This essay argues that the practice ofmedicine is not a phronetic activity in theoriginal Aristotelian sense of that term. Jonsen andToulmin are two philosophers who have conflated thetechne of medicine with phronesis. Thisconflation ignores Aristotle's crucial distinctionbetween techne and phronesis and his useof the medical analogy. It is argued that medicalreasoning is similar to phronesis but does notexemplify it. Phronesis will not save thelife of medical ethics. The concept could be utilized as amoral prosthetic.

Individuals are more likely to remember emotional than neutral information, but this benefit does not always extend to the surrounding background information. This memory narrowing is theorised to be linked to the availability of attentional resources at encoding. In contrast to the predictions of this theoretical account, altering participants' attentional resources at encoding by dividing attention did not affect emotion-induced memory narrowing. Attention was divided using three separate manipulations: a digit ordering task (Experiment 1), an arithmetic task (Experiment 2) and (...) an auditory discrimination task (Experiment 3). Across all three experiments, divided attention decreased memory across the board but did not affect the degree of memory narrowing. These findings suggest that theories to explain memory narrowing must be expanded to include other potential mechanisms beyond the limitations of attentional resources. (shrink)

The standard approach to ethics in psychotherapy is to focus on the therapist. Although normative “boundary” ethics revolves around what the therapist ought, or ought not, to do, virtue ethics can revolve around the kind of person the therapist ought to be. One can thus apply virtue ethical theory to clinical practice and argue for therapist virtues that are relevant to meeting professional standards and to working effectively through the problems that arise in psychotherapy. Considerably less attention has been paid (...) to how virtue ethics relates to the patient. The ethics of psychotherapy can also revolve around the sort of person the patient should be. I argue that there are nascent virtues which the patient can bring to psychotherapy that, when cultivated with the therapist, can facilitate a beneficial outcome and virtues that can be seen as psychotherapeutic goals toward which the patient ought to strive. (shrink)

Intra-individual variability (IIV) refers to within-person variability in behavioural task responses. Several factors can influence IIV, including aging and cognitive demands. The present study investigated effects of aging on IIV of response times during executive functioning tasks. Known age-related differences in cognitive control and emotion processing motivated evaluating how varying the design of emotional response inhibition tasks would influence IIV in older and younger adults. We also tested whether IIV predicted inhibitory control across task designs and age groups. Older and (...) younger adults (N = 237) completed one of three versions of a stop-signal task, which all displayed happy, fearful, or neutral faces in Stop trials. An independent group of older and younger adults (N = 80) completed a go/no-go task also employing happy, fearful and neutral faces. Results showed older adults had more consistent responses (lower IIV) than younger adults in the stop-signal task, but not the go/no-go task. Lower IIV predicted more efficient emotional response inhibition for fear faces in the stop-signal task, but only when attention to emotion was task-relevant. Collectively, this study clarifies effects of aging and task design on IIV and illustrates how task design impacts the relationship between IIV and emotional response inhibition in younger and older adults. (shrink)

A signal challenge of twenty-first century psychiatry is the effective treatment of existential/spiritual suffering in palliative care. This chapter will concentrate on research to assess the therapeutic potential of psilocybin to assuage that suffering. If a “psychedelic experience” can facilitate an acceptance of impending death, and reduce the existential suffering of those who endure it, it could prove to be a valuable intervention where one is sorely needed. The therapeutic use of psilocybin with dying patients (hereinafter patients) raises numerous questions (...) about research trial design, the model of psychiatry that might accommodate it, and the kind of experience it induces. Are these the sorts of experience that psychiatric treatment should effect on troubled patients? Is spiritual care within the ambit of psychiatry? There are epistemological questions as to the veridicality of the psychedelic experience. How much credence should we give it? I will argue in cautious support of ongoing research to evaluate the therapeutic use of psilocybin in palliative care. This argument can be extended to research on its therapeutic use in psychotherapy. The chapter will focus on four questions: (1) what is the ethical justification for this research on patients? (2) What types of research trial design are best used to assess the purported benefits of a psychedelic drug experience? (3) What is the epistemic warrant of the “mystical” and “noetic” facets of this experience? (4) What models of (a) psychiatry and (b) drug action could accommodate the therapeutic use of psilocybin in palliative care? (shrink)

Socially responsible investment (SRI) has increasingly assumed a major role in global equity markets. In this article we argue that the continued growth in investors seeking to align their ethical concerns with their investment strategies may influence the way in which the employment relationship is managed in publicly-listed corporations. After tracing the historical development of SRI, its implications for the conduct of human resource management (HRM) are examined. We conclude by analysing a number of the key problems associated with investor (...) confidence in SRI funds and present a range of suggested techniques for improving screening methodologies. (shrink)

The Healing Virtues explores the intersection of psychotherapy and virtue ethics - with an emphasis on the patient's role within a healing process. It considers how the common ground between the therapeutic process and the cultivation of virtues can inform the efforts of both therapist and patient. Within this book, the Duff R. Waring argues that there is a case for patient virtues that are crucially relevant to working through the problems in living that arise in psychotherapy, e.g., honesty, courage, (...) humility, perseverance. The central idea is that treatment may need to build virtues while it ameliorates problems. Hence, the patient's work in psychotherapy can both challenge character strengths and result in their further development. (shrink)

Uchiyama et al. reveal how group-structured cultural variation influences measurements of trait heritability. We argue that understanding culture's influence on phenotypic heritability can clarify the impact of culture on genetic inheritance, which has implications for long-term gene–culture coevolution. Their analysis may provide guidance for testing our hypothesis that cultural adaptation is superseding genetic adaptation in the long term.

Prior to the emergence of the formalized commentarial traditions of the Early Imperial era (221 BCE–220 CE), the Odes seem typically to have been encountered “in motion” or “in use” as quoted speech in early historical and philosophical works. By studying the way the Odes are used in an understudied text—the Guoyu 國語 (Discourses of the states), probably compiled in the late Warring States era (ca. 475–221 BCE)—this article explores how historical speeches and anecdotes were used as an early form (...) of commentary, variously contextualizing, explaining, paraphrasing, glossing, and interpreting the Odes. Before the invention of comprehensive, systematic commentaries associating each poem with a particular historical context and meaning, texts like the Guoyu provided early readers with guides to understanding and using classical texts, and many of their exegetical forms and strategies anticipate the commentarial traditions of the early empires. This article shows that historical speeches were one way in which early Chinese elites were trained in how to read and use the Odes appositely and sensitively, and that we can think of such speeches as a form of commentary. (shrink)

Dinner times provide rich opportunities for overt and covert socialization. Drawing upon a larger corpus of 35 video-recorded family meals involving the three-year-old Zoe and her parents, this conversation analytic study describes how Zoe displays such agency through the practice of “voicing control” – momentarily sounding and acting like an adult by performing a range of controlling acts such as leading, instructing, advising, assessing, and mediating. I argue that by playing with such activities bound to the category of a higher (...) position than hers, the child manages to grow “a head taller” in the Vygotskyan sense. The findings contribute to the budding literature on documenting socialization in naturalistic settings with a specific focus on the child’s role in such socialization. (shrink)

CELL AND PSYCHE THE BIOLOGY OF PURPOSE By EDMUND W. SINNOTT. PREFACE TO THE TORCHBOOK EDITION: SINCE the publication of this little book, as the McNair Lectures at the University of North Carolina, the author has written two others, as well as a number of papers, on the same gen eral theme. Though these elaborate the argument a little further, the essence of it is in Cell and Psyche. This is admittedly a specula tion, but one based solidly on biological (...) fact. It has been regarded as rather visionary and metaphysical by some people, but others have been attracted to it by the suggestion it offers for a better understanding of the ancient problem of how mind and body are related to each other. This problem is of such paramount impor tance, not only for a knowledge of what man really is but for the construction of a satisfying life philosophy, that any light thrown on it should be welcome. The suggestion that man's physical life grows out of the basic goal-seeking and purposiveness found in all organic behavior and that this, in turn, is an aspect of the more general self - regulating and normative character evident in the development and activities of living organisms, is at least worth serious consideration. If we are to avoid a dualistic idea of man's nature and to construct a true monism that does not require the sacrifice of the significance of either mind or body, some such conception as this seems a rea sonable means of doing so. It is to be hoped that the wider distri bution now made possible for the present book may result in a more general consideration of this particular relationship between biol ogy and philosophy* E. W. S. CONTENTS: Introduction. i I. Organization, the Distinctive Character of All Life 15 II. Biological Organization and Psychological Activity 43 IIL Some Implications for Philosophy 75 Suggested Readings. 112 Index. 117. INTRODUCTION: IN THE CLAMOR and confusion of our times one fact grows ever clearer beliefs are important. One of the major problems with which men now are faced per haps, indeed, the most important one is the wide dis agreement which still exists in their fundamental philos ophies. What course a man will follow, or a nation, is set in no small measure by his basic creed, by what he really thinks about the true nature of a human being his personality, his freedom, his destiny, his relations to others and to the rest of the universe; by the judgments lie makes as to what qualities and courses of action are admirable and should command his allegiance. These are not academic questions merely. They arc ancient mys teries which long have troubled human hearts and seem today almost as far as ever from solution. The answer a ny* n gives to them is the most significant thing that one can know about him. We may be tempted to under estimate the importance of these inner directives and turn instead to outer influences, to economic and social factors, as more decisive for our actions. But when we look at what the philosophy of Marx has done to set one half the world against the other, at the basic divergence between the thinking of East and West, and at so many other differences in political and religious beliefs which now divide mankind, we can hardly doubt the profound practical import of men's philosophies. It is still true today that as a man thinketh in his heart, so is he. In the minds of men are the most fateful battles fought. Against those ideologies we condemn, force in the end will fail. If our opponents cannot be convinced, or their ideas reconci. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Biologist Sinnott, Dean of Yale's Graduate School, tries to find some common foundation for the spiritual feelings of man and the facts about material life discovered by biologists.

Grunbaum claims that the remedial failure of atreatment's characteristic factors is thegeneric, objective property of a placebo. Hestipulates that a treatment is placebic if thisremedial failure exacerbates the targetdisorder. This stipulation can subsume asplacebic effects that might be solelypharmacological, e.g., paradoxical reactions tocertain psychiatric drugs. If that exacerbationcan be explained pharmacologically, then wemight question whether Grunbaum's definitionalscheme captures the core identity of what weusually intend by the placebo concept. Ipropose that this core identity is bestcaptured by a symbolic meaning hypothesis (...) inwhich psychological factors exert thedeterminative influence. (shrink)

The aim of this article is to demonstrate the intricate operation of the adverb `also' in actual interaction at a level of detail that dictionary definitions have failed to capture. Using primarily a conversation analytic framework in examining two data corpora, which include a series of graduate seminar discussions and television roundtable discussions, I argue that the semantic features of `also' are strategically deployed to accomplish complex interactional goals in a disjunctive or disaffiliative environment. In a disjunctive environment, `also' can (...) be invoked to legitimize one's speaking rights - to get the floor. In a disaffiliative environment, `also' can be mobilized to either soften or strengthen a disaffiliative action in subsequent talk. These practices of `also' are accounted for in part by the tensions between coherence and continuation, and in part by the institutional contexts of news media and graduate seminar. (shrink)

Kamm's approach to patient selection qualifies the notion that fairness makes need for scarce, transplantable organs inversely proportional to age. She defines need as how much adequate conscious life a person will have had before death. Length of adequate conscious life correlates highly with age. If so, then younger persons are usually needier than older ones. Since Kamm allows for past periods of non‐adequate conscious life, I argue that this correlation may be neither as close, nor as easy to apply, (...) as she wants it to be. Fairness should require assessment of experiential content in determining how long one's life has been adequately conscious. I argue that such assessments involve some of the goods of experience and quality of life judgements that Kamm thinks a reliance on adequate conscious life will avoid. (shrink)

The central issue of this dissertation is known in bioethics as the problem of fair chances versus best outcomes. The decision-making context is patient selection for scarce, transplantable organs. This problem poses two options for patient selection: either select by a procedure which affords fair chances to all medically suitable transplant candidates or select those whose prognoses indicate the highest levels of prospective medical benefit. The fair chances/best outcomes problem is essentially a problem of choosing between lives. An egalitarian approach (...) to patient selection favours fair chances. A utilitarian approach favours best outcomes. My project is a sustained defence of an egalitarian approach. It targets first a rule utilitarian argument for maximizing medical benefit. It targets second an argument that fairness in patient selection requires a preference for saving younger lives. I argue that patients should have prognoses at or above a threshold level of medical benefit to be medically suitable candidates. I propose random selection by lottery as a means of final selection that equally values lives. I argue that equality of opportunity best reflects an egalitarian commitment to equal concern and respect. (shrink)

This line has long been a crux in the interpretation of Pindar, and there is still no consensus on its syntax or meaning. The conclusions reached by Stefan Radt , 148–74) and Richard Stoneman , 65–70) in the most recent studies of the problem are in all respects at variance. The cardinal difficulty of0 the line is the sense of , which must be elucidated before one can attempt to disentangle the syntax. I believe that previous commentators have overlooked or (...) misapplied crucial parallel passages because of their preconceptions about the nature of the metaphor here. (shrink)

The expert clinical community is split about whether the difference between antidepressant treatment and treatment with placebos stems from the efficacy of the drug or from subjects’ heightened expectancy enhanced by side effects—i.e., enhanced placebo effects. Proving whether pharmacological efficacy has been established reliably by randomized controlled trials of antidepressant drugs is difficult, primarily because substituting a placebo for an effective treatment in the control arm of a trial is ethically questionable. I argue that clinical equipoise permits the use of (...) active placebo controls in trials that test antidepressants. Placebo controls for drug trials are ethically defensible and scientifically justified when we have evidence that a standard treatment might only work because of enhanced placebo effects, and when a respectable minority of the expert clinical community endorses these concerns. (shrink)

This article offers a conceptual analysis of self-respect and self-esteem that informs the ethics of psychotherapy in palliative care. It is focused on Chochinov’s Dignity Therapy, an internationally recognized treatment offered to dying patients who express a need to bolster their sense of self-worth. Although Dignity Therapy aims to help such patients affirm their value through summarized life stories that are shared with their survivors, it is not grounded in a robust theory of self-respect. There is reason to be skeptical (...) about deathbed narratives, and Dignity Therapy can unintentionally encourage distorted representations at odds with the self-respect it aims to affirm. Dignity therapy can also encourage distortions of self-esteem that are in conflict with self-respect. Although Chochinov does not address it, the distinction between self-respect and self-esteem is relevant to deathbed accounts. Dillon’s feminist revisioning of self-respect can inform the practice of Dignity Therapy by encouraging honest life stories through a reckoning with one’s moral complexity, especially in moral generativity cases where patients seek forgiveness, relate atonement, or present their lives as examples to be followed. Her concept of self-esteem allows for therapeutic benefits that are less demanding, but no less significant, than those derived from a moral reckoning. Appropriate affirmations of self-esteem can provide much-needed solace when self-respect is damaged beyond adequate repair. Dillon’s account of self-respect and self-esteem enables a richer understanding of the kinds of personal evaluation and disclosure that Dignity Therapy accommodates. As such, their place in Dignity Therapy needs more critical evaluation than it has received. (shrink)

Human cooperation is highly unusual. We live in large groups composed mostly of non-relatives. Evolutionists have proposed a number of explanations for this pattern, including cultural group selection and extensions of more general processes such as reciprocity, kin selection, and multi-level selection acting on genes. Evolutionary processes are consilient; they affect several different empirical domains, such as patterns of behavior and the proximal drivers of that behavior. In this target article, we sketch the evidence from five domains that bear on (...) the explanatory adequacy of cultural group selection and competing hypotheses to explain human cooperation. Does cultural transmission constitute an inheritance system that can evolve in a Darwinian fashion? Are the norms that underpin institutions among the cultural traits so transmitted? Do we observe sufficient variation at the level of groups of considerable size for group selection to be a plausible process? Do human groups compete, and do success and failure in competition depend upon cultural variation? Do we observe adaptations for cooperation in humans that most plausibly arose by cultural group selection? If the answer to one of these questions is “no,” then we must look to other hypotheses. We present evidence, including quantitative evidence, that the answer to all of the questions is “yes” and argue that we must take the cultural group selection hypothesis seriously. If culturally transmitted systems of rules (institutions) that limit individual deviance organize cooperation in human societies, then it is not clear that any extant alternative to cultural group selection can be a complete explanation. (shrink)

Originally published in 1957 and written by one of the 20th Century's leading botanists and a fierce advocate of organicism, this book explores concepts about man and his relation to life and the universe, and about the great creative and spiritual powers within and around him. The author provides answers to perennial human questions whilst discussing the problems of sin, justice, ugliness and beauty.

We agree that evolutionary perspectives may help us organize many divergent realms of the science of human behavior. Nevertheless, an imperative to unite all social science under an evolutionary framework risks turning off researchers who have their own theoretical perspectives that can be informed by evolutionary theory without being exclusively defined by it. We propose a few considerations for scholars interested in joining the evolutionary and social sciences.

The Malleus Maleficarum was a detailed manual for Dominican witch-hunters. It codified specific criteria for identifying witches and guidelines for their application. It elaborated a system of symptoms that indicated illness caused by witchcraft . These symptoms were seen as the visible projections of a vast and complex organization of behavior. Since the existence of witches was presupposed by those who used the manual, its criteria were confirmed repeatedly during the Inquisition. Once the Malleus was published, its diagnostic system acquired (...) a momentum of its own and generated its own evidence . Its authors saw physicians as experts at distinguishing physical illnesses from those caused by witchcraft. The authors began the manual by asserting that belief in the existence of witches is an essential part of the Catholic faith. Priests and inquisitors were not to doubt the existence of witches . Like the Malleus Maleficarum, the Diagnostic and Statistical Manual is a detailed text which codifies specific criteria for identifying people who are seen as abnormal. It codifies guidelines for applying these criteria and elaborates a system of symptoms that indicates illnesses known as mental disorders. These symptoms are seen as the visible projections of a vast and complex organization of behavior. Since the existence of these disorders is presupposed by many of those who use the manual, its criteria are confirmed repeatedly in the diagnostic process. Once DSM was published , its diagnostic system acquired a momentum of its own and has generated its own evidence. Its authors regard psychiatrists as experts at applying the manualís criteria. They are also seen as experts at distinguishing mental disorders from other illnesses. Belief in the existence of mental disorders is an essential part of the psychiatric faith. (shrink)

By the time of his death in 1989, R.D. Laing was already history. His status as a countercultural legend remained intact, but he had gone from icon to relic. His intellectual and political credibility reached a peak in the late 1960s that he never regained. For many, the publication of The Politics of Experience and The Bird of Paradise in 1967 presaged his critical demise into bad poetry and bellicose shamanism. Laing himself was keenly aware of his fall from popular (...) grace. (shrink)