In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

In this chapter, it is argued that the Mind-Body Powers model of neural correlates of consciousness provides a metaphysical framework that yields the theoretical possibility of empirically detecting consciousness. Since the model is informed by an Aristotelian-Thomistic hylomorphic ontology rather than a physicalist ontology, it provides a philosophical foundation for the science of consciousness that is an alternative to physicalism. Our claim is not that the Mind-Body Powers model provides the only alternative, but rather that it provides a sufficient framework (...) for empirically detecting and scientifically studying consciousness. Elsewhere, the integrated information theory’s prediction about the neural correlate of being conscious has been used to illustrate how the Mind-Body Powers model grounds the possibility of empirically detecting consciousness (see M. Owen, 2021, ch. 8). The theory’s prediction was used as one plausible example of a hypothesis about the nature and location of the neural correlate that can be combined with the model. However, there is no settled conclusion about which neurobiological theory of consciousness accurately identifies the neural mechanisms corresponding to being conscious (NAS, 2021, p. 39; Sattin et al., 2021; Seth, 2017; Seth & Bayne, 2022). Therefore, this work will employ another plausible neurobiological prediction provided by the Temporal Circuit Hypothesis. The hypothesis is combined with the Mind-Body Powers model to demonstrate that empirically detecting consciousness is metaphysically plausible wholly apart from a physicalist framework. (shrink)

Psychological essentialism is the belief that some internal, unseen essence or force determines the common outward appearances and behaviors of category members. We investigated whether reasoning about transplants of bodily elements showed evidence of essentialist thinking. Both Americans and Indians endorsed the possibility of transplants conferring donors' personality, behavior, and luck on recipients, consistent with essentialism. Respondents also endorsed essentialist effects even when denying that transplants would change a recipient's category membership (e.g., predicting that a recipient of a pig's heart (...) would act more pig-like but denying that the recipient would become a pig). This finding runs counter to predictions from the strongest version of the “minimalist” position (Strevens,2000), an alternative to essentialism. Finally, studies asking about a broader range of donor-to-recipient transfers indicated that Indians essentialized more types of transfers than Americans, but neither sample essentialized monetary transfer. This suggests that results from bodily transplant conditions reflect genuine essentialism rather than broader magical thinking. (shrink)

In response to commentators, we argue that whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. We also reject preferentially allocating vaccines to countries that hosted trials because doing so unethically favours those with research infrastructure, rather than those facing the worst burdens from COVID-19.

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Context The attitudes of medical professionals towards physician assisted dying have been widely discussed. Less explored is the level of agreement among physicians on the possibility of ‘rational suicide’—a considered suicide act made by a sound mind and a precondition of assisted dying legislation. Objective To assess attitudes towards rational suicide in a representative sample of senior doctors in England and Wales. Methods A postal survey was conducted of 1000 consultants and general practitioners randomly selected from a commercially available database. (...) The main outcome of interest was level of agreement with a statement about rational suicide. Results The corrected participation rate was 50%; 363 questionnaires were analysed. Overall 72% of doctors agreed with the possibility of rational suicide, 17% disagreed, and 11% were neutral. Doctors who identified themselves as being more religious were more likely to disagree. Some doctors who disagreed with legalisation of physician assisted suicide nevertheless agreed with the concept of rational suicide. Conclusions Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In this contribution we investigate the conceptual coherence of penal substitution and its moral validity. After assessing two opposing modern contributions, we turn to Reformed and medieval scholasticism. This scholastic manoeuvre sheds additional light on the analytic questions at issue. Following Owen and Scotus in their use of a relational analysis of guilt and its punishment, we argue that penal substitution is conceptually and morally coherent, albeit not univocally vis-à-vis ordinary punishment. Absent from the case of substitution is personal deservedness; (...) herein we follow Murphy. However, this leaves open the conceptual possibility of representative deservedness. (shrink)

This article examined the effects of body–object interaction (BOI) on semantic processing. BOI measures perceptions of the ease with which a human body can physically interact with a word's referent. In Experiment 1, BOI effects were examined in 2 semantic categorization tasks (SCT) in which participants decided if words are easily imageable. Responses were faster and more accurate for high BOI words (e.g., mask) than for low BOI words (e.g., ship). In Experiment 2, BOI effects were examined in a semantic (...) lexical decision task (SLDT), which taps both semantic feedback and semantic processing. The BOI effect was larger in the SLDT than in the SCT, suggesting that BOI facilitates both semantic feedback and semantic processing. The findings are consistent with the embodied cognition perspective (e.g., Barsalou's, 1999, Perceptual Symbols Theory), which proposes that sensorimotor interactions with the environment are incorporated in semantic knowledge. (shrink)

The essays in this volume were written to celebrate the sixtieth birthday of G. E. L. Owen, who by his essays and seminars on ancient Greek philosophy has made a contribution to its study that is second to none.

Critique de la possibilité d'individus non-substantiels récurrents que G. E. L. Owen repère dans l'«Organon» d'Aristote. Soulevant le problème ontologique de l'un et du multiple, des entités particulières et des entités universelles chez Aristote, l'A. montre qu'un individu unique en nombre ne peut se reproduire périodiquement et que le statut modal des individus récurrents contredit la définition du sujet présent dans les «Catégories» . Conformément aux conditions de la ressemblance établies par Aristote dans les «Topiques», l'A. conclut à l'impossibilité d'individus (...) substantiels ou non-substantiels universels. (shrink)

Stolen Legacy by George G.M. James refutes the Euro-centric myth that the origin of Western philosophy is Greek. First published in 1954, this book was seminal in leading to a radical reappraisal of a philosophical system long thought to be of European origin. It is an essential work in the syllabus for the study of Western philosophy.

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

Aristotle and the sea battle, by G. E. M. Anscombe.--Aristotle's different possibilities, by K. J. J. Hintikka.--On Aristotle's square of opposition, by M. Thompson.--Categories in Aristotle and in Kant, by J. C. Wilson.--Aristotle's Categories, chapters I-V: translation and notes, by J. L. Ackrill--Aristotle's theory of categories, by J. M. E. Moravcsik.--Essence and accident, by I. M. Copi.--Tithenai ta phainomena, by G. E. L. Owen.--Matter and predication in Aristotle, by J. Owens.--Problems in Metaphysics Z, chapter 13, by M. J. Woods.--The (...) meaning of agathon in the Ethics of Aristotle, by H. A. Prichard.--Agathon and eudaimonia in the Ethics of Aristotle, by J. L. Austin.--The final good in Aristotle's Ethics, by W. F. R. Hardie.--Aristotle on pleasure, by J. O. Urmson.--Bibliography (p. 335-41). (shrink)

Aristotle and the sea battle, by G. E. M. Anscombe.--Aristotle's different possibilities, by K. J. J. Hintikka.--On Aristotle's square of opposition, by M. Thompson.--Categories in Aristotle and in Kant, by J. C. Wilson.--Aristotle's Categories, chapters I-V: translation and notes, by J. L. Ackrill.--Aristotle's theory of categories, by J. M. E. Moravcsik.--Essence and accident, by I. M. Copi.--Tithenai ta phainomena, by G. E. L. Owen.--Matter and predication in Aristotle, by J. Owens.--Problems in Metaphysics Z, chapter 13, by M. J. Woods.--The (...) meaning of agathon in the Ethics of Aristotle, by H. A. Prichard.--Agathon and eudaimonia in the Ethics of Aristotle, by J. L. Austin.--The final good in Aristotle's Ethics, by W. F. R. Hardie.--Aristotle on pleasure, by J. O. Urmson.--Bibliography (p. 335-341). (shrink)

Aristotle argued that you need some wealth to live well. The Stoics argued that you could live well with or without wealth. But the Cynics argued that wealth is a hinderance. For the Cynics, a good life consists in self-sufficiency, or being able to rule and help yourself. You accomplish this by living simply and naturally, and by subjecting yourself to rigorous philosophical exercises. Cynics confronted people to get them to abandon extraneous possessions and positions of power to live better. (...) And while the Cynics were experts in living in this way, their ascetic lifestyles made their message curious to some audiences. This paper reflects on Cynic ascetic practices and the ways others perceived them. (shrink)

The Body–Object Interaction (BOI) variable measures how easily a human body can physically interact with a word's referent (Siakaluk, Pexman, Aguilera, Owen, & Sears, ). A facilitory BOI effect has been observed with adults in language tasks, with faster and more accurate responses for high BOI words (e.g., mask) than for low BOI words (e.g., ship; Wellsby, Siakaluk, Owen, & Pexman, ). We examined the development of this effect in children. Fifty children (aged 6–9 years) and a group of 21 (...) adults completed a word naming task with high and low BOI words. Younger children (aged 6–7 years) did not show a BOI effect, but older children (aged 8–9 years) showed a significant facilitory BOI effect, as did adults. Magnitude of children's BOI effect was related to age as well as reading skills. These results suggest that bodily experience (as measured by the BOI variable) begins to influence visual word recognition behavior by about 8 years of age. (shrink)