I suggest that the diagnosis that an individual self-diagnoses with can be influenced by levels of public awareness. Accurate diagnosis requires consideration of multiple diagnoses. Sometimes, different diagnoses can overlap with one another and can only be differentiated in subtle and nuanced ways, but particular diagnoses vary considerably in levels of public awareness. As such, an individual may meet the diagnostic criteria for one diagnosis but self-diagnoses with a different diagnosis because it is better known. I then outline a potential (...) negative consequence of this. Psychiatric diagnoses can grant access to what I call social resources, namely, political advocacy, campaigning for support, participating in scientific research, building diagnostic cultures, and opportunity for social interactions with people who have the same diagnosis. The strength of the social resources for a particular diagnosis can be made stronger when more people have that diagnosis. As such, inaccurate self-diagnosis can result in the social resources for one diagnosis being strengthened whilst not being strengthened in relation to another diagnosis in comparison to accurate diagnosis. This shows how inaccurate self-diagnosis can alter the distribution of social resources. We need to consider whether this is unfair to people who are diagnosed with less well-known conditions. (shrink)

Self-diagnosis in psychiatry is where individuals diagnose themselves rather than rely upon official diagnosticians to supply a psychiatric diagnosis. The accuracy of self-diagnosis is a contested topic. In this paper, I outline what arguments are needed to see self-diagnosis as accurate and how different approaches to self-diagnosis require different arguments. I show how different arguments are required to justify accuracy for an autistic individual judging they are autistic compared to non-autistic individuals judging they are not autistic. Different arguments are required (...) if a self-diagnosing individual accepts or rejects official diagnostic criteria. Finally, different arguments are required depending upon whether diagnoses are seen as objective entities, the product of theoretical virtues or practically useful groupings. All these approaches require unique arguments to justify the accuracy of self-diagnosis. Identifying the required arguments for different approaches is a stepping stone toward establishing whether those arguments and which of those arguments can be successfully justified. (shrink)

I argue that the recurring practice of self-diagnosis of psychiatric conditions such as autism spectrum disorder and attention-deficit/hyperactivity disorder on social media platforms poses a threat to personal autonomy understood as self-governance. My main argument is that self-diagnosis conducted without professional expertise is prone to lead to misdiagnosis, which can take the form of a distortion of self-image. This may result in pathologizing normal experiences and behaviors and the adoption of behavioral adjustments that harm those who engage in self-diagnosis. Acknowledging (...) that the surge of self-diagnosis content is a response to inadequacies of mental health care systems in many parts of the world, I argue against prohibiting such content and end with a more modest suggestion of implementing warnings alongside it on social media platforms, as is already common practice for misinformation content on diseases like Covid-19. (shrink)

In this paper I describe and analyze the need for an alternative, non-clinical approach to counseling, i.e., philosophical counseling. Throughout the first part of this paper. I aim to prove pragmatically the truth or validity of this new non-clinical approach to counseling by describing its effectiveness in a case-study. In the second part, I suggest that many philosophers have made use of philosophical self-diagnosis and self-help to improve their own well-being, although for their private practice of philosophy they did not (...) use the words I have chosen here. I exemplify this by analyzing the representative life narrative of Jean-Jacques Rousseau as a case study. (shrink)

Neurodiversity, the advocacy position that autism and related conditions are natural variants of human neurological outcomes that should be neither cured nor normalized, is based on the assertion that autistic people have unique neurological differences. Membership in this community as an autistic person largely results from clinical identification, or biocertification. However, there are many autistic individuals who diagnose themselves. This practice is contentious among autistic communities. Using data gathered from Wrong Planet, an online autism community forum, this article describes the (...) debate about self-diagnosis amongst autistic self-advocates and argues for the acceptance of the practice in light of the difficulties in verifying autism as a ‘natural kind.’ This practice can counteract discriminatory practices towards and within the autistic community and also work to verfiy autistic self-knowledge and self-expertise. This discussion also has important implications for other neurocommunities, neuroethical issues such as identity and privacy, and the emerging field of critical autism studies. (shrink)

This paper explores the factors that contribute to the degree of a mood disorder patient’s self- insight, defined here as her understanding of the particular contingencies of her life that are responsive to her personal identity, interpersonal relationships, illness symptoms, and the relationship between these three necessary components of her lived experience. I consider three factors: (i) the Diagnostic Statistical Manual of Mental Disorders (DSM), (ii) the DSM culture, and (iii) the cognitive architecture of the self. I argue that the (...) symptom-based descriptions of mood disorders which eliminate the subjective features of the patient’s illness experience, in conjunction with the features of the DSM-culture and the cognitive biases that guide the patient, contribute to the impoverishment of her self-insight. The resulting impoverished self-insight would prevent her from developing resourceful responses to her interpersonal problems. In analyzing how these factors combine to influence the patient’s self-insight, I distinguish the therapeutic impact of receiving a psychiatric diagnosis, which facilitates patient’s clinical treatment, from its reflective impact, how the diagnosis informs the patient’s reflection on who she is, how her mental disorder is expressed, and how her interpersonal relationships proceed. I substantiate my argument by considering a patient’s memoir of psychopathology. (shrink)

Categorization-based diagnosis, which endeavors to be consistent with the third-person, objective measures of science, is not always adequate with respect to problems concerning diagnostic accuracy, demarcation problems when there are comorbidities, well-documented problems of symptom amplification, and complications of stigmatization and looping effects. While psychiatric categories have proved useful and convenient for clinicians in identifying a recognizable constellation of symptoms typical for a particular disorder for the purposes of communication and eligibility for treatment regimes, the reification of these categories has (...) without doubt had negative consequences for the patient and also for the general understanding of psychiatric disorders. We argue that a complementary, integrated framework that focuses on descriptive symptom-based classifications (drawing on phenomenological interview methods and narrative) combined with a more comprehensive conception of the human subject (found in the pattern theory of self), can not only offer a solution to some of the vexed issues of psychiatric diagnosis but also support more efficacious therapeutic interventions. (shrink)

The aim of this article is to inquire into today's social pathologies, i.e. the negative consequences of the developmental processes of society. In a dialogue with Axel Honneth, the article asserts that a shift has occurred in individualization, a shift that implies a fundamental change in social pathologies: Social pathologies no longer derive from social barriers inhibiting self‐realization but from self‐realization itself. As a consequence, philosophy of education, rather than sociology, appears to be the relevant field of study. The article (...) develops a social‐analytical perspective on ‘sickness in self‐Bildung’, which is conceived as a ‘refusal to transcend oneself into sociality’, and offers interpretations of present pathologies such as depression, anorexia, populist freedom of speech, and demonic rage. (shrink)

Alasdair MacIntyre’s work in ethics follows in the footsteps of twentieth century efforts to put the ideals of Enlightenment and modernity on trial, and his book After Virtue diagnoses a wide-spread malaise in contemporary moral discourse. As a corrective to this condition, MacIntyre offers a remedy along Aristotelian-Thomistic lines. He specifically conceives of a recovery of these lines that would allow for a common ground in moral debates which would reveal the normative and teleological character of the human good. However, (...) within these pages, I argue that MacIntyre underestimates how his moral corrective is actually a re-inscription of the Enlightenment project, and thus equally doomed to failure. I do this by sketching out three different lines. First, I present MacIntyre’s appraisal of modern moral discourse, which has long since abandoned a reliance on Aristotelian principles of ethics. Second, I outline an informative disjunction MacIntyre sets up between having to choose between a Nietzschean or an Aristotelian model of ethical action. Last, I argue that MacIntyre’s own choice, simultaneously based on, but also diverging from, Aristotle fails because his revamped account of the virtue formation so necessary for modern human flourishing leaves open a space for its development according to contingent histories and traditions, which implies an attenuated account of the virtue ethics he seeks to recover, and vindicates, rather than condemns, the Enlightenment’s attempt to liberate moral theories from its strict teleological forbears. (shrink)

Hájek has recently presented the following paradox. You are certain that a cable guy will visit you tomorrow between 8 a.m. and 4 p.m. but you have no further information about when. And you agree to a bet on whether he will come in the morning interval (8, 12] or in the afternoon interval (12, 4). At first, you have no reason to prefer one possibility rather than the other. But you soon realise that there will definitely be a future (...) time at which you will (rationally) assign higher probability to an afternoon arrival than a morning one, due to time elapsing. You are also sure there may not be a future time at which you will (rationally) assign a higher probability to a morning arrival than an afternoon one. It would therefore appear that you ought to bet on an afternoon arrival. The paradox is based on the apparent incompatibility of the principle of expected utility and principles of diachronic rationality which are prima facie plausible. Hájek concludes that the latter are false, but doesn't provide a clear diagnosis as to why. We endeavour to further our understanding of the paradox by providing such a diagnosis. (shrink)

Self-illness ambiguity is a difficulty to distinguish the ‘self’ or ‘who one is’ from one's mental disorder or diagnosis. Although self-illness ambiguity in a psychiatric context is often deemed to be a negative phenomenon, it may occasionally have a positive role too. This paper investigates whether and in what sense self-illness ambiguity could have a positive role in the process of recovery and self-development in some psychiatric contexts by focusing on a specific case of mental disorder – anorexia nervosa.

From the care Plato takes in describing the excellence of the doctor in book 3 to the characterization of various pathological elements in the regimes he describes in book 8, the Republic teems with references to medical terms and concepts. The following investigates the breadth of the influence of medicine on the Republic. I argue that a medical vocabulary proves indispensable to indicating the relationship between philosophy and politics that the Republic envisages. In order to do so, this paper examines (...) the confluence of medicine and metaphysics revealed by a comparison between the discussion of the divided line and ancient characterizations of diagnosis. I then conclude with a reading of the Glaucus image in book 10 that emphasizes its self-diagnostic character. (shrink)

Inflammatory bowel disease is chronic and incurable. Imperious diarrhea, rectal bleeding, fatigue, and weight loss, the main manifestations, cause a decrease in the quality of the patient’s personal and professional life. The objectives of this study were to identify a possible relationship between early maladaptive schemas and disease activity status using logistic regression, to identify the prevalence of early maladaptive schemes in patients and to propose a psychotherapeutic intervention plan. The following were found in a sample of 46 patients aged (...) 16–76 years. An increase in the domain overvigilance and inhibition score had a significant effect, with an increase of 1.137 CI95% [1.031, 1.254] of the risk of the disease being diagnosed as active. High and very high scores were observed for the emotional deprivation scheme and dependence/incompetence, vulnerability to harm and illness and subjugation schemas. The results show that the proposed model could predict and reconfirm the diagnosis; patients have specific psychotherapeutic needs. The therapeutic goal would be to offer care, empathy and protection, to strengthen self-confidence, to make patients realize that they have the ability to cope, to provide permission, encourage the patient to experiment, and guide the patient to express their anger healthily. The therapy scheme’s intervention could lead to increased long-term disease management capacity and, consequently, reduce costs directly and indirectly caused by this condition. (shrink)

The phenomenon of self-healing forces has again and again challenged doctors in the different historical periods of medical science. They relied on effects of self-healing forces in diagnosis and therapy. They also tried to explain these effects based on the current model of organism. The understanding of this phenomenon has always influenced the understanding of therapy and played a role in defining the concept of health and disease. In the 17th and 18th century the idea of self-healing force was interpreted (...) as a phenomenon related to the organic forces, whereas in the 19th century the explanation was reduced to a materialistic mechanism. Nowadays the knowledge of heath-shock-proteins open the way of a new understanding of the organic defense mechanisms. (shrink)

The self-other asymmetry is a prominent and important feature of common-sense morality. It is also a feature that does not find a home in standard versions of act-utilitarianism. Theodore Sider has attempted to make a place for it by constructing a novel version of utilitarianism that incorporates the asymmetry into its framework. So far as I know, it is the best attempt to bring the two together. I argue, however, that Sider's ingenious attempt fails. I also offer a diagnosis that (...) explains why no theory that remains recognizably act-utilitarian can successfully incorporate the asymmetry. (shrink)

I explicate and defend Kant's analysis of “skepticism” as a single, metaphilosophically unified rational phenomenon (at A756–764/B784–797, for instance). Kant anticipates one of the defining trends of contemporary epistemology's approach to radical philosophical skepticism: the thought that skepticism cannot be directly refuted, by demonstrating its falsity, but must be diagnosed, to show that its premises are unnatural, and consequently fail to be rationally compelling from within our own nonskeptical standpoint. Kant's most ambitious claim here is that he will develop this (...) diagnosis in a unitary fashion, by demonstrating that Cartesian, Humean, Pyrrhonian, and Agrippan skepticism are essentially interrelated as so many means to “the skeptic's” defining philosophical end. This “unity thesis” comes in both weak and strong variations. First, and more weakly, Kant argues that apparently distinct skeptical problematics share certain crucial metaphilosophical assumptions about the nature of reason, and the role of philosophical self-knowledge. More strongly, he also claims that the four problematics just mentioned are related hierarchically, in that the more fundamental skeptical worries constitute the essential dialectical context for the less fundamental ones, such that the more superficial problematics only arise if a logically prior worry is first acceded to. By showing how deeply these two unity theses structure Kant's Critical methodology, I argue that the Kantian view of philosophy as a “doctrine of wisdom” incorporates, and arguably surpasses, a number of key insights found in more recent work. The final result is that the transcendental philosopher may hope to co-opt the attractions of skepticism without making any unnecessary concessions along the way. (shrink)

The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom. Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that threaten their autonomy. Understanding (...) the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women's reproductive freedom. -/- McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged. She also shows how women's experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book's theoretical components are grounded in women's concrete experiences. The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. -/- McLeod also discusses what health-care providers can do to minimize the barriers to women's self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy. (shrink)

This paper articulates a dilemma posed by philosophical counseling literature that presupposes diagnostic recognition. In addition, guests often bring self-ascribed mental health diagnoses from their previous experience, and requests the philosophical counselor to de-diagnose or otherwise reinterpret their problems. Although philosophical counselors can do this, we cannot skirt philosophical diagnosis. The paper’s thesis is that it behooves philosophical counselors to differentiate these types of diagnosis and to know when we are doing one or the other, including the utilization of diagnostic (...) recognition. Anecdotes from the author’s philosophical counseling sessions are included to illustrate the discussion. The paper concludes that the space of philosophical diagnosis is neither incommensurate with, nor incompatible with clinical diagnosis. On the contrary, the space of philosophical diagnosis ought to harbor the possibility of clinical diagnostic recognition. The philosophical counselor’s repertoire of diagnostic intuitions should cultivate the intuitive recognition of clinical prototypes. (shrink)

Conceptually, recognition claims a cardinal role in many prominent philosophical theories. Kant, in the Critique of Pure Reason, uses the German word Rekognition—a term that in many ways has no antecedent in prior tradition—to signify the identification, the grasping of, a unified meaning through thought. However, it is through Hegel that a substantial step in practical philosophy is taken, and recognition is put into dialogue with self-consciousness and freedom. Hegel uses the German word Anerkennung, in the period of Jena Realphilosophie, (...) to mean the "real" actualization of freedom through a struggle which leads to two different levels of recognition: legal and moral—their forms constituted by love... (shrink)

An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We show that the experience of asymptomatic disease can involve (...) ‘mismatches’ between one’s beliefs about one’s health status on the one hand, and bodily sensations or past experience on the other. Patients’ attempts to integrate these diagnoses into their self-narratives often involve either forming inaccurate beliefs about bodily sensations and/or past experience, or coming to believe that feelings and experience do not necessarily track or predict health status, leading to an ongoing sense of vulnerability to ill health. These resulting alterations in self-understanding can sometimes be considered harmful, in view of their implications for ascriptions of responsibility and ongoing anxiety. (shrink)

We suggest a fuller understanding of the obligation to respect patient autonomy can be gained by recognizing patients as historically and socially situated agents, whose values are developed, challenged, and changed, rather than merely applied, in their decision-making about their use of preimplantation genetic diagnosis or preimplantation genetic screening (PGD/PGS). We ground this discussion in empirical research on the patients experiences with PGD/PGS, and conclude by suggesting that promoting patients’ self-respect is a useful ethical standard for providers and practices to (...) recognize. (shrink)

Psychiatric diagnoses are increasingly seen as viable categories around which self and social identities might be drawn. This introduces a new pressure on the “boundary problem” for psychiatry: when members of the public request diagnoses to affirm their self-identities how should we draw the line between mental disorder and normality? If psychiatrists have the authority to recognize and diagnose mental disorder, how can roles as diagnosers and gate-keepers be balanced in a post-stigma era of mental health care? Focusing on the (...) disorder identified would-be patient who would not attract the diagnosis they seek were they not to seek it, this essay explores what it means to have an identity bound to a psychiatric diagnosis and considers a framework for psychiatrists to negotiate clinical encounters that involve the seeking of identity affirming diagnoses. (shrink)

This paper has two objectives 1) to study the influence of digital and new technology on COVID-19 diagnosis and healthcare 2) To propose the integral guideline solutions of the infectious disease for the future. COVID-19 stands for corona (CO), virus (VI), disease (D), or SARS-CoV-2, is a respiratory virus first identified in December 2019 in Wuhan, China(WHO, 2019). It is an epidemiological crisis that caused the deaths and sudden destruction of wealth and health of people around the world. Many countries (...) responded to the crisis with what could only be called urgent prevention and treatment. In the 21st century, our society is based on digital and new technology that can control and prevent the COVID-19 pandemics. However, these ways for solving the problem of COVID-19 pandemics are rising an epistemological crisis too. There are some problems with the COVID-19 diagnosis. From Buddhist philosophy perspective, COVID-19 teaches us the coronavirus is causing us to experience some heightened forms of the three marks of our existence which are the impermanence (aniccā), the suffering (duḥkha), and the non-self (anatta). The establishment of scientific expertise and innovation has shown its value and educating the public about testing, diagnosis, communication, treatment, and vaccine development technology for prevention the of infectious diseases in the future. (shrink)

BackgroundThe diagnosis of Attention deficit hyperactivity disorder is primarily dependent on parents’ and teachers’ reports, while children’s own perspectives on their difficulties and strengths are often overlooked.GoalTo further increase our insight into children’s ability to reliably report about their ADHD-related symptoms, the current study examined the associations between children’s self-reports, parents’ and teachers’ reports, and standardized continuous performance test data. We also examined whether the addition of children’s perceptions of ADHD-symptoms to parents’ and teachers’ reports would be reflected by objective (...) and standardized data.MethodsThe study included 190 children with ADHD, aged 7–10 years, who were referred to a pediatric neurologic clinic. A retrospective analysis was conducted using records of a clinical database. Obtained data included children’s self-reports of their attention level and ADHD-related symptoms, parent, and teacher forms of the Conners ADHD rating scales, Child Behavior Checklist, Teacher’s Report Form, and CPT scores.ResultsChildren’s self-evaluations of their functioning were globally associated with their teachers’ and parents’ evaluations, but not uniquely. Children’s self-reports of ADHD symptoms were not uniquely linked to a specific CPT impairment index, but to a general likelihood of having an impaired CPT. The CPT performance successfully distinguished between the group of children who defined themselves as inattentive and those who did not.ConclusionPrimary school children with ADHD are able to identify their limitations and needs difficulties and that their perspectives should inform clinical practice and research. The clinical and ethical imperative of taking children’s perspectives into account during ADHD diagnosis and treatment is highlighted. (shrink)

Background: Newer “closed-loop” neurostimulation devices in development could, in theory, induce changes to patients’ personalities and self-perceptions. Empirically, however, only limited data of patient and family experiences exist. Responsive neurostimulation (RNS) as a treatment for refractory epilepsy is the first approved and commercially available closed-loop brain stimulation system in clinical practice, presenting an opportunity to observe how conceptual neuroethical concerns manifest in clinical treatment. Methods: We conducted ethnographic research at a single academic medical center with an active RNS treatment program (...) and collected data via direct observation of clinic visits and in-depth interviews with 12 patients and their caregivers. We used deductive and inductive analyses to identify the relationship between these devices and patient changes in personality and self-perception. Results: Participants generally did not attribute changes in patients’ personalities or self-perception to implantation of or stimulation using RNS. They did report that RNS affected patients’ experiences and conceptions of illness. In particular, the capacity to store and display electrophysiological data produced a common frame of reference and a shared vocabulary among patients and clinicians .Discussion: Empirical experiences of a clinical population being treated with closed-loop neuromodulation do not corroborate theoretical concerns about RNS devices described by neuroethicists and technology developers. However, closed-loop devices demonstrated an ability to change illness experiences. Even without altering identify and self-perception, they provided new cultural tools and metaphors for conceiving of epilepsy as an illness and of the process of diagnosis and treatment. These findings call attention to the need to situate neuroethical concerns in the broader contexts of patients’ illness experiences and social circumstances. (shrink)

This paper provides a comprehensive exploration of the transformative role of generative AI models, specifically Generative Adversarial Networks (GANs) and Variational Autoencoders (VAEs), in the realm of medical diagnosis. Drawing from the philosophy of medicine and epidemiology, the paper examines the technical, ethical, and philosophical dimensions of integrating generative models into healthcare. A case study featuring Emily underscores the pivotal support generative AI can offer in complex medical diagnoses. The discussion extends to the application of GANs and VAEs in medical (...) imaging, emphasizing their potential in improving diagnostics, treatment planning, and medical research. The paper further delves into challenges and controversies, addressing issues of anatomical accuracy, biases in training data, interpretability of AI-generated medical images, and ethical considerations, for example, the phenomenon of "Dr. Google" and its implications for self-diagnosis, particularly in the context of the increasing role of generative AI models in healthcare. The concluding section emphasizes the need for health literacy, responsible use of online information, and collaborative decision-making between patients and healthcare providers. We advocate for interdisciplinary collaborations to establish ethical guidelines and ensure responsible AI use in healthcare. (shrink)

In cases of depression where linguistic meaning has collapsed, there is good reason to believe that a long-term strategy for recovery must include rehabilitating the depressive person's capacity for meaningful speech. This requires that the patient participate actively in interpreting her own pain. In this essay, I argue that medical diagnosis can tempt patients, particularly women, to circumvent this process of interpretation. To explain this danger, I draw on Julia Kristeva's clinical analyses of depression and recent studies on the correlation (...) between depression and self-silencing. (shrink)

The critical theory of the Frankfurt School starts with an explanatory-diagnostic analysis of the social pathologies of the present followed by anticipatory-utopian reflection on possible treatments for these disorders. This approach draws extensively on parallels to medicine. I argue that the ideas of social pathology and crisis that pervade the methodological writings of the Frankfurt School help to explain critical theory’s contention that the object of critique identifies itself when social institutions cease to function smoothly. However, in reflecting on the (...) role that reason and self-awareness play in the second stage of social criticism, I contend that this model is actually better conceptualized through the lens of the psychoanalyst rather than the physician. Although the first generation’s explicit commitment to psychoanalysis has dissipated in recent critical theory, faith in a rationalized ‘talking cure’ leading to greater self-awareness of existing pathologies remains at the core of the Frankfurt School. (shrink)

I propose that paradigmatic cases of self-deception satisfy the following conditions: (a) the person who is self-deceived about not-P pretends (in the sense of makes-believe or imagines or fantasizes) that not-P is the case, often while believing that P is the case and not believing that not-P is the case; (b) the pretense that not-P largely plays the role normally played by belief in terms of (i) introspective vivacity and (ii) motivation of action in a wide range of circumstances. Understanding (...) self-deception in this way is highly natural. And it provides a non-paradoxical characterization of the phenomenon that explains both its distinctive patterns of instability and its ordinary association with irrationality. Why, then, has this diagnosis been overlooked? I suggest that the oversight is due to a failure to recognize the philosophical significance of a crucial fact about the human mind, namely, the degree to which attitudes other than belief often play a central role in our mental and practical lives, both by "influenc[ing our]... passions and imagination," and by "governing.. .our actions.". (shrink)

Diagnostic self-testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point-of-care facilities and at home. Designed to allow earlier detection of diseases, self-testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home-based diagnostic technology for individuals and society remain unclear due to their novelty. We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home-based self-testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation. While the ethical issues are not necessarily new, the development of home-based self-testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Eric Voegelin and Eugen Rosenstock-Huessy provide an interesting and important contrast in their Augustinian diagnoses of modernity and the role of revolution and faith in salvation in history. For Eric Voegelin the desolation of modern humanity springs from its unreal elevation of the self – its Gnostic inheritance – and its immanentization of God and the eschaton into history and progress. In keeping with this is the moderns’ failure to appreciate that the symbolic order required for a fulfilling human community (...) and experience relies upon the necessity of maintaining God as a beyond in relation to society, man and world. Rosenstock-Huessy is also concerned that the failure of the moderns to understand the sign and significance of God is disastrous. And like Voegelin he is deeply opposed to modern Gnosticism and the pathologies that emerge from it, but Rosenstock-Huessy is also interested in something that is not Voegelin’s primary concern – mainly the role of providence in history. (shrink)

In “Mad Narratives: Self-Constitutions Through the Diagnostic Looking Glass,” by using narrative approaches to the self, I explore how the diagnosis of mental disorder shapes personal identities and influences flourishing. My particular focus is the diagnosis grounded on the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM). I develop two connected accounts pertaining to the self and mental disorder. I use the memoirs and personal stories written by the subjects with a DSM diagnosis as illustrations to bolster (...) my claims. First, expanding on the narrative approaches to the self, I explain how narratives about a subject shape her self-constitution. I elucidate how this process is generated by drawing on research in developmental psychology, cognitive science, and social psychology. Next, using this account as a springboard, I argue that the DSM diagnosis of mental disorder serves as a source of narrative, entering into the patients’ autobiographical and social narratives. This plays an important role in the diagnosed subjects’ self-understanding, self-constitution and flourishing. In this vein, how mental disorders are classified is not only a theoretical question about accurately taxonomizing the various experiences related to mental distress but also an ethical question about which ways of talking about mental disorders will allow subjects to respond effectively to their psychological distress, to flourish and to live autonomous and fulfilling lives. Finally, I suggest that the DSM-based narratives wield a double-edged sword when it comes to the subject’s flourishing: On the one hand, there are problems with some DSM-based narratives that stem from the DSM diagnostic schema and the culture of DSM diagnoses. These problems render these DSM-based narratives unbeneficial for flourishing as they constrain the range of adoptive social, cognitive and emotional responses the subjects can give to their mental disorders. On the other hand, there are grounds to believe that some DSM-based narratives help subjects to flourish. For instance, they provide certainty to subjects' otherwise puzzling symptoms and help them reach out to others with similar experiences. Understanding how the DSM-based narratives can both benefit and harm will help us address problems with psychiatric diagnoses and the dissemination of knowledge about mental disorders in popular culture. The project aims to convince both philosophers and psychiatrists that no plausible theory of the self can be developed without attending to the topic of mental disorder and that no theory of mental disorder can be complete without devising the tools provided by the philosophical approaches to the self as well as developmental and social psychology. It also calls for methodological alterations in mental health ethics research, arguing that a careful scrutiny of mental disorder memoirs can advance the ethical underpinnings to the practice of psychiatry. (shrink)

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs written by (...) people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)

The nature of self has been discussed for centuries, with myriad theories specifying propositions of the form ‘The self is X’. Recently, psychology and neuroscience have added further such propositions and have sought to specify neural correlates for X. In this thesis, theories leading to all such propositions are subjected to methodological criticism. Specifically targeted are those theories that construct metaphysical, essentialist propositions on the nature of the self, and all other abstract concepts, more generally. On this point, it is (...) concluded that theories of this type would benefit from taking into account the nature of language and the role it plays in the development of a theory. Theories that fail to consider language, run the risk of producing theoretical work affected by linguistic biases, those inherent to the language faculty. In this thesis, the biases of interest are referred to as ‘noun phrase reification’ and ‘clausal reification’, and an awareness of these is important for they can subvert the meanings of propositions, rendering them, and the theories built upon them, true by definition. In consideration of this methodological critique, a new theoretical approach to the self and to other abstract concepts is argued for. This new way of theorising combines aspects of basic scientific methodology with statistical modelling and linguistic theory, in which, the triangulation between two or more people, engaged in the act of naming objects and behaviours plays a formative role. Building on this new method in the context of the self, two experiments are performed using the electroencephalography neuroimaging technique; first in neurotypical adults, then in patients with a diagnosis of schizophrenia, a disorder commonly associated with an attenuated selfhood. It is hoped that this body of theoretical and empirical work will facilitate and catalyse progress on abstract concepts and their associated problems. (shrink)

Zygmunt Bauman has devoted considerable amount of attention to the discussion of the educational challenges in liquid modernity. While a good deal of professional attention has been given to Bauman’s concept in various fields and disciplines, his views on education have received relatively little response by educational theorists and practitioners. The aim of this article is to assess Bauman’s prognosis and diagnosis for education in liquid modernity and argue that even if one generally accepts Bauman’s portrayal of current society, his (...) educational view must presuppose ‘solid’ elements if it is to remain consistent. The article offers some critical reflections with regard to these themes by appealing in particular to the notion of self-critical appropriation, as it is employed in the work of Jurgen Habermas. It is with this notion that it is possible to overcome inconsistencies in Bauman’s educational views and form the basis for understanding how to account for the development of authentic personhood in the social climate of liquid modernity. (shrink)

Phenomenological psychiatry has suffered from a failure to translate its insights into terms specific enough to be applied to psychiatric diagnosis or to be used in contemporary research programs. This difficulty can be understood in light of the well-known tradeoff between reliability and validity. We argue, however, that with sufficient ingenuity, phenomenological concepts can be adapted and applied in a research context. Elsewhere, we have described a phenomenologically oriented conception of schizophrenia as a self- or ipseity-disorder with two main facets: (...) decline in the sense of existing as a subject of awareness (diminished self-affection) and heightened awareness of aspects of experience that would normally remain tacit or presupposed (hyperreflexivity). This approach is consistent with Minkowski, Blankenburg, and Kimura and offers one possible synthesis of their views. Here we describe two areas of empirical research that are congruent with, or actually inspired by, a phenomenological approach emphasizing such disorders of consciousness and self-experience: (1) Phenomenologically oriented, interview studies show that, whereas negative-symptom patients generally deny any diminishment of affect and thinking, they do describe qualitative alterations of experience suggestive of hyperreflexivity and diminished self-affection. (2) Another line of research suggests that the early detection of schizophrenic symptoms may be enhanced by adopting a phenomenological approach. (shrink)

Introducción: La asignatura Metodología de la Investigación Cualitativa en Salud se imparte a los estudiantes de tercer año de la Licenciatura en Enfermería en la modalidad de clase teórico-práctica como forma organizativa de la docencia. Ello recalca la importancia del trabajo independiente. Las insuficiencias con relación a éste inciden directamente en la asimilación y apropiación de los conocimientos de la asignatura. Objetivo: Elaborar una estrategia didáctica que contribuya al desarrollo del trabajo independiente correspondiente a la asignatura Metodología de la Investigación (...) Cualitativa en Salud.Material y métodos: Se realizó una investigación de desarrollo, encaminada a perfeccionar el proceso docente educativo en la Facultad de Enfermería, de la Universidad de Ciencias Médicas de Camagüey, durante el curso escolar 2011-2012. Para el diagnóstico inicial se procedió al análisis de documentos: los planes de estudio y el programa de la asignatura. También se aplicaron encuestas a un grupo de estudiantes y al colectivo de profesores que imparten la asignatura. Una vez elaborada la estrategia se evaluó por criterio de expertos. Resultados y discusión: La estrategia pone a disposición de la comunidad académica un software educativo que relaciona los contenidos de la asignatura, lo que permitirá al estudiantado realizar las tareas docentes que se orientan en clases así como asimilar, consolidar y sistematizar los conocimientos con mayor facilidad. Introduction: The subject Methodology of Qualitative Research in Health is taught to the students of the third year of the Bachelor in nursing in the form of theoretical and practical lesson as organizational way of teaching. This underscores the importance of self-employment. The shortcomings in relation to this affect directly the assimilation and appropriation of knowledge in the subject. Objective: To develop a teaching strategy that contributes to the development of self-employ ment for the subject Methodology of Qualitative Research in Health. Material aids and methods: A development research was made which aims at improving the educational teaching process in the Faculty of nursing from the University of Medical Sciences in Camagüey, during the 2011-2012 course. For an initial diagnosis the analyses of documents was made: the curriculum and the program of the course. Surveys were also applied to a group of students and the staff of teachers of the subject. Once the strategy was made it was evaluated through criteria of experts. Results and discussion: Strategy makes available to the academic community educational software that relates to the contents of the course, allowing students to perform teaching tasks which are assigned in lessons as well as assimilate, consolidate and systematize the knowledge easiest. (shrink)

Computer multistage adaptive test combines the advantages of paper and pencil-based test and computer-adaptive test. As CAT, MST is adaptive based on modules; as P&P, MST can meet the need of test developers to manage test forms and keep test forms parallel. Cognitive diagnosis can accurately measure students’ knowledge states and provide diagnostic information, which is conducive to student’s self-learning and teacher’s targeted teaching. Although MST and CD have a lot of advantages, many factors prevent MST from applying to CD. (...) In this study, we first attempt to employ automated test assembly to achieve the objectives of MST in the application of CD via heuristic algorithms. The mean correct response probability of all KSs for each item is used to describe the item difficulty of CD. The attribute reliability in CD is defined as the test quantitative target. A simulation study with the G-DINA model was carried out to investigate the proposed CD-MST, and the results showed that the assembled panels of CD-MST satisfied the statistical and the non-statistical constraints. (shrink)

In his book Das Recht der Freiheit (2011), Axel Honneth develops a theory of social justice that incorporates negative, reflexive and social forms of freedom as well as the institutional conditions necessary for their reproduction. This account enables the identification of social pathologies or systemic normative deficits that frustrate individual efforts to relate their actions reflexively to a normative order and inhibits their ability to recognize the freedom of others as a condition of their own. In this article I utilize (...) Honneth’s theory in the diagnosis of a contemporary social pathology, which impedes social recognition and thereby contributes to social injustice. I argue that this particular social pathology – associated with the Second Amendment right to bear arms – has given rise to a pernicious form of subjectivity, which I call self-defensive. I conclude with some remarks concerning what this application reveals about the strengths and weaknesses of Honneth’s account. (shrink)

First published in 1996, _The Embedded Self_ was lauded as "a brilliant and long overdue rapprochement between psychoanalysis and family therapy conceived by a practitioner trained and experienced in both modalities of treatment." Mary-Joan Gerson’s integrated presentation of psychodynamic and family systems theory invited therapists of either orientation to learn the tools and techniques of the other, to mutual benefit. Firmly grounded in detailed case presentations, her focus on family therapy examined its history, organizing concepts, and developmental approaches, and addressed (...) practical questions of diagnosis, clinical interaction, and referrals. A dozen years later, the psychoanalytic community is more open to integrating perspectives, and the growth of analysts working with couples and families necessitates an update of the material presented in _The Embedded Self_. Similarly, the family therapy community has deepened its interest in individual dynamics within systemic patterning. From a new and revised perspective on the possibilities of integration, Gerson covers the latest research in neuroscience and the transmission of affect within intimate relationships, with a new chapter on attachment theory and emotionally focused therapy. Sections on narrative therapy and psychoanalytically-oriented family therapy are expanded as well. _The Embedded Self_ was a sterling introduction to family systems theory and therapy, and enhanced the work of analysts and family and couples therapists alike. The second edition proves no different in its context but wider in its scope, further enhancing the work of the family therapist interested in individual dynamics, and preparing the psychodynamically-oriented therapist who seeks to extend her craft from the dyad to the triad, and beyond. (shrink)

The modern editions of the Diagnostic and Statistical Manual of Mental Disorders, beginning with DSM-III in 1980, emerged in response to notable challenges to psychiatry’s practices and ways of knowing in the early 1970s. Because these challenges threatened psychiatry’s scientific self-understanding and moral authority, they exemplify what Alasdair MacIntyre has termed “epistemological crisis.” As a response to crisis, the modern DSM has been a stunning political achievement, providing the central diagnostic constructs around which psychiatric research, practice, and reimbursement has been (...) organized for four decades. Indeed, the DSM’s authority survives in the face of ongoing trenchant scientific and philosophical critique. But if psychiatry is to be healthy, it must be epistemologically humble, reckoning honestly with the limits of the DSM before a future epistemological crisis destabilizes it entirely. (shrink)

The paper criticizes two prominent accounts which purport to explain normativity by appealing to some relation that one bears to oneself. Michael Bratman argues that one has reason to be formally coherent because otherwise one would fail to govern oneself. And David Velleman argues that one has reason to be formally coherent because otherwise one would be less intelligible to oneself. Both Bratman and Velleman argue in quite different ways that rational coherence is normative because it is necessary for the (...) instantiation or promotion of the independently normative self-relation they invoke. But the paper presents a similar scenario which arguably exposes a failure of extensional adequacy common to both accounts: one can instantiate the self-relation in question without being formally coherent. A brief diagnosis is offered for why two such different accounts turn out to be vulnerable to a similar counterexample, suggesting that other accounts which appeal to self-relations in a broadly similar way might also suffer from the problem identified here. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Accurate Self-Assessment, Autonomous Ignorance, and the Appreciation of DisabilityJoel Anderson (bio) and Warren Lux (bio)In their thoughtful commentaries on our essay, "Knowing your own strength: Accurate self-assessment as a requirement for personal autonomy," George Agich, Ruth Chadwick, and Dominic Murphy (2004) provide both criticisms and insights that give us a context in which to clarify further our claim that one's autonomy is impaired when one is unable to appreciate (...) whether one has the capacities required for tasks one is undertaking. We focus on two issues: the extent to which our account of autonomy suggests a problematically "externalist" or "objective" approach and the issue of whether our talk of accurate self-assessment entails an overdemanding requirement that one know numerous facts about oneself to count as autonomous.The External Point of ViewFor many, the idea that specific regions of the brain might be relevant to a person's autonomy evokes nightmarish, startlingly reductionist visions of a world in which informed consent is decided on the basis of neuroimaging. In arguing that a capacity for self-assessment is essential for autonomy and also presupposes executive function that is often impaired by prefrontal damage, we do not wish to engage in such reductionism by suggesting that there is any straightforward, one-to-one mapping comparable to that presupposed by the nightmare scenarios. Given what we know about the brain's plasticity, the prospects (although limited at present) for neurorehabilitation, the multiplicity of the instantiation of autonomy-related capacities, and, especially, the constitutively moral/normative dimensions of these capacity concepts, such mappings are clearly problematic. This is true even in the easy cases, which, as Murphy points out, include our case of "John." This is all the more true with regard to the more complicated psychiatric cases, including disorders such as depression where the normative dimensions and the greater interpretive leeway in diagnosis preclude reductionist solutions (See Anderson 2004). For these reasons and for independent philosophical reasons, we are uncomfortable with the label "externalist," [End Page 309] although we acknowledge and confirm our view that externally applied neuroscientific notions—and evidence—can inform these matters. Nonetheless, we do not wish to argue for a fully externalist point of view, especially when paired with the idea that we are advocating a "smooth naturalistic picture of the cognitive basis of autonomy" (Murphy 2004, 303). Murphy puts us in some terrific company with the likes of John Doris, Shaun Nichols, and—we would add—himself, and this is welcome and flattering. But, to avoid any misunderstanding of an issue that we do not actually take up in our essay, we should caution that we do not endorse a program of naturalizing the normativity on which many of central autonomy-related concepts are based. The notion, for example, of what it is to assess competently one's chances of success cannot be replaced with a set of nomological regularities or a self-applying list of necessary and sufficient conditions.Appreciating Disability and Knowing the FactsOne of the central challenges we face in presenting our approach is to distinguish our requirement of "accurate self-assessment" from an implausible requirement that one have no false beliefs about one's capacities. In different ways, all three commentaries make it clear that our argument would benefit from further clarification of this distinction.In her commentary, Chadwick suggests that our approach may commit us to requiring too much self-knowledge, specifically, that it seems to require accurate knowledge of things like our genetic makeup as a requirement for autonomy. To begin with, it is worth underscoring again that the requirement we have introduced is explicitly task specific: we are focused here on whether an agent has an understanding of things that are relevant for undertaking an intended task, and declarative knowledge of facts, genetic or otherwise, about oneself is relevant only insofar as they bear on that understanding.But Chadwick's point clearly goes deeper. In that regard, it is particularly important to underscore that ours is actually a requirement that has less to do with knowing facts—even task-specific ones—about oneself and much more to do with having the ability to incorporate available... (shrink)

The current middle schools teach Oriental Ethics by utilizing moral education textbooks. Textbooks of moral education nurture moral ethics and etiquette needed for leading our lives and make us scrupulously reflect ethical issues and revise them involved in society and our lives thereby helping us to lead our lives in a desirable way and therefore contribute to the development of our society and this world. In case of presenting materials for textbook reading related to Western philosophy described in the textbooks (...) of moral education, they schematize them for students to easily understand and help them to explore them while in case of oriental ones, it is found to be quite insufficient and the reason is that only few of them who write textbooks are majored in oriental philosophy or oriental ethics. So it is quite appropriate that when writing and examining the content involved in oriental ethics, more than a certain proportion should be allocated to the people who are majored in oriental philosophy or oriental ethics. To revitalize oriental ethics education in middle schools, the content of the subject should be made easy and interesting to approach and to do this the utmost efforts of the writers are required. Furthermore, more good quality books other than the textbooks which are easy to read and help students to gain wisdom of lives are needed. If necessary, a system where the scholars can advise or provide related materials on the questions of the teachers or the students on line. Along with that, the teachers teaching oriental ethics should give them fun and inspiration, training their thoughts and moral judgment capacity To raise the level of the middle school students’ response regarding oriental ethics other than the classes of moral education, a variety of mind training programs which enliven the students’ self respect and understand other people and relieve their stress should be developed and the efforts to apply them should be accompanied. (shrink)

While often dubbed “the bible of contemporary psychiatry” and widely hailed as providing “a benchmark” for the profession, on closer inspection the DSM is seen to be shot through with philosophical assumptions that restrict its theoretical cogency and limit it clinical efficacy. Hence, in the interests of enhanced patient-care it is important to think critically about the DSM, with a view to maximising its diagnostic strengths while minimising its weaknesses. The critical analysis undertaken in the present paper underscores the importance (...) of not construing the DSM as a self-contained diagnostic tool but of viewing it, rather, as an indispensable component in a more comprehensive, multidimensional diagnostic process. More specifically, the contention is that the DSM’s diagnostic limitations evoke a biopsychosocial framework of application as their necessary corrective, notwithstanding the entrenched tendency to construe these approaches as oppositional. Further, it is contended that a hermeneutically informed biopsychosocial template has particular advantages as an integrating framework. (shrink)

ABSTRACTDiagnostic self‐testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point‐of‐care facilities and at home. Designed to allow earlier detection of diseases, self‐testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home‐based diagnostic technology for individuals and society remain unclear due to their novelty.We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home‐based self‐testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation.While the ethical issues are not necessarily new, the development of home‐based self‐testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

In the last twenty-five years, several authors have raised problems to the thesis that privileged self-knowledge is compatible with content externalism. In particular, the 'slow-switching' argument, which was originally put forth by Paul Boghossian (1989), aims to show that there is no satisfactory account of how we can have privileged knowledge about our own thoughts given content externalism. Though many philosophers have found ways to block the argument, no one has worried to address a major worry that Boghossian had when (...) he presented the argument, which is to understand under which conditions privileged self-knowledge is possible given content externalism. In this paper, I offer a diagnosis of why the slow-switching argument fails and I show how the diagnosis enables us to provide a partial response to Boghossian's worry. (shrink)