Griffiths and Matthewson (2018) employ the selected effects theory to contend that disease involves the impairment of the normal functioning of biological items. Since the selected effects theory focuses on the past effects of those items, I refer to their proposal as “aetiological naturalism”. In this paper, I argue that aetiological naturalism cannot constitute an adequate theory of disease. This is due to the fact that the selected effects theory, which lies at the heart of aetiological naturalism, is flawed. One (...) promise of the selected effects theory is indeed that it is able to account for our normative intuitions about dysfunctional biological items by grounding them on the concept of natural selection incorporated in the selected effects theory itself, where this promise rests upon its claim that appealing to the fitness-enhancing effect of biological items can always explain why they persisted in a population. However, I contend that the naturalisation of normativity cannot be cashed out in terms of biological items’ past effects by discussing two biological phenomena: phenotypic plasticity and negative frequency-dependent selection. I illustrate that in both cases the selected effects theory cannot recognise adaptive items as having a selected effects function, therefore preventing the possibility to assign them any dysfunction. The normative force of the selected effects theory is consequently much diminished, leading in turn to a weakening of aetiological naturalism, given that such project actually relies on the assumed normative force of the selected effects theory itself. (shrink)

Uncertainty in the field of child psychiatry may at times lead to groundless assumptions about the aetiology and pathology of psychiatric disorders of childhood. Treatment based on non-validated assumptions may be ineffective and may cause more harm than good. The case is presented of infantile autism which was at first attributed by clinicians to a specific negative effect of parents on their children. Evidence grounded on research did subsequently refute the assumption implicating the parents in the aetiology of (...) this disorder. An explanatory assumption can become evidence if it is tested and found valid. To avoid serious errors in the understanding and treatment of child psychiatric disorders, the clinician should always consider critically assumptions and opinion, provided in lieu of evidence. (shrink)

During the Italian campaigns of the French Revolutionary Wars (1796–1801), several epidemic outbreaks sparked acrimonious aetiological debates: were the fevers spread by soldiers and prisoners of war, or produced by environmental factors? This debate was not only a scientific issue, but also a political one, for causation was linked to accountability. Looking at a series of medical investigations written by French military practitioners, this paper argues that theories of contagion were used by civilians to accuse the army of spreading disease, (...) in what I describe as an “aetiology of blame.” Likewise, military officials attempted to absolve themselves of responsibility for the spread of disease by focusing on unwholesome environments, depicting diseases as unavoidable fatalities. Military doctors thus supported French imperial endeavours by obscuring the army's responsibility for the spread of diseases, putting forward aetiologies of fate and blaming individual behaviour. Even when they did not radically dismiss contagionist perspectives, military practitioners insisted on a wide range of pathogenic causes. Their discourses were in line with medical theories of the time, but they downplayed the responsibility of the army for the spread of diseases, which they depicted as a factor among others. Military doctors were thus not always involved in the direct and deliberate production of ignorance, but they did sustain controversies and uncertainty. (shrink)

The common autoimmune disease type 1 diabetes provides a paradigm for the genetic analysis of multifactorial disease. Disease occurrence is attributable to the interaction with the environment of alleles at many loci interspersed throughout the genome. Their mapping and identification is difficult because the disease-associated alleles occur almost as commonly in patients as in healthy individuals; even the highest-risk genotypes bestow only modest risks of disease. The identification of common quantitative trait loci (QTL) in autoimmune disease and in other common (...) disorders, therefore,requires a very close marriage of genetics and biology. Two QTLs have been identified in human type 1 diabetes: the major histocompatibility complex HLA class II loci and a promoter polymorphism of the insulin gene. The evidence for their primary roles in disease aetiology demonstrates the necessity of combined studies of genetics and biology. Their functions and interaction underpin an emerging picture of the basic causes of the disease and direct analyses towards other candidate genes and pathways. The genetic tools used for QTL identification include transgenesis and gene knockouts, whole genome scanning for linkage, mouse congenic strains, linkage disequilibrium mapping, and the establishment of ancestral haplotypes among disease-associated chromosomes. BioEssays 1999;21:164–174. © 1999 John Wiley & Sons, Inc. (shrink)

This chapter explores the suggestion that early attachment underpins the human capacity for empathy, and that empathy, in turn, is a condition of moral competence. We are disposed by nature to seek intimacy with our human conspecifics: the securely attached child learns that, whatever perils the world may hold, his well-being is shielded within the private sphere of personal intimacy. But why should secure attachment also favour—as it does—recognition of moral obligations towards those with whom we have no special standing (...) and share no personal destiny—recognition that the claims of persons as such merit our attention and regard? One answer to this question looks beyond the fact of secure attachment to a further psychological capacity, our capacity for empathy: secure attachment promotes susceptibility to empathy, and an appropriate susceptibility to empathy is a condition of basic moral competence. The chapter proposes that the deeper and more persisting significance of empathy to morality can be understood from a developmental perspective. Looking to mentalization-based attachment theory allows us to understand how empathic mirroring enters into our earliest intimate, interactions with other persons, securing our default commitment to recognizing their reality as bound up with our own. In this way, empathy constitutes one of the natural foundations on which the more complex architecture of moral experience is constructed. Attachment theory helps us to understand the indispensable role empathy plays at the beginning of the circuitous road to virtue. (shrink)

Roughly half way through the fourthGeorgic, Virgil confronts a sad reality: on occasion the entire population of a hive can perish without warning and leave the bee-keeping farmer bee-less. In response to such a devastating loss, the poet describes an Egyptian procedure, to which modern critics have given the namebugonia, whereby the farmer acquires a new swarm of bees from the putrefying carcass of a dead ox (4.281–314). After the account ofbugonia, the poem takes a notoriously unexpected turn. Virgil asks (...) the Muses about the origins of this practice and then recounts the exploits of Aristaeus, an inhabitant of the georgic world whose own bees once succumbed to famine and disease. In the narrative that follows, Aristaeus consults his mother Cyrene and the seer Proteus, who tells him about Orpheus’ descent to the underworld. The narrative ends when Aristaeus, thanks to the teaching of his mother, performs a series of activities that culminates in a new swarm of bees bursting forth from the putrefying carcass of a dead ox (4.315–558). The aetiological character of the Aristaeus narrative is clear—Virgil promises to trace the Egyptian procedure back to its firstorigo(4.286), and when he addresses the Muses, he specifically asks what god discovered the practice and whence it took its first beginnings (4.315–16). But for what activity does the story actually offer anaition? (shrink)

In this paper, I utilise the tools of analytic philosophy to amalgamate mono-causal and multi-causal theories of disease. My aim is to better integrate viral and socio-economic explanations of AIDS in particular, and to consider how the perceived divide between mono-causal and multi-causal theories played a role in the tragedy of AIDS denialism in South Africa in the early 2000s. Currently, there is conceptual ambiguity surrounding the relationship between mono-causal and multi-causal theories in biomedicine and epidemiology. Mono-causal theories focus on (...) single, typically microbial, sources of illness and are most concerned with infectious diseases. By contrast, multi-causal theories allow for multiple factors to underpin a disease’s aetiology, including socio-economic and behavioural factors, and they usually focus on chronic non-communicable diseases. However, if these theories are taken to be strictly distinct, this prevents the inclusion of both microbial and socio-economic factors in a single explanation of any particular disease. This strict distinction became a problem when trying to explain the disproportionate prevalence of AIDS in southern Africa and ultimately contributed to the tragedy of AIDS denialism in South Africa. In tandem with viewing how the perceived divide between multi-causal and mono-causal theories underpinned AIDS denialism, I examine Thabo Mbeki’s specific role, while acknowledging that AIDS is being deprioritised on a broader international level. Overall, I will demonstrate that any long-term plan to eliminate AIDS will require viral and socio-economic factors to be considered simultaneously and that such a theoretical approach requires a clearer understanding of the underlying concepts of disease aetiology. (shrink)

Despite the diagnostic relevance of thought insertion for disorders such as schizophrenia, the debates about its aetiology are far from resolved. This paper claims that in paying exclusive attention to the perceptual and cognitive impairments leading to delusional experiences in general, current deficit approaches overlook the role that affective disturbances might play in giving rise to cases of thought insertion. In the context of psychosis, affective impairments are often characterized as a consequence of the stress and anxiety caused by (...) delusional episodes. However, here I explore some of the conceptual and empirical reasons to think that affective problems might in fact play a crucial doxastic role in the aetiology of thought insertion. Finally, I conclude by proposing a way of integrating the main insights of my analysis with the current ‘two-factor’ deficit approach to thought insertion and I explore the potential adaptive role that some delusions might have within this framework. (shrink)

Medically unexplained symptoms (MUS) remain recalcitrant to the medical profession, proving less suitable for homogenic treatment with respect to their aetiology, taxonomy and diagnosis. While the majority of existing medical research methods are designed for large scale population data and sufficiently homogenous groups, MUS are characterised by their heterogenic and complex nature. As a result, MUS seem to resist medical scrutiny in a way that other conditions do not. This paper approaches the problem of MUS from a philosophical point (...) of view. The aim is to first consider the epistemological problem of MUS in a wider ontological and phenomenological context, particularly in relation to causation. Second, the paper links current medical practice to certain ontological assumptions. Finally, the outlines of an alternative ontology of causation are offered which place characteristic features of MUS, such as genuine complexity, context-sensitivity, holism and medical uniqueness at the centre of any causal set-up, and not only for MUS. This alternative ontology provides a framework in which to better understand complex medical conditions in relation to both their nature and their associated research activity. (shrink)

The interactions between genetic and environmental risk factors contribute to the aetiology of complex human diseases. Genome‐wide association studies (GWAS) have revealed that most of the genetic variants associated with complex diseases are located in the non‐coding part of the genome, preferentially within enhancers. Enhancers are distal cis‐regulatory elements composed of clusters of transcription factors binding sites that positively regulate the expression of their target genes. The generation of genome‐wide maps for histone marks (e.g., H3K27ac), chromatin accessibility and transcription (...) factor and coactivator (e.g., p300) binding profiles have enabled the identification of enhancers across many human cell types and tissues. Nonetheless, the functional and pathological consequences of the majority of disease‐associated genetic variants located within enhancers seem to be rather minor under normal conditions, thus questioning their medical relevance. Here we propose that, due to the prevalence of enhancer redundancy, the pathological effects of many disease‐associated non‐coding genetic variants might be preferentially (or even only) manifested under environmental stress. (shrink)

Heart disease is a complex condition that is a leading cause of death worldwide. It is often seen as a disease of affluence, yet is strongly associated with a gradient in socio-economic status. Its highly complex causality means that many different facets of social and economic life are implicated in its aetiology, including factors such as workplace hierarchy and agricultural policy, together with other well-known factors such as what passes for individual 'lifestyle'. The very untangling of causes for heart (...) disease thus inevitably raises social, moral and political issues. These include the proper role of the individual and of larger social forces in its aetiology, prevention and treatment. The construction of risk factors for heart disease likewise is enmeshed with questions of distributive justice in the responsible targeting of those at risk for heart disease, a debate which has received much overt attention in the medical literature, but less attention within the ethical literature. Strategies for addressing a condition of such complex causality can be highly diverse, from pharmaceutical to social interventions, and value issues attach to the choice and presentation of such strategies. For example, prevention strategies may raise complex issues of responsibility and of judgements of what it is to 'live well'. Further ethical debate on this highly political disease would be welcome. (shrink)

Our understanding of the complexity of the oral biome and of the role of the various constituent bacteria in the aetiology of dental disease is growing. Probiotics and their relationship with prebiotics, as well as other microbiome‐based interventions, could be useful in preventing and treating dental disease and in promoting oral health. However, given the promise and early stage of this treatment approach, there are also a number of ethical, social and regulatory issues associated with innovative probiotic therapy. In (...) this article, a brief update is given on contemporary theories of the aetiology and management of the two commonest dental diseases, and on the roles of pre‐ and probiotics and oral biome transplant in the management of these diseases. The focus is primarily on four core issues: informed consent, risk–benefit assessment, how to determine suitable healthy donors, and commercialization and regulation. We discuss the safety and benefits of oral probiotics, not only concerning the products and quality control during their manufacture, but also regarding the depth of public knowledge about this topic. We point out that the requirement of listing ingredients honestly might be insufficient, and that the prevalent rhetoric of ‘natural’ and ‘organic’ as well as some health claims in the translational, innovative probiotic industry and markets are themselves misleading and should be carefully scrutinized. Finally, we suggest an ethical imperative to find a balance between scientific research and industry, and public health in the regulation of probiotics. (shrink)

Francesco O. Zamboni. At the Roots of Causality: Ontology and Aetiology from Avicenna to Fakhr al-Dīn al-Rāzī (Nedenselliğin Köklerinde: İbn Sînâ’dan Fahreddin Râzî’ye Ontoloji ve Etiyoloji/Neden Bilimi), Leiden, Boston: Brill, 2023. xi + 344 sayfa. ISBN 9789004684874.

Gettier's reminder that knowledge cannot be identified with justified true belief started a heated debate about what knowledge really is.

The book investigates how Avicenna's doctrine of efficient causality relates to his general ontology, as well as how the two are interpreted, defended, and challenged in the early phase of Avicenna's Islamic reception (the eleventh and twelfth centuries).

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ovid’s Causes: Cosmogony and Aetiology in the MetamorphosesMargaret Worsham MusgroveK. Sara Myers. Ovid’s Causes: Cosmogony and Aetiology in the Metamorphoses. Ann Arbor: University of Michigan Press, 1994. xvi + 206 pp. Cloth, $32.50.This book takes seriously Ovid’s claim in the proem of the Metamorphoses that his work will encompass the entire universe. Ovid’s primaque ab origine mundi (1.3) must be read as a statement of thematic, (...) not merely chronological scope. “The origin of the world” will continue as a central concern throughout the poem. Myers reads the cosmogony of Book 1 as a continuation of the programmatic statement of the proem: Ovid is allying himself with the tradition of natural-philosophical poetry, as originated by Hesiod and adapted to Hellenistic standards by Apollonius and Vergil. The theme of cosmogony does not merely “frame” the poem, and does not surface only in the explicit creation stories of Book 1 and the didactic discourse of Pythagoras in 15, but instead pervades the entire work. Aetiological stories, as explanations of where individual phenomena come from, continue the scientific theme displayed in the opening cosmogony. The whole Metamorphoses can thus be read as an exploration of the type of poetry which investigates origins of everything, from the universe to natural features to cultural institutions. We should credit Myers with elucidating this cosmogony-aetiology link, which breaks us free of narrow, literal categories, and allows us to see the similar poetic aims of these two literary devices. Her introductory chapter, exploring “The Generic Question” of the Metamorphoses and of post-Callimachean literature in general, points out how recent Latin scholarship has already begun to blur some of those long-unquestioned black-and-white distinctions between genres.At the same time, Myers acknowledges the clash between science (or natural philosophy) and myth. Ovid uses “scientific” language, often in the form of Lucretian allusions, to recount fantastic mythological tales of creatures whose very existence would be questioned by the philosophers. Chapter 1 examines metamorphosis stories which involve natural phenomena, such as the cosmos itself, various animals, etc. Metamorphosis is seen and narrated as a kind of scientific process; hence Ovid’s detailed descriptions of the moment of transformation. [End Page 338] But by calling attention to the incongruity of his subject and his language, Ovid questions the authority of cosmogony to validate myth and of myth to convey the truth.The remainder of Myers’ book focuses on the way in which Ovid unmasks the devices used in aetiological poetry’s claim to a voice of authority. Chapter 2 examines the Alexandrian affiliations of aetiological stories explaining the origins of cultural or religious institutions. This chapter follows something of the approach of P. Knox in the studious attempt to look at the elegiac, unepic features of Ovid’s narrative. Myers investigates the language used to mark a story as an aetion: words such as causa, origo, novus, and unde. Partially through comparison with Ovid’s technique in Fasti (a consistently aetiological, didactic poem) and through examination of the fragments of Callimachus, she also points out certain narrative techniques as characteristic of aetiology. The embedded narrative, related by a supposedly authoritative informant, is revealed as part of the modus operandi of didactic and aetiological poetry.This chapter is perhaps Myers’ most valuable contribution, because it gives us a rationale for some of the seemingly odd features of Ovid’s narrative. One example: why, at Met. 4.772–89, are Perseus’ most famous adventures reported only in indirect statement? Variatio for its own sake is not an adequate answer. Genre would seem to be part of the explanation: battles with monsters belong in epic, a genre which Ovid eschews, at least for the moment. But beyond that negative explanation, Myers suggests a positive one. After the indirect report, someone asks Perseus for an aetiological story: why Medusa had snakes in her hair. His answer in direct speech displays several of the linguistic features which Myers has identified as characteristic of aetia. Thus, Ovid depicts Perseus not so much at a Homeric banquet, with stories of battles and conquests, but at a Callimachean one, with learned exchanges of aetiological myths (cf... (shrink)

In At the Roots of Causality, Francesco Omar Zamboni examines several doctrines related to Avicenna’s writings on existence, contingency, and causality, which generated debate in the two hundred ye...

What is the significance of empirical work on moral judgement for moral philosophy? Although the more radical conclusions that some writers have attempted to draw from this work are overstated, few areas of moral philosophy can remain unaffected by it. The most important question it raises is in moral epistemology. Given the explanation of our moral experience, how far can we trust it? Responding to this, the view defended here emphasizes the interrelatedness of moral psychology and moral epistemology. On this (...) view, the empirical study of moral judgement does have important implications for moral philosophy. But moral philosophy also has important implications for the empirical study of moral judgement. (shrink)

I begin by examining how genetics drivesschizophrenia research, and raise both familiar andrelatively novel criticisms of the evidence putativelysupporting the genetic basis of schizophrenia. Inparticular, I call attention to a set of concernsabout the effects of placentation on concordance ratesof schizophrenia in monozygotic twins, which furtherweakens the case for schizophrenia''s so-called stronggenetic component. I then underscore two criticalpoints. First, I emphasize the importance of takingseriously considerations about the complexity of bothontogenesis and the development of hereditarydiseases. The recognition of developmentalconstraints and (...) supports is crucial, for attention todevelopment exposes the naivete of too many models ofgene action in the aetiology of disease. Secondly, Iattend to those schizophreniologists who ignoremethodological criticisms and thus presume a geneticbasis for schizophrenia, and then seek the schizophrenic genotype lacking an adequatephenotype. In response I attempt to demonstrate thenecessity of a sustained effort at characterizing thephenotype of schizophrenia as an enabling conditionfor the whole enterprise of psychiatric genetics – andfor psychiatry itself. Without the organism-levelphenotype, research at the level of genes will remainunproductive – assuming of course that research at thegenetic level is appropriate at all. (shrink)

Aetiological poetry tends to be mature poetry in both a literary and a political sense. Interest in antiquarian lore belongs in general to a poet's middle and later years when youthful and audacious quests for what is avant-garde and anti-establishment have yielded to conservatism and a desire to preserve the past. Propertius and Ovid both turned to aetiological poetry after a long apprenticeship in amatory ‘nugae’ which enabled them, like their predecessor, Callimachus, to embellish their work with a diversity of (...) artistic devices founded on considerable poetic skill and literary experience. With this, a vital ploy to engage the sympathy of a sophisticated audience, went the poise and urbanity with which the aetiological poet found humour in the pose of earnest researcher, in the naivety of primitive cult and in clever literary adaptations. Moreover, dedication to a form of writing essentially nationalist and conservative encouraged a tone of patriotic pride and allusions, even compliments, to the ruling powers. In the light of such considerations we may examine Ovid's account of the ‘Ludi Megalenses’. The ‘Megalensia’ furnished Ovid with a goddess who had enjoyed fame and even notoriety in the pages of Roman literature. In addition to showing a poetic and neoteric interest in the orgiastic elements of her cult and the alien music of her retinue Roman poetry could reflect too the awe and reverence inspired of old by the Great Mother and expressed in the Greek poets, whom Lucretius claimed as his sources in his powerfully beautiful excursus on Cybele worship. Again, Cybele's importance in Rome had been augmented by her Trojan origins, concerning which a canonical Augustan theology had been established by Vergil in the Aeneid. (shrink)

The literature on the aetiology of serial killing has benefited from analyses which offer an alternative perspective to individual/psychological approaches and consider serial murder as a sociological phenomenon. The main argument brought to bear within this body of work identifies the socio-economic and cultural conditions of modernity as enabling and legitimating the motivations and actions of the serial killer. This article interrogates this work from the standpoint of a gendered reading of modernity. Using the Yorkshire Ripper case, it emphasizes (...) how in addition to the political economy, gender relations and masculinity shape the dynamics of serial murder and its representation. (shrink)

It is almost universally believed that some infinite regresses are vicious, and also almost universally believed that some are benign. In this paper I argue that regresses can be vicious for several different sorts of reasons. Furthermore, I claim that some intuitively vicious regresses do not suffer from any of the particular aetiologies that guarantee viciousness to regresses, but are nevertheless so on the basis of considerations of parsimony. The difference between some apparently benign and some apparently vicious regresses, then, (...) turns out to be a matter of a more general assessment of costs and benefits, making viciousness of regresses in some cases less of a local matter than is usually thought. (shrink)

Standard accounts of the senses attempt to answer the question how and why we count five senses ; none of the standard accounts is satisfactory. Any adequate account of the senses must explain the significance of the senses, that is, why distinguishing different senses matters. I provide such an explanation, and then use it as the basis for providing an account of the senses and answering the counting question.

In this paper we argue that the insistence by Fodor et. al. that the Language of Thought hypothesis must be true rests on mistakes about the kinds of explanations that must be provided of cognitive phenomena. After examining the canonical arguments for the LOT, we identify a weak version of the LOT hypothesis which we think accounts for some of the intuitions that there must be a LOT. We then consider what kinds of explanation cognitive phenomena require, and conclude that (...) three main confusions lead to the invalid inference of the truth of a stronger LOT hypothesis from the weak and trivial version. These confusions concern the relationship between syntax and semantics, the nature of higher-level causation in cognitive science, and differing roles of explanations invoking intrinsic structures of minds on the one hand, and aetiological or evolutionary accounts of their properties on the other. (shrink)

Gyngell and colleagues consider that the recent Nuffield Council report does not go far enough: heritable genome editing is not just justifiable in a few rare cases; instead, there is a moral imperative to undertake it. We agree that there is a moral argument for this, but in the real world it is mitigated by the fact that it is not usually possible to ensure a better life. We suggest that a moral imperative for HGE can currently only be concluded (...) if one first buys into an overly deterministic view of a genome sequence, and the role of variation within in it, in the aetiology of the disease: most diseases cannot simply be attributed to specific genetic variants that we could edit away. Multiple, poorly understood genetic and environmental factors interact to influence the expression of diseases with a genetic component, even well understood ‘monogenic’ disorders. Population-level genome analyses are now demonstrating that many genetic ’mutations' are much less predictive than previously thought 1. Furthermore, HGE might introduce new risks just as it reduces old ones; or remove protections not yet clearly delineated. (shrink)

The catch 22 situation in psychiatry is that for precise diagnostic categories/criteria, we need precise investigative tests, and for precise investigative tests, we need precise diagnostic criteria/categories; and precision in both diagnostics and investigative tests is nonexistent at present. The effort to establish clarity often results in a fresh maze of evidence. In finding the way forward, it is tempting to abandon the scientific method, but that is not possible, since we deal with real human psychopathology, not just concepts to (...) speculate over. Search for clear-cut definitions/diagnostic criteria in psychiatry must be relentless. There is a greater need to be ruthless and blunt in this, rather than being accommodative of diverse opinions. Investigative tests - psychological, serum, CSF, or neuroimaging - are only corroborative at present; they need to become definitive. Medicalisation appears most prominent in psychiatry; so, diagnostic proliferation and fuzziness appear inevitable. And yet, the established diagnostic entities need to forward greater and conclusive precision. Also, the need for clarity and precision must outweigh pandering to and mollifying diverse interests, moreso in the upcoming revision of diagnostic manuals. This is specially because the DSM-5, being an Association manual, may need to accommodate powerful member lobbies; and ICD-11 may similarly need to cater to diverse country lobbies. Finding precise biological correlates of psychiatric phenomena, whether through neuroimaging, molecular neurobiology and/or neurogenomics, is the right way forward. It is in the 1.5-kg structure in the cranium that all secrets of psychiatric conditions lie. Social forces, behavioural modification, psychosocial restructuring, study of intrapsychic processes, and philosophical insights are not to be discounted, but they are supplementary to the primary goal - studying and deciphering those brain processes that result in psychiatric malfunction. Experimental breakthroughs, both in psychiatric aetiology and therapeutics, will come mainly from biology and its adjunct, psychopharmacology; while supplementary and complementary breakthroughs will come from the psychosocial, cognitive and behavioural approaches; the support base will come from phenomenology, epidemiology, nosology and diagnostics; while insights and leads can hopefully come from many fields, especially the psychosocial, the behavioural, the cognitive and the philosophical. Major energies must now be marshalled towards finding biomarkers and deciphering the precise phenotype-genotype-endophenotype axis of psychiatric disorders. Energies also need to be focussed on unravelling those critical processes in the brain that tip the scale towards psychiatric disorders. At how those critical processes are set into motion by forces de novo, in utero, in the genes and their expression, by the environment's psychopathological social forces - stress, peer pressure, poverty, deprivation, alienation, malnutrition, discrimination of various types (caste, gender, race, etc.), mass conflicts (war, terror attacks, etc.), disasters (natural and man-made), religious/ideological fascism - or social institutions like marriage, family, work place, political governance, etc. Ultimately, we must decipher how the brain goes into malfunction when such varied forces impinge on it, which precise cortical areas and neuronal cellular and molecular processes are involved in such malfunction and its manifestation, as also which of these are involved when malfunction ceases and health is restored, and the psychosocial processes and institutions which aid such health restoration, as also those which promote well-being and help in primary prevention. Emphasis on the brain and its intimate neurological and molecular mechanisms will not impinge on, or nullify, importance of the 'mind,' wherein subtle and gross brain functions in the form of behaviour, thought and emotions in all their ramifications will continue to be the focus of psychological, cognitive, sociological, psychopharmacological, behavioural and philosophical research. Progress in brain research must move in tandem with progress in 'mind' research. (shrink)

Journal Name: Philologus Issue: Ahead of print.

Bernard Lonergan's cognitive theory challenges us to raise questions about both the cognitive process through which obesity is perceived as a behaviour change issue and the objectivity of such a moral judgment. Lonergan's theory provides the theoretical tools to affirm that anti-fat discrimination, in the United States of America and in many industrialized countries, is the result of both a group bias that resists insights into the good of other groups and a general bias of anti-intellectualism that tends to set (...) common sense against insights that require any thorough scientific analyses. While general bias diverts the public's attention away from the true aetiology of obesity, group bias sustains an anti-fat culture that subtly legitimates discriminatory practices and policies against obese people. Although anti-discrimination laws may seem to be a reasonable way of protecting obese and overweight individuals from discrimination, obesity bias can be best addressed by reframing the obesity debate from an environmental perspective from which tools and strategies to address both the social and individual determinants of obesity can be developed. Attention should not be concentrated on individuals' behaviour as it is related to lifestyle choices, without giving due consideration to the all-encompassing constraining factors which challenge the social and rational blindness of obesity bias. (shrink)

There is no satisfactory account for the general phenomenon of confabulation, for the following reasons: (1) confabulation occurs in a number of pathological and non-pathological conditions; (2) impairments giving rise to confabulation are likely to have different neural bases; and (3) there is no unique theory explaining the aetiology of confabulations. An epistemic approach to defining confabulation could solve all of these issues, by focusing on the surface features of the phenomenon. However, existing epistemic accounts are unable to offer (...) sufficient conditions for confabulation and tend to emphasise only its epistemic disadvantages. In this paper, we argue that a satisfactory epistemic account of confabulation should also acknowledge those features which are (potentially) epistemically advantageous. For example, confabulation may allow subjects to exercise some control over their own cognitive life which is instrumental to the construction or preservation of their sense of self. (shrink)

Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have (...) ethical implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations. (shrink)

Moral distress has been the subject of extensive research and debate in the nursing ethics literature since the mid-1980s, but the concept has received comparatively little attention from those working outside of applied ethics. In this article, I defend a care ethical account of moral distress, according to which the phenomenon is the product of an agent’s inability to live up to one of her caring commitments. This account has a number of attractions. First, it places a greater emphasis on (...) the importance of the relationship between the caregiver and her cared-for than that found in previous accounts. Second, it does not make problematic assumptions about the correctness of a caregiver’s moral judgments, as has been claimed in relation to previous accounts of moral distress. Finally, my account allows for a clear conceptual distinction to be drawn between moral distress and other forms of negative moral emotion such as guilt and regret. Earlier accounts draw this distinction by appealing to the causal aetiology of moral distress, but as I show here, such appeals are ultimately unsuccessful unless they are made from an explicitly care ethical starting point. One of the implications of my account is that moral distress has the potential to occur in the context of any caregiving relationship. This claim is explored in the final section of the paper, in relation to student-teacher and parent-child caregiving. (shrink)

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the (...) book is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals. (shrink)

Recent developments in the psychological and social sciences have seen a surge of attention to concepts of embodiment. The burgeoning field of embodied cognition, as well as the long-standing tradition of phenomenological philosophy, offer valuable insights for theorising how people come to understand the world around them. However, the implications of human embodiment have been largely neglected by one of the key frameworks for conceptualising the development of social knowledge: Social Representations Theory. This article seeks to spark a dialogue between (...) Social Representations Theory and embodiment research. It outlines the position the body occupies in the existing theoretical and empirical social representations literature, and argues that incorporating concepts gleaned from embodiment research may facilitate a more comprehensive account of the aetiology of social representations. The value of analytic attention to embodiment is illustrated with reference to a recent study of social representations of neuroscience, which suggested that embodied experience can shape the extent to which people engage with certain topics, the conditions under which they do so, and the conceptual and affective content of the ensuing representations. The article argues that expanding Social Representations Theory's methodological and conceptual toolkit, in order to illuminate the interplay between embodied experience and social communication in the development of common-sense knowledge, promises productive directions for empirical and theoretical advancement. (shrink)