Coming from a prosperous London Quaker family, the author Priscilla Wakefield wrote educational books for children, and one work for adults, Reflections on the Present Condition of the Female Sex, also reissued in this series. This 1796 book on botany, a science which 'contributes to health of body and cheerfulness of disposition' but is difficult to study because of its Latin nomenclature and the cost of textbooks, offers a simple introduction for children through the medium of letters between (...) sisters, as 'Felicia' shares with 'Constance' her growing understanding of plant science. Felicia's governess is a follower of Linnaeus, whose classificatory system is described as 'the one universally adopted', and by the twenty-eighth and final letter, Felicia is describing the class Cryptogamia. This illustrated account in simple language gives an insight into the level of education thought appropriate for young girls at the end of the eighteenth century. (shrink)

In this wide-ranging interview Priscilla Alderson discusses how she came to research parental and childhood consent and became a sociologist and how, late in her career, she became convenor of the critical realism group started by Roy Bhaskar at the Institute for Education in London. She discusses aspects of her seminal research over the years on multiple subjects, such as the rights of children, and reflects on what critical realism has added to her social research.

Christopher Boorse’s biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield’s harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze (...) Boorse’s central argument for the sufficiency claim, the “pathologist argument,” which takes pathologists’ intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion. (shrink)

Wakefield’s harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction and a value component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that (...) dysfunctions need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction’s harmfulness is best understood in dispositional terms. (shrink)

In ‘Rethinking Disease’, Powell and Scarffe1 propose what in effect is a modification of Jerome Wakefield’s2 3 harmful dysfunction analysis (HDA) of medical (including mental) disorder. The HDA maintains that ‘disorder’ (or ‘disease’ in Powell and Scarffe’s terminology) is a hybrid factual and value concept requiring that a biological dysfunction, understood as a failure of some feature to perform a naturally selected function, causes harm to the individual as evaluated by social values. Powell and Scarffe accept both the HDA’s (...) evolutionary biological function component and its incorporation of a value component. Their proposed ‘new twist’ is to revise the value component: ‘Our proposed definition of disease is as follows: a biomedical state is a disease only if it implicates a biological dysfunction that is, or would be, properly disvalued’. So, they propose that a disorder is a ‘properly disvalued dysfunction’ rather than a ‘harmful dysfunction’, an approach they term ‘thickly normative’ in contrast to the thin normative approach of the HDA. There has been a surge of interest recently in better understanding the ‘harm’ component of the HDA. Powell and Scarffe’s analysis is a helpful contribution to this discussion. We focus here exclusively on their proposal regarding the analysis of the concept of disorder and ignore many important related issues that the authors address, ranging from prioritising resource allocation between disorders and non-disorders to whether the concept of disorder should be replaced by a generic welfarist concept. The resolution of these additional issues depends on first understanding ‘disorder’. The authors’ proposed changes to the HDA also deserve evaluation because the HDA, which has been endorsed by leading nosologists,4 plays an influential role in nosological debate across categories of disorder ranging, for example, from sexual paraphilias5 to psychopathy.6 A basic problem is that Powell and Scarffe misinterpret …. (shrink)

In the past three decades a number of narrative self-concepts have appeared in the philosophical literature. A central question posed in recent literature concerns the embodiment of the narrative self. Though one of the best-known narrative self-concepts is a non-embodied one, namely Dennett’s self as ‘a center of narrative gravity’, others argue that the narrative self should include a role for embodiment. Several arguments have been made in support of the latter claim, but these can be summarized in two main (...) points. Firstly, a logical one: without taking the body into account Dennett’s theory becomes self-refuting. Secondly, a more practical/phenomenological point: a disembodied self-concept overlooks how personal the body is, and as such should be considered part of the self. In this paper I endorse these criticisms of non-embodied narrative self-concepts, but I argue that the relationship between the narrative self and the body is far from sufficiently fleshed out. I claim that the narrative self and the body are much more interwoven than the above criticisms suggest. What I aim to show in this paper is that the relationship between the body and the narrative self is interactive rather than unidirectional: not only does our body shape our narrative self, but our narrative self also shapes our body. The upshot of this is a better conception of the self is as a dynamic interaction between its various aspects. (shrink)

This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...) to framing ethical questions are also considered. Being aware of the four theories’ influence can help when seeking to understand and possibly change clinical ethics committee routines. The paper is not a research report but is informed by a recent study in two London paediatric cardiac units. Forty-five practitioners and related experts were interviewed, including eight members of ethics committees, about the work of informing, preparing and supporting families during the extended process of consent to children’s elective heart surgery. The mosaic of multidisciplinary teamwork is reported in a series of papers about each profession, including this one on bioethics and law and clinical ethics committees’ influence on clinical practice. The qualitative social research was funded by the British Heart Foundation, in order that more may be known about the perioperative views and needs of all concerned. Questions included how disputes can be avoided, how high ethical standards and respectful cooperation between staff and families can be encouraged, and how minors’ consent or refusal may be respected, with the support of clinical ethics committees. (shrink)

Neoliberalism, health and illness are all vast topics that range from global to local, personal to political. Critical realism offers valuable concepts, which help to extend and deepen analysis of...

As a study involving diabetes care demonstrates, children sometimes have a much more sophisticated capacity for taking charge of their own health care decisions than is usually recognized in bioethics. Protecting these children from their disease means involving them in their treatment as much as possible, helping them to understand it and take responsibility for it so that they can navigate the multitude of daily decisions that become part of the diabetes medical regimen.

Consent can only be voluntary, freely given and uncoerced. Can this legal adult standard also apply to children? High-risk surgery is seldom a wanted choice, but compared with the dangers of the un...

With the increase in the costs of providing education and concerns about financial responsibility, heightened consideration of accountability and results, elevated awareness of the range of teacher skills and student learning styles and needs, more focus is being placed on the promises offered by online software and educational technology. One of the most heavily marketed, exciting and controversial applications of edtech involves the varied educational programs to which different students are exposed based on how big data applications have evaluated their (...) likely learning profiles. Characterized most often as ‘personalized learning,’ these programs raise a number of ethical concerns especially when used at the K-12 level. This paper analyzes the range of these ethical concerns arguing that characterizing them under the general rubric of ‘privacy’ oversimplifies the concerns and makes it too easy for advocates to dismiss or minimize them. Six distinct ethical concerns are identified: information privacy; anonymity; surveillance; autonomy; non-discrimination; and ownership of information. Particular attention is paid to whether personalized learning programs raise concerns similar to those raised about educational tracking in the 1950s. The paper closes with discussion of three themes that are important to consider in ethical and policy discussions. (shrink)

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

Children's autonomy includes, as far as possible, self-determination, bodily integrity and the right to influence outcomes. Limits to bodily integrity, which involves no touching without the child's consent or tacit agreement, are discussed. The clinical, legal and ethics literature tends to agree that children may give valid consent to major recommended treatment from around 12 years but may not refuse it until they are legal adults. Research shows that young children are more aware of their bodily integrity and autonomy, of (...) morality and decision making, than was assumed in the past. Adults therefore need to inform children and respect their initially instinctive efforts to protect their bodily integrity. Unlike assent, consent involves patients being adequately informed and being able to accept or refuse proposed treatment. Reasons are given for adults’ need to consult with children when determining their best interests. Beyond words, giving or withholding consent also involves emotions of fear, trust and courage, besides embodied reactions of cooperating with treatment or resisting it, in which young children actively engage. Some clinicians work with the informed cooperation of young children who need lifesaving treatment, and at times accept their refusal. Reasons for differences between mainstream experts’ views and clinical practices are considered. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Makes a Mental Disorder Mental?Jerome C. Wakefield (bio)Keywordsharmful dysfunction, mental disorder, intentionality, mental dysfunction, mental functioning, phenomenality, somatic disorderWhat makes a medical disorder mental rather than (exclusively) somatic or physical? Psychiatry to some extent depends for its existence as a medical specialty on the distinction between mental and somatic disorders, yet the history of this distinction presents a bewildering array of puzzling judgments, radical shifts, and seemingly (...) arbitrary distinctions. The historical observation that putative mental disorders are often reclassified as physical disorders as soon as their physiologic basis is understood further confuses matters. Moreover, recent debates about such classifications often seem to reflect desires to protect professional turf or obtain optimal reimbursement for treatment more than they do the application of a coherent conceptual distinction. No wonder that Brülde and Radovic (2006) disarmingly admit at the outset of their exploration of this question that there is a case to be made that their topic is relatively unimportant or even meaningless intellectually, a rare way to start an inquiry!Could there nonetheless be a cogent conceptual distinction lurking here? Brülde and Radovic usefully invite us to reframe the question, in effect as follows: Suppose we pay attention to professional and lay judgments as evidence but at the same time try to avoid being ensnared by the distortions resulting from turf issues and other pragmatic motives and constraints. Can we then identify some principled distinction in this domain that is worth making and that interestingly corresponds to the distinction generally made between mental disorders and strictly somatic disorders? Brülde and Radovic do not come to any confident or compelling conclusion about this.My answer, based on my harmful dysfunction analysis of disorder (Wakefield, 1992a, 1992b, 1999a, 1999b), is that a mental disorder is a harmful mental dysfunction, where a mental dysfunction is a failure of the capacity of some mental mechanism to perform a function for which it was biologically designed. I argue that, owing to a series of logical missteps, Brülde and Radovic needlessly reject this view. After some preliminary comments and clarifications, I defend the internal dysfunction approach from the objections posed by Brülde and Radovic, and then conclude by elaborating this view in some new ways. Note that Brülde and Radovic critique something they call the "internal cause view" of what makes a disorder mental, and they name others who hold that view. However, my work figures prominently in their discussion, and for expository simplicity, I will presume to simply construe their arguments as aimed at the harmful dysfunction analysis. [End Page 123]Clarifying the QuestionIt is easy to misconstrue the question "What makes a mental disorder mental" as demanding a precise account of the mental, an error to which Brülde and Radovic succumb in their repeated complaints that various writers do not present principled accounts of the mental but rely on lists of prototypical mental states or tentative guidelines to fix the reference of mental. We would need a precise definition of mental if the problem were how to classify cases in which it is ambiguous whether some phenomenon is mental or physical. We might imagine, for example, someone being genuinely puzzled as to whether inability to sleep is failure of a mental function or process. But this sort of puzzle about the boundaries of the mental is not the problem with which Brülde and Radovic are concerned; anyway, ambiguous cases may just be inherently ambiguous. The problem, which a crisp definition of mental will not resolve, is what relation mental states or mechanisms must have to a disorder to make it a mental disorder; must there be mental symptoms, or mental dysfunctions, or either one, and so on? But, even if a precise resolution of the nature of the mental is not needed, some notion of the mental domain is essential in pursuing this discussion. We can pick out the mental ostensively, by pointing to lots of examples (e.g., perception, motivation, emotion, thought, and sensation) much more confidently than we can define it in a principled way. But because Brülde and Radovic find fault in such ostensive reference fixing, let me... (shrink)

This article reviews practitioners’ evaluations of in-hospital ethics seminars. A qualitative study included 11 innovative in-hospital ethics seminars, preceded and followed by interviews with most participants. The settings were obstetric, neonatal and haematology units in a teaching hospital and a district general hospital in England. Fifty-six health service staff in obstetric, neonatal, haematology, and related community and management services participated; 12 attended two seminars, giving a total of 68 attendances and 59 follow-up evaluation interviews. The 11 seminars facilitated by an (...) ethicist addressed the key local concerns of staff about the social and ethical consequences of advances in genetics and their impact on professional policies and practice. Seminar agendas were drawn from prior interviews with 70 staff members. During evaluation interviews, participants commented on general aspects that they had enjoyed, how the sessions could be improved, timing, the mix of participants, the quality of the facilitation, whether sessions should be more challenging, after-effects of sessions, and interest in attending seminars and contacting the ethicist in future. Participants valued the increased interprofessional understanding and coherent discussion of many pressing issues that addressed important though seldom discussed ethical questions. The seminars worked well in the different hospitals and specialties. (shrink)

Background: While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings. Research objective: The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker. Research design and participants: (...) A critical moral ethnography was conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials. Ethical considerations: After receiving ethics approval, signed informed consent was obtained from participants before data collection. Results: Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage. Discussion: The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women. Conclusion: Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice. (shrink)

In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. In Part 1, I argued that, even if one accepts Lewis’s critique of the brain evidence presented for the brain-disease view, his arguments fail to establish that addiction is not a disorder. Relying on my harmful dysfunction analysis of disorder, I defended the view (...) that addiction is a medical disorder and a brain disorder. In Part 2, I consider some broader philosophical issues raised by Lewis’s arguments: I consider a larger puzzle, at the heart of the neo-Kraepelinian program in contemporary psychiatry, that is raised by Lewis’s argument that addiction is not a disorder because the brain displays no damage but only normal learning: must all mental disorders be brain disorders, or can mental disorders occur in normal brains? I argue that mental disorders can occur in normal brains. I critique Lewis’s response to the evolutionary “novel environment” approach to explaining why addiction is a disorder. Lewis agrees with brain-disease proponents that interpreting addiction as brain disorder relieves addicts of moral censure, but I argue that moral defect and brain disease are not exclusive. Finally, I consider Lewis’s “developmental-learning” account of addiction that encourages positive and empowering narrativizing of addiction, but I argue that the developmental-learning view is vacuous due to use of an overly broad notion of “development.”. (shrink)

This review begins with a detailed focus on the Turnaway Study, which addresses associations among early abortion, later abortion, and denied abortion relative to various outcomes including mental health indicators. The Turnaway Study was comprised of 516 women; however, an exact percentage of the population is not discernable due to missing information. Extrapolating from what is known reveals a likely low of 0.32% to a maximum of 3.18% of participants sampled from the available the pool. Motivation for conducting the Turnaway (...) Study, methodological deficiencies (sampling issues and others), and bias are specifically addressed. Despite serious departures from accepted scientific practices, journals in psychology and medicine have published dozens of articles generated from the study’s data. The high volume of one-sided publications has stifled dialogue on potential adverse psychological consequences of this common procedure. Following a critical analysis of the Turnaway Study, an overview of the strongest studies on abortion and mental health is offered. This comprehensive literature comprised of numerous large-scale studies from across the globe has been largely overlooked by scientists and the public, while the Turnaway Study dominates the media, information provided to women, and legal challenges involving abortion restrictions. In the final section of this article, literature reviews by professional organizations are considered, demonstrating that the biased science characterizing the Turnaway Study is aligned with a pervasive and systemic phenomenon wherein deriving reliable and valid results via careful attention to methodology and scrutiny by the scientific community have been supplanted by politics. (shrink)

Background: The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. Objective: To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. Design: We tested the hypothesis that (...) use of a narrative pedagogy assignment related to ethics would improve student nurse’s perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student’s perception of their role as a patient advocate. Ethical considerations: Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. Setting: School of Nursing at a small liberal arts college in the Northeastern United States. Participants: A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Findings: Results indicated significant differences in student nurse’s perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Conclusion: Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of narrative pedagogy on nursing student’s perception of the nurse’s advocacy role. (shrink)

In the first part of this article, I argue that Christopher Megone's natural-kind interpretation of Aristotle's argument that "the function of a human being is reason" does not resolve major puzzles about the argument, specifically the puzzles of why a human being has a function and why reason is that function. I attempt to resolve these puzzles by supplementing the natural-kind account with the doctrine that reason is the master regulatory natural function by which individuals enter into social life. In (...) the second half, I critique Megone's value account of function and argue for a nonevaluative, causal-explanatory account of function and teleological explanation. (shrink)

This Article doDespite obvious differences in the Aristotelian and Stoic theories of responsibility, there is surprisingly a deeper structural similarity between the two. The most obvious difference is that Aristotle is (apparently) a libertarian and the Stoics are determinists. Aristotle holds adults responsible for all our "voluntary" actions, which are defined by two criteria: the "origin" or cause of the action must be "in us" and we must be aware of what we are doing. An "involuntary" action, for which we (...) are not responsible, is one that fails to meet either one of these two criteria. Aristotle is a libertarian insofar as he insists that all voluntary actions are "in our power" to perform or not. As determinists the Stoics cannot admit this sort of freedom, but they still consider the agent to be a vital link in the chain of events, so they redefine what is "in our power" as what comes about "through us." The terminology is different, but I argue that these actions, for which the Stoics hold us responsible, are in fact coextensive with Aristotle's voluntary actions. An "impression" is the first necessary condition for action, and is a sort of visual image of the object stimulating one to act. The right sort of impression activates the agent's "impulse," an internal movement of soul or mind, which is the direct cause of action. But impulse is always accompanied by "assent," which is the mind's affirming the truth of the proposition that we ought to go after the object stimulating our impulse. Thus, since assent is a necessary condition for action, we always act knowing what we are doing. This means that all actions caused by our own impulse and assent are by Aristotle's criteria voluntary, where impulse provides the internal origin of the action and assent provides the awareness of what is being done. I conclude that the Stoic and Aristotelian classes of what one is responsible for are coextensive, their criteria defining responsible actions are nearly identical, and the only substantial difference is that Aristotle claims such actions are in our power to do or not do while the Stoics say that such actions are necessitated (by our internal nature as well as external factors). es not have an abstract. (shrink)

The sociology of literature, in the first of many paradoxes, elicits negations before assertions. It is not an established field or academic discipline. The concept as such lacks both intellectual and institutional clarity. Yet none of these limitations affects the vitality and rigor of the larger enterprise. We use the sociology of literature here to refer to the cluster of intellectual ventures that originate in one overriding conviction: the conviction that literature and society necessarily explain each other. Scholars and critics (...) of all kinds congregate under this outsize umbrella only to differ greatly in their sense of what they do and what sociology of literature does. They subscribe to a wide range of theories and methods. Many would not accept the sociology of literature as an appropriate label for their own work; other would refuse it to their colleagues. Nevertheless, every advocate agrees that a sociological practice is essential to literature. For the sociology of literature does not constitute just one more approach to literature. Because it insists upon a sociology of literary knowledge and literary practice within the study of literature, the sociology of literature raises questions basic to all intellectual inquiry.The sociology of literature begins in diversity. The way that is combines the ancient traditions of art with the modern practices of social science makes the very term something of an oxymoron. There is not one sociology of literature, there are many sociological practices of literature, each of which operates within a particular intellectual tradition and specific institutional context. These practices cross basic divisions within the contemporary intellectual field, especially within the university. Inherently interdisciplinary, the sociology of literature is subject to constant reformulation as scholars re-evaluate their disciplines. In consequence, disciplinary boundaries seem less rigid, less logical, and, hence, less authoritative than ever before. Even so—and this is another paradox of the sociology of literature—any sociological conception of literature is best situated in terms of an original discipline and its institutional setting. However frequently individual scholars cross over disciplinary lines, the fundamental divisions retain their force. Priscilla Parkhurst Ferguson is professor of French at the University of Illinois at Chicago; she is author of Literary France: The Making of a Culture. Philippe Desan, whose Naissance de la method: Machiavelle, la Ramée, Bodin, Montaigne, Descartes was published in 1987, is an assistant professor at the University of Chicago. Wendy Griswold, associate professor of sociology at the University of Chicago, recently published Renaissance Revivals: City Comedy and Revenge Tragedy in the London Theatre, 1576-1980. (shrink)

The harmful dysfunction (HD) analysis of "disorder" holds that disorders are harmful failures of "designed" (that is, naturally selected) functions. Murphy and Woolfolk (2000) present a series of proposed counterexamples to the HD analysis to support their claim that it fails to provide a necessary condition for disorder. They argue that disorder can exist where there is no failed function, as in failed spandrels and inflamed vestigial organs, and that there can be disorders when everything is working as designed, as (...) in environment--design mismatches and disorders acquired through normal learning processes. They also argue that the HD analysis suffers from methodological problems, including value-ladenness of dysfunction judgments and unwarranted assumptions about the nature of internal mechanisms and their functions. -/- In this paper, each of these objections is critically evaluated. Reanalysis of the proposed counterexamples is argued to reveal strong support for the HD analysis. For example, failed spandrels are considered disorders when and only when they imply failures of designed functions; dysfunctions of vestigial organs involve failures of function at the tissue level, not the organ level; mechanism-environment mismatches are not considered disorders; and conditions acquired through normal learning processes can involve dysfunctions and are considered disordered only when they do. Murphy and Woolfolk's methodological objections are found to be based on a misinterpretation of the HD analysis. It is concluded that Murphy and Woolfolk fail to offer a cogent objection to the HD analysis. (shrink)

In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. Addiction is currently classified as a medical disorder in DSM-5 and ICD-10. It is further labeled a brain disease by NIDA, based on observed brain changes in addicts that are interpreted as brain damage. Lewis argues that the changes result instead from normal neuroplasticity (...) and learning in response to the intense rewards provided by addictive substances, thus that addiction is not a brain disease and by implication not a medical disorder at all. I argue that even if one accepts Lewis’s reinterpretation of the brain evidence, his conclusions do not follow. Relying on my harmful-dysfunction analysis of medical disorder, I defend the view that substance addiction is in fact a medical disorder and a brain disorder. In Part 1, I identify five arguments Lewis puts forward against the brain-disease view and evaluate them as arguments that addiction is not a disorder: Addiction is not a chronic, relapsing condition; There is no clear boundary between addiction and other strong desires; Negative consequences are not unique to disorders; The brain disease model does not account for behavioral addictions; and, Addiction is like love. I argue that Lewis’s arguments are invalid because they fail to take account of the context of addiction and its relation to biological design. (shrink)

Pierre-Henri Castel provides a short but richly argued precis of his recently published two-volume 1,000-page masterwork on the history of obsessive-compulsive disorder. Having not read the as-yet-untranslated books, I write this commentary from Plato’s cave, trying to infer the reality of Castel’s analysis from expository shadows. I am unlikely to be more successful than Plato’s poor troglodytes, so I apologize ahead of time for any misunderstandings. Moreover, I cannot assess Castel’s detailed evidential case for his substantive theses.1 I thus focus (...) on some key philosophical issues that impinge on an area of my concern, the concept of mental disorder. Castel is a rare breed of French.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mental Disorder and Moral Responsibility:Disorders of Personhood as Harmful Dysfunctions, With Special Reference to AlcoholismJerome C. Wakefield (bio)Keywordsalcohol dependence, philosophy of psychiatry, mental disorder, harmful dysfunction, psychiatric diagnosis, person, moral responsibilityIn his paper, Ethical Decisions in the Classification of Mental Conditions as Mental Illness, Craig Edwards grapples with a profound problem: why is it that when we classify a mental condition as a mental disorder, that tends to (...) take the condition out of the sphere of moral responsibility or virtuousness of character? For example, it is not uncommon when someone commits suicide and the question is raised as to why he or she did it, that instead of a reason or character trait that would place the act within a moral calculus, one is offered the explanation "she was clinically depressed" or "he was bipolar," and this tends to terminate discussion and make reasons and moral evaluation superfluous. Why does such a comment have that effect?As Edwards notes, this can get complicated as the moral and the disordered interact. Certainly people are sometimes morally responsible for acting on their disordered impulses (as in pedophilia), and they are responsible for putting themselves in the way of disorder, as when someone imbibes in a way likely to lead to alcoholism. But at the normal/disorder divide, there seems to be a consistent lifting of some responsibility, reflecting the application of the sick role. For example, the rough equivalent of our current category of post-traumatic stress disorder (PTSD) was recognized as a disorder in earlier wars ("shell shock," "war neurosis"), but often considered an expression of cowardice; the cowardice was morally evaluable as a failure of virtue (even if, like many personality traits, being a coward is not within the person's direct voluntary control) and led to contempt for those with PTSD, but nonetheless—except in cases thought to be malingering—the PTSD that resulted constituted a disorder for which the individual was [End Page 91] not in the same direct sense blameworthy. This moral shift requires explanation.This topic also has important social ramifications. Relief from responsibility may sound like a good thing, and it is trumpeted by mental health advocates as a reason for supporting the classification of many conditions as disorders. But as Edwards is aware, it is a two-edged sword. Disordered status may allow escape from censure and offer the protections of the sick role, but it also changes the relationship of the agent to his or her own actions and imposes the responsibility of the sick role on the individual to attempt to change ("get better"). The sick role allows for no defense of an idiosyncrasy based on normal variation ("It takes all kinds…") or the individual's eccentric vision or steadfast integrity, for that vision or sense of integrity are now seen as pathological and not morally legitimate. The individual is subjected to endless entreaties to seek help and it is implied that not to do so is irresponsible, so that a decision to embrace one's nature and remain as one is becomes illegitimate. Moreover, the sick role allows for no explanation in terms of the individual's normal defensive response to unjust, deprived, or challenging social or environmental circumstances, thus weakening the motives for social change rather than individual intervention.In sum, there is an inevitable sense in which being placed in the sick role inherently stigmatizes the "sick" condition in virtue of the special moral attitudes extended to the disordered. Cultures can thus easily exploit the sick role and its much-touted relief from responsibility to extend the reach of social control processes. This is one reason why the distinction between disorder and non-disorder is so important, and why it is crucial to identify when non-disordered conditions are mislabeled as disorders—as when, for example, psychiatry gets it wrong about the distinction between normal and disordered sadness (Horwitz and Wakefield, 2007). Such overpathologization can redefine the boundaries of our moral universe on mistaken grounds.Edwards offers two provocative answers—not entirely at ease with each other—to the question of why mental disorders relieve the patient from moral responsibility: (1) mental disorders are... (shrink)

Recent studies of semantic memory have investigated two theories of optimal search adopted from the animal foraging literature: Lévy flights and marginal value theorem. Each theory makes different simplifying assumptions and addresses different findings in search behaviors. In this study, an experiment is conducted to test whether clustering in semantic memory may play a role in evidence for both theories. Labeled magnets and a whiteboard were used to elicit spatial representations of semantic knowledge about animals. Category recall sequences from a (...) separate experiment were used to trace search paths over the spatial representations of animal knowledge. Results showed that spatial distances between animal names arranged on the whiteboard were correlated with inter-response intervals during category recall, and distributions of both dependent measures approximated inverse power laws associated with Lévy flights. In addition, IRIs were relatively shorter when paths first entered animal clusters, and longer when they exited clusters, which is consistent with marginal value theorem. In conclusion, area-restricted searches over clustered semantic spaces may account for two different patterns of results interpreted as supporting two different theories of optimal memory foraging. (shrink)

We use the construct of the “other” to explore how hate operates rhetorically within the virtual conclave of Stormfront, credited as the first hate Web site. Through the Internet, white supremacists create a rhetorical vision that resonates with those who feel marginalized by contemporary political, social, and economic forces. However, as compared to previous studies of on-line white supremacist rhetoric, we show that Stormfront discourse appears less virulent and more palatable to the naive reader. We suggest that Stormfront provides a (...) “cyber transition” between traditional hate speech and “reasonable racism,” a tempered discourse that emphasizes pseudo-rational discussions of race, and subsequently may cast a wider net in attracting audiences. (shrink)

This book consists of a focused and systematic analysis of Freud’s implicit argument for unconscious mental states. The author employs the unique approach of applying contemporary philosophical methods, especially Kripke-Putnam essentialism, in analyzing Freud’s argument. The book elaborates how Freud transformed the intentionality theory of his Cartesian teacher Franz Brentano into what is essentially a sophisticated modern view of the mind. Indeed, Freud redirected Brentano's analysis of consciousness as intentionality into a view of consciousness-independent intentionalism about the mental that in (...) effect set the agenda for latter-twentieth-century philosophy of mind. (shrink)

This study examined the relation between professional affiliation and the framing of expert congressional testimony about nicotine's addictiveness. Experts were chosen from three different types of sponsoring organizations: the tobacco industry, government, and independent research organizations, both pro- and anti-tobacco. The study sought to identify common technical biases and policy concerns that could define an overall “expert” attitude, as well as differences where the experts’ framing of nicotine addiction would reveal attempts to favor their own institutions. Semantic network analysis was (...) applied to each group's discourse, thereby clustering associated words that represented major themes in each type of expert group. Clusters revealed a common preoccupation with narrowly defined, lab-based evidence, but more locally, each group framed the issues to support its sponsor's strategy. (shrink)

This book is the recent addition to the Clarendon Later Ancient Philosophers series, and its greatest significance lies in its being the sole commentary on Against the Grammarians. It also provides the only English alternative to Bury’s 1949 translation in the Loeb edition. As such, it is a clear and readable translation, although, of course, there is no Greek text provided.

Buscando apresentar uma interpretação para EN I 4 1095a31-b13, este artigo defende que a digressão nela feita por Aristóteles pretende caracterizar a investigação recém iniciada como promissora, opondo-a, ainda que não explicitamente, ao modo rígido socrático-platônico de fazer Ética ou Política. Para tanto, propõe-se uma interpretação pouco usual do termo que como o princípio buscado e não como ponto de partida da investigação. Recusa-se igualmente ver na passagem mencionada uma referência ao modo ou etapas de aquisição de virtude moral ou (...) prudência, mas de um corpo preciso de conhecimento ou ciência, a Ética ou Política. (shrink)

A major obstacle to formulating a broad-content intentional psychology is the occurrence of ''Frege cases'' - cases in which a person apparently believes or desires Fa but not Fb and acts accordingly, even though "a" and "b" have the same broad content. Frege cases seem to demand narrow-content distinctions to explain actions by the contents of beliefs and desires. Jerry Fodor ( The elm and the expert: Mentalese and its semantics , Cambridge, MA: MIT Press, 1994) argues that an explanatorily (...) adequate broad-content psychology is nonetheless possible because Frege cases rarely occur in intentional-explanatory contexts, and they are not systematically linked to intentional laws in a way that demands intentional explanation. Thus, he claims, behaviors associated with Frege cases can be considered ceteris-paribus exceptions to broad-content intentional laws without significantly decreasing the explanatory power of intentional psychology. I argue that Frege cases are plentiful and systematically linked to intentional laws in a way that requires intentional explanation, specifically in the explanation of why certain actions are not performed. Consequently, Frege-case behaviors cannot be construed as ceteris-paribus exceptions to intentional laws without significantly eroding the explanatory power of intentional psychology and reducing the rationality of the agent. Fodor thus fails to save broad-content psychology from the prima facie objections against it based on Frege cases. (shrink)

Pregnancy and childbirth have become a dangerous journey for Black women as harrowing stories of death and near‐death experiences resonate within Black communities. While the causes of pregnancy‐related morbidity and mortality are well documented, little is known about how Black Canadian women feel protected from undesirable maternal health outcomes when accessing and receiving pregnancy and intrapartum care. This critical qualitative inquiry sheds light on Black women's perceived sense of safety in accessing pregnancy and intrapartum care. Twenty‐four in‐depth interviews were conducted (...) with Black women who were pregnant or had given birth. Five interconnected themes were generated through thematic analysis: (1) There is a lot of prejudice towards us, (2) We are treated as sick bodies, (3) There is a lot of stereotypes towards us, (4) Our care is lacking in quality, and (5) We feel unsafe in the healthcare system. These themes highlight the perils faced by Black women accessing pregnancy and intrapartum care. The right to safe motherhood and equitable care for Black women should be a national priority in Canada to avert a looming crisis. (shrink)

This essay assesses Gentile's contributions to practical philosophy, showing how a distinctive but idiosyncratic moral theory emerges over the course of his systematic works. Wakefield argues that Gentile's thoroughgoing anti-realism does not, as some critics have thought, leave him unable to distinguish reasonable from unreasonable arguments or good from bad reasons for action. While actual idealism veers too close to implausible relativism to have much use as an all-purpose philosophical outlook, argues Wakefield, it retains real power as a (...) practical theory. (shrink)

This is a brief reply to the roundtable entitled ‘Does critical realism need the concept of three domains of reality?’ in which Dave Elder-Vass, Tom Fryer, Ruth Porter Groff, Cristián Navarrete and...

In October 2019, the Belgian government announced the opening of an asylum center in a former retirement home, leading to civic and political protest that escalated into arson. We examine the construction of the events before, on, and after the arson by analyzing 135 articles from Flemish newspapers, the public broadcaster’s news website, and alternative media between October 25 and November 30, 2019 using qualitative content analysis. Our analysis emphasizes journalists’ role as gatekeepers, deciding which actors get access and legitimation (...) in media coverage. Focus is on the dynamic process of how events become discursively constructed through the interventions of journalists and their sources attempting to gain primary definer status. Our analysis confirms that institutional sources remain more likely to achieve primary definer status in legacy news media. Alternative media perform similar discursive interventions as legacy news media but utilize them to provide access and legitimacy to different actors and standpoints. In the first days of news coverage, in particular, the narratives developed in right-leaning alternative media seemed to spread in legacy news media. In the following days, governmental actors and experts, through their interventions in legacy news media, were able to steer the discourse in a different direction. (shrink)

This paper has the intention of discussing about the public entertainment such as the theater, competitions in the circus and fights in the amphitheater. We’ll explain their origins and how they’ve originated from religious ceremonies to various forms of entertainment. We’ll also illustrate their types and respective organizations as well as their evolution over time, of how theater enters into decline and lease space to popular representations, and how the games in the circus and in the amphitheater become increasingly cruel. (...) By focusing on the public games in Rome we try to explain how they affected life in the Urbs and how they were used by the powerful to please the population. (shrink)

Através da inquirição filosófica, objetiva-se estabelecer contornos nítidos entre definições precedentes ao Behaviorismo Radical, através de incursões conceituais nesse campo do saber. Evidenciam-se os pressupostos filosóficos que alicerçam o campo conceitual da filosofia da ciência do comportamento.