The practice of covertly administering medication is controversial. Although condemned by some as overly paternalistic, others have suggested that it may be acceptable if patients have permanent mental incapacity and refuse needed treatment. Ethical, legal, and clinical considerations become more complex when the mental incapacity is temporary and when the medication actually serves to restore autonomy. We discuss these issues in the context of a young man with schizophrenia. His mother had been giving him antipsychotic medication covertly in his soup. (...) Should the doctor continue to provide a prescription, thus allowing this to continue? We discuss this case based on the “four principles” ethical framework, addressing the conflict between autonomy and beneficence/non-maleficence, the role of antipsychotics as an autonomy restoring agent, truth telling and the balance between individual versus family autonomy. (shrink)

In this essay, I introduce the symposium on Jordan Wessling’s book, Love Divine: A Systematic Account of God’s Love for Humanity, by discussing its origin as a book panel, providing the context for the significance of Wessling’s contribution, and previewing the essays that follow.

Trenton Merricks has objected to dualist conceptions of the Incarnation in a similar way to Jaegwon Kim’s pairing problem. On the original pairing problem, so argues Kim, we lack a pairing relationship between bodies and souls such that body A is causally paired with soul A and not soul B. Merricks, on the other hand, argues that whatever relations dualists propose that do pair bodies and souls together (e.g. causal relations) are relations that God the Son has with all bodies (...) whatsoever via his divine attributes (e.g. God the Son could cause motion in any and all bodies via his omnipotence). So if we count these relations as sufficient for embodiment, then dualism implies that God the Son is embodied in all bodies whatsoever. I shall argue that while the original pairing problem might be easily answerable, the Christological pairing problem is not and that dualists must shift some of their focus from the defense of the soul’s existence to explicating the nature of the mind-body relationship. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Background: Freezing of gait is a common symptom in Parkinson’s disease and can be difficult to treat with dopaminergic medications or with deep brain stimulation. Novel stimulation paradigms have been proposed to address suboptimal responses to conventional DBS programming methods. Burst-cycling deep brain stimulation delivers current in various frequencies of bursts, while maintaining an intra-burst frequency identical to conventional DBS.Objective: To evaluate the safety and tolerability of BCDBS in PD patients with FOG.Methods: Ten PD subjects with STN or GPi DBS (...) and complaints of FOG were recruited for this single center, single blinded within-subject crossover study. For each subject, we compared 4, 10, and 15 Hz BCDBS to conventional DBS during the PD medication-OFF state.Results: There were no serious adverse events with BCDBS. It was feasible and straightforward to program BCDBS in the clinic setting. The benefit was comparable to conventional DBS in measures of FOG, functional mobility and in PD motor symptoms. BCDBS had lower battery consumption when compared to conventional DBS.Conclusions: BCDBS was feasible, safe and well tolerated and it has potential to be a viable future DBS programming strategy. (shrink)

The etiology of visual hallucinations is largely undetermined in schizophrenia. Collerton et al.'s PAD model partly concurs with what we know about neurocognition in schizophrenia, but we need to specify the types of perceptual and attentional abnormalities that are implicated in recurrent complex visual hallucinations (RCVH). Available data suggest that abnormal attentional control and top-down processing play a larger role than the ventral stream deficits.

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)

ObjectiveTo prospectively study the cingulate cortex for the localization and role of the grasping action in humans during electrical stimulation of depth electrodes.MethodsAll the patients with intractable focal epilepsy and a depth electrode stereotactically placed in the cingulate cortex, as part of their pre-surgical epilepsy evaluation from 2015 to 2017, were included. Cortical stimulation was performed and examined for grasping actions. Post-implantation volumetric T1 MRIs were co-registered to determine the exact electrode position.ResultsFive patients exhibited contralateral grasping actions during electrical stimulation. (...) All patients had electrodes implanted in the ventral bank of the right cingulate sulcus adjacent to the vertical anterior commissure line. Stimulation of other electrodes in adjacent regions did not elicit grasping.ConclusionGrasping action elicited from a localized region in the mid-cingulate cortex directly supports the concept of the cingulate cortex being crucially involved in the grasping network. This opens an opportunity to explore this region with deep brain stimulation as a motor neuromodulation target for treatment in specific movement disorders or neurorehabilitation. (shrink)

According to Kant, we refer to what is out there in the world by performing a demonstrative act, like pointing at an object with a finger. A Kantian mode of demonstrative reference is characterized by the existence of a real, 2-placed affective relation between an intuiting subject and the referent. Parsons suggests that Kantian intuition is both singular and immediate, and immediacy demands an object of intuition to be present, a condition clearly satisfied by objects within our immediate perceptual field. (...) But since we do not have an immediate relation with remote objects, the scope of our demonstrative reference is severely restricted by intuitional immediacy. I wish to develop a global Kantian intuition in order to extend the scope of demonstrative reference. Kant's ontology of space entails that the global representability of space be given to an intuiting subject as a form of intuition. According to Melnick, Kantian intuition is a kinematic operation which involves directing attention and moving about. To make contact with the world, the subject must move away from its locale: although a spatially remote object is not immediately present, we can shift our location by taking a path such that W will become so. Once we are close enough to be affected by W, we will be able to point at W and say "This." Thus, the intuitive scope of demonstrative reference is globalized as we shift our location. (shrink)

Background: Ethical nursing practice is increasingly challenging, and strategies for addressing ethical dilemmas are needed to support nurses’ ethical care provision. Conscientious objection is one such strategy for addressing nurses’ personal, ethical conflicts, at times associated with conscience. Exploring both conscience and conscientious objection provides understanding regarding their implications for ethical nursing practice, research, and education. Research aim: To analyze the concepts of conscience and conscientious objection in the context of nurses. Design: Concept analysis using the method by Walker and (...) Avant. Research context: Data were retrieved from Philosopher’s Index, PubMed, and CINAHL with no date restrictions. Ethical consideration: This analysis was carried out per established, scientific guidelines. Findings: Ethical concepts are integral to nursing ethics, yet little is known about conscientious objection in relation to conscience for nurses. Of note, both concepts are well established in ethics literature, addressed in various nursing codes of ethics and regulatory bodies, but the meaning they hold for nurses and the impact they have on nursing education and practice remain unclear. Discussion and conclusion: This article discusses the relevance of conscience and conscientious objection to ethical nursing practice and proposes a model case to show how they can be appreciated in the context of nurses. Conscientious objection is an option for ethical transparency for nurses but is situated in contentious discussions over its use and has yet to be fully understood for nursing practice. Conscience is an element in need of more exploration in the context of conscientious objection. Further research is warranted to understand how nurses respond to conscience concerns in morally, pluralistic nursing contexts. (shrink)

Drawing on the behavioral theory, this study examines how the misalignment between a firm's environmental effort and the level of subsidies received from the government in affecting the firm's investment in non-environmental R&D. Based on a sample of Chinese A-share listed firms from 2008 to 2019 and using polynomial regression techniques, our findings reveal that firms in the “low effort-high subsidies” group exhibit lower non-environmental R&D intensity compared to firms in the “high effort-low subsidies” group. This study contributes to the (...) literature by shedding light on the interplay between corporate environmental efforts, government subsidies, and non-environmental R&D investment. The findings suggest the importance of aligning the environmental efforts of firms with subsidy levels from the government to effectively allocate resources for different types of R&D. The implications of this research suggest that firms should carefully consider aligning their environmental efforts with government subsidies to optimize their investment in non-environmental R&D and overall innovation strategy. Furthermore, the study indicates that firms and governments should prudently balance the relationship between environmental R&D and non-environmental R&D to avoid any negative impact on the latter. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were statistically (...) significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

That conditional, if-then reasoning does not emerge until 4–5 years has long been accepted. Here we show that children barely 3 years old can do conditional reasoning. All that was needed was a superficial change to the stimuli: When color was a property of the shapes rather than of the background, 3-year-olds could succeed. Three-year-olds do not seem to use color to inform them which shape is correct unless color is a property of the shapes themselves. While CD requires integrating (...) color and shape information, the dimensional change card sort task requires keeping those dimension cognitively separate – inhibiting attention to one when sorting by the other. For DCCS, a superficial change to the stimuli that is the inverse of what helps on CD enables 3-year-olds to succeed when normally they do not until ∼4⁤12 years. As we and others have previously shown, 3-year-olds can succeed at DCCS when color is a property of the background, instead of a property of the stimulus. Our findings on CD and DCCS suggest that scaffolding preschoolers’ emerging conceptual skills by changing the way stimuli look enables 3-year-olds to demonstrate reasoning abilities long thought beyond their grasp. Evidently, children of 3 years have difficulty mentally separating dimensions of the same object and difficulty mentally integrating dimensions not part of the same object. Our present CD findings plus our earlier DCCS findings provide strong evidence against prominent cognitive complexity, conditional reasoning, and graded memory theories for why 3-year-olds fail these two tasks. The ways we have traditionally queried children may have obscured the budding reasoning competencies present at 3 years of age. (shrink)

Human motor learning is governed by a suite of interacting mechanisms each one of which modifies behavior in distinct ways and rely on different neural circuits. In recent years, much attention has been given to one type of motor learning, called motor adaptation. Here, the field has generally focused on the interactions of three mechanisms: sensory prediction error SPE-driven, explicit, and reinforcement learning. Studies of these mechanisms have largely treated them as modular, aiming to model how the outputs of each (...) are combined in the production of overt behavior. However, when examined closely the results of some studies also suggest the existence of additional interactions between the sub-components of each learning mechanism. In this perspective, we propose that these sub-component interactions represent a critical means through which different motor learning mechanisms are combined to produce movement; understanding such interactions is critical to advancing our knowledge of how humans learn new behaviors. We review current literature studying interactions between SPE-driven, explicit, and reinforcement mechanisms of motor learning. We then present evidence of sub-component interactions between SPE-driven and reinforcement learning as well as between SPE-driven and explicit learning from studies of people with cerebellar degeneration. Finally, we discuss the implications of interactions between learning mechanism sub-components for future research in human motor learning. (shrink)

I argue that the contextualist anti-skeptical strategy fails because it misconstrues skepticism by overlooking two important aspects of skepticism: first, all of our knowledge of the external world is brought into question at one fell swoop; second, skepticism depends on certain ideas about sense-perception and its role in our knowledge of the world. Contextualists may have solved ‘the skeptical paradox’ in their own terms, but such a solution cannot in any way make skepticism less threatening to human knowledge or to (...) the philosophical understanding of human knowledge. I also discuss some important aspects of the practice of knowledge attribution in order to show that the more we can make sense of particular knowledge attributions, the less we can take skepticism seriously, and that the practice of knowledge attribution as we understand and engage in it presupposes that we have knowledge of the world. (shrink)

Purpose: The aim of this research was to test whether Hong Kong science students would prefer a learning environment based on critical constructivism and whether a closer preferred-actual fit to such an environment would be associated with better learning outcomes. Method: The participants were 149 Hong Kong secondary school Chemistry students aged 16--19 years. They completed actual and preferred forms of a Chinese version of the Constructivist Learning Environment Survey and measures of self-efficacy and intrinsic value of their Chemistry course. (...) Their Chemistry examination scores were also obtained at the end of the course. Findings: Analysis showed that these students would prefer their Chemistry classrooms to be more personally relevant, to allow students more say and to share more control, and to encourage more negotiation with their teacher. Regression surface analysis showed that congruence of person environment fit did not influence examination results but was associated with greater valuing of the course and higher student self-efficacy. Research implications: Further research with a wider sampling from Hong Kong and elsewhere and focusing on other subject areas will be necessary to assess the generalizability of these findings. Practical implications: It seems that educational reforms based on critical constructivist principles may be of value in non-Western contexts. Original value: Educational reforms in Hong Kong and elsewhere currently are based on traditional constructivist principles. But this is the first research to support a more radical approach in what is usually regarded as a relatively conservative Asian educational context. (shrink)

I thought the paper by Kai-yee Wong and Chris Fraser was fascinating and insightful. Two things I especially appreciated are the clarity with which they summarize my views. I think they are quite fair and accurate. Second, I appreciate their suggestion that the way to deal with the practical problem of weakness of will has much to do with the role of the Background in shaping our actions. I think they are especially on the right track when they say (...) that the improvement of Background skills may actually narrow the range of real options for action, (p. 21) nonetheless, they do not decrease freedom. As they say, “It is a process of strengthening the self, and the agent is likely to experience the concomitant restriction of ‘live’ options not as a limitation but as strength of character.” (p. 21). That seems to me very much on the right track. What they are suggesting, and it is a powerful addition to my own writings, is that we should not just think of the Background as facilitating languages, games and social practices generally, but for morality as well (p. 23). (shrink)

David B. Wong proposes that there can be a plurality of true moralities, moralities that exist across different traditions and cultures, all of which address facets of the same problem: how we are to live well together. Wong examines a wide array of positions and texts within the Western canon as well as in Chinese philosophy, and draws on philosophy, psychology, evolutionary theory, history, and literature, to make a case for the importance of pluralism in moral life, and (...) to establish the virtues of acceptance and accommodation. Wong's point is that there is no single value or principle or ordering of values and principles that offers a uniquely true path for human living, but variations according to different contexts that carry within them a common core of human values. We should thus be modest about our own morality, learn from other approaches, and accommodate different practices in our pluralistic society. (shrink)

This essay explains the inescapability of moral demands. I deny that the individual has genuine reason to comply with these demands only if she has desires that would be served by doing so. Rather, the learning of moral reasons helps to shape and channel self- and other-interested motivations so as to facilitate and promote social cooperation. This shaping happens through the “embedding” of reasons in the intentional objects of motivational propensities. The dominance of the instrumental conception of reason, according to (...) which reasons must be based in desires of the individual, has made it harder to recognize that reasons shape desires. I attempt to undermine this dominance by arguing that the concept of a self that extends over time is constructed to meet the demands of social cooperation. Prudential reasons to act on behalf of the persisting self's desires are often taken to constitute the paradigm of reasons based on desires of the individual. But such reasons, along with the very concept of the persisting self, are constructed to promote human cooperation and to shape the individual's desires. (shrink)

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1984.

The practice of critical care medicine has long been a difficult task for most critical care physicians in the densely populated city of Hong Kong, where we face limited resources and a limited number of intensive care beds. Our triage decisions are largely based on the potential of functional reversibility of the patients. Provision of graded care beds may help to relieve some of the demands on the intensive care beds. Decisions to forego futile medical treatment are frequently physician-guided family-based (...) decisions, which is quite contrary to the Western focus on patient autonomy. However, as people acquire knowledge about health care and they become more aware of individual rights, our critical care doctors will be able to narrow the gaps between the dif ferent concepts of medical ethics among our professionals as well as in our society. An open and caring attitude from our intensivists will be important in minimizing the cross-cultural conflict on the complex issue of medical futility. (shrink)

Perhaps the central focus of American bioethics has been to push against medical paternalism on the grounds that it impedes the autonomy of patients—that is, their ability to make choices of their...

Three distinct but related questions can be asked about the meaningfulness of one's life. The first is 'What is the meaning of life?', which can be called 'the cosmic question about meaningfulness'; the second is 'What is a meaningful life?', which can be called 'the general question about meaningfulness'; and the third is 'What is the meaning of my life?', which can be called 'the personal question about meaningfulness'. I argue that in order to deal with all three questions we (...) should start with the personal question. There is a way of understanding the personal question which allows us to answer it independently of any consideration of the cosmic question, but which nonetheless helps us see why the cosmic question should be dismissed as a bad question. Besides, a recommendable answer to the general question can be derived from my understanding of how the personal question should be answered. Two notions are essential to my account, namely, the notion of identities and the notion of a biographical life. And the account can be epitomized in this enticing way: a person's life is meaningful if it contains material for an autobiography that she thinks is worth writing and others think is worth reading. (shrink)

Depression is vastly heterogeneous in its symptoms, neuroimaging data, and treatment responses. As such, describing how it develops at the network level has been notoriously difficult. In an attempt to overcome this issue, a theoretical “negative prediction mechanism” is proposed. Here, eight key brain regions are connected in a transient, state-dependent, core network of pathological communication that could facilitate the development of depressive cognition. In the context of predictive processing, it is suggested that this mechanism is activated as a response (...) to negative/adverse stimuli in the external and/or internal environment that exceed a vulnerable individual’s capacity for cognitive appraisal. Specifically, repeated activation across this network is proposed to update an individual’s brain so that it increasingly predicts and reinforces negative experiences over time—pushing an individual at-risk for or suffering from depression deeper into mental illness. Within this, the negative prediction mechanism is poised to explain various aspects of prognostic outcome, describing how depression might ebb and flow over multiple timescales in a dynamically changing, complex environment. (shrink)

What is the significance of bodily awareness for bodily action? The orthodox philosophical account from O'Shaughnessy claims that bodily awareness is necessary for bodily action. Whilst O'Shaughnessy's account appears to be consonant with the phenomenology of ordinary agency, it falls afoul to empirical counterexamples. The failure of O'Shaughnessy's account and its cousins might suggest that bodily action does not depend on bodily awareness. On the contrary, I argue that the contrast between the character of afferented and deafferented agency shows that (...) bodily awareness is crucial to explaining the distinctive character of bodily action in neurologically normal agents. In particular, the capacity to feel one's body ‘from the inside’ appears to be a condition on the capacity to act with one's body in a way that is not like remote control. This dependency of capacities is at once empirically adequate and in tune with the phenomenology of ordinary agency. (shrink)

Is the ancient Confucian ideal of he 和, ‘harmony,’ a viable ideal in pluralistic societies composed of people and groups who subscribe to different ideals of the good and moral life? Is harmony compatible with accepting, even encouraging, difference and the freedom to think differently? I start with seminal characterizations of harmony in Confucian texts and then aim to chart ways harmony and freedom can be compatible and even mutually supportive while recognizing the constant possibility of conflict between them. I (...) shall point out how the Confucian notion of harmony resonates with the Indian King Asoka's project of promoting religious pluralism. Along the way, I will make some comments of a ‘meta’ nature about the kind of interpretation I am offering of harmony in the Confucian texts and the use to which I am putting this interpretation by setting it in the context of societies that in important respects are quite different from the ones from which concepts of harmony originally emerged. (shrink)

Is bodily awareness a condition on bodily action? I approach this question by weaving an argument based on considerations from action theory, the phenomenology of embodied agency, and from the psychology and neuroscience of action. In this paper, I discuss two accounts on which bodily awareness is a condition on bodily action. The first is an influential philosophical account from O'Shaughnessy, which claims that bodily awareness is necessary for the online control of bodily action. I argue that there are empirical (...) counterexamples to O'Shaughnessy's account. Instead I propose an account on which the capacity for bodily awareness is a condition on our capacity for ordinary bodily action. This alternative account does justice to the causal and functional character of ordinary bodily action as well as its phenomenology. It is also consistent with the psychology and neuroscience of action. I provide a two-stage argument for my view. The first stage shows that a sense of the spatial possibilities of one's body is a condition on intentionally acting with one's body. The second stage demonstrates that bodily awareness is a condition on a normal afferented agent's sense of the actions open to him through examining the role of bodily awareness in motor imagery and the role of motor imagery in preparatory processes for everyday actions. (shrink)

In Public Reason Confucianism, Kim Sungmoon presents a perfectionist theory that is based on a partially comprehensive Confucian doctrine but is non-sectarian, since the doctrine is widely shared in East Asian societies. Despite its attractiveness, I argue that this project, unfortunately, fails because it is still vulnerable to the sectarian critique. The blurred distinction between partially and fully comprehensive doctrines will create a loophole problem. Sectarian laws and policies may gain legitimacy that they do not deserve. I further defend political (...) Confucianism, which is regarded by Kim as an inadequately intelligible form of Confucianism. Kim assumes a too narrow understanding of intelligibility. Although political Confucianism may not be politically intelligible, it is civically intelligible, i.e. it is culturally intelligibly different from other political theories in terms of its implications in citizens’ actions in civil society. In light of civic intelligibility, the distinctiveness of political Confucianism should not be underestimated. (shrink)

International observers and critics often attack China's Internet policy on the basis of liberal values. If China's Internet is designed and built on Confucian values that are distinct from, and sometimes incompatible to, liberal values, then the liberalist critique ought to be reconsidered. In this respect, Mary Bockover's “Confucian Values and the Internet: A Potential Conflict” appears to be the most direct attempt to address this issue. Yet, in light of developments since its publication in 2003, it is time to (...) re-examine this issue. In this paper, I revisit Bockover’s argument and show why it fails. Using social media as an example, I offer an alternative argument to show why the Internet remains largely incompatible with Confucian values. I end this paper by suggesting how to recontextualise the Confucian way of life and to redesign social media in accordance to Confucian values in the information society. (shrink)

Much philosophical progress has been made in elucidating the idea of evolutionary contingency in a recent re-burgeoning of the debate. However, additional progress has been impaired on three fronts. The first relates to its characterisation: the under-specification of various contingency claims has made it difficult to conceptually pinpoint the scope to which ‘contingency’ allegedly extends, as well as which biological forms are in contention. That is—there appears to be no systematic means with which to fully specify contingency claims which has (...) led to a tendency for authors to talk past each other. Secondly, on the matter of evidence, recent research has focused on the evidential import of convergent evolution which is taken to disconfirm the evolutionary contingency thesis. However, there has been a neglect of convergent evolution’s converse: ‘evolutionary idiosyncrasies’ or the singular evolution of certain forms, which I argue is evidentially supportive of evolutionary contingency. Thirdly, evolutionary contingency has often been claimed to vary in degrees and that the debate, itself, is a matter of ‘relative significance’. However, there has been no formal method of evaluating the strength of contingency and its relative significance in a particular domain. In this paper, I address all three issues by proposing a systematic means of fully specifying contingency theses with the concept of the modal range. Secondly, I propose an account of evolutionary idiosyncrasies, investigate the explanations for their occurrences, and, subsequently, spell out their significance with respect to the evolutionary contingency thesis. Finally, having been equipped with the evidential counterpart to convergent evolution, I shall sketch a likelihood framework for evaluating, precisely on the basis of a sequence of opposing data, the strength and relative significance of evolutionary contingency in a particular domain. With this in hand, the relative observations of idiosyncrasies and convergences can be informative of the strength and relative significance of contingency in any particular domain. (shrink)

Since the announcement and establishment of the Oversight Board (OB) by the technology company Meta as an independent institution reviewing Facebook and Instagram’s content moderation decisions, the OB has been subjected to scholarly scrutiny ranging from praise to criticism. However, there is currently no overarching framework for understanding the OB’s various strengths and weaknesses. Consequently, this article analyses, organises, and supplements academic literature, news articles, and Meta and OB documents to understand the OB’s strengths and weaknesses and how it can (...) be improved. Significant strengths include its ability to enhance the transparency of content moderation decisions and processes, to effect reform indirectly through policy recommendations, and its assertiveness in interpreting its jurisdiction and overruling Meta. Significant weaknesses include its limited jurisdiction, limited impact, Meta’s control over the OB’s precedent, and its lack of diversity. The analysis of a recent OB case in Ethiopia shows these strengths and weaknesses in practice. The OB’s relationship with Meta and governments will lead to challenges and opportunities shaping its future development. Reforms to the OB should improve the OB’s control over its precedent, apply OB precedent to currently disputed cases, and clarify the standards for invoking OB precedent. Finally, these reforms provide the foundation for an additional improvement to address the OB’s institutional weaknesses, by involving users in determining whether the OB’s precedent should be applied to decide current content moderation disputes. (shrink)

In response to the Royal Society report’s claim that “the acceptability of geo­engineering will be determined as much by social, legal, and political issues as by scientific and technical factors” (Geoengineering the Climate: Science, Governance and Uncertainty [London: Royal Society, 2009], ix), a number of authors have suggested the key to this challenge is to engage the public in geoengineering decision-making. In effect, some have argued that inclusion of the public in geoengineering decision-making is necessary for any geoengineering project to (...) be morally permissible. Yet, while public engagement on geoengineering comes in various forms, the discussion in geoengineering governance and the ethics of geoengineering have too often conceptualized it exclusively in terms of public participation in decision-making, and supported it by various liberal democratic values. However, if the predominant understanding of public engagement on—or, the role of the public in—geoengineering decision-making is indeed only grounded on liberal democratic values, then its normative relevance could be challenged by and in other ethical-political traditions that do not share those values. In this paper, I shall explore these questions from a Confucian perspective. I argue that the liberal democratic values invoked in support of the normative importance of public participation are, at least, foreign to Confucian political philosophy. This presents a prima facie challenge to view public participation in geoengineering decision-making as a universal moral requirement, and invites us to reconsider the normative significance of this form of public engagement in Confucian societies. Yet, I contend that the role of the public remains normatively significant in geoengineering governance and the ethics of geoengineering from a Confucian perspective. Drawing from recent work on Confucian political philosophy, I illustrate the potential normative foundation for public engagement on geoengineering decision-making. (shrink)