This critical reflection on the ethical concerns of current practice is underpinned by a systematic synthesis of current evidence focusing on why and how children are held or restrained for clinical procedures within acute care and the experiences of those present when a child is held against their wishes. Empirical evidence from a range of clinical settings internationally demonstrates that frequently children are held for procedures to be completed; younger children and those requiring procedures perceived as urgent are more likely (...) to be held. Parents and health professionals express how holding children for procedures can cause feelings of moral distress expressed as uncertainty, guilt and upset and that this act breaches the trusting and protective relationship established with children. Despite this, children's rights and alternatives to holding are not always respected or explored. Children's experiences and perceptions are absent from current literature. Children and young people have a moral right to have their voice and protests heard and respected and for these to inform judgements of their best interests and the actions of health professionals. Without robust evidence, debate and recognition that children are frequently held against their wishes in clinical practice for procedures which may not be urgent, children's rights will continue to be compromised. (shrink)

This article brings together research from the fields of chronic pain management and somatic practices to develop a novel framework of principles to support people living with persistent pain. These include movement-based approaches to awareness of the internal body (interoception), the external environment (exteroception) and movement in space (proprioception). These significantly work with the lived subjective experiences of people living with pain, to become aware of body signals and self-management of symptoms, explore fear and pleasure of movement, and understand how (...) social environments impact on pain. This analysis has potential to create new ways of supporting, understanding and articulating pain experiences, as well as shaping the future of somatic practices for chronic pain. (shrink)

BRADLEY SK and CARTER B. Nursing Inquiry 2011; 18: 303–312 Deconstructing child and adolescent mental health: questioning the ‘taken‐for‐granted’…We present a critical deconstructive reading, seeking to problematise ‘taken‐for‐granted’ assumptions in child and adolescent mental health (CAMH). The start point for this critical reading is conventional ‘history‐telling’ within CAMH. The aim is not to take issue with the detail in such histories but to critically examine the texts, so as to highlight constructions that structure the presentation of conventional histories and possible (...) purposes that such constructions may serve. The argument is that such conventional histories leave key questions not just unanswered, but unconsidered – a tendency that can be seen throughout the CAMH literature more generally. Therefore, we then pursue critical discussion of how ‘taken‐for‐granted’ constructions of CAMH enabled psychiatry to successfully expand its power and influence to establish hegemony over ‘problem children’. We do not claim any closure to this critical reading; that is, we do not claim that our critical deconstructive reading is the only reading possible. Similarly, it is not presented in any sense as ‘final word’. Rather our hope for this work is that it might stimulate readers to question the ‘taken‐for‐granteds’ that we present, and indeed others that they might identify themselves. In so doing, it is our hope that creative dialogue might ensue. (shrink)

YouTube has been implicated in the transformation of users into extremists and conspiracy theorists. The alleged mechanism for this radicalizing process is YouTube’s recommender system, which is optimized to amplify and promote clips that users are likely to watch through to the end. YouTube optimizes for watch-through for economic reasons: people who watch a video through to the end are likely to then watch the next recommended video as well, which means that more advertisements can be served to them. This (...) is a seemingly innocuous design choice, but it has a troubling side-effect. Critics of YouTube have alleged that the recommender system tends to recommend extremist content and conspiracy theories, as such videos are especially likely to capture and keep users’ attention. To date, the problem of radicalization via the YouTube recommender system has been a matter of speculation. The current study represents the first systematic, pre-registered attempt to establish whether and to what extent the recommender system tends to promote such content. We begin by contextualizing our study in the framework of technological seduction. Next, we explain our methodology. After that, we present our results, which are consistent with the radicalization hypothesis. Finally, we discuss our findings, as well as directions for future research and recommendations for users, industry, and policy-makers. (shrink)

Recent thinking within philosophy of mind about the ways cognition can extend has yet to be integrated with philosophical theories of emotion, which give cognition a central role. We carve out new ground at the intersection of these areas and, in doing so, defend what we call the extended emotion thesis: the claim that some emotions can extend beyond skin and skull to parts of the external world.

Extended Cognition examines the way in which features of a subject's cognitive environment can become constituent parts of the cognitive process itself. This volume explores the epistemological ramifications of this idea, bringing together academics from a variety of different areas, to investigate the very idea of an extended epistemology.

According to reductive intellectualists about knowledge-how :147–190, 2008; Philos Phenomenol Res 78:439–467, 2009) knowledge-how is a kind of knowledge-that. To the extent that this is right, then insofar as we might conceive of ways knowledge could be extended with reference to active externalist :7–19, 1998; Clark in Supersizing the mind: embodiment, action, and cognitive extension: embodiment, action, and cognitive extension. Oxford University Press, Oxford, 2008) approaches in the philosophy of mind, we should expect no interesting difference between the two. However, (...) insofar as anti-intellectualist approaches to knowledge-how are a viable option, there is an overlooked issue of how knowledge-how might be extended, via active externalism, in ways very differently from knowledge-that. This paper explores this overlooked space, and in doing so, illustrates how a novel form of extended knowledge-how emerges from a pairing of active externalism in the philosophy of mind with anti-intellectualism in the theory of knowledge. Crucial to our argument will be a new way of thinking about the extended mind thesis, as it pertains to the kinds of state one is in when one knows how to do something, and how this state connects with non-accidentally successful performance. (shrink)

If individual knowledge and justification can be vanquished by epistemic defeaters, then the same should go for group knowledge. Lackey (2014) has recently argued that one especially strong conception of group knowledge defended by Bird (2010) is incapable of preserving how it is that (group) knowledge is ever subject to ordinary mechanisms of epistemic defeat. Lackey takes it that her objections do not also apply to a more moderate articulation of group knowledge--one that is embraced widely in collective epistemology--and which (...) she does not challenge. This paper argues that given certain background premises that are embraced by orthodox thinking in collectivist epistemology, the more moderate account of group knowledge cannot make sense of either psychological or normative epistemic defeaters. I conclude by offering some suggestions for how the more moderate proposal might avoid this result. (shrink)

Internalist approaches to epistemic justification are, though controversial, considered a live option in contemporary epistemology. Accordingly, if ‘active’ externalist approaches in the philosophy of mind—e.g. the extended cognition and extended mind theses—are _in principle_ incompatible with internalist approaches to justification in epistemology, then this will be an epistemological strike against, at least the _prima facie_ appeal of, active externalism. It is shown here however that, contrary to pretheoretical intuitions, neither the extended cognition _nor_ the extended mind theses are in principle (...) incompatible with two prominent versions of epistemic internalism—viz., accessibilism and mentalism. In fact, one possible diagnosis is that pretheoretical intuitions regarding the incompatibility of active externalism with epistemic internalism are symptomatic of a tacit yet incorrect identification of epistemic internalism with epistemic individualism. Thus, active externalism is not in principle incompatible with epistemic internalism per se and does not significantly restrict one’s options in epistemology. (shrink)

The paper asks whether diagrams in mathematics are particularly fruitful compared to other types of representations. In order to respond to this question a number of examples of propositions and their proofs are considered. In addition I use part of Peirce’s semiotics to characterise different types of signs used in mathematical reasoning, distinguishing between symbolic expressions and 2-dimensional diagrams. As a starting point I examine a proposal by Macbeth. Macbeth explains how it can be that objects “pop up”, e.g., as (...) a consequence of the constructions made in the diagrams of Euclid, that is, why they are fruitful. It turns out, however, that diagrams are not exclusively fruitful in this sense. By analysing the proofs given in the paper I introduce the notion of a ‘faithful representation’. A faithful representation represents as either an image or as a metaphor. Secondly it represents certain relevant relations. Thirdly manipulations on the representations respect manipulations on the objects they represent, so that new relations may be found. The examples given in the paper illustrate how such representations can be fruitful. These examples include proofs based on both symbolic expressions as well as diagrams and so it seems diagrams are not special when it comes to fruitfulness. Having said this, I do present two features of diagrams that seem to be unique. One consists of the possibility of exhibiting the type of relation in a diagram—or simply showing that a relation exists—as a contrast to stating in words that it exists. The second is the spatial configurations possible when using diagrams, e.g., allowing to show multiple relations in a single diagram. (shrink)

A novel solution is offered for how emotional experiences can function as sources of immediate prima facie justification for evaluative beliefs, and in such a way that suffices to halt a justificatory regress. Key to this solution is the recognition of two distinct kinds of emotional skill (what I call generative emotional skill and doxastic emotional skill) and how these must be working in tandem when emotional experience plays such a justificatory role. The paper has two main parts, the first (...) negative and the second positive. The negative part criticises the epistemic credentials of Epistemic Perceptualism (e.g., Tappolet 2012, 2016; Doring 2003, 2007; Elgin 2008; Roberts 2003), the view that emotional experience alone suffices to prima facie justify evaluative beliefs in a way that is analogous to how perceptual experience justifies our beliefs about the external world. The second part of the paper develops an account of emotional skill and uses this account to frame a revisionary form of Epistemic Perceptualism that succeeds where the traditional views could not. I conclude by considering some objections and replies. (shrink)

According to Paul Boghossian (2006, 73) a core tenet of epistemic relativism is what he calls epistemic pluralism, according to which (i) ‘there are many fundamentally different, genuinely alternative epistemic systems’, but (ii) ‘no facts by virtue of which one of these systems is more correct than any of the others’. Embracing the former claim is more or less uncontroversial–viz., a descriptive fact about epistemic diversity. The latter claim by contrast is very controversial. Interestingly, the Wittgenstenian ‘hinge’ epistemologist, in virtue (...) of maintaining that rational evaluation is essentially local, will (arguably, at least) be committed to the more controversial leg of the epistemic pluralist thesis, simply in virtue of countenancing the descriptive leg. This paper does three central things. First, it is shown that this ‘relativistic’ reading of Wittgenstein’s epistemology is plausible only if the locality of rational evaluation (in conjunction with a reasonable appreciation of epistemic diversity) commits the Wittgenstenian to a further epistemic incommensurability thesis. Next, Duncan Pritchard’s (e.g., 2009; 2015) novel attempt to save the hinge epistemologist from a commitment to epistemic incommensurability is canvassed and critiqued. Finally, it is suggested how, regardless of whether Pritchard’s strategy is successful, there might be another very different way—drawing from recent work by John MacFarlane (2014)—for the hinge epistemologist to embrace epistemic pluralism while steering clear of epistemic relativism, understood in a very specific way. (shrink)

A popular view in mainstream social epistemology maintains that, in the face of a revealed peer disagreement over p, neither party should remain just as confident vis-a-vis p as she initially was. This ‘conciliatory’ insight has been defended with regard to individual epistemic peers. However, to the extent that (non-summativist) groups are candidates for group knowledge and beliefs, we should expect groups (no less than individuals) to be in the market for disagreements. The aim here will be to carve out (...) and explore an extension of the conciliatory insight from individual peer disagreement to group peer disagreement; in doing so, I'll raise and address three key problems that face any plausible defence of such a constraint. (shrink)

First, a theoretical background to the volume’s topic, extended epistemology, is provided by a brief outline of its cross-disciplinary theoretical lineage and some key themes. In particular, it is shown how and why the emergence of recent and more egalitarian thinking in the cognitive sciences about the nature of human cognizing and its bounds—viz., the so-called ‘extended cognition’ program, and the related idea of an ‘extended mind’—has important and interesting ramifications in epistemology. Second, an overview is provided of the papers (...) included as chapters in the volume. The sixteen contributions are divided into two categories: those that engage with foundational issues to do with extended epistemology, and those that pursue applications of extended epistemology to new areas of research. (shrink)

Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations. Consider a condition prevalent in a population, customarily labelled with diagnosis A. We propose that overdiagnosis is occurring in respect of that condition in that population when the condition is being identified and labelled with diagnosis A in that population ; this identification and labelling would be accepted as (...) correct in a relevant professional community; but the resulting label and/or intervention carries an unfavourable balance between benefits and harms. We identify challenges in determining and weighting relevant harms, then propose three central ethical considerations in overdiagnosis: the extent of harm done, whether harm is avoidable and whether the primary goal of the actor/s concerned is to benefit themselves or the patient, citizen or society. This distinguishes predatory, misdirected and tragic overdiagnosis; the degree of harm moderates the justifiability of each type. We end with four normative challenges: methods for adjudicating between professional standards and identifying relevant harms and benefits should be procedurally just; individuals, organisations and states are differently responsible for addressing overdiagnosis; overdiagnosis is a matter for distributive justice: the burdens of both overdiagnosis and its prevention could fall on the least-well-off; and communicating about overdiagnosis risks harming those unaware that they may have been overdiagnosed. These challenges will need to be addressed as the field develops. (shrink)

Anti-intellectualists about knowledge-how insist that, when an agent S knows how to φ, it is in virtue of some ability, rather than in virtue of any propositional attitudes, S has. Recently, a popular strategy for attacking the anti-intellectualist position proceeds by appealing to cases where an agent is claimed to possess a reliable ability to φ while nonetheless intuitively lacking knowledge-how to φ. John Bengson & Marc Moffett (2009; 2011a; 2011b) and Carlotta Pavese (2015a; 2015b) have embraced precisely this strategy (...) and have thus claimed, for different reasons, that anti-intellectualism is defective on the grounds that possessing the ability to φ is not sufficient for knowing how to φ. We investigate this strategy of argument-by-counterexample to the anti- intellectualist’s sufficiency thesis and show that, at the end of the day, anti-intellectualism remains unscathed. (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

According to the ‘starting-gate’ interpretation of equality of opportunity, individuals who enjoy equal starts can legitimately become unequal to the extent that their differences derive from choices for which they can be held responsible. There can be no coercive transfers of resources in favour of individuals who disregarded their own futures, and no limits on the right of an individual to distribute resources intrapersonally. This paper assesses two ways in which advocates of equality of opportunity might depart from the starting-gate (...) interpretation. The first involves limiting the degree to which people are liable to pay the costs of their past choices. The second involves limiting their initial opportunities so as to prevent certain risky or apparently short-sighted choices. The paper compares these alternatives in terms of their compatibility with a particular conception of persons as morally equal and temporally extended. It constructs this conception by combining reductionist premises about personal identity with the premise that our status as equals is based on the fundamental requirement of opacity respect. Two conclusions about equality of opportunity are shown to follow from this conception of persons as morally equal and temporally extended: the first is that an individual’s liability to pay the costs of her past choices does not diminish over time; the second is that the individual’s initial scope of choice, in bringing about intrapersonal distributions between her current and future selves, can nevertheless be permissibly limited. The two conclusions are consistent, and the second allows for departures from starting-gate equality of opportunity. (shrink)

A criticism of some research involving Aboriginal people is that it is not equitable in its design or application, further disadvantaging the poor and marginalized. In Australia, much research has been done on Aboriginal people, but Aboriginal people themselves have benefited little, adding to distrust between Aboriginal and non-Aboriginal people over many years. Is it possible to take “scientific” research practices and transform them into research that can be done with a community rather than on a community? How can research (...) findings benefit Aboriginal people? This chapter shares our study of Aboriginal people’s stories of diabetes care. It is a collaborative story told by four Aboriginal Health Workers and two non-Aboriginal researchers which focuses on methodology rather than findings. We share aspects of our research which we propose values Aboriginal people and invites participation and reciprocity at design, data collection, and research translation stages. We discuss tensions which occur between the “scientific way” and the “culturally appropriate way” and describe how we resolved this. Imposing research designs and practices on Aboriginal people and communities without consideration that each community is unique has the potential to cause further harm and disempowerment. Valuing an Aboriginal way of knowing influenced all aspects of our study design and procedures. We would like to inspire others to challenge methodological norms to develop research methods with their community to allow the unique voice of their community to be heard and for this to facilitate pragmatic change leading to meaningful improvements in health. (shrink)

In recent decades, it has been argued that the modern concept of forgiveness is absent from Aristotle’s conception of συγγνώμη as it appears in his Rhetoric and Nicomachean Ethics. In this paper, I argue that Aristotle’s view is more modern than it might appear. I defend the idea that Aristotle’s treatment of συγγνώμη, when seen in conjunction with his theory of ethical decision, involuntary action, and character alteration, commits him to a cognitive and emotional theory of forgiveness that is both (...) well-grounded and thoroughly modern. I go on to claim that Aristotle’s view of συγγνώμη helps to solve at least four controversial problems about the nature of forgiveness raised by modern philosophers: how one can forgive a wrong without condoning it, whether forgiveness is a duty, whether moral luck requires us to forgive more widely, and whether forgiveness ought to be unconditional. (shrink)

The misuse of alcohol inflicts a major toll on individual users, their families, and the wider society. This includes disruptions of family life, violence, absenteeism and problems in the workplace, child neglect and abuse, and excess morbidity and mortality. The World Health Organization estimates that alcohol ranks eighth among global risk factors for death and is the third leading global risk factor for disease and disability. In the United States, alcohol dependence affects four to five percent of the population at (...) any given time. Alcohol dependence also exacts a significant financial toll.... (shrink)

In this article, we examine the ways gendered frames shift to make room for societal changes while maintaining existing pillars of systemic gender inequality. Utilizing the case of U.S. media representations of transgender people who reproduce, we analyze how media outlets make room for increasing societal recognition of transgender people and maintain cisnormative and repronormative traditions and beliefs in the process. Specifically, we outline how these media outlets accomplish both outcomes in two ways. First, they reinforce cisgender-based repronormativity via conceptualizations (...) of transgender reproduction as new and occurring in contrast to normative, cisgender reproduction. Second, they create a transnormative reproductive subject, which establishes a new socially sanctioned script for what it means to be transgender and what types of transgender experience may be recognized or accepted in mainstream society. In conclusion, we draw out implications for understanding how social authorities may shift existing gender frames to make room for changes in society while at the same time maintaining normative beliefs. These normative beliefs continue to facilitate societal patterns of gender inequality within such new frames. (shrink)

Contemporary debates about epistemic luck and its relation to knowledge have traditionally proceeded against a tacit background commitment to cognitive internalism, the thesis that cognitive processes play out inside the head. In particular, safety-based approaches (e.g., Pritchard 2005; 2007; Luper-Foy 1984; Sainsbury 1997; Sosa 1999; Williamson 2000) reveal this commitment by taking for granted a traditional internalist construal of what I call the cognitive fixedness thesis—viz., the thesis that the cognitive process that is being employed in the actual world is (...) always ‘held fixed’ when we go out to nearby possible worlds to assess whether the target belief is lucky in a way that is incompatible with knowledge. However, for those inclined to replace cognitive internalism with the extended mind thesis (e.g., Clark and Chalmers 1998), a very different, ‘active externalist’ version of the cognitive fixedness thesis becomes the relevant one for the purposes of assessing a belief’s safety. The aim here will be to develop this point in a way that draws out some of the important ramifications it has for how we think about safety, luck and knowledge. (shrink)

If we want our intellectual lives to go as well as possible, should we be ‘delegating’ as many information-gobbling tasks to our gadgets as we can? If not, then how much cognitive outsourcing is too much, and relatedly, what kinds of considerations are relevant to determining this? I submit that one particular dimension of intellectual flourishing that will be helpful for the purpose of exploring such questions is that of intellectual autonomy, and in particular, what I’ll describe as the value (...) of one’s freedom to achieve. Several related conclusions are drawn and then applied to recent discussions in the philosophy of education concerning education’s epistemic aims. (shrink)

Of all the criticisms that Aristotle gives of his predecessors’ theories of soul in De anima I.3–5, none seems more unmotivated than the ones directed against the world soul of Plato’s Timaeus. Against the current scholarly consensus, I claim that the status of Aristotle’s criticisms is philosophical rather than eristical, and that they provide important philosophical reasons, independent of Phys. VIII.10 and Metaph. Λ.6, for believing that νοῦς is without spatial extension, and that its thinking is not a physical motion.

Mainstream epistemology has typically taken for granted a traditional picture of the metaphysics of mind, according to which cognitive processes (e.g. memory storage and retrieval) play out entirely within the bounds of the skull and skin. But this simple ‘intracranial’ picture is falling in- creasingly out of step with contemporary thinking in the philosophy of mind and cognitive science. Likewise, though, proponents of active exter- nalist approaches to the mind—e.g. the hypothesis of extended cognitition (HEC)—have proceeded by and large without (...) asking what epistemological ramifications should arise once cognition is understood as criss-crossing the bounds of brain and world. This paper aims to motivate a puzzle that arises only once these two strands of thinking are brought in contact with one another. In particular, we want to first highlight a kind of con- dition of epistemological adequacy that should be accepted by proponents of extended cognition; once this condition is motivated, the remainder of the paper demonstrates how attempts to satisfy this condition seem to inevitably devolve into a novel kind of epistemic circularity. At the end of the day, proponents of extended cognition have a novel epistemological puzzle on their hands. (shrink)

We aim to move the externalism and self-knowledge debate forward by exploring two novel sceptical challenges to the prospects of self-knowledge of a paradigmatic sort, both of which result from ways in which our thought content, cognitive processes and cognitive successes depend crucially on our external environments. In particular, it is shown how arguments from extended cognition ; Clark A. Supersizing the mind: Embodiment, action, and cognitive extension. Oxford: Oxford University Press ) and situationism, Alfano M. Expanding the situationist challenge (...) to reliabilism about inference. In Fairweather A Virtue epistemology naturalized, Springer, Dordrecht, pp 103–122 ; Doris JM. Noûs 32:504–530, Doris JM. Lack of character: Personality and moral behavior. Cambridge University Press, Cambridge ; Harman G. Proceedings of the Aristotelian Society. 99:315–331, Harman G. Proceedings of the Aristotelian Society 100:223–226 ) pose hitherto unexplored challenges to the prospects of self-knowledge as it is traditionally conceived. It is shown, however, that, suitably understood, these apparent challenges in fact only demonstrate two ways in which our cognitive lives can be dependent on our environment. As such, rather than undermining our prospects for attaining self-knowledge, they instead illustrate how self-knowledge can be extended and expanded. (shrink)

Relativists about knowledge ascriptions think that whether a particular use of a knowledge-ascribing sentence, e.g., “Keith knows that the bank is open” is true depends on the epistemic standards at play in the assessor’s context—viz., the context in which the knowledge ascription is being as- sessed for truth or falsity. Given that the very same knowledge-ascription can be assessed for truth or falsity from indefinitely many perspectives, relativism has a striking consequence. When I ascribe knowledge to someone (e.g., when I (...) say that, at a particular time, “Keith knows that the bank is open”), what I’ve said does not get a truth-value absolutely, but only relatively. If this semantic thesis about the word “knows” and its cognates is true, what implications would this have for epistemology, the philosophical theory of knowledge? e present aim will be to engage with this mostly unexplored question, and then to consider how the epistemological conclusions drawn might bear on the plausibility of a relativist semantics for “knows”. (shrink)

It seems, at first glance, that a Kantian ethics approach to moral enhancement would tend towards the position that there could be no place for emotional modulation in any understanding of the endeavour, owing to the typically understood view that Kantian ethics does not allow any role for emotion in morality as a whole. It seems then that any account of moral bioenhancement which places emotion at its centre would therefore be rejected. This article argues, however, that this assumption is (...) incorrect. Given later writings by Kant on the role of sympathy, and taking into account other concerns in Kantian ethics, it may in fact be the case that Kantian ethics would allow for an account of moral bioenhancement through emotional modulation, and that in some cases such an intervention might even be considered to be a duty. (shrink)

Two arguments against the compatibility of epistemic internalism and content externalism are considered. Both arguments are shown to fail, because they equivocate on the concept of justification involved in their premises. To spell out the involved equivocation, a distinction between subjective and objective justification is introduced, which can also be independently motivated on the basis of a wide range of thought experiments to be found in the mainstream literature on epistemology. The subjective/objective justification distinction is also ideally suited for providing (...) new insights with respect to central issues within epistemology, including the internalism/externalism debate and the New Evil Demon intuition. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 19 Heft: 1 Seiten: 163-188.