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)

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 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)

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)

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)

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)

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)

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)

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)

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)

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)

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 (...) class='Hi'>diagnosis that explains why no theory that remains recognizably act-utilitarian can successfully incorporate the asymmetry. (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)

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. (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)

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)

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)

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)

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)

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)

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)

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 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)

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)

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)

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)

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)

In this paper I discuss John Searle?s selective view of intentionality of mental states, and place it in the context of impairment to personal identity that occurs in mental illness. I criticize Searle?s view that intentionality characterizes some but not all mental states; I do so both on principled and on empirical grounds. I then proceed to examine the narrative theory of self, advanced by Paul Ricoeur, Marya Schechtman and others, and explore the extent to which the theory fits (...) a more generalized view of intentionality that would apply to all mental states. This discussion is followed by a brief consideration of the way in which the modern DSM-based psychiatric diagnosis and treatment, reductively and mechanistically, dispenses with the issues of?strong ontology?, namely the life events and values that mental states might in fact reach for, even when ostensibly without reference. In this sense, DSM-inspired psychiatry is based on a Searlian view of mental states. It is contrasted with the narrative theory of self which, rather than defining madness by clusters of symptoms, seeks to understand the underlying ontology of reference by looking for both the initial script of the person?s?life narrative? and for ruptures and knots in that narrative that might give rise to madness. Finally I discuss and evaluate the perspective of personality enhancement through counseling aimed at repairing the personal narrative. nema. (shrink)

In the present article, we aimed at describing the diagnostic process in Psychiatry through a phenomenological perspective. We have identified 4 core concepts which may represent the joints of a phenomenologically oriented diagnosis. The "tightrope walking" attitude refers to the psychiatrist's ability to swing between 2 different and sometimes contrasting tendencies (e.g., engagement and disengagement). The "holistic experience" includes all those intuitive, nonverbal, and pre-thematic elements that emerge in the early stages of the clinical encounter as an emanation of (...) the atmospheric quality of the intersubjective space. The "co-construction of symptoms" regards the hermeneutic process behind psychiatric symptoms, involving both the patient as a self-interpreting agent and the clinician as a translator of his/her experience. Finally, by the "evolving typification" we mean that the closer the relationship becomes with the patient, the more specific and nuanced becomes the typification behind psychiatric diagnosis. Each of these concepts will be accompanied by an extract from a clinical case deriving from one of the authors' most recent clinical experiences. (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)

Background: Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Depression affects an estimated one in 15 adults (6.7%) in any given (...) year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment and give the appropriate method of treatment through several tips that concern the disease and how to treat it and we will see it through the application on the expert system. Methods: in this paper the design of the proposed Expert System which was produced to help Psychologist in diagnosing depression disease through its symptoms such as: a loss of energy, a change in appetite, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness, feelings of worthlessness, guilt or hopelessness and thoughts of self-harm or suicide. The proposed expert system presents an overview about depression disease is given, the cause of diseases is outlined and the treatment of disease whenever possible is given out. SL5 Object Expert System language was used for designing and implementing the proposed expert system. Results: The proposed depression disease diagnosis expert system was evaluated by psychologist students and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for psychologist, patients with depression and newly graduated psychologist. (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)

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 objective of analysis is new opportunities in the study of self-awareness, which became possible through the use of an interdisciplinary approach. This approach allows to solve number of conceptual and methodological problems in psychology and psychiatry. The general development of psychiatry in the 20th and early 21st centuries was to improve diagnosis and therapy based on objectively measured indicators. There is a very superficial development of the phenomenology of self-awareness disorders as a result. The interdisciplinary point (...) of view may be the beginning of new theoretical studies of self-awareness in philosophy, as well as provoke pragmatic conclusions for psychological and psychiatric science. Authors claim that the delimitation of the methodological tools of various sciences in the study of self-awareness is unnecessary in principle. interdisciplinary view should be formed by philosophers. The phenomenology of Karl Jaspers and his concept of self-awareness in this sense are heuristically attractive. The authors propose a working model of self-awareness, based on the phenomenological approach of Jaspers, on the ideas of his followers, and also abandoning the disciplinary view of the subject. In this model self-awareness is described through its specific functions. That may be pragmatically useful for mental health professionals: psychiatrists, psychologists and psychotherapists and it may be interesting to philosophers using phenomenological analysis. (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)

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 (...) class='Hi'>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)

Most of Terence Penelhum’s essays collected in his Themes in Hume are already recognized as classics in Hume scholarship. Bringing them together only reinforces their strengths: clarity and sensitivity in exposition combined with charity and acuity in criticism. Penelhum wrote them over a course of almost fifty years, and we can see in them the evolution in his attitude towards Hume. In the earliest essay — the 1955 ‘Hume on Personal Identity’ — Penelhum offers a quick and local diagnosis (...) of Hume’s errors: he has mistakenly assumed that an object must be unchanging for it to be identical through time. But in the later essays, especially the three new ones, Penelhum recognizes that his earlier local insights must be balanced by a wider reading of Hume. After all, he does not, for example, talk about the self only to say that it is a bundle of perceptions; it is also crucial to his treatment of the passions, especially the indirect, person-oriented passions, and is an essential component in his explanation of sympathy, the ultimate source of our moral judgments. Moreover, as Penelhum notes, seeing the self as constituted out of its perceptions, rather than standing over them so as to judge their legitimacy as guides to action or knowledge, is what allows Hume to attempt a ‘science of man’ — a quasi-Newtonian project of discovering the principles governing the perceptions in the mind-bundle. (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)

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 chapter attempts to “re-boot” the discussion of Harry Frankfurt’s approach to autonomy, in the service of a new diagnosis of the strengths and weaknesses of his satisfaction-based ontology of the will. Criticisms of Frankfurt’s work have tended to focus on a lack of normative foundations, often missing Frankfurt’s aim of shifting discussions of autonomy towards a focus on avoiding passivity in how one cares about what one cares about, while still acknowledging the central role of volitional necessity and, (...) especially, self-satisfaction in autonomous agency. Although this approach provides Frankfurt with interesting ways of deflecting criticisms that are ethical in character, the lack of attention to the hermeneutic and linguistic dimensions of our inner life, leaves his approach with insufficient grounds for identifying the passivity of those who are unable or unwilling to engage in genuine self-interpretation. (shrink)

Psychiatric diagnosis serves many functions in the struggle for recognition, such as access to public mental health systems and legal compensation, but it is not necessarily well-equipped for the task of self-understanding and reconfiguration of personal values in the recovery process – and the likelihood of optimal outcome that is geared to the individual person's quality of life. Call this the transformative dimension of recognition in the complex journey from diagnosis to therapeutic empathy in the doctor–patient relationship.Patients (...) who are diagnosed with a serious and enduring mental health condition often find it difficult to make sense of themselves in relation to their... (shrink)

Objectives: To compare attitudes of medical and law students toward informing a cancer patient about diagnosis and prognosis and to examine whether differences are related to different convictions about benefit or harm of information.Setting and design: Anonymous questionnaires were distributed to convenience samples of students at the University of Geneva containing four vignettes describing a cancer patient who wishes, or alternatively, who does not wish to be told the truth.Participants: One hundred and twenty seven medical students and 168 law (...) students.Main outcome measures: Five point Likert scale of responses to the vignettes ranging from “certainly inform” to “certainly not inform” the patient.Results: All medical students and 96% of law students favoured information about the diagnosis of cancer if the patient requests it. Seventy four per cent of medical students and 82% of law students favoured informing a cancer patient about his or her prognosis . Thirty five per cent of law students and 11.7% of medical students favoured telling about the diagnosis and 25.6% of law students and 7% of medical students favoured telling about the prognosis even if the patient had clearly expressed his wish not to be informed. Law students indicated significantly more often than medical students reasons to do with the patient’s good, legal obligations, and the physician’s obligation to tell the truth, and significantly less often than medical students that their attitude had been determined predominantly by respect for the autonomous choice of the patient.Conclusion: Differences in attitudes according to the type of case and the type of studies were related to convictions about the benefit or harm to the patient caused by being given information. The self reported reasons of future physicians and future lawyers are helpful when considering means to achieve a better acceptance of patients’ right to know and not to know. (shrink)