ObjectiveHead and neck cancer treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: the prevalence, level, and course of body image concerns; correlates of upon cancer diagnosis body image concerns; predictors of immediate post-treatment body image concerns; and association between body image concerns (...) and levels of anxiety, depression, suicidal ideation, support, and alcohol and drug misuse.MethodsTwo hundred and twenty-three, newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model.ResultsSixty-eight percent of patients with HNC presented some level of body image concerns. Body image concerns at baseline and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment, 89% presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism.ConclusionThis longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions. (shrink)

This highly multidisciplinary collection discusses an increasingly important topic among scholars in science and technology studies: objectivity in science. It features eleven essays on scientific objectivity from a variety of perspectives, including philosophy of science, history of science, and feminist philosophy. Topics addressed in the book include the nature and value of scientific objectivity, the history of objectivity, and objectivity in scientific journals and communities. Taken individually, the essays supply new methodological tools for theorizing what is valuable in the pursuit (...) of objective knowledge and for investigating its history. The essays offer many starting points, while suggesting new avenues of research. Taken collectively, the essays exemplify the very virtues of objectivity that they theorize—in reading them together, the reader can sense various anxieties about the dangerously subjective in our age and locate commonalities of concern as well as differences of approach. As a result, the volume offers an expansive vision of a research community seeking a communal understanding of its own methods and its own epistemic anxieties, struggling to enunciate the key problems of knowledge of our time and offer insight into how to overcome them. -/- (Contributors: Alex Csiszar, Scott Edgar, Peter Galison, Ian Hacking, Sandra Harding, Moira Howes, Paolo Savoia, Judy Segal, Joan Steigerwald, and Alison Wylie). (shrink)

There are at least two different aspects of our rational evaluation of agents’ doxastic attitudes. First, we evaluate these attitudes according to whether they are supported by one’s evidence (substantive rationality). Second, we evaluate these attitudes according to how well they cohere with one another (structural rationality). In previous work, I’ve argued that substantive and structural rationality really are distinct, sui generis, kinds of rationality – call this view ‘dualism’, as opposed to ‘monism’, about rationality – by arguing that the (...) requirements of substantive and structural rationality can come into conflict. In this paper, I push the dialectic on this issue forward in two main ways. First, I argue that the most promising ways of resisting the diagnosis of my cases as conflicts still end up undermining monism in different ways. Second, supposing for the sake of argument that we should understand the cases as conflicts, I address the question of what we should do when such conflicts arise. I argue that, at least in a prominent kind of conflict case, the coherence requirements take precedence over the evidential requirements. (shrink)

We investigate the impact of informal arguments on judgments about thought experiment cases in light of Deutsch and Cappelen’s mischaracterization view, which claims that philosophers’ case judgments are primarily based on arguments and not intuitions. If arguments had no influence on case judgments, this would seriously challenge whether they are, or should be, based on arguments at all—and not on other cognitive sources instead, such as intuition. In Experiment 1, we replicated Wysocki’s (Rev Philos Psychol 8(2):477–499, 2017) pioneering study on (...) a Gettier-style case, and we confirmed that the informal arguments used by him had no significant effect. However, we also included an improved argument for ascribing knowledge, which did have a significant effect even in Wysocki’s original design. We therefore followed up with Experiment 2 on three Gettier-style cases, where we used a more natural dialogical format for presenting both case descriptions and informal arguments. Overall, we found a clear impact of prima facie good pro and con arguments on case judgments. The issue of argument impact is thus no obstacle to arguing about thought experiments. (shrink)

Some combinations of attitudes--of beliefs, credences, intentions, preferences, hopes, fears, and so on--do not fit together right: they are incoherent. A natural idea is that there are requirements of "structural rationality" that forbid us from being in these incoherent states. Yet a number of surprisingly difficult challenges arise for this idea. These challenges have recently led many philosophers to attempt to minimize or eliminate structural rationality, arguing that it is just a "shadow" of "substantive rationality"--that is, correctly responding to one's (...) reasons. -/- In *Fitting Things Together*, Alex Worsnip pushes back against this trend--defending the view that structural rationality is a genuine kind of rationality, distinct from and irreducible to substantive rationality, and tackling the most important challenges for this view. In so doing, he gives an original positive theory of the nature of coherence and structural rationality that explains how the diverse range of instances of incoherence can be unified under a general account, and how facts about coherence are normatively significant. He also shows how a failure to focus on coherence requirements as a distinctive phenomenon and distinguish them adequately from requirements of substantive rationality has led to confusion and mistakes in several substantive debates in epistemology and ethics. -/- Taken as a whole, Fitting Things Together provides the first sustained defense of the view that structural rationality is a genuine, autonomous, unified, and normatively significant phenomenon. (shrink)

Outside the philosophy classroom, global skeptics – skeptics about all (purported) knowledge of the external world – are rare. But there are people who describe themselves as “skeptics” about various more specific domains, including self-professed “skeptics” about the reality of anthropogenic climate change. There is little to no philosophical literature that juxtaposes the climate change skeptic with the external world skeptic. While many “traditional” epistemologists assume that the external world skeptic poses a serious philosophical challenge in a way that the (...) climate change skeptic doesn’t, many “applied” or “social” epistemologists assume that there isn’t much to be learned from debates about the external world skeptic, finding her challenge to be distant from both common sense and real-world concerns. I try to show that both of these views are mistaken. The external world skeptic raises deep questions that are important for our everyday deliberation about what to believe, and there are significant structural parallels between the arguments for external world skepticism and those for at least a form of climate change skepticism that is idealized – but not too idealized! – from the views of flesh-and-blood climate change skeptics. As such, we have strong reasons to think in parallel about how to reply to both skeptics’ challenges. I thus finish by (briefly) considering how different widespread responses to the external world skeptic might or might not generalize happily to the climate change skeptic’s challenge. (shrink)

Especially but not exclusively in the United States, there is a significant gulf between expert opinion and public opinion on a range of important political, social, and scientific issues. Large numbers of lay people hold views contrary to the expert consensus on topics such as climate change, vaccines, and economics. Much political commentary assumes that ordinary people should defer to experts more than they do, and this view is certainly lent force by the literally deadly effects of many denials of (...) established science. But there are complex philosophical issues here, concerning, among other things, (i) what an expert is; (ii) what kind of deference is called for; (iii) and when deference is called for. This entry gives an overview of these three issues and recent work on them. It then examines some potential collective and pragmatic disadvantages of deference, before concluding with reflections on what we can say to those who distrust experts. (shrink)

This is volume One of texts (from sanskrit and Tibetan sources) of the two planned volumes on Buddhist Ligic (the second volume to be on topics and opponents).

Deceptive implicatures are a subtle communicative device for leading someone into a false belief. However, it is widely accepted that deceiving by means of deceptive implicature does not amount to lying. In this paper, we put this claim to the empirical test and present evidence that the traditional definition of lying might be too narrow to capture the folk concept of lying. Four hundred participants were presented with fourteen vignettes containing utterances that communicate conversational implicatures which the speaker believes to (...) be false. We further collected several potential proxy measures of lying, to get a better understanding of when a deceptive implicature is considered a case of lying. The results indicate that most implicatures (ten out of fourteen) were evaluated as lies and that lie ratings were closely tracked by the degree to which speakers were considered to have committed themselves to the truth of the content conveyed by their deceptive implicatures. (shrink)

This essay examines a recent line of thought in aesthetics that challenges realist-leaning aesthetic theories. According to this line of thought, aesthetic diversity and disagreement are good, and our aesthetic judgments, responses, and attachments are deeply personal and even identity-constituting. These facts are further used to support anti-realist theories of aesthetic normativity. I aim to achieve two goals: (1) to disentangle arguments concerning diversity, disagreement, and personality; and (2) to offer realist-friendly replies to all three.

The lack of access to gender-affirming surgery represents a significant unmet health care need within the transgender community, frequently resulting in depression and self-destructive behavior. While some transgender people may have access to gender reassignment surgery, an overwhelming majority cannot afford facial feminization surgery. The former may be covered as a “medical necessity,” but FFS is considered “cosmetic” and excluded from insurance coverage. This demarcation between “necessity” and “cosmetic” in transgender health care based on specific body parts is in direct (...) opposition to the scientific community’s understanding of gender dysphoria and professional guidelines for transgender health. GRS affects one’s ability to function in an intimate relationship, while FFS has the same impact on social interactions an, therefore may have a far greater implication for one’s quality of life. FFS is a cost-effective intervention that needs to be covered by insurance policies. The benefits of such coverage far exceed the insignificant costs. (shrink)

The term ‘coherence’ (and its antonym ‘incoherence’) is used in a bewildering variety of ways in epistemology (and in philosophy more broadly). This entry attempts to bring some discipline to uses of the term by offering a taxonomy of notions of coherence (and incoherence), and then surveying which of the resulting notions is (or should be) at work in the various different contexts in which it is deployed.

Suicide is the 10th leading cause of death in the United States and the second cause of death among those ages 15–24 years. The current standard of care for suicidality management often involves an involuntary hospitalization deemed necessary by the attending psychiatrist. The purpose of this article is to reexamine the ethical tradeoffs inherent in the current practice of involuntary psychiatric hospitalization for suicidal patients, calling attention to the often-neglected harms inherent in this practice and proposing a path for future (...) research. With accumulating evidence of the harms inherent in civil commitment, we propose that the relative value of this intervention needs to be reevaluated and more efficacious alternatives researched. Three arguments are presented: (1) that inadequate attention has been given to the harms resulting from the use of coercion and the loss of autonomy, (2) that inadequate evidence exists that involuntary hospitalization is an effective method to reduce deaths by suicide, and (3) that some suicidal patients may benefit more from therapeutic interventions that maximize and support autonomy and personal responsibility. Considering this evidence, we argue for a policy that limits the coercive hospitalization of suicidal individuals to those who lack decision-making capacity. (shrink)

In this paper, we consider how certain longstanding philosophical questions about mental representation may be answered on the assumption that cognitive and perceptual systems implement hierarchical generative models, such as those discussed within the prediction error minimization framework. We build on existing treatments of representation via structural resemblance, such as those in Gładziejewski :559–582, 2016) and Gładziejewski and Miłkowski, to argue for a representationalist interpretation of the PEM framework. We further motivate the proposed approach to content by arguing that it (...) is consistent with approaches implicit in theories of unsupervised learning in neural networks. In the course of this discussion, we argue that the structural representation proposal, properly understood, has more in common with functional-role than with causal/informational or teleosemantic theories. In the remainder of the paper, we describe the PEM framework for approximate Bayesian inference in some detail, and discuss how structural representations might arise within the proposed Bayesian hierarchies. After explicating the notion of variational inference, we define a subjectively accessible measure of misrepresentation for hierarchical Bayesian networks by appeal to the Kullbach–Leibler divergence between posterior generative and approximate recognition densities, and discuss a related measure of objective misrepresentation in terms of correspondence with the facts. (shrink)

Philosophy of Medicine provides a fresh and comprehensive treatment of the topic. It offers a novel theory of the nature of medicine, and proposes a new attitude to medicine, aimed at improving the quality of debates between medical traditions and facilitating medicine's decolonization.

An introduction to the long-forgotten healing methods of the Essenes—an ancient sect of Jewish mystics—that offers useful tools, meditations, and visualizations for modern-day practitioners Until the discovery of the Dead Sea Scrolls in 1946, there was little known about The Essenes, a brotherhood of holy men and women living together within a community over two thousand years ago. The Essenes considered themselves to be a separate people—not because of external signs like skin color or hair color, but because of the (...) illumination of their inner life and their knowledge of the hidden mysteries of nature unknown to other men. The Gate of Light is based on Lars Muhl’s lifelong search for God. It doesn’t claim any absolute truths but sets out to provide a practice based on Essene teachings that allows us to look at how we judge ourselves and how we live in the world. Muhl asks: What motivates us? How do we create a balance between thoughts, words, and actions? How do we align ourselves in relation to our higher self and become the universal light beings we are meant to be? The Essenes understood that everything is interactively connected and that everything is energy. For them, God was the name for the highest form of awareness, something omnipresent and—if a human wished to learn how—they could communicate with this ever-present energy; through this communication humans could realize their full potential. Drawing on this ancient knowledge, Muhl presents a complete practice to help us recognize and answer the above questions. He particularly looks at: Grief and Happiness, Balance and Awareness, Selflessness, Boredom and Renunciation, Loneliness, Gratitude, Silence and Thoughtfulness. (shrink)

Frances Kamm has for some time now been a foremost champion of non-consequentialist ethics. One of her most powerful non-consequentialist themes has been the idea of inviolability. Morality's prohibitions, she argues, confer on persons the status of inviolability. This thought helps articulate a rationale for moral prohibitions that will resist the protean threat posed by the consequentialist argument that anyone should surely be willing to violate a constraint if doing so will minimize the overall number of such violations. As Kamm (...) put it in a 1992 article, ‘If morality permitted minimizing violations of persons by violating other persons, then each of those saved as well as those persons used to save others would be less inviolable. It is the permission, not any actual violation of persons, that makes this so.’ Now, as thus baldly asserted, this claim borders on the conclusory. It is almost as if the claim were that morality conferred on persons the following status: that of being protected from consequentialism. One wants to hear in what inviolability consists, in more detail, so that we can understand it independently of the negation of consequentialism. And there is also an opposite problem: if inviolability is a good, then why can't consequentialism take it into account? Hence, one also wants to hear why this would not be the case. (shrink)

This chapter explores the idea that causal inference is warranted if and only if the mechanism underlying the inferred causal association is identified. This mechanistic stance is discernible in the epidemiological literature, and in the strategies adopted by epidemiologists seeking to establish causal hypotheses. But the exact opposite methodology is also discernible, the black box stance, which asserts that epidemiologists can and should make causal inferences on the basis of their evidence, without worrying about the mechanisms that might underlie their (...) hypotheses. I argue that the mechanistic stance is indeed a bad methodology for causal inference. However, I detach and defend a mechanistic interpretation of causal generalisations in epidemiology as existence claims about underlying mechanisms. (shrink)

Evidence from functional neuroimaging of the human brain indicates that information about salient properties of an object¿such as what it looks like, how it moves, and how it is used¿is stored in sensory and motor systems active when that information was acquired. As a result, object concepts belonging to different categories like animals and tools are represented in partially distinct, sensory- and motor property-based neural networks. This suggests that object concepts are not explicitly represented, but rather emerge from weighted activity (...) within property-based brain regions. However, some property-based regions seem to show a categorical organization, thus providing evidence consistent with category-based, domain-specific formulations as well.Acronyms and DefinitionsBiological motion: motion of animate agents characterized by highly flexible, fully articulated motion vectors, in contrast to the rigid, unarticulated motion vectors associated with most tools.Category-specific disorder: a relatively greater impairment in retrieving information about members of one superordinate object category (e.g., animals) as compared with other categories following brain injury or diseaseIPS: intraparietal sulcusLO: lateral occipital cortexObject concept: memory representations of a class or category of objects. Necessary for numerous cognitive functions including identifying an object as a member of a specific category and drawing inferences about object propertiespMTG: posterior middle temporal gyruspSTS: posterior superior temporal sulcusRepetition suppression: decreased neural response associated with repeated presentation of an identical, or a semantically/conceptually related, stimulusSD: semantic dementiaSemantic memory: a large division of long-term memory containing knowledge about the world including facts, ideas, beliefs, and conceptsSemantic priming: a short-lasting facilitation in processing a stimulus due to the prior presentation of a semantically related stimulusTMS: transcranial magnetic stimulationVPMC: ventral premotor cortex. (shrink)

Much of our ordinary thought and talk about responsibility exhibits what I call the ‘pie fallacy’—the fallacy of thinking that there is a fixed amount of responsibility for every outcome, to be distributed among all those, if any, who are responsible for it. The pie fallacy is a fallacy, I argue, because how responsible an agent is for some outcome is fully grounded in facts about the agent, the outcome and the relationships between them; it does not depend, in particular, (...) on how responsible anyone else is for that same outcome. In this paper, I explore how the pie fallacy can arise by considering several different kinds of case in which two or more agents are responsible for the same outcome. I’ll end with some brief remarks on the potential consequences of my arguments for how to think about responsibility in war. (shrink)

Mark Johnston has recently argued that four-dimensionalist theories of persistence are incompatible with some of our most basic ethical and prudential principles. I argue that although Johnston’s arguments succeed on a worm-theoretic account of persistence, they fail on a stage-theoretic account. So much the worse, I conclude, for the worm theory.

L’article esquisse une histoire de la notion de milieu en confrontant l’article de Georges Canguilhem, « Le vivant et son milieu » (1946), à celui de Leo Spitzer « Milieu et ambiance » (1942). Alors que Spitzer conteste l’opposition entre un milieu abstrait et un environnement « chaud », Canguilhem entend transformer les éléments d’une compréhension mécaniste du milieu en une idée vitaliste et productive de l’interaction mutuelle entre milieu et organisme. L’article se concentre ensuite sur la perspective littéraire et (...) esthétique de la discussion de la relation entre le vivant et son milieu, à partir de l’Histoire de la littérature anglaise de Taine. Dans deux textes de 1930 et 1931, Canguilhem présente une critique véhémente de Taine et oppose à la compréhension déterministe du milieu un concept esthétique qu’il réinvestit pour les sciences de la vie : le concept de création. En repensant la notion de milieu à travers une « esthétique du milieu », l’article conclut en opposant les critiques de Spitzer et de Canguilhem adressées à la compréhension déterministe du milieu et montre que l’opposition radicale entre détermination et création, que Canguilhem semble établir dans ses premiers textes, est reformulée dans son étude postérieure sur Le normal et le pathologique. La vie est créatrice relativement à son milieu au travers des déplacements vers un nouveau milieu, qui est lui-même, à son tour, vulnérable, précaire et inachevé. Pour penser une telle esthétique du milieu, il faut remodeler la notion d’activité artistique à partir d’un concept du vivant qui se forme dans sa confrontation constante avec son milieu. (shrink)

Recent work on rationality has been increasingly attentive to “coherence requirements”, with heated debates about both the content of such requirements and their normative status (e.g., whether there is necessarily reason to comply with them). Yet there is little to no work on the metanormative status of coherence requirements. Metaphysically: what is it for two or more mental states to be jointly incoherent, such that they are banned by a coherence requirement? In virtue of what are some putative requirements genuine (...) and others not? Epistemologically: how are we to know which of the requirements are genuine and which aren’t? This paper tries to offer an account that answers these questions. On my account, the incoherence of a set of attitudinal mental states is a matter of its being (partially) constitutive of the mental states in question that, for any agent that holds these attitudes jointly, the agent is disposed, when conditions of full transparency are met, to give up at least one of the attitudes. (shrink)

Perceptual experiences justify beliefs—that much seems obvious. As Brewer puts it, “sense experiential states provide reasons for empirical beliefs” (this volume, xx). In Mind and World McDowell argues that we can get from this apparent platitude to the controversial claim that perceptual experiences have conceptual content: [W]e can coherently credit experiences with rational relations to judgement and belief, but only if we take it that spontaneity is already implicated in receptivity; that is, only if we take it that experiences have (...) conceptual content. (1994, 162) Brewer agrees. Their view is sometimes called conceptualism; nonconceptualism is the rival position, that experiences have nonconceptual content. One initial obstacle is understanding what the issue is. What is conceptual content, and how is it different from nonconceptual content? Section 1 of this paper explains two versions of each of the rival positions: state (non)conceptualism and content (non)conceptualism; the latter pair is the locus of the relevant dispute. Two prominent arguments for content nonconceptualism—the richness argument and the continuity argument—both fail (section 2). McDowell’s and Brewer’s epistemological defenses of content conceptualism are also faulty (section 3). Section 4 gives a more simple-minded case for conceptualism; finally, some reasons are given for rejecting the claim—on one natural interpretation—that experiences justify beliefs. (shrink)

Alex Oliver and Timothy Smiley provide a new account of plural logic. They argue that there is such a thing as genuinely plural denotation in logic, and expound a framework of ideas that includes the distinction between distributive and collective predicates, the theory of plural descriptions, multivalued functions, and lists.

This book investigates context-sensitivity in natural language by examining the meaning and use of a target class of theoretically recalcitrant expressions. These expressions-including epistemic vocabulary, normative and evaluative vocabulary, and vague language -exhibit systematic differences from paradigm context-sensitive expressions in their discourse dynamics and embedding properties. Many researchers have responded by rethinking the nature of linguistic meaning and communication. Drawing on general insights about the role of context in interpretation and collaborative action, Silk develops an improved contextualist theory of CR-expressions (...) within the classical truth-conditional paradigm: Discourse Contextualism. The aim of Discourse Contextualism is to derive the distinctive linguistic behavior of a CR-expression from a particular contextualist interpretation of an independently motivated formal semantics, along with general principles of interpretation and conversation. It is shown how in using CR-expressions, speakers can exploit their mutual grammatical and world knowledge, and general pragmatic reasoning skills, to coordinate their attitudes and negotiate about how the context should evolve. The book focuses primarily on developing a Discourse Contextualist semantics and pragmatics for epistemic modals. The Discourse Contextualist framework is also applied to other categories of epistemic vocabulary, normative and evaluative vocabulary, and vague adjectives. The similarities/differences among these expressions, and among context-sensitive expressions more generally, have been underexplored. The development of Discourse Contextualism in this book sheds light on general features of meaning and communication, and the variety of ways in which context affects and is affected by uses of language. Discourse Contextualism provides a fruitful framework for theorizing about various broader issues in philosophy, linguistics, and cognitive science. (shrink)

The article concerns a mediaeval Indian debate over whether, and if so how, we can know that a self exists, understood here as a subject of cognition that outlives individual cognitions, being their common substrate. A passage that has not yet been translated from Sanskrit into a European language, from Jayanta Bhaṭṭa’s Nyāyamañjarī, ‘Blossoms of Reasoning’, is examined. This rich passage reveals something not yet noted in secondary literature, namely that Mīmāṃsakas advanced four different models of what happens when the (...) self perceives itself. The article clarifies the differences between the four, and the historical and logical relationships between them. It also hypothesizes pressures that constituted the need for the creation of the newer views, i.e. perceived problems with the earlier views, which the proponents of the newer views saw themselves as overcoming. (shrink)

This is the first book to systematically examine the underlying theory of evidence in Anglo-American legal systems. Stein develops a detailed and innovative theory which sets aside the traditional vision of evidence law as facilitating the discovery of the truth. Combining probability theory, epistemology, economic analysis, and moral philosophy, he argues instead that the fundamental purpose of evidence law is to apportion the risk of error in conditions of uncertainty.

Philosophy and Phenomenological Research, Volume 103, Issue 3, Page 687-709, November 2021.

We welcome Blumenthal-Barby’s et al. (2022) plaidoyer for the integration of philosophy in bioethics because of a perceived mutual benefit. Drawing on experience from a collaborative project, funde...