Background: Family therapy is considered as the gold standard in treatment of adolescents with anorexia nervosa (AN). Among the different types of family therapy, multi-family therapy (MFT) is increasingly used for treating AN, and shows promising results. In this article, our focus relied on the patients’ and their parents’ perceptions of the effectiveness and the underlying mechanisms of the MFT. Methods: The present pilot exploratory qualitative study included two focus groups conducted using a semi-structured approach: one with the adolescents (n= (...) 3), and another with one or two of their parents (n= 4 mothers;n= 2 fathers). The subjects discussed were the changes observed in both AN symptoms and family interactions following therapy, and the mechanisms underlying these changes. We crossed the perspectives of the adolescents and of the parents on these two points. Results: Qualitative analysis revealed that while both adolescents and parents had difficulties relating the changes they observed in the last year to MFT, they were able to say that the group cohesion had several positive effects and that their family dynamics had improved. In the light of analysis the adolescents perceived more improvements related eating disorders symptoms than their parents did, while parents were concerned about a negative effect of MFT on their children. Discussion: While both patients and parents perceived improvements in both AN symptoms and family interactions in the past year, it was not clear if they considered MFT to have led to these improvements. FG also explored the MFT mechanisms underlying changes. Both adolescents and their parents stressed the beneficial effects of identification to others members of the group and shared experience to overcome social isolation. Parents also mentioned the sympathy they felt for each other. The idea that they give a central place to families in the therapy was also described by the families. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

The medicalisation of pregnancy and childbirth has been encouraged by the continuing growth of technology that can be applied to the reproductive journey. Technology now has the potential to fully separate reproduction from the human body with the prospect of ectogenesis—the gestation of a fetus outside of the human body. This paper considers the issues that have been caused by the general medicalisation of pregnancy and childbirth and the impact that ectogenesis may have on these existing issues. The medicalisation of (...) pregnancy and childbirth is criticised for its impact on the relationship between doctors and pregnant women and the way in which doctors treat fetuses. It is argued that ectogenesis may cause more imbalance in the doctor and intended parent relationship and may result in an increased lack of clarity regarding a doctor’s duty to the fetus. This paper finds that extensive guidance and revised legislation will be necessary to minimise the impact of ectogenesis on the existing issues caused by the medicalisation of reproduction. (shrink)

This paper is divided into two parts. In Section 1, I explore and defend a “regulative view” of folk-psychology as against the “standard view”. On the regulative view, folk-psychology is conceptualized in fundamentally interpersonal terms as a “mind-making” practice through which we come to form and regulate our minds in accordance with a rich array of socially shared and socially maintained sense-making norms. It is not, as the standard view maintains, simply an epistemic capacity for coming to know about the (...) mental states and dispositions already there. Importantly, the regulative view can meet and beat the standard at its own epistemic game. But it also does more. In Section 2, I show how the regulative view makes progress on two other problems that remain puzzling on the standard view: the problem of “first-person authority” – accounting for the special features of self-knowledge; and the problem of “reactive.. (shrink)

This paper examines the methodological claim made famous by P.F. Strawson: that we understand what features are required for responsible agency by exploring our attitudes and practices of holding responsible. What is the presumed metaphysical connection between holding responsible and being fit to be held responsible that makes this claim credible? I propose a non-standard answer to this question, arguing for a view of responsible agency that is neither anti-realist (i.e. purely 'conventionalist') nor straightforwardly realist. It is instead ‘constructivist’. On (...) the ‘Scaffolding View’ I defend, reactive attitudes play an essential role in developing, supporting, and thereby maintaining the capacities that make for responsible agency. While this view has relatively novel implications for a metaphysical understanding of capacities, its chief virtue, in contrast with more standard views, is providing a plausibly defensible account of how so-called responsible agents genuinely deserve to be treated as such. (shrink)

Philosophers and social scientists have focussed a great deal of attention on our human capacity to trust, but relatively little on the capacity to hope. This is a significant oversight, as hope and trust are importantly interconnected. This paper argues that, even though trust can and does feed our hopes, it is our empowering capacity to hope that significantly underwrites—and makes rational—our capacity to trust.

Numerous societal issues, from climate change to pandemics, require public engagement with scientific research. Such engagement reveals challenges that can arise when experts communicate with laypeople. One of the most common frameworks for framing these communicative interactions is the deficit model of science communication, which holds that laypeople lack scientific knowledge and/or positive attitudes towards science, and that imparting knowledge will fill knowledge gaps, lead to desirable attitude/behavior changes, and increase trust in science. §1 introduces the deficit model in more (...) detail and shows that adhering to this model often fails to achieve its aims, which motivates the main question of this chapter: how can Ludwik Fleck’s theory of thinking collectives address the persistent problem of deficit approaches in science communication? I suggest that it can do so by exposing the deficit model’s implicit assumption of an expert-lay divide. Accordingly, §2 lays out Fleck’s theory and §3 contrasts it with contemporary debates about science communication. Following this descriptive work, §4 draws on Fleck’s ideas to make four concrete suggestions for further questioning the expert-lay divide. (shrink)

We call systematic disputes that are particularly hard to resolve deep disagreements. We can divide most theories of deep disagreements in analytic epistemology into two camps: the Wittgensteinian view and the fundamental epistemic principles view. This essay analyzes how both views deal with two of the most pressing issues a theory of deep disagreement must address: their source and their resolution. After concluding that the paradigmatic theory of each camp struggles on both fronts, the essay proceeds to show that, despite (...) their differences, these theories share some core assumptions and think of deep disagreements similarly: as grounded in fundamental epistemic differences between the parties. This underlying conception of deep disagreements the author calls “the fundamental model.” The essay provides reasons to be wary of this conception, and hence, mainstream epistemologists’ treatment of the issue. (shrink)

The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied in clinical (...) settings. It is precisely for this reason that we draw on the reported experiences of neonatal intensive care (NICU) parents since they present the closest analogy which can be drawn with the technology.1 What we reject in Kennedy’s response, however, is the claim that the experiences of NICU parents have been ‘exploited’ by us.2 Studies documenting the experiences of NICU parents were drawn on to indicate that our considerations are more than mere speculation. As stated, the experiences of NICU parents, particularly the pregnant individual who experiences pregnancy loss, are the closest indication we have of how AAPT and what it entails may be experienced. To claim that this data is being exploited by us is to undermine the very purpose that such research is undertaken—to indicate how future care may be improved. It would be much more harmful to not use this information. While we believe that experiences of …. (shrink)

In Building Better Beings, Vargas develops and defends a naturalistic account of responsibility, whereby responsible agents must possess a feasibly situated capacity to detect and respond to moral considerations. As a preliminary step, he also offers a substantive account of how we might justify our practices of holding responsible—viz., by appeal to their efficacy in fostering a ‘valuable form of agency’ across the community at large, a form of agency that precisely encompasses sensitivity to moral considerations. But how do these (...) accounts relate to one another? Though I find much that is appealing in Vargas’s general approach, I challenge his insistence that these accounts should be treated as ‘conceptually independent’, arguing that this generates an objectionable “justification gap”: on his analysis, someone could remain an appropriate target of our responsibility practices and yet fail to be a morally responsible agent. In closing, I offer a potential solution to this problem, though it means re-visioning how the account of moral responsibility is conceptually tied to the justification of our responsibility practices. (shrink)

This paper describes a live ethics case project that can be used to teach ethics in a broad variety of business classes. The live case differs from regular cases in that it involves a current situation. Students select an on-going or current event that involves ethical violations and write a case about it. They then present their case and run a debate about the challenges and issues outlined in the case and the actions that could have or should have been (...) taken. The dynamic project fulfills the key criteria for effective ethics education since it increases awareness of the complexity of ethical challenges, allows application of concepts, creates a personal emotional engagement in the case, is relevant, holds students accountable for their position, and creates a setting that encourages students to think critically about ethics. (shrink)

En este capítulo, analizo a qué se refiere Kuhn cuando habla de metáfora en las Conferencias Notre Dame, pero sobre todo a explorar a qué no se refiere. En la primera sección, analizo por qué Kuhn usa el término “metáfora” para referirse al proceso de aprendizaje de lenguaje científico, en particular, los paralelismos que encuentra entre ambos fenómenos. En la segunda sección, se presentan algunos aspectos centrales de dos teorías influyentes sobre la metáfora: la teoría del mapeo estructural y la (...) teoría de las metáforas conceptuales. Luego, en la sección III, vuelvo a Kuhn para ver las diferencias cruciales que encontramos entre los procesos metafóricos y el proceso de ostensión del que habla el autor. Finalmente, presento una noción del segundo Wittgenstein, la idea de figura, para ofrecer una nueva forma de interpretar la idea de que el cambio revolucionario involucra un cambio en la metáfora central. (shrink)

Volume 3, Issue 1, March 2019, Page 48-59.

Is it possible to disagree with someone without considering them cognitively flawed? The answer seems to be a resounding yes: disagreeing with someone doesn't entail thinking less of them. You can disagree with someone and not think that they are unreasonable. Deep disagreements, however, may challenge this assumption. A disagreement is deep when it involves many interrelated issues, including the proper way to resolve the disagreement, resulting in its persistence. The parties to a deep disagreement can hold neutral or even (...) positive judgements of each other's epistemic character, as parties’ judging each other's epistemic character negatively (i.e., epistemic disdain) is not a defining feature of deep disagreements. When analysing real-life cases, however, we find that epistemic disdain is typical of deep disagreements. In this article, I analyse why this is the case. Given that epistemic disdain undermines cognitive peerhood, the prospects of deep disagreements between epistemic peers seem bleak. Finally, it is discussed how the phenomenon of epistemic disdain, as it relates to deep disagreements, may increase affective polarisation. (shrink)

This paper argues that our folk-psychological expertise is a special case of extended and enculturated cognition where we learn to regulate both our own and others’ thought and action in accord with a wide array of culturally shaped folk-psychological norms. The view has three noteworthy features: it challenges a common assumption that the foundational capacity at work in folk-psychological expertise is one of interpreting behaviour in mentalistic terms, arguing instead that successful mindreading is largely a consequence of successful mindshaping; it (...) argues that our folk-psychological expertise is not only socially scaffolded in development, it continues to be socially supported and maintained in maturity, thereby presenting a radically different picture of what mature folk-psychological competency amounts to; it provides grounds for resisting a recent trend in theoretical explanations of quotidian social interaction that downplays the deployment of sophisticated mentalizing resources in understanding what others are doing. (shrink)

In Building Better Beings, Vargas develops and defends a naturalistic account of responsibility, whereby responsible agents must possess a feasibly situated capacity to detect and respond to moral considerations. As a preliminary step, he also offers a substantive account of how we might justify our practices of holding responsible—viz., by appeal to their efficacy in fostering a ‘valuable form of agency’ across the community at large, a form of agency that precisely encompasses sensitivity to moral considerations. But how do these (...) accounts relate to one another? Though I find much that is appealing in Vargas’s general approach, I challenge his insistence that these accounts should be treated as ‘conceptually independent’, arguing that this generates an objectionable “justification gap”: on his analysis, someone could remain an appropriate target of our responsibility practices and yet fail to be a morally responsible agent. In closing, I offer a potential solution to this problem, though it means re-visioning how the account of moral responsibility is conceptually tied to the justification of our responsibility practices. (shrink)

In his 2014 article “Motivations for Relativism as a Solution to Disagreements”, Steven Hales argues that relativism is a plausible disagreement resolution strategy for epistemically irresolvable disagreements. I argue that his relativistic strategy is not adequate for disagreements of this kind, because it demands an impossible doxastic state for disputants to resolve the disagreement. Contrarily, Fogelin’s :1–8, 1985) theory of deep disagreement does not run into the same problems. Deep disagreements, according to Fogelin, cannot be resolved through argumentation because the (...) conditions for argumentation are lacking in such contexts. I advance the view that deep disagreements arise due to differences in disputants’ mutually supporting interrelated beliefs. This view avoids the hurdles caused by the tiered structure of support found at the heart of Hales’s view on disagreement: the assumption that belief and perspective can be separated, and that disagreement is located. (shrink)

Prenatal screening, consisting of maternal serum screening and nuchal translucency screening, is on the verge of expansion, both by being offered to more pregnant women and by screening for more conditions. The Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists have each recently recommended that screening be extended to all pregnant women regardless of age, disease history, or risk status. This screening is commonly justified by appeal to the value of autonomy, or women's (...) choice. In this paper, I critically examine the value of autonomy in the context of prenatal screening to determine whether it justifies the routine offer of screening and the expansion of screening services. I argue that in the vast majority of cases the option of prenatal screening does not promote or protect women's autonomy. Both a narrow conception of choice as informed consent and a broad conception of choice as relational reveal difficulties in achieving adequate standards of free informed choice. While there are reasons to worry that women's autonomy is not being protected or promoted within the limited scope of current practice, we should hesitate before normalizing it as part of standard prenatal care for all. (shrink)

In “The Logic of Deep Disagreements,” Robert Fogelin claims that parties to a deep disagreement lack the common ground needed for arguments to work, making the disagreement impervious to rational resolution. Although Fogelin’s article received numerous responses, there has been no attempt to elucidate the epistemological theory behind Fogelin’s theses. In this article, I examine Fogelin’s theory of deep disagreements in light of his broader philosophy. The picture that emerges is that of relativism of distance, à la Bernard Williams. By (...) interpreting Fogelin’s theory as relativism of distance, it avoids some of the critiques that have been raised against it. (shrink)

This paper presents a new theory of modal reasoning, i.e. reasoning about what may or may not be the case, and what must or must not be the case. It postulates that individuals construct models of the premises in which they make explicit only what is true. A conclusion is possible if it holds in at least one model, whereas it is necessary if it holds in all the models. The theory makes three predictions, which are corroborated experimentally. First, conclusions (...) correspond to the true, but not the false, components of possibilities. Second, there is a key interaction: it is easier to infer that a situation is possible as opposed to impossible, whereas it is easier to infer that a situation is not necessary as opposed to necessary. Third, individuals make systematic errors of omission and of commission. We contrast the theory with theories based on formal rules. (shrink)

What is hope? Though variously characterized as a cognitive attitude, an emotion, a disposition, and even a process or activity, hope, more deeply, a unifying and grounding force of human agency. We cannot live a human life without hope, therefore questions about the rationality of hope are properly recast as questions about what it means to hope well. This thesis is defended and elaborated as follows. First, it is argued that hope is an essential and distinctive feature of human agency, (...) both conceptually and developmentally. The author then explores a number of dimensions of agency that are critically implicated in the art of hoping well, drawing on several examples from George Eliot’s Middlemarch. The article concludes with a short section that suggests how hoping well in an individual context may be extended to hope at the collective level. (shrink)

The class forcing theorem, which asserts that every class forcing notion ${\mathbb {P}}$ admits a forcing relation $\Vdash _{\mathbb {P}}$, that is, a relation satisfying the forcing relation recursion—it follows that statements true in the corresponding forcing extensions are forced and forced statements are true—is equivalent over Gödel–Bernays set theory $\text {GBC}$ to the principle of elementary transfinite recursion $\text {ETR}_{\text {Ord}}$ for class recursions of length $\text {Ord}$. It is also equivalent to the existence of truth predicates for the (...) infinitary languages $\mathcal {L}_{\text {Ord},\omega }$, allowing any class parameter A; to the existence of truth predicates for the language $\mathcal {L}_{\text {Ord},\text {Ord}}$ ; to the existence of $\text {Ord}$ -iterated truth predicates for first-order set theory $\mathcal {L}_{\omega,\omega }$ ; to the assertion that every separative class partial order ${\mathbb {P}}$ has a set-complete class Boolean completion; to a class-join separation principle; and to the principle of determinacy for clopen class games of rank at most $\text {Ord}+1$. Unlike set forcing, if every class forcing notion ${\mathbb {P}}$ has a forcing relation merely for atomic formulas, then every such ${\mathbb {P}}$ has a uniform forcing relation applicable simultaneously to all formulas. Our results situate the class forcing theorem in the rich hierarchy of theories between $\text {GBC}$ and Kelley–Morse set theory $\text {KM}$. (shrink)

The team has become a popular model to organize joint human–robot behavior. Robot teammates are designed with high-levels of autonomy and well-developed coordination skills to aid humans in unpredictable environments. In this paper, we challenge the assumption that robots will succeed as teammates alongside humans. Drawing from the literature on human teams, we evaluate robots’ potential to meet the requirements of successful teammates. We argue that lacking humanlike mental models and a sense of self, robots may prove untrustworthy and will (...) be rejected from human teams. Benchmarks for evaluating human–robot teams are included, as are guidelines for defining alternative structures for human–robot groups. (shrink)

One of the more radical transhumanist proposals for future human being envisions the uploading of our minds to a digital substrate, trading our dependence on frail, degenerating “meat” bodies for the immortality of software existence. Yet metaphor studies indicate that our use of metaphor operates in our bodily inhabiting of the world, and a phenomenological approach emphasizes a “hybridity” to human being that resists traditional mind/body dichotomies. Future scenarios envisioning mind uploading and disembodied artificial intelligence (AI) share an apocalyptic category (...) with more traditional religious eschatologies, though they differ markedly in content; therefore, the insights of embodied cognition and their uptake in technological innovation are considered as they apply to theological concerns. Theology often functions in debates over the technological future to critique or to caution. However, theologians may learn from their technological dialogue partners when it comes to the future of embodiment and its implications for the construction and practice of theology. (shrink)