Prior research suggests that most people perceive themselves to be more altruistic than the average population, an observation known as the better-than-average (BTA) effect. Understanding the BTA effect carries significant public health implications, as self-perceived altruism is closely related to altruistic behaviors, which plays a significant role in individual and societal well-being. However, little is known about whether subpopulations with specific sociodemographic profiles are more likely to hold BTA altruistic self-perceptions, making it difficult to design targeted programs based on multiple (...) sociodemographic characteristics to promote altruistic behaviors. This study addresses this gap by identifying the sociodemographic profiles of populations who are more likely to exhibit BTA effects on trait altruism. Data were derived from a representative sample of Hong Kong citizens (n= 1,185) in the 2017 Hong Kong Altruism Survey. A latent class analysis was performed using four domains of sociodemographic characteristics: sex, age, religion, and socioeconomic status. Multivariate multinomial logistic regressions were conducted to examine associations between class membership, BTA effect, and altruistic behaviors. The results yielded four classes of sociodemographic profiles. Middle-aged, Christian/Catholic, highly educated, and high-income individuals (Class 4, 17.8%) were most likely to exhibit BTA effects and behave altruistically; Class 3 (14.0%) were older, male, no/other religious belief, low education, and least likely to exhibit BTA effects and behave altruistically. Findings improve the understanding of the sociodemographic profiles of people showing BTA effects and facilitate targeted policy development to effectively promote altruism. (shrink)

PurposeIn Western society, the measurement of weight is prioritized over a person’s bodily experience. Hermeneutic philosopher Gadamer warned against the emphasis on measurement, rather than experience, in the medical sciences. An examination of the complexity of the experience of weight provides the opportunity to shift focus from quantifying the connection between health and weight to the experience of the person being weighed.MethodsThis qualitative hermeneutic study aims to understand people’s experiences of weight from the interviews of professionals and lay experts. Interviews (...) were analyzed using an interpretive hermeneutic method.ResultsThe interviews revealed that weight was experienced as a number imbued with meaning and bias, as a number that could be manipulated, and as a constant and anticipated bodily change. Weight change was expected and often unwelcomed, despite weight being a quality of the body that is always in flux. External measures of weight meant to monitor wellness and health inadvertently became an unhealthy fixation that prevented some participants from fully participating in life events and appreciating the stages their bodies were in.ConclusionWeight change is a necessary condition of being human, and bodies are and will be constantly changing. To achieve health and harmony, one must fit together the acceptance of change and their bodily experience of weight. It is often the preoccupation with weight, not weight itself, that gets in the way of living. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

:Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be (...) intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: the literal meaning, the physician’s intended meaning, and the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

P. F. Strawson suggests an anti-sceptical strategy which consists in offering good reason for ignoring scepticism rather than trying to refute it, and the reason he offers is that beliefs about the external world are indispensable to us. I give an exposition of Strawson's arguments for the indispensability thesis and explain why they are not strong enough. I then propose an argument based on some of Davidson's ideas in his theory of radical interpretation, which I think can establish the indispensability (...) thesis. Finally, I spell out the force of Strawson's anti-sceptical strategy by arguing that we have good reason for ignoring scepticism not only because beliefs about the world are indispensable, but also because it is irrational to have both beliefs about the world and sceptical doubts. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hermeneutics, Neuroscience and PsychiatryMichael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio)Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family.Why does this patient present in such a way at this (...) particular point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them.Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights.This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021).PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses.Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia.ReferencesWong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google ScholarWong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349... (shrink)

The defining principle of evolutionary biology is that all species, extant and extinct, evolved from ancient prokaryotic cells. Their initial appearance and adaptive evolution are proposed to have been accompanied by a cellular sentience, by feelings, subjectivity or, in a word, 'consciousness'. Prokaryotic cells, such as archaea and bacteria, have natural unitary, valence-marked 'mental' representations. They process and evaluate sensory information in a context-dependent manner. They learn, establish memories, and communicate using biophysical fields acting on excitable membranes. Symbiotic eukaryotic cells, (...) which evolved much later, initiated a compound cellular subjectivity utilizing 'senomic' and 'ephaptic' principles that evolved into the varieties of consciousness seen in multicellular species. This Cellular Basis of Consciousness (CBC) model provides a novel framework within which to approach fundamental issues such as the origins of life and the emergence of mind. (shrink)

“The forms of thought are first set out and stored in human language,” we read in the preface to the second edition of Hegel’s Science of Logic. Man thinks through language, and everything he “transforms into language and expresses in it contains a category, whether concealed, mixed, or well defined”. Language, then, harbors thought categories. There is a philosophy of language, but there is also a philosophy implied in language. How is this supposed to work? More specifically, how is this (...) supposed to work in Hegel’s own use of language?This paper is an attempt to give a simple answer to this question. There have been scholarly attempts to tie Hegel’s philosophy to his use of language.1 This paper... (shrink)

The intensive process of differentiation of knowledge that has in the past decade come to include philosophy has had the results, inter alia, that ethics, esthetics, and empirical sociology have undergone a kind of secondary "branching off" from the philosophy of society and culture . On the level of teaching this had the consequence that a department of esthetics and ethics was carved out of the department of historical materialism at the Philosophical Faculty of Moscow University, and was subsequently divided (...) into departments of esthetics and ethics, respectively. It was thus that the independent department of ethics made its appearance for the first time in the history of Moscow University. This occurred in 1969, and recently the department of Marxist- Leninist ethics marked its modest first decade. (shrink)

Highlighting the relations between De Anima II.5 and De Anima III.4, this paper argues that Aristotle held a surprisingly dynamic view of the intellect. According to this view, the intellect is in...

But beyond doubt also, the primacy that Plato gives to the imitation of, or participation in the Ideas, apparently substantially existing, is the main reason why critics have refused to recognize or consider possible any mode of conceptual immanence in the mind of the Demiurge or whomever they regard as the Platonic God. Text on text could be cited to exemplify the role of the Ideas as archetypes. Yet it seems rather strange that Plato should conceive of two simultaneous objects (...) of imitation, the Supreme Being and the Ideas. Despite the plurality of Ideas, however, some critics have recognized a centripetal tendency in the dialogues toward the primacy of the Good, or the One, or the Beautiful, or Being, over subordinate Ideas. Was there possibly some similar tendency toward unity of some sort between the Supreme Intellect and the Intelligibles, his archetypes, which in the Timaeus are the ideal Living Exemplar of the cosmos? (shrink)