An increasing shortage of transplant donor organs currently results in an escalating number of preventable human deaths. Xenotransplantation. the use of animal organs for transplantation into humans, is now heralded as medicine's most viable answer to the urgent and insurmountable human organ scarcity. Although claimed to be a biomedical prerogative, xenotransplantation is a cultural phenomenon - a procedure engaging both the physical and symbolic manipulation of human and nonhuman bodies, thereby transforming corporeality, identity, and culture. Biomedical and scientific discourses about (...) xenografts have obscured issues related to nonhuman animals and also could be distressful to human organ recipients, revealing that the xenograft may not be widely embraced. (shrink)

Both philosophers and psychologists have argued for the existence of distinct kinds of explanations, including teleological explanations that cite functions or goals, and mechanistic explanations that cite causal mechanisms. Theories of causation, in contrast, have generally been unitary, with dominant theories focusing either on counterfactual dependence or on physical connections. This paper argues that both approaches to causation are psychologically real, with different modes of explanation promoting judgments more or less consistent with each approach. Two sets of experiments isolate the (...) contributions of counterfactual dependence and physical connections in causal ascriptions involving events with people, artifacts, or biological traits, and manipulate whether the events are construed teleologically or mechanistically. The findings suggest that when events are construed teleologically, causal ascriptions are sensitive to counterfactual dependence and relatively insensitive to the presence of physical connections, but when events are construed mechanistically, causal ascriptions are sensitive to both counterfactual dependence and physical connections. The conclusion introduces an account of causation, an "exportable dependence theory," that provides a way to understand the contributions of physical connections and teleology in terms of the functions of causal ascriptions. (shrink)

Teleological explanations (TEs) account for the existence or properties of an entity in terms of a function: we have hearts because they pump blood, and telephones for communication. While many teleological explanations seem appropriate, others are clearly not warranted-for example, that rain exists for plants to grow. Five experiments explore the theoretical commitments that underlie teleological explanations. With the analysis of [Wright, L. (1976). Teleological Explanations. Berkeley, CA: University of California Press] from philosophy as a point of departure, we examine (...) in Experiment 1 whether teleological explanations are interpreted causally, and confirm that TEs are only accepted when the function invoked in the explanation played a causal role in bringing about what is being explained. However, we also find that playing a causal role is not sufficient for all participants to accept TEs. Experiment 2 shows that this is not because participants fail to appreciate the causal structure of the scenarios used as stimuli. In Experiments 3-5 we show that the additional requirement for TE acceptance is that the process by which the function played a causal role must be general in the sense of conforming to a predictable pattern. These findings motivate a proposal, Explanation for Export, which suggests that a psychological function of explanation is to highlight information likely to subserve future prediction and intervention. We relate our proposal to normative accounts of explanation from philosophy of science, as well as to claims from psychology and artificial intelligence. (shrink)

Traditional approaches to moral psychology assumed that moral judgments resulted from the application of explicit commitments, such as those embodied in consequentialist or deontological philosophies. In contrast, recent work suggests that moral judgments often result from unconscious or emotional processes, with explicit commitments generated post hoc. This paper explores the intermediate position that moral commitments mediate moral judgments, but not through their explicit and consistent application in the course of judgment. An experiment with 336 participants finds that individuals vary in (...) the extent to which their moral commitments are consequentialist or deontological, and that this variation is systematically but imperfectly related to the moral judgments elicited by trolley car problems. Consequentialist participants find action in trolley car scenarios more permissible than do deontologists, and only consequentialists moderate their judgments when scenarios that typically elicit different intuitions are presented side by side. The findings emphasize the need for a theory of moral reasoning that can accommodate both the associations and dissociations between moral commitments and moral judgments. (shrink)

Scientific and ‘intuitive’ or ‘folk’ theories are typically characterized as serving three critical functions: prediction, explanation, and control. While prediction and control have clear instrumental value, the value of explanation is less transparent. This paper reviews an emerging body of research from the cognitive sciences suggesting that the process of seeking, generating, and evaluating explanations in fact contributes to future prediction and control, albeit indirectly by facilitating the discovery and confirmation of instrumentally valuable theories. Theoretical and empirical considerations also suggest (...) why explanations may nonetheless feel intrinsically valuable. The paper concludes by considering some implications of the psychology of explanation for a naturalized philosophy of explanation. (shrink)

The issue of how to incorporate the individual's first‐hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces and (...) suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in‐depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions. (shrink)

In his book Doing Without Concepts, Edouard Machery argues that cognitive scientists should reject the concept of “concept” as a natural, psychological kind. I review and critique several of Machery’s arguments, focusing on his definition of “concept” and on claims against the possibility and utility of a unified account of concepts. In particular, I suggest ways in which prototype, exemplar, and theory-theory approaches to concepts might be integrated.

Recent theoretical and empirical work suggests that explanation and categorization are intimately related. This paper explores the hypothesis that explanations can help structure conceptual representations, and thereby influence the relative importance of features in categorization decisions. In particular, features may be differentially important depending on the role they play in explaining other features or aspects of category membership. Two experiments manipulate whether a feature is explained mechanistically, by appeal to proximate causes, or functionally, by appeal to a function or goal. (...) Explanation type has a significant impact on the relative importance of features in subsequent categorization judgments, with functional explanations reversing previously documented effects of [”]causal status’. The findings suggest that a feature’s explanatory importance can impact categorization, and that explanatory relationships, in addition to causal relationships, are critical to understanding conceptual representation. (shrink)

The ability to generalize from the known to the unknown is central to learning and inference. Two experiments explore the relationship between how a property is explained and how that property is generalized to novel species and artifacts. The experiments contrast the consequences of explaining a property mechanistically, by appeal to parts and processes, with the consequences of explaining the property functionally, by appeal to functions and goals. The findings suggest that properties that are explained functionally are more likely to (...) be generalized on the basis of shared functions, with a weaker relationship between mechanistic explanations and generalization on the basis of shared parts and processes. The influence of explanation type on generalization holds even though all participants are provided with the same mechanistic and functional information, and whether an explanation type is freely generated (Experiment 1), experimentally provided (Experiment 2), or experimentally induced (Experiment 2). The experiments also demonstrate that explanations and generalizations of a particular type (mechanistic or functional) can be experimentally induced by providing sample explanations of that type, with a comparable effect when the sample explanations come from the same domain or from a different domains. These results suggest that explanations serve as a guide to generalization, and contribute to a growing body of work supporting the value of distinguishing mechanistic and functional explanations. (shrink)

In pedagogical contexts and in everyday life, we often come to believe something because it would best explain the data. What is it about the explanatory endeavor that makes it essential to everyday learning and to scientific progress? There are at least two plausible answers. On one view, there is something special about having true explanations. This view is highly intuitive: it’s clear why true explanations might improve one’s epistemic position. However, there is another possibility—it could be that the process (...) of seeking, generating, or evaluating explanations itself puts one in a better epistemic position, even when the outcome of the process is not a true explanation. In other words, it could be that accurate explanations are beneficial, or it could be that high-quality explaining is beneficial, where there is something about the activity of looking for an explanation that improves our epistemic standing. The main goal of this paper is to tease apart these two possibilities, both theoretically and empirically, which we align with “Inference to the Best Explanation” and “Explaining for the Best Inference”, respectively. We also provide some initial support for EBI and identify promising directions for future research. (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

In a world plagued by disagreement and conflict one might expect that the exact sciences of logic and mathematics would provide a safe harbor. In fact these disciplines are rife with internal divisions between different, often incompatible, systems. Do these disagreements admit of resolution? Can such resolution be achieved without disturbing assumptions that the theorems of logic and mathematics state objective truths about the real world? In this original and historically rich book John Woods explores apparently intractable disagreements in (...) logic and the foundations of mathematics and sets out conflict resolution strategies that evade or disarm these stalemates. An important sub-theme of the book is the extent to which pluralism in logic and the philosophy of mathematics undermines realist assumptions. This book makes an important contribution to such areas of philosophy as logic, philosophy of language and argumentation theory. It will also be of interest to mathematicians and computer scientists. (shrink)

Use of electronic health records within clinical encounters is increasingly pervasive. The digital record allows for data storage and sharing to facilitate patient care, billing, research, patient communication and quality-of-care improvement—all at once. However, this multifunctionality is also one of the main reasons care providers struggle with the EHR. These problems have often been described but are rarely approached from a philosophical point of view. We argue that a postphenomenological case study of the EHR could lead to more in-depth insights. (...) We will focus on two concepts—transparency and multistability—and translate them to the specific situation of the EHR. Transparency is closely related to an embodiment relation in which the user becomes less aware of the technology: it fades into the background, becoming a means of experience. A second key concept is that of multistability, referring to how a technology can serve multiple purposes or can have different meanings in different contexts. The EHR in this sense is multistable by design. Future EHR design could incorporate multistable information differently, allowing the provider to focus on patient care when interacting with the EHR. Moreover we argue that the use of the EHR in the daily workflow should become more transparent, while awareness of the computer in the specific context of the patient-provider relationship should increase. (shrink)

Information and computer technology has come to play an increasingly important role in medicine, to the extent that e-health has been described as a disruptive innovation or revolution in healthcare. The attention is very much focused on the technology itself, and advances that have been made in genetics and biology. This leads to the question: What is changing in medicine today concerning e-health? To what degree could these changes be characterized as a ‘revolution’? We will apply the work of Thomas (...) Kuhn, Larry Laudan, Michel Foucault and other philosophers—which offers an alternative understanding of progress and revolution in medicine to the classic discovery-oriented approach—to our analysis. Nowadays, the long-standing curative or reactive paradigm in medicine is facing a crisis due to an aging population, a significant increase in chronic diseases and the development of more expensive diagnostic tools and therapies. This promotes the evolution towards a new paradigm with an emphasis on preventive medicine. E-health constitutes an essential part of this new paradigm that seeks to solve the challenges presented by an aging population, skyrocketing costs and so forth. Our approach changes the focus from the technology itself toward the underlying paradigm shift in medicine. We will discuss the relevance of this approach by applying it to the surge in digital self-tracking through health apps and wearables: the recognition of the underlying paradigm shift leads to a more comprehensive understanding of self-tracking than a solely discovery-oriented or technology-focused view can provide. (shrink)

Conditionals has at its center an extended essay on this problematic and much-debated subject in the philosophy of language and logic, which the widely respected Oxford philosopher Michael Woods had been preparing for publication at the time of his death in 1993. It appears here edited by his eminent colleague David Wiggins, and is accompanied by a commentary specially written by a leading expert on the topic, Dorothy Edgington. This masterly and original treatment of conditionals will demand the attention (...) of all philosophers working in this area. (shrink)

Assisted suicide, many argue, honors self‐determination in returning control of their dying to patients themselves. But physician assistance and measures proposed to safeguard patients from coercion in fact return ultimate authority over this “private and deeply personal” decision to medicine and society.

Educational policy and social sciences researchers have been studying dishonest behaviors among students for a long time. In this bibliometric study we examine the extant literature on academic dishonesty until 2017. We also analyze the specific case of the literature on plagiarism since it is arguably one of the most common academic dishonest behavior. We aim at identifying the intellectual structure of the field of academic dishonesty and plagiarism. Results show that Donald L. McCabe and Richard L. Marsh appear as (...) the most productive authors. Furthermore, Whitley, 235–274, 1998) “Factors associated with cheating among college students: A review”, and Pennycook, 201–230, 1996), entitled “Borrowing others’ words: Text, ownership, memory, and plagiarism” are the most cited publications on academic dishonesty and on plagiarism, respectively. Additionally, a strong connection between the McCabe and Treviño articles emerged from the co-citation analysis on academic dishonesty, and also a strong relationship between Pennycook, 201–230, 1996) and Pecorari, 317–345, 2003), suggesting that these articles are strongly connected. Results suggest that these are the most influential authors and articles of the field. (shrink)

This paper proposes two interrelated arguments: first, it is argued that agro-commodity traders are uniquely placed at the crossroads of agricultural trade to benefit from agricultural commodity speculation; and second, that the networks constituting their operations are central to their hedging activities. The case of Cargill—the largest privately owned company in the United States and one of the largest agricultural traders in the world—is used to support this argument by unpacking its operations, structure, and hedging strategies. In order to connect (...) the operations of Cargill to its speculating strategies, this paper first traces how agriculture and finance have become increasingly intertwined leading to heightened agricultural commodity speculation. Second, Cargill will be positioned within this process by analyzing how it has financialized its own strategies and its Corporate Platform. Third, Black River Asset Management, Cargill’s private equity arm, will be analyzed to show how it uses the information moving through Cargill’s Platform to engage in hedging and/or speculation. (shrink)

Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and (...) ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns. (shrink)

We explore how principles predicting the success of a medical information commons advantaged or disadvantaged three MIC initiatives in three Canadian provinces. Our MIC case examples demonstrate that practices and policies to promote access to and use of health information can help improve individual healthcare and inform a learning health system. MICs were constrained by heterogenous health information protection laws across jurisdictions and risk-averse institutional cultures. A networked approach to MICs would unlock even more potential for national and international data (...) collaborations to improve health and healthcare. (shrink)

The understanding of a wide array of practices related to fraud, bribery, corruption, and more widely, illicit practices have been capturing the attention of practitioners and management researchers worldwide. A substantial portion of the extant research has used university students to measure their actual or intended cheating behaviours and often studies have tested for variations across countries and cultures. We highlight some major concerns in this stream of inquiry and discuss both the definition and some inconclusive results in prior studies, (...) namely those deriving from differences in cheating behaviour across different cultural contexts. We suggest the need to examine intentionality, and further advance that intentionality may assume a reactive or a proactive essence. Depending on the social and formal contexts of different countries, both reactive and proactive intentions lead to distinct moral concerns, which we name in this work omorality (meaning ‘our morality’) or immorality (in the traditional sense). (shrink)

Knobe considers two explanations for the influence of moral considerations on cognitive systems: the position, and the position. We suggest that this dichotomy conflates questions at computational and algorithmic levels, and suggest that distinguishing the issues at these levels reveals a third, viable option, which we call the position.

ObjectiveAre people with a characteristically large physiological sway rendered particularly unstable when standing on a moving surface? Is postural sway in standing individuals idiosyncratic? In this study, we examine postural sway in individuals standing normally, and when subtle continuous sinusoidal disturbances are applied to their support platform. We calculate consistency between conditions to verify if sway can be considered characteristic of each individual. We also correlate two different aspects of participants’ responses to disturbance; their sway velocity and their regulation of (...) body orientation.MethodsNineteen healthy adults (age 29.2 ± 3.2 years) stood freely on footplates coaxially aligned with their ankles and attached to a motorized platform. They had their eyes closed, and hips and knees locked with a light wooden board attached to their body. Participants either stood quietly on a fixed platform or on a slowly tilting platform (0.1 Hz sinusoid; 0.2 and 0.4 deg). Postural sway size was separated into two entities: (1) the spontaneous sway velocity component (natural random relatively rapid postural adjustments, RMS body angular velocity) and (2) the evoked tilt gain component (much slower 0.1 Hz synchronous tilt induced by the movement of the platform, measured as peak-to-peak (p-p) gain, ratio of body angle to applied footplate rotation).ResultsThere was no correlation between the velocity of an individual’s sway and their evoked tilt gain (r= 0.34,p= 0.15 andr= 0.30,p= 0.22). However, when considered separately, each of the two measurements showed fair to good absolute agreement within conditions. Spontaneous sway velocity consistently increased as participants were subjected to increasing disturbance. Participants who swayed more (or less) did so across all conditions [ICC(3,k)= 0.95]. Evoked tilt gain also showed consistency between conditions [ICC(3,k)= 0.79], but decreased from least to most disturbed conditions.ConclusionThe two measurements remain consistent between conditions. Consistency between conditions of two very distinct unrelated measurements reflects the idiosyncratic nature of postural sway. However, sway velocity and tilt gain are not related, which supports the idea that the short-term regulation of stability and the longer-term regulation of orientation are controlled by different processes. (shrink)

The new interdisciplinary field of experimental philosophy has emerged as the methods of psychological science have been brought to bear on traditional philosophical issues. Oxford Studies in Experimental Philosophy is the place to go to see outstanding new work in the field, by both philosophers and psychologists.

Wonach streben wir am meisten im Leben? Liebe, Glück, Gesundheit – oder vielleicht Erklärungen? Für die Psychologin und Philosophin Tania Lombrozo sind Warum-Fragen die Triebfedern des Denkens.

Recent expansions of federal and state law enforcement databanks to include DNA samples and profiles of innocent persons threaten individual privacy, impose unjustifiable costs on society, and may undermine our pursuit of justice. The move to permanently retain DNA from arrestees and proposals for a universal database should be vigorously opposed on matters of principle, legality, and practicality.

Expressivists explain the expression relation which obtains between sincere moral assertion and the conative or affective attitude thereby expressed by appeal to the relation which obtains between sincere assertion and belief. In fact, they often explicitly take the relation between moral assertion and their favored conative or affective attitude to be exactly the same as the relation between assertion and the belief thereby expressed. If this is correct, then we can use the identity of the expression relation in the two (...) cases to test the expressivist account as a descriptive or hermeneutic account of moral discourse. I formulate one such test, drawing on a standard explanation of Moore's paradox. I show that if expressivism is correct as a descriptive account of moral discourse, then we should expect versions of Moore's paradox where we explicitly deny that we possess certain affective or conative attitudes. I then argue that the constructions that mirror Moore's paradox are not incoherent. It follows that expressivism is either incorrect as a hermeneutic account of moral discourse or that the expression relation which holds between sincere moral assertion and affective or conative attitudes is not identical to the relation which holds between sincere non-moral assertion and belief. A number of objections are canvassed and rejected. (shrink)

. On June 13, 2013, the Supreme Court issued a unanimous decision in Association for Molecular Pathology v. Myriad Genetics, holding that a naturally occurring DNA segment that has merely been “isolated” is not patent eligible, and effectively overturning a longstanding policy that had allowed for patents to be issued on thousands of human genes. Drawing largely on the expert testimony and arguments presented during the court proceedings, this paper provides an overview of the discovery and patenting of the BRCA1 (...) and BRCA2 genes at issue in the case, the impacts of gene patents on biomedical research and innovation and clinical practice, and the legal analysis presented by the plaintiffs throughout the case for how patents issued on genes violate the Patent Act and the U.S. Constitution. Finally, it discusses how the Court’s decision in this case marked an extraordinary victory not only for the plaintiffs directly involved, but more generally for women, patients, researchers, civil liberties, and the future of medicine. (shrink)

On November 2, 2004, California voters elected to radically expand their state criminal DNA database through the passage of Proposition 69. The approved ballot initiative authorized DNA collection and retention from all felons, any individuals with past felony convictions – including juveniles – and, beginning in 2009, all adults arrested for any felony offense. This dramatic database expansion threatens civil liberties and establishes a dangerous precedent for U.S. criminal databases.

A book chapter exploring the potential consquences and ethical ramifications of using coercive measures within community mental healthcare. We argue that, althogh the move towards 'care in the community' may have had liberalising motivations, the subsequent reduction in inpatient or other supported residential provision, means that there has been an increasing move towards coercive measures outside of formal inpatient detention. We consider measures such as Community Treatment Orders, inducements, and other forms of leverage, explaining the underlying concepts, aims, and exploring (...) adverse consequences and ethical difficulties. (shrink)

Musicians generally believe that memory differs from one person to the next. As a result, memorizing strategies that could be useful to almost everyone are not widely taught. We describe how an 18-years old piano student (Grade 7, ABRSM), learned to memorize by recording her thoughts, a technique inspired by studies of how experienced soloists memorize. The student, who had previously ignored suggestions that she play from memory, decided to learn to memorize, selecting Schumann’s “Der Dichter Spricht” for this purpose. (...) Rather than explicitly teaching the student how to memorize, the teacher taught her to record her thoughts while playing by marking them on copies of the score, adapting an approach used previously in research with experienced performers. Over a 6½ week period, the student recorded her thoughts during practice (five times) and while performing from memory for the teacher (three times). The student also video-recorded 3 weeks of practice, three performances, and the reconstruction of the piece from memory after a 9½-weeks break. The thoughts that the student reported were prepared during practice, stable over time, and functioned as memory retrieval cues during reconstruction. This suggests that the student memorized in the same way as the more experienced musicians who have been studied previously and that teaching student musicians to record their thoughts may be an effective way to help them memorize. The speed and durability of her memorization surprised the student, inspiring her to perform in public and to use the same technique for new pieces. (shrink)

Despite extensive evidence for its effectiveness, ECT remains the subject of fierce opposition from those contesting its benefits and claiming extreme harms. Alongside some reflections on my experiences of this treatment, I examine the case against ECT, and find that it appears to rest primarily on unsubstantiated claims about major ethical violations, rather than clinical factors such as effectiveness and risk.

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts (...) to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. (shrink)

This article explores and critically contextualises the photographic production of heliotherapist Auguste Rollier (1874–1954), specifically the ‘patient portraits’ photographed at his Leysin sanatoria over a substantial period of four decades, c.1903–1944. It argues that these photographs, ignored in secondary literature, were particularly persuasive in communicating the natural healing powers of sunlight and through their international dissemination brought Rollier's work professional acclaim and prestige. Always presenting anonymous patients, and most often children, the images produced for Rollier's work interweave aesthetic and medical (...) interests. Whether through the aesthetics of the photograph, of the positioning and appearance of the patient's body, or of the language used to describe these, issues of beauty and harmony were significant preoccupations for Rollier and the dissemination of his heliotherapeutic practice. The article argues that these aesthetic preoccupations drove his work, that the patient's progress and final cure, and thus the therapy's efficacy, were determined by aesthetic criteria—read through the body itself and its photographic representation. This legibility, of the body and its photography, was crucial to articulating the sun's perceived natural ability to improve, heal and even ‘rebuild’ individual patients into socially and physically productive citizens. As such, the article contends, Rollier privileged image over word, conceiving the former as possessing an unequalled ‘eloquence’ to communicate the efficacy and social potential of heliotherapy. (shrink)

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (shrink)

This article explores the hermeneutical force and flexibility of the 9/11 idiom, by identifying some ways in which it served as an interpretative framework for the attacks of 26 November 2008 in Mumbai. The idiom’s transposition to Mumbai represented, in part, a contest over American rhetorical capital. Re-territorialized as ‘India’s 9/11’, the idiom has re-signified a range of local interests, aspirations, and contests over urban space and identity in Mumbai. In this context, I examine two symmetrical developments within the civic (...) spaces of the city in the immediate aftermath. The first involves the emergence of an upwardly mobile middle class and elite as it took the form of collective survivor-spectator, appearing as a coherent, highly visible and effective public agent. The second involves an apparent suspension of competing narratives of urban terror, which in the past have been enacted through demotic violence in the form of the communal riot. The article suggests that these developments in Mumbai must be read through the city’s incorporation into an emergent narrative of ‘global’ or so-called ‘9/11-type’ terror. In the case of 26/11, the terrorist attacks were possibly understood as the exercise of ideological indifference to identity, as levelling the value and distinction of moral communities to the abject experience of sheer bodily life. (shrink)

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH (...) at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

Explanation has been an important topic of study in philosophy of science, in epistemology, and in other areas of philosophy. In parallel, psychologists have been studying children's and adults’ explanations, including their role in inference and in learning. This entry reviews recent work that begins to bridge the philosophy and psychology of explanation, with sections introducing recent empirical work on explanation by philosophers, formal and functional accounts of explanation, inference to the best explanation, the role of explanation in discovery, and (...) the implications of empirical work on explanation for the “negative program” in experimental philosophy. (shrink)

This essay positions the figure and thought of T.W. Adorno in relation to Mulk Raj Anand, and the latter’s foundational contributions to the modern Indian novel in English. In Adorno’s musical writings, “late style” features as a methodological premise, or an expository mode that removes the work from conventional norms of evaluation. Late style is directed especially toward canonized works that seem to lack current artistic or social relevance, despite their culturally privileged standing. The essay approaches Adorno and Anand, accordingly: (...) Their affiliations with European modernism and postcolonial realism, respectively, are read in late style, or, as largely obsoleted formations of the previous century. Focussing on Anand’s historical fiction, Across the Black Waters, my essay recuperates the novel’s vision of a single if internally differentiated twentieth-century: By imagining the Great War as world-historical crisis, Anand’s novel stage... (shrink)

The vast majority of research in nursing ethics over the last decade indicates that nurses may not be fully prepared to ‘deliver the good(s)’ for their patients, or to contribute appropriately in the wider current health care climate. When suitable research projects were evaluated for this article, one key question emerged: if nurses are educationally better prepared than ever before to exercise their ethical decision-making skills, why does research still indicate that the expected practice-based improvements remain elusive? Hence, a number (...) of ideas gleaned from recent research about the current nature of nursing ethics, and especially teaching nursing ethics to student nurses, are analysed and critiqued in this article, which concludes with a cluster of ideas and conclusions based on that analysis. It is hoped that such a review may serve as a catalyst for nurse educators to re-examine their teaching practices with a view to enhancing good (i.e. ethical) nursing practice through educational means. (shrink)