The general definition of mental disorder stated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders seems to identify a mental disorder with a harmful dysfunction. However, the presence of distress or disability, which may be bracketed as the presence of harm, is taken to be merely usual, and thus not a necessary requirement: a mental disorder can be diagnosed as such even if there is no harm at all. In this paper, we focus on the (...) harm requirement. First, we clarify what it means to say that the harm requirement is not necessary for defining the general concept of mental disorder. In this respect, we briefly examine the two components of harm, distress and disability, and then trace a distinction between mental disorder tokens and mental disorder types. Second, we argue that the decision not to regard the harm requirement as a necessary criterion for mental disorder is tenable for a number of practical and theoretical reasons, some pertaining to conceptual issues surrounding the two components of harm and others pertaining to the problem of false negatives and the status of psychiatry vis-à-vis somatic medicine. However, we believe that the harm requirement can be maintained among the specific diagnostic criteria of certain individual mental disorders. More precisely, we argue that insofar as the harm requirement is needed among the specific diagnostic criteria of certain individual mental disorders, it should be unpacked and clarified. (shrink)

In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.

The diagnosis of idiopathic short stature refers to children who are considerably shorter than average without any identified medical reason. The US Food and Drug Administration authorised marketing of recombinant human growth hormone for ISS in 2003, while the European Medicines Agency refused it in 2007. This paper examines the arguments for these decisions as detailed in selected FDA and EMA documents. It combines argumentative analysis with an approach to policy analysis called ‘What’s the problem represented to be’. It argues (...) that the FDA presents its approval as an argument for equity of access to the treatment, describing short stature as a potential disadvantage, and assuming that height normalisation is a clinically meaningful result. The EMA, instead, refuses marketing authorisation with an argument that there is an imbalance of risks and benefits, describing ISS as a healthy condition, and arguing that hGH should provide some psychosocial and/or quality of life benefits to children with ISS other than height gain. This paper then discusses how these arguments could be read through different models of disability, particularly through the medical model of disability and the relational, experiential, and cultural understandings of disability. (shrink)

This study explores the intra-organizational antecedents of sustainable governance by examining the impact of female presence at the corporate apex. Drawing upon the upper echelon theory, we investigate whether women in top positions influence sustainable governance practices. Our research focuses on a sample of companies operating within two distinct market economies: liberal market economies (LMEs) and coordinated market economies (CMEs). The United States, represented by the S&P100, and the United Kingdom, represented by the FTSE100, serve as examples of LMEs. Conversely, (...) Germany (DAX30), France (CAC40), Spain (IBEX35), and Switzerland (SMI) are illustrative of CMEs. Analyzing archival data spanning from 2010 to 2019, we confirm that the presence of a critical mass of women on the board of directors significantly increases the likelihood of establishing a sustainability committee within organizations. This relationship holds true across both LMEs and CMEs, highlighting the universal importance of gender diversity in driving sustainable governance initiatives. Interestingly, we observe that the impact of women with structural power on sustainability committee formation is specific to LMEs, suggesting the context-dependent nature of female leadership in sustainable governance. (shrink)

La discussione generale sulla filosofia della scienza contemporanea è complicata dal numero e dall’eterogeneità delle scienze, mentre lo studio di temi specifici porta inevitabilmente a dissertazioni specialistiche che mancano nel dare ragione della trama di senso sottostante. Questo Piccolo trattato di epistemologia intende occupare uno spazio vuoto, proponendo alcuni temi chiave per la comprensione dei meccanismi alla base della conoscenza scientifica: i rapporti tra filosofia e scienze, siano esse naturali o umane; la complessa relazione tra fatti e valori; la distinzione (...) tra scoperta e giustificazione; la necessità di un discorso etico sulla ricerca, che chiami in causa categorie come fiducia, empatia, altruismo ed egoismo. Con un approccio chiaro e rigoroso, il volume intende rivolgersi a quell’ampia fascia di pubblico interessata alle tematiche centrali dell’epistemologia, della filosofia e delle scienze. (shrink)

Human experience has a symbolic structure. By focusing on the symbolism of human action, this essay considers the reciprocal influences and the essential differences between Paul Ricœur’s hermeneutics and Clifford Geertz’s cultural anthropology. Through reference to Ricœur’s Lectures on Ideology and Utopia, the section on “Ideology, Utopia, and Politics” in From Text to Action, and Geertz’s 1973 book The Interpretation of Cultures, this paper aims at reconstructing the dialogue between these thinkers. I begin with a broad framing of the encounter (...) between Ricœur and Geertz, and then turn to the notion of the symbolic mediation of action, considering it as the shared key concept between these authors. These reflections will lead to an examination of the semiotic conception of culture, opening up the discussion of a nonpejorative dimension of ideology. (shrink)

Background: The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses’ involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance of (...) a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. Objective: To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Research design: Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Participants and research context: Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse’s experience in exercising autonomy relating to end-of-life decision-making. Ethical considerations: Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. Findings: The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Conclusion: Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude that inserts them into the decision-making process. (shrink)

Background Only a few studies have been conducted to assess physicians’ knowledge of legal standards. Nevertheless, prior research has demonstrated a dearth of medical law knowledge. Our study explored physicians’ awareness of legal provisions concerning informed consent and confidentiality, which are essential components of the physician-patient relationship of trust. -/- Methods A cross-sectional study assessed attending physicians’ legal knowledge of informed consent and confidentiality regulations. The study was conducted in nine hospitals in Dolj County, Romania. Physicians were given a questionnaire (...) with ten scenarios and instructed to select the response that best reflected their practice. We assessed the responses of physicians who claimed their practice to be entirely legal. Their legal knowledge was evaluated by comparing their answers to applicable laws. We also calculated a score for the physicians who admitted to committing a legal breach. -/- Results Of the 305 respondents, 275 declared they never committed any law violation. However, their median correct answer score was 5.35 ± 1.66 out of 10. The specialty was the strongest predictor of legal knowledge, with emergency physicians rating the lowest and non-surgical physicians scoring the highest. Physicians who worked in both private and public sectors were better knowledgeable about legal issues than those who worked exclusively in the public sector. Results indicate that physicians are aware of the patient’s right to informed consent but lack comprehensive understanding. While most physicians correctly answered simple questions, only a tiny minority identified the correct solution when confronted with ethical dilemmas. The physicians who acknowledged breaching the law, on the other hand, had a slightly higher knowledge score at 5.45 ± 2.18. -/- Conclusion Legal compliance remains relatively low due to insufficient legal awareness. Physicians display limited awareness of legal requirements governing patient autonomy, confidentiality, and access to health data. Law should be taught in all medical schools, including undergraduate programs, to increase physicians’ legal knowledge and compliance. (shrink)

Over the last three quarters of a century, international guidelines and regulations have undergone significant changes in how children are problematised as participants in biomedical research. While early guidelines enacted children as vulnerable subjects with diminished autonomy and in need of special protection, beginning in the early 2000s, international regulatory frameworks defined the paediatric population as vulnerable due to unaddressed public health needs. More recently, ethical recommendations have promoted the active engagement of minors as research partners. In this paper, I (...) adopt a post-structuralist approach to policy analysis to examine deep-seated assumptions and presuppositions underlying the changes in the problematisation of children as biomedical research participants over time. While biomedical research ethics focuses on the autonomy and vulnerability of minors, ethical guidelines are situated in specific sociocultural contexts, shaped, among other things, by contingent public health needs and changing conceptions of the value of research and science for society. In the process, I demonstrate the challenge of moving away from an approach that in taking adults as the model overshadows the complexity of children’s lived experiences as well as their personal, cultural, and social lives. The lack of acknowledgement of this complexity makes children vulnerable to epistemic injustice, which is particularly crucial to address in public involvement initiatives. (shrink)

Riassunto: In questo contributo analizzeremo il criterio del danno, presente nella definizione generale di disturbo mentale del DSM. La questione ha rilevanza sia da un punto di vista filosofico, perché il danno è una componente normativa e valoriale, non oggettiva, sia da un punto di vista clinico, perché chi ha difeso il criterio del danno ha spesso sostenuto che in sua assenza avremmo troppi falsi positivi. Infine, ha importanza dal punto di vista socio-sanitario in relazione al rapporto tra la psichiatria (...) e la medicina non psichiatrica, nello specifico tra il DSM e l’ICD. Sosterremo che ci sono buone ragioni per non mantenere il danno come criterio necessario nella definizione generale del disturbo mentale. Dopo una breve introduzione, forniremo una panoramica storica sul ruolo del criterio del danno nelle varie edizioni del DSM. Successivamente si illustrerà la principale obiezione contro l’inclusione del criterio del danno nella definizione generale di disturbo mentale, ossia il problema dei falsi negativi, per poi presentare e discutere ulteriori ragioni – medico-pratiche e concettuali – che depongono a sfavore dell’attribuzione di un forte peso al criterio del danno. In sede conclusiva ribadiamo come la decisione presa dalla task force del DSM-5 di escludere il criterio del danno dalla definizione generale di disturbo mentale debba essere sostenuta. Parole chiave: Danno; Disabilità; Disagio; Disturbo mentale; DSM “Harm” as Criterion for the Definition of Mental Disease in DSM. Some Epistemological Reflections: In this paper, we analyse the harm requirement in the general definition of mental disorder in the Diagnostic and Statistical Manual for Mental Disorders. This issue has both philosophical and clinical relevance: on the one hand the harm requirement is a normative, value-laden, non-objective component in the definition of mental disorder; on the other hand, the harm requirement has often been defended on the grounds that it prevents an increase in false positives. The issue is also important in assessing the relationship between psychiatry and somatic medicine, more precisely, between the DSM and the International Classification of Diseases. We argue that there are good reasons not to maintain the harm requirement in the general definition of mental disorder. After a brief introduction, we overview the history of the harm requirement across the various editions of the DSM. Then, we examine the main objection to the inclusion of the harm requirement in the general definition of mental disorder, that is, the problem of false negatives, and also present several other points – both practical and conceptual – that help demonstrate why the harm requirement is inadequate as a definiens of mental disorder. To conclude, we stress that the decision of the DSM-5 task force not to regard the harm requirement as a necessary component of mental disorder should be endorsed. Keywords: Harm; Disability, Distress; Mental Disorder; DSM. (shrink)

Reason and rationality represent crucial elements of the self-image of human beings and have unquestionably been among the most debated issues in Western philosophy, dating from ancient Greece, through the Middle Ages, and to the present day. Many words and thoughts have already been spent trying to define the nature and standards of reason and rationality, what they could or ought to be, and under what conditions something can be said to be rational. This volume focuses instead on the relationships (...) of reason and rationality to some relevant specific topics, i.e., science, knowledge, gender, politics, ethics, religion, aesthetics, language, logic, and metaphysics, trying to uncover and clarify both the connections and differences in their various characterisations and uses. (shrink)

Philosophers of medicine have formulated different accounts of the concept of disease. Which concept of disease one assumes has implications for what conditions count as diseases and, by extension, who may be regarded as having a disease and for who may be accorded the social privileges and personal responsibilities associated with being sick. In this article, we consider an ideal diagnostic test for coronavirus disease 2019 infection with respect to four groups of people—positive and asymptomatic; positive and symptomatic; negative; and (...) untested—and show how different concepts of disease impact on the disease and sickness judgements for these groups. The suggestion is that sickness judgements and social measures akin to those experienced during the current COVID-19 outbreak presuppose a concept of disease containing social harm as a component. We indicate the problems that arise when adopting this kind of disease concept beyond a state of emergency. (shrink)

En este trabajo analizo la concepción de Eugenio Bulygin respecto de aquellos enunciados jurídicos que afirman que una cierta acción es jurídicamente obligatoria, prohibida o permitida. Conforme a Bulygin, estos enunciados son ambiguos. Ellos pueden ser enunciados empíricos externos que afirman la existencia o validez de una norma, o pueden ser enunciados normativos internos que expresan una norma, o una actitud moral absoluta. En el trabajo sostengo que, para una concepción positivista, si el derecho es concebido como un conjunto de (...) normas, los enunciados bajo análisis no enuncian un hecho empírico, pero tampoco expresan una actitud moral absoluta. Ellos ciertamente enuncian un hecho normativo: la validez o existencia jurídica de una entidad normativa, que es relativa a un determinado tiempo y lugar. En mi opinión, la dificultad de Bulygin para admitir este tipo de enunciados se debe fundamentalmente a la presuposición de una falsa dicotomía entre dos modos en los que una entidad puede existir: uno empírico y otro normativo. Con el fin de criticar esta aparente dicotomía presento brevemente una concepción constructivista de la existencia de normas. Si mi razonamiento es correcto, esta concepción es adecuada para explicar, desde una perspectiva teórica positivista, aquellos enunciados que expresan el hecho normativo de la existencia o validez jurídica de una norma. In this paper I analyze Bulygin's conception of those legal statements asserting that a certain action is legally obligatory, prohibited or permitted. According to Bulygin, these statements are ambiguous. They can be external, empirical statements expressing the existence or validity of a legal norm, but they can also be internal, normative statements expressing a norm or an absolute, moral attitude. In the paper I attempt to defend that for a positivist theory, if law is conceived as a set of norms, this kind of statements do not report an empirical fact, but do not express an absolute moral attitude either. They surely assert a normative fact: the legal existence or validity of a normative entity, which is relative to a certain time and place. In my view, Bulygin's failure to see this point is fundamentally due to the assumption of a false dichotomy between two ways in which an entity can exist: one empirical, the other normative. In order to criticize this apparent dichotomy, I briefly sketch a constructivist conception in which we can say that legal norms exist. If my reasoning is correct, this conception is apt to explain those statements expressing the normative fact that a norm exists or is legally valid. (shrink)

La posizione e il ruolo della filosofia nelle Università sono sempre stati oggetto di interesse, in particolare da parte dei detentori della disciplina, evidentemente convinti di un suo statuto speciale all’interno del percorso formativo. In questo articolo si prendono brevemente in esame le posizioni di alcuni filosofi che si sono esplicitamente esposti al riguardo, da Kant a Heidegger, da Ortega y Gasset a Martha Nussbaum, quali testimoni illustri dell’imprescindibilità dei contenuti e dei metodi della filosofia per ogni campo del sapere, (...) tanto più oggi, che l’utilità del pensiero umanistico viene disconosciuta in favore di una formazione sempre più tecnica e specializzata. (shrink)

Name der Zeitschrift: Nietzsche-Studien Jahrgang: 45 Heft: 1 Seiten: 221-221.

Name der Zeitschrift: Nietzsche-Studien Jahrgang: 45 Heft: 1 Seiten: 222-222.

I testi biblici si guardano, rinviano l'uno all'altro, si citano si rispecchiano l'uno nell'altro, e il frutto di tale rispecchiamento precipita a formare nuovi strati testuali.

Although Nietzsche never formulated an actual political theory, his critique of modernity and his search for alternative solutions to raise the 'human type' are certainly part of a “große Politik” project, which, however, belongs more to the realm of philosophy and culture than to that of a science of government. In opposition to homologating organisations - political, economic, moral - that have robbed man of his most peculiar energies, Nietzsche works for the promotion of a strong individuality that alone can (...) promise lasting constructions. Originality and the ability to incorporate discordant elements are, for Nietzsche, symptoms of a superior culture: the 'good European' of the future will therefore be the one who, beyond narrow personal and national boundaries, will be able to open up to fruitful hybridisation. Nietzsche - Politics - Individual - Democracy - Tocqueville. (shrink)

In Davidson’s opinion, the model of triangulation, which is a situation where two or more sufficiently similar interacting creatures respond to one another within a shared external environment, can give explanation to how concepts and mental contents are acquired and also clarify their very nature. In this paper, I will explore the model of triangulation, its various levels, and its specific role in concept acquisition. I will then assess the plausibility of Davidson’s account and suggest a few possible amendments to (...) the model of triangulation, in order to make it effective in explaining the process of concept acquisition. Finally, I will argue that the model of triangulation cannot be disconnected from holism and will briefly sketch some consequences of this claim. (shrink)

According to the minimal version of the traditional analysis of knowledge, there are (at least) three necessary components to knowledge, that is, truth, belief and justification. In this paper we will argue that even in a global sceptical scenario, all three conditions minimally necessary for knowledge can be satisfied. In particular, we will focus on the justification requirement and analyse two “traditional” theories of justification, i.e., coherentism and foundationalism, as well as a more “innovative” one, i.e., reliabilism. Then, we will (...) conclude that if we want to continue to claim that, in a global sceptical scenario, a cognitive subject does not know (almost) anything, we should recognise that she may still have justified true beliefs, and we should, therefore, look elsewhere for the reasons why she lacks knowledge. (shrink)

BackgroundThis study analyzed the difference in psychological distress of the healthcare workers in three different periods of the coronavirus disease 2019 (COVID-19) pandemic in Argentina. Specifically, from the third week of the mandatory quarantine through the two following weeks.MethodsAnalysis of the responses of 1,458 members of the health personnel was done on a questionnaire on healthcare workers concerns regarding the care of patients with coronavirus, indicators of depression, anxiety, intolerance of uncertainty, and coping.ResultsThe psychological indicators that were considered presented differences (...) between the evaluated periods. Perceived concerns about the possibility of infecting loved ones and infecting themselves were greatest in the periods after the onset of the pandemic. In addition, the perception of how the work environment worsened and how lack of sleep interfered with their work was also higher in periods 2 and 3. The same results were found in the indicators of depression, anxiety, and intolerance of uncertainty. Finally, the indicators of high tension and concurrent lack of emotional control, which was greater in the last periods evaluated, were also expressed in the coping strategies (showing emotional lability, only contained by hypercontrol).ConclusionThe differences found in the psychological indicators between the evaluated periods support the need for early psychological care of health personnel which should be a priority of public health and a fundamental fact to increase its immediate effectiveness in the care of infected patients. (shrink)

La realización de homenajes a figuras apreciadas del mundo académico impone el reto de seleccionar cuál sea el contenido de lo presentado en el evento para que éste se constituya en una auténtica muestra de reconocimiento de sus méritos.En ocasión de la mesa de homenaje a Gregorio Klimovsky, organizada por la Universidad Torcuato Di Tella a instancias de Guillermo Ranea, y convocada en el seno de las XX Jornadas de Epistemología e Historia de la Ciencia, el 26 de noviembre de (...) 2009, en La Falda (Córdoba), Alberto Moretti y Alejandro Cassini, plasmaron la mejor opción. Ambos eligieron analizar tesis filosóficas defendidas por el recordado y querido maestro, tanto en su obra como en las distintas ocasiones de diálogo que mantuvo con pares y discípulos. Se trató de la mejor elección porque de este modo no sólo ambos contribuyen a la difusión de las ideas de Klimovsky sino también, y con gran cuidado analítico, las conjugan con otras doctrinas presentes en el escenario filosófico contemporáneo, destacando así su actualidad y valía. (shrink)

The relationships between philosophy and its history have been discussed at great length along the last decades. We analyze some aspects of this debate. Particularly, we question the thesis according to which to know history of philosophy is a necessary condition for doing philosophy. We disclose some assumptions, generally implicit ones, strongly related to it.

Most studies investigating the relationship between cultural constructs and ethical perception have focused on individual- and societal-level values without much attention to other type of cultural constructs such as social beliefs. In addition, we need to better understand how social beliefs are linked to ethical perception and the level of analysis at which social beliefs may best predict ethical perceptions. This research contributes to the cross-cultural ethical perception literature by examining the relationship of individual-level social cynicism belief, one of five (...) universally endorsed social beliefs, together with individual social dominance orientation and the perception of unethical behavior. By means of two studies, we examine these relationships across societies that significantly differ on societal-level social cynicism belief. Using 371 business students from Russia and the U.S. in Study 1 and 268 professionals from Portugal and the U.S. in Study 2, we found that individual-level social cynicism belief was positively associated with social dominance orientation. Social dominance orientation, in turn, mediated the relationship between individual social cynicism belief and the perception of unethical behavior. Although we found significant societal-level differences in social cynicism belief in both studies, the relationships between individual-level social cynicism belief, social dominance orientation, and the perception of unethical behavior were structurally equivalent across societies in both studies, suggesting that societal-level differences did not significantly affect these relationships. Implications for cross-cultural business ethics research and practice are discussed. (shrink)

Introduction to the book symposium “THE BIOPSYCHOSOCIAL MODEL OF HEALTH AND DISEASE: NEW PHILOSOPHICAL AND SCIENTIFIC DEVELOPMENTS BY DEREK BOLTON AND GRANT GILLETT”.