐dimensional semantic space, and that variations in the meanings of words shape the landscape of this space. (shrink)

Hurley’s is a difficult book to work through—partly because of its length and the complexity of its arguments, but also because each of the ten essays of which it is composed has a rather different starting point and focus, and because few of her arguments achieve real closure. Essay 2 discusses competing interpretations of Kant, essay 4 articulates nonconceptual forms of self-consciousness, essay 5 offers fresh interpretations of commissurotomy patients’ behavior, essay 6 develops an objection to Wittgenstein on rule following, (...) essay 8 attacks an alleged assumption of externalism, and chapter 10 explores the possibility of combining a “motor theory” and a “control theory” of perception. This is a very rich brew, and at least half the challenge this book presents consists in discerning its central argument and conclusion with enough precision to bring criticism to bear. (shrink)

Contingent transcranialists claim that the physical mechanisms of mind are not exclusively intracranial and that genuine cognitive systems can extend into cognizers' physical and socio-cultural environments. They further claim that extended cognitive systems must include the deep functional integration of external environmental resources with internal neural resources. They have found it difficult, however, to explicate the precise nature of such deep functional integration and provide compelling examples of it. Contingent intracranialists deny that extracranial resources can be components of genuine extended (...) cognitive systems. They claim that transcranialists fallaciously conflate coupling with constitution and construe cognition as extending always from brains into world rather than world into brains. By using insights from recent research in developmental psychology and by explicating the nature of one form that deep functional integration can take, I argue that (i) transcranialists do not fallaciously conflate coupling wth constitution, and (ii) human emotional ontogenesis is a world-to-brain transcranial achievement. Jennifer Greenwood is a PhD Candidate in Philosophy at the School of History, Philosophy, Religion, and Classics, University of Queensland. (shrink)

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

(No abstract is available for this citation).

In this paper, I explore the implications of adopting one model of self rather than another in respect to one particular feature of our mental life. The need to explain synchronic unity in normal subjectivity, and also to explain the apparent and puzzling absence of synchronic unity in certain symptoms of severe mental disorder, I show, becomes more pressing with one particular model. But in the process of developing that explanation we learn something about subjectivity and perhaps also something about (...) brain functioning. (shrink)

The paper aims to develop a theoretical reflection on existing knowledge in public policy and its implementation in the nineties. This is a documental research design of bibliographical nature. The results reveal that the body of knowledge in public policy has been under the domain of rational choice theory and the assumptions of the neoclassical school. I conclude that, in the context of an alternative model to the neoliberal one, one need a different theoretical tool for alternative public policy that (...) consider social rationality moving away from a deterministic and technical policy. Este trabajo tiene como propósito desarrollar una reflexión teórica al conocimiento existente en materia de política pública y de su implementación en la década de los noventa. Esta es una investigación documental con un tipo de diseño de carácter bibliográfico. Los resultados revelan que el cuerpo de conocimientos en materia de política pública, ha estado bajo el dominio de la Teoría de la Elección Racional y de los supuestos de la Escuela Neoclásica. Se concluye que, en el marco de un modelo alternativo al neoliberal, se necesita un instrumental teórico diferente para una política pública alternativa. Esto pasa por considerar una racionalidad social que se aleje de una concepción determinista y técnica de la política. (shrink)

Book synopsis: The book illustrates the concept of action in three different contexts - the justification of actions, people's life history, and pragmatism. The special feature of this book is that a comprehensive view of this kind marks a departure from the atomistic approach of action theory, which in itself raises a number of questions. If actions are not justified by mental states, how can persons then act for reasons? How can persons' actions over time be described, and what is (...) the connection with the question of personal identity? If there is to be a unified understanding of the person, does the practical have to take precedence over the theoretical, and what does this mean for epistemology, for example? The ten contributors to this volume engage in an instructive manner with these and similar questions in the three sections of the book. (shrink)

Eudaimonism is often regarded as egoistic. If it recommends that agents pursue their own good because it is their own good, it is guilty as charged. But excellence‐prior eudaimonism offers a non‐egoistic alternative to this welfare‐prior eudaimonism. Excellence‐prior eudaimonism recommends that an agent live in a way that is in fact good for the agent, but it does not regard the agent’s own good as necessarily that for the sake of which the agent acts, nor does it regard living well (...) as justified by the fact that it is good for the agent, but simply because it is good. The Christian eudaimonisms of Augustine and Aquinas are best understood as deepened forms of excellence‐prior eudaimonism. (shrink)

This discussion is about the moods characteristic of depressive and manic states. Moods are distinguished from the emotions they often accompany, and the relationship between these less and more cognitive, and seemingly less and more intentional, states is provided preliminary clarification. Epistemic deficiencies identified here, when combined with differences of quality and quantity in the moods and motivations that beset the depression and mania sufferer, seem likely to hinder self-knowledge and self-integration. These deficiencies, it is argued, may help explain why (...) the extreme moods found in states of depression and mania contribute to our inclination to regard these conditions as disorder. (shrink)

This chapter contains sections titled: Of Ouija Boards and Bar Owners1 Bad Reasons for Condemning Tattoos Some Moral Compliments My Complaint Traditional Virtue Ethics Virtue Ethics and Tattoos Tough Tattoos … What Lies Beneath.

Hastings Center Report, Volume 52, Issue S1, Page S66-S68, March‐April 2022.

As virtuous leadership appears to be under severe pressure in all areas of life, it is the aim of this article to determine whether this biblical axiom holds suitable and valuable guidelines to counter contemporary leadership traps and assist leaders not to succumb to ambitious leadership cravings. The article determines whether the biblical axiom, the first shall be last and the last shall be first, holds the capacity to invert the corrupt pressure-cooker drives for both religious and secular leadership ambitions. (...) It examines the biblical and ethical wisdom of this teaching as well as the authoritative relevance it holds for leadership formation and practice. It determines whether a biblically infused value system still contains the moral capacity that contributes to the observance of resonant and ethical leadership capable of reversing pervasive situations of corrupt and incompetent leadership. In addition, the article contemplates the Christian weight of this biblical axiom to place those who are last, first in the service of leadership. In the same vein, it examines some of the ‘leadership traps’ experienced by persons who occupy lay, clerical, professional and secular positions. It endeavours to offer reflective biblical, moral and spiritual solutions that arise from the spirituality offered by Matthew 20:16 to current leadership demises.Contribution: The theme of the Leadership conference where this article was presented was the biblical verse: ‘The first shall be last and the last shall be first’. The article focuses directly on the implications of the biblical axiom and relate, as well as, translate it to leadership difficulties as experienced today. (shrink)

On an attractive, naturalistically respectable theory of intentionality, mental contents are a form of measurement system for representing behavioral and psychological dispositions. This chapter argues that a consequence of this view is that the content/attitude distinction is measurement system relative. As a result, there is substantial arbitrariness in the content/attitude distinction. Whether some measurement of mental states counts as characterizing the content of mental states or the attitude is not a question of empirical discovery but of theoretical utility. If correct, (...) this observation has ramifications in the theory of rationality. Some epistemologists and decision theorists have argued that imprecise credences are rationally impermissible, while others have argued that precise credences are rationally impermissible. If the measure theory of mental content is correct, however, then neither imprecise credences nor precise credences can be rationally impermissible. (shrink)

We argue that strong moral objections to widespread implementation of uterine transplantation persist despite recent live births following the procedure. These objections relate not only to the serious medical risk to which live donors are currently subject but also to the strength of pronatalistic and biologistic social forces. We explore medical risk in light of various factors and treat questions relating uterine transplantation to gestational surrogacy.

This article draws on the suggestion that modern technology is “autonomous” in that our social control mechanisms are unable to control technology and instead merely adapt society to integrate new technologies. In this article, I suggest that common law judges tend systematically to support the integration of novel technologies into society. For example, courts sometimes require parties seeking compensation for serious injuries to submit to medical technologies to which the parties object for genuine reasons of fear or moral objection. Where (...) a novel technology alters the environment in some way, courts sometimes legitimize that alteration by refusing to recognize harm and instead characterizing avoidance of the technology as self-imposed harm. The examples selected in this article were chosen to support the hypothesis in one way or another, and future work will aim to look for counter examples and to conduct a more complete assessment of the hypothesis. (shrink)

This paper examines the recent rise of initiatives for responsible agricultural investment and provides a preliminary assessment of their likely success in curbing the ecological and social costs associated with the growth in private financial investment in the sector over the past decade. I argue that voluntary responsible investment initiatives for agriculture are likely to face similar weaknesses to those experienced in responsible investment initiatives more generally. These include vague and difficult to enforce guidelines, low participation rates, an uneven business (...) case, and confusion arising from multiple and competing initiatives. In addition, the large diversity of investors and high degree of complexity of financial investments further complicate efforts to discern who bears the burden of responsibility in practice. As a result, there is a strong likelihood that voluntary governance initiatives for responsible agricultural investment will shift discourse more than they will change practice. (shrink)

Under what circumstances should the federal government pay for outpatient prescription drugs? Should the government (and by extension, taxpayers) pay for all of the drugs prescribed by health care providers, regardless of price or use—adhering to a medical standard? Or should taxpayers only pay for prescriptions supported by scientific evidence of effectiveness—a scientific standard?

In this introduction to the edited volume, we briefly describe some of the current challenges faced by public mental health initiatives, at both the national and global level. We also include several general remarks on interdisciplinary methodology in public mental health ethics, followed by short descriptions of the chapters included in the volume.