Sometimes healthcare professionals conscientiously refuse to treat patients despite the patient requesting legal, medically indicated treatments within the professionals’ remit. Recently, there has been a proliferation of views using the concept of public reason to specify which conscientious refusals of treatment should be accommodated. Four such views are critically assessed, namely, those of Robert Card, Massimo Reichlin, David Scott, and Doug McConnell. This paper argues that McConnell’s view has advantages over the other approaches because it combines the (...) requirement that healthcare professionals publicly justify the grounds of their conscientious refusals of treatment with the requirement that those grounds align with minimally decent healthcare. This relatively restrictive approach accommodates conscientious refusals from minimally decent healthcare professionals while still protecting good healthcare, the independence of the healthcare professions, and the fiduciary relationships. (shrink)

Current mainstream approaches to conscientious objection either uphold the standards of public health care by preventing objections or protect the consciences of health‐care professionals by accommodating objections. Public justification approaches are a compromise position that accommodate conscientious objections only when objectors can publicly justify the grounds of their objections. Public justification approaches require objectors and assessors to speak a common normative language and to this end it has been suggested that objectors should be required to cast their objection in terms (...) of public reason. We provide critical support for such a public reason condition and argue that it would be neither too demanding nor too permissive. We also respond to objections that it unfairly favours secular over religious objectors and that public reasons cannot be held with the kind of sincerity thought to characterize conscientious objections. (shrink)

Healthcare systems around the world are struggling to maintain a sufficient workforce to provide adequate care during the COVID-19 pandemic. Staffing problems have been exacerbated by healthcare workers refusing to work out of concern for their families. I sketch a deontological framework for assessing when it is morally permissible for HCWs to abstain from work to protect their families from infection and when it is a dereliction of duty to patients. I argue that it is morally permissible for HCWs to (...) abstain from work when their duty to treat is outweighed by the combined risks and burdens of that work. For HCWs who live with their families, the obligation to protect one’s family from infection contributes significantly to those burdens. There are, however, a range of complicating factors including the strength of duty to treat which varies according to the HCW’s role, the vulnerability of family members to the disease, the willingness of family members to risk infection and the resources available to the HCW to protect their family. In many cases, HCWs in ‘frontline’ roles with a weak duty to treat and families at home will be morally permitted to abstain from work given the risks posed by COVID-19; therefore, society should provide additional incentives to maintain sufficient staff in these roles. (shrink)

Robert Card’s “Reasonability View” is a significant contribution to the debate over the place of conscientious objection in health care. In his view, conscientious objections can only be accommodated if the grounds for the objection meet a reasonability standard. I identify inconsistencies in Card’s description of the reasonability standard and argue that each version he specifies is unsatisfactory. The criteria for reasonability that Card sets out most frequently have no clear underpinning principle and are too permissive of immoral objections. Card (...) has also claimed that petitioners must justify their positions with Rawlsian public reason. I argue that, although the resulting reasonability standard is principled, it is overly restrictive. I also show that a reasonability standard built on Rawls’ more lenient conception of reasonableness would be overly permissive of objections at odds with professional healthcare standards. Finally, I argue for my favored solution, which bases the reasonability standard on minimal professional standards. (shrink)

ABSTRACT Choice theorists such as George Ainslie and Gene Heyman argue that the drug-seeking behaviour of addicts is best understood in the same terms that explain everyday choices. Everyday choices, they claim, aim to maximise the reward from available incentives. Continuing drug-use is, therefore, what addicts most want given the incentives they are aware of but they will change their behaviour if and when better incentives become available. This model might explain many typical cases of addiction, but there are hard (...) cases that pose a problem. In these hard cases the addicted individual does not cease using drugs in the face of consequences that are so adverse it is implausible that they are unaware of more rewarding paths of action. These cases force the choice theorist into a dilemma: either these addicts? drug use does not count as action and so is best described by a neurobiological model, or reference to ?reward? in these cases means merely ?motivated? and so provides no explanatory power. We propose a different model of motivation that takes self-conception into account. We show how that can better explain the hard cases of addiction and also inform our understanding of recovery and self-control. (shrink)

Why do some addicted people chronically fail in their goal to recover, while others succeed? On one established view, recovery depends, in part, on efforts of intentional planning agency. This seems right, however, firsthand accounts of addiction suggest that the agent’s self-narrative also has an influence. This paper presents arguments for the view that self-narratives have independent, self-fulfilling momentum that can support or undermine self-governance. The self-narrative structures of addicted persons can entrench addiction and alienate the agent from practically feasible (...) recovery plans. Strategic re-narration can redirect narrative momentum and therefore support recovery in ways that intentional planning alone cannot. (shrink)

ABSTRACT‘Self-ambiguity’, we suggest, is best understood as an uncertainty about how strongly a given feature reflects who one truly is. When this understanding of self-ambiguity is applied to a view of the self as having both essential and shapable components, self-ambiguity can be seen to have two aspects: (1) uncertainty about one's essential or relatively unchangeable characteristics, e.g. one's sexuality, and (2) uncertainty about how to shape oneself, e.g. which values to commit to, actions to pursue, or essential features to (...) identify with. We explain how a narrative account of agency can accommodate these forms of self-ambiguity and argue that such an account also reveals another kind of self-ambiguity, namely, (3) uncertainty about whether one's established self-narrative represents who one really is. We illustrate this third form of self-ambiguity in the context of addiction where people's established addiction self-narratives make it difficult to identify with recovery. We argue that recovery will require embracing, especially, our third form of self-ambiguity as a chance for positive self-transformation. Treatment for addiction should, therefore, support people in going through and ultimately narratively resolving the inevitable self-ambiguities of the recovery process. (shrink)

All people are vulnerable to having their self-concepts shaped by others. This article investigates that vulnerability using a theory of narrative self-constitution. According to narrative self-constitution, people depend on others to develop and maintain skills of self-narration and they are vulnerable to having the content of their self-narratives co-authored by others. This theoretical framework highlights how vulnerability to co-authoring is essential to developing a self-narrative and, thus, the possibility of autonomy. However, this vulnerability equally entails that co-authors can undermine autonomy (...) by contributing disvalued content to the agent’s self-narrative and undermining her authorial skills. I illustrate these processes with the first-hand reports of several women who survived sexual abuse as children. Their narratives of survival and healing reveal the challenges involved in developing the skills required to manage vulnerability to co-authoring and how others can help in this process. Finally, I discuss some of the implications of co-authoring for the healthcare professional and the therapeutic relationship. (shrink)

In recent decades, researchers have attempted to prospectively identify individuals at high risk of developing psychosis in the hope of delaying or preventing psychosis onset. These psychosis risk individuals are identified as being in an ‘At-Risk Mental State’ (ARMS) through a standardised psychometric interview. However, disclosure of ARMS status has attracted criticism due to concerns about the risk–benefit ratio of disclosure to patients. Only approximately one quarter of ARMS patients develop psychosis after three years, raising concerns about the unnecessary harm (...) associated with such ‘false-positive’ results. These harms are especially pertinent when identifying psychosis risk individuals due to potential stigma and discrimination in a young clinical population. A dearth of high-quality evidence supporting interventions for ARMS patients raises further doubts about the benefit accompanying an ARMS disclosure. Despite ongoing discussion in the bioethical literature, these concerns over the ethical justification of disclosure to ARMS patients are not directly addressed in clinical guidelines. In this paper, we aim to provide a unified disclosure strategy grounded in principle-based analysis for ARMS clinicians. After considering the ethical values at stake in ARMS disclosure, and their normative significance, we argue that full disclosure of the ARMS label is favoured in the vast majority of clinical situations due to the strong normative significance of enhancing patients' understanding. We then compare our framework with other approaches to ARMS disclosure and outline its limitations. (shrink)

The COVID-19 pandemic has created unusually challenging and dangerous workplace conditions for key workers. This has prompted calls for key workers to receive a variety of special benefits over and above their normal pay. Here, we consider whether two such benefits are justified: a no-fault compensation scheme for harm caused by an epidemic and hazard pay for the risks and burdens of working during an epidemic. Both forms of benefit are often made available to members of the armed forces for (...) the harms, risks and burdens that come with military service. We argue from analogy that these benefits also ought to be provided to key workers during an epidemic because, like the military, key workers face unavoidable harms, risks and burdens in providing essential public good. The amount of compensation should be proportional to the harm suffered and the amount of hazard pay should be proportional to the risk and burden endured. Therefore, key workers should receive the same amount of compensation and hazard pay as the military where the harms, risks and burdens are equivalent. In the UK, a form of no-fault compensation has recently been made available to the surviving families of key workers who suffer fatal COVID-19 infections. According to our argument, however, it is insufficient because it offers less to key workers than is made available to the families of armed services personnel killed on duty. (shrink)

Addiction involves a chronic deficit in self-governance that treatment aims to restore. We draw on our interviews with addicted people to argue that addiction is, in part, a problem of self-narrative change. Over time, agents come to strongly identify with the aspects of their self-narratives that are consistently verified by others. When addiction self-narratives become established, they shape the addicted person’s experience, plans, and expectations so that pathways to recovery appear implausible and feel alien. Therefore, the agent may prefer to (...) enact her disvalued self-narrative because at least it represents who she takes herself to be. To recover, the agent needs to conduct narrative work, adjusting her existing self-narrative so that it better supports recovery-directed narrative projections. Reducing cravings, managing withdrawals, increasing self-control, and developing goals are all important for recovery but those approaches will often be in vain if the influence of self-narrative is ignored. If our analysis is correct, addiction treatment will typically be more effective if it incorporates support for self-narrative change. (shrink)

Daniel Sulmasy has recently argued that good medicine depends on physicians having a wide discretionary space in which they can act on their consciences. The only constraints Sulmasy believes we should place on physicians’ discretionary space are those defined by a form of tolerance he derives from Locke whereby people can publicly act in accordance with their personal religious and moral beliefs as long as their actions are not destructive to society. Sulmasy also claims that those who would reject physicians’ (...) right to conscientious objection eliminate discretionary space thus undermining good medicine and unnecessarily limiting religious freedom. I argue that, although Sulmasy is correct that some discretionary space is necessary for good medicine, he is wrong in thinking that proscribing conscientious objection entails eliminating discretionary space. I illustrate this using Julian Savulescu and Udo Schuklenk’s system for restricting conscientious objections as a counter-example. I then argue that a narrow discretionary space constrained by professional ideals will promote good medicine better than Sulmasy’s wider discretionary space constrained by his conception of tolerance. Sulmasy’s version of discretionary space would have us tolerate actions that are at odds with aspects of good medicine, including aspects that Sulmasy himself explicitly values, such as fiduciary duty. Therefore, if we want the degree of religious freedom in the public sphere that Sulmasy favours then we must decide whether it is worth the cost to the healthcare system. (shrink)

Psychiatric involvement in patient morality is controversial. If psychiatrists are tasked with shaping patient morality, the coercive potential of psychiatry is increased, treatment may be unfairly administered on the basis of patients’ moral beliefs rather than medical need, moral disputes could damage the therapeutic relationship and, in any case, we are often uncertain or conflicted about what is morally right. Yet, there is also a strong case for the view that psychiatry often works through improving patient morality and, therefore, should (...) aim to do so. Our goal is to offer a practical and ethical path through this conflict. We argue that the default psychiatric approach to patient morality should be procedural, whereby patients are helped to express their own moral beliefs. Such a procedural approach avoids the brunt of objections to psychiatric involvement in patient morality. However, in a small subset of cases where patients’ moral beliefs are sufficiently distorted or underdeveloped, we claim that psychiatrists should move to a substantive approach and shape thecontentof those beliefs when they are relevant to psychiatric outcomes. The substantive approach is prone to the above objections but we argue it is nevertheless justified in this subset of cases. (shrink)

The 2023 doctors’ strikes in the UK have elicited a familiar moral outcry that such strikes are morally wrong. We consider five arguments that might be thought to show doctors’ strikes are morally impermissible but show that they all fail. The most we can conclude from such arguments is that doctors’ strikes are morally permissible in a narrower range of circumstances than strikes in other sectors. We then outline two independent but compatible justifications for doctors’ strikes, one that appeals to (...) doctors’ interests in fair pay and working conditions and one that appeals to doctors’ duty to protect public health. We also suggest that doctors’ strikes can be supererogatory when they aim to correct a government failing in its own duty to protect public health. Finally, we assess the 2023 UK doctors’ strikes. We conclude that they are justified and there is a case for considering them supererogatory. (shrink)

In this chapter we focus on the structure of close personal relations and diagnose how these relationships are disrupted by addiction. We draw upon Peter Strawson’s landmark paper ‘Freedom and Resentment’ (2008, first published 1962) to argue that loved ones of those with addiction veer between, (1) reactive attitudes of blame and resentment generated by disappointed expectations of goodwill and reciprocity, and (2) the detached objective stance from which the addicted person is seen as less blameworthy but also as less (...) fit for ordinary interpersonal relationships. We examine how these responses, in turn, shape the addicted person’s view of themselves, their character and their capacities, and provide a negative narrative trajectory that impedes recovery. We close with a consideration of how these effects might be mitigated by adopting less demanding variations of the participant stance. (shrink)

In this chapter we draw comparisons between Kass’ views on the normative authority of repugnance and social intuitionist accounts of moral judgement which are similarly sceptical about the role of reasoned reflection in moral judgement. We survey the empirical claims made in support of giving moral primacy to intuitions generated by emotions such as repugnance, as well as some common objections. We then examine accounts which integrate intuition and reflection, and argue that plausible accounts of wisdom are in tension with (...) Kass’ claim that our inarticulable emotional responses can be the expression of deep wisdom. We conclude that while repugnance and other emotions have a role to play in informing deliberation and judgement, we have reason to be cautious in giving them normative authority. Affective responses alone cannot discharge the burden of justification for moral judgement and are just one tool relied upon by those we consider wise. (shrink)

On the mainstream view, consciences are valuable because they promote moral unity. However, conscience, so defined, will systematically prevent moral growth that threatens unity, even when unity has formed around oppressive moral values. This motivates Carolyn McLeod's alternative ‘Dynamic View’ whereby consciences are valuable to the extent that they are dynamic. Consciences are dynamic when they interact with our best moral judgements to shape or ‘retool’ the moral values underpinning conscience, sometimes at an initial cost to unity. We modify and (...) extend McLeod's account in two ways: (1) We object to her claim that conscience encourages its own retooling. We argue that the opposite is true – conscience creates a motivational barrier to change that moral judgement must overcome to successfully retool conscience. The task of ensuring dynamism, therefore, falls to moral judgement. (2) However, this motivational barrier enables conscience to play a valuable role that McLeod overlooks – compensating for the limitations of moral judgement. On our Balanced View, the value of conscience depends on it being sufficiently open to being shaped by our best moral judgements but inert enough to compensate for distorted moral judgements and to guide action when under cognitive load. (shrink)

Self-narrative is often, perhaps primarily, a tool of self- constitution, not of truth representation. We explore this theme with reference to our own recent qualitative interviews of substance-dependent agents. Narrative self- constitution, the process of realizing a valued narrative projection of oneself, depends on one’s narrative tracking truth to a certain extent. Therefore, insofar as narratives are successfully realized, they have a claim to being true, although a certain amount of self-deception typically comes along for the ride. We suggest that, (...) because agents typically value certain outcomes more highly than truth for truth’s sake, it makes sense to narrate in ways that aren’t strictly true if that helps ensure highly valued outcomes do come true. Walker (2012) outlines three ways of defending the truth of past-directed narratives, but the role of future-directed narratives in realizing highly valued truths provides her a fourth way. (shrink)

Australasian Journal of Philosophy, Volume 89, Issue 4, Page 753-754, December 2011.

Research in anthropology has shown that kin terminologies have a complex combinatorial structure and vary systematically across cultures. This article argues that universals and variation in kin terminology result from the interaction of (1) an innate conceptual structure of kinship, homologous with conceptual structure in other domains, and (2) principles of optimal, “grammatical” communication active in language in general. Kin terms from two languages, English and Seneca, show how terminologies that look very different on the surface may result from variation (...) in the rankings of a universal set of constraints. Constraints on kin terms form a system: some are concerned with absolute features of kin (sex), others with the position (distance and direction) of kin in “kinship space,” others with groups and group boundaries (matrilines, patrilines, generations, etc.). Also, kin terms sometimes extend indefinitely via recursion, and recursion in kin terminology has parallels with recursion in other areas of language. Thus the study of kinship sheds light on two areas of cognition, and their phylogeny. The conceptual structure of kinship seems to borrow its organization from the conceptual structure of space, while being specialized for representing genealogy. And the grammar of kinship looks like the product of an evolved grammar faculty, opportunistically active across traditional domains of semantics, syntax, and phonology. Grammar is best understood as an offshoot of a uniquely human capacity for playing coordination games. (shrink)

The placebo effect is now generally defined widely as an individual’s response to the psychosocial context of a clinical treatment, as distinct from the treatment’s characteristic physiological effects. Some researchers, however, argue that such a wide definition leads to confusion and misleading implications. In response, they propose a narrow definition restricted to the therapeutic effects of deliberate placebo treatments. Within the framework of modern medicine, such a scope currently leaves one viable placebo treatment paradigm: the non-deceptive and non-concealed administration of (...) ‘placebo pills’, or open label placebo (OLP) treatment. In this paper I consider how the placebo effect occurs in OLP. I argue that a traditional belief-based account of OLP is paradoxical. Instead, I propose an account based on the non-doxastic attitude of pretence, understood within a fictionalist framework. (shrink)

This publication discusses how modernist techniques for depicting characters' thoughts, feelings, and desires have been reinvented by some of the most influential and innovative writers of the postwar period, including Vladimir Nabokov, Samuel Beckett, Toni Morrison, John Banville, J.M. Coetzee, and Eimear McBride.

RésuméDans ce dialogue, deux personnages principaux, Philopolis et Éleuthérios, proposent la position communautarienne et la position contractualiste libérale comme fondements de la théorie politique. Le débat se déroule, comme tout bon débat devrait lefaire, autour d'une bouteille de Chardonnay.

Body theory is the work of historians, sociologists, philosophers, and other scholars in the past twenty to twenty-five years that explicitly focuses on the body, especially on sexuality and gender. The body is seen as an ideological surface on which history and politics inscribe their truths. It is, in short, a corporeal epistemology standing in opposition to all the old cognitive epistemologies (e.g., Descartes, Locke, and modern analytic thought as a whole). Régimes of power are known through the way they (...) oppress, manipulate, and construct the human body. Body theory includes the work of Michel Foucault, Thomas Laquer, and feminist scholars such as Hélène Cixous, Laura Mulvey, and Elaine Showalter. This work is carried on, by and large, in the methodological atmosphere of a constructivist notion of gender, sexuality, social ideas, and the self. (shrink)

This book provide a unique glimpse into the lives and thinking of famous yoga masters through their correspondance with Dr. Harry Dickman.

This self-contained introduction to natural language semantics addresses the majortheoretical questions in the field. The authors introduce the systematic study of linguistic meaningthrough a sequence of formal tools and their linguistic applications. Starting with propositionalconnectives and truth conditions, the book moves to quantification and binding, intensionality andtense, and so on. To set their approach in a broader perspective, the authors also explore theinteraction of meaning with context and use (the semantics-pragmatics interface) and address some ofthe foundational questions, especially in connection (...) with cognition in general. They also introducea few of the most accessible and interesting ideas from recent research to give the reader a bit ofthe flavor of current work in semantics. The organization of this new edition is modular; after theintroductory chapters, the remaining material can be covered in flexible order. The book presupposesno background in formal logic (an appendix introduces the basic notions of set theory) and only aminimal acquaintance with linguistics. This edition includes a substantial amount of completely newmaterial and has been not only updated but redesigned throughout to enhance itsuser-friendliness. (shrink)

It is common to think of medical and ethical modes of thought as different in kind. In such terms, some clinical situations are made more complicated by an additional ethical component. Against this picture, we propose that medical and ethical modes of thought are not different in kind, but merely different aspects of what it means to be human. We further propose that clinicians are uniquely positioned to synthesise these two aspects without prior knowledge of philosophical ethics.

In his philosophical works Cicero addresses a number of questions concerning the role of old men in politics, most obviously in his dialogue De senectute of 44 BCE. How best should the old participate in politics and the wider community—what, if anything, do the old have to offer that is special or unique? How should the generations fit together in the body politic, and should age be a factor in the structural organisation of states? Should the old rule? This chapter (...) makes the following argument: (1) in De senectute Cicero develops a coherent line on the special political role of old men within the constitutional framework set out in his earlier De re publica, which can be seen as a call to arms in the contemporary Roman political context; and (2) this line is not just a restatement of traditional republican ideals: in a similar vein to what we see in De re publica, Cicero draws on and adapts some of the most important arguments from Plato’s Republic when addressing these questions regarding the role of old men in politics. (shrink)

The kin selection hypothesis posits that male androphilia (male sexual attraction to adult males) evolved because androphilic males invest more in kin, thereby enhancing inclusive fitness. Increased kin-directed altruism has been repeatedly documented among a population of transgendered androphilic males, but never among androphilic males in other cultures who adopt gender identities as men. Thus, the kin selection hypothesis may be viable if male androphilia was expressed in the transgendered form in the ancestral past. Using the Standard Cross-Cultural Sample (SCCS), (...) we examined 46 societies in which male androphilia was expressed in the transgendered form (transgendered societies) and 146 comparison societies (non-transgendered societies). We analyzed SCCS variables pertaining to ancestral sociocultural conditions, access to kin, and societal reactions to homosexuality. Our results show that ancestral sociocultural conditions and bilateral and double descent systems were more common in transgendered than in non-transgendered societies. Across the entire sample, descent systems and residence patterns that would presumably facilitate increased access to kin were associated with the presence of ancestral sociocultural conditions. Among transgendered societies, negative societal attitudes toward homosexuality were unlikely. We conclude that the ancestral human sociocultural environment was likely conducive to the expression of the transgendered form of male androphilia. Descent systems, residence patterns, and societal reactions to homosexuality likely facilitated investments in kin by transgendered males. Given that contemporary transgendered male androphiles appear to exhibit elevated kin-directed altruism, these findings further indicate the viability of the kin selection hypothesis. (shrink)

This chapter provides a critical account of Cicero’s discussion of the nature of the soul and the emotions in the Tusculan Disputations. The first two sections trace the key steps of Cicero’s argumentation, as he critically evaluates the strengths and weaknesses of various competing views in the Greek philosophical tradition. Cicero ultimately purports to favor Plato’s position on the immortality of the soul and the Stoics’ cognitivist account of the emotions. The final section draws attention to the ways in which (...) Cicero employs and evaluates these philosophical resources in the realm of therapeutic practice, as he reflects on his own experience of suffering and loss. Cicero showcases the practical utility of a flexible therapeutic model that focuses on the transformation of beliefs: while he clearly favors the Stoic explanation of the emotions, he does not feel compelled to recommend only the therapy in agreement with that explanation. This pragmatic approach can be seen as a distinctive aspect of Cicero’s own philosophical practice. (shrink)

In this nationwide study of American and Canadian journalists, I found that their moral and ethical values are solidly connected to the Judeo-Christian tradition, even among those who do not claim to be religiously oriented. This study shows that religious values are imbedded deeply, if not always consciously, in the moral and ethical values of journalists and that journalists of varying religious orientations tend to endorse a core group of moral and ethical principles at the heart of the religious heritage (...) of the United States and Canada. However, journalists have expanded their definition of what religion coverage means in an increasingly diverse and secular society, and few want to connect their professional values only with Christian teaching. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.1 (2005) 83-85 [Access article in PDF] Lacan, Science, and Determinism Douglas McConnell Grant Gillett Keywords Lacan, the unconscious, free will Van Staden And Hinshelwood's commen-taries raise a number of issues, but there are two particular themes common to both that we pick up in this response.The first theme concerns the reconcilability of Lacanian theory to the disciplines of analytic philosophy and "Anglo-American positivist (...) psychiatry." This is closely related to the relationship between the unconscious and the empirical sciences discussed in the editorial (McConnell and Pickering 2005). The second theme concerns the relevance of Lacanian theory to our understanding of free will and the structure of the mind. Lacan, Analytic Philosophy, and Scientific Psychiatry First, psychoanalysis or psychotherapy generally should not try to reunite with neuroscience because of the fundamental difference in their approaches to the patient, which is likely to mean that even if a theoretical rapprochement can be found, a working relationship is unlikely.Although there are many facets of Lacan's theory that were not addressed in our paper and even if many of those are totally irreconcilable to analytic philosophy, we believe that we have addressed the most ontologically fundamental issues and that these can genuinely contribute to and challenge analytic philosophy of mind.As Hinshelwood points out, psychiatry does operate with a philosophical basis, critical (or sometimes relatively uncritical) scientific realism (even though it may not be acknowledged), and it as such it can legitimately be contributed to or challenged by the philosophical aspects of Lacanian theory outlined in our paper.In fact, the theoretical basis is evinced in van Staden's commentary when he remarks on the relation between Lacanian theory and psychiatry: "... the unconscious is not only structured like a language but actually reflects and is produced by linguistic interaction between the subject and others. This is a difficult claim to verify, no doubt, but it prompts further related questions... whether the conscious mind is structured like a language" (van Staden 2005, 78). And one must ask whether this is the kind of claim that can be verified or whether it is a hermeneutic claim (in somewhat the way suggested by Jaspers), serving more as a framing belief to allow people to make sense of what has influenced them in their life histories and is currently played out in their relationships with others. We would lean toward this interpretation of the unconscious, explicitly distancing ourselves from any overreaching, quasi-scientific realism about unconscious contents and mental structures, but clinging to the thought that dealing with such contents is an essential part of the therapeutic encounter. [End Page 83]Looked at in this way, both the Lacanian unconscious and conscious mental life bear the imprint of language due to the subject's immersion and participation in the symbolic realm. This may seem a "difficult claim to verify," but because verification is linked to the scientific framework of inquiry rather than the hybrid that is clinical knowledge, we would better regard it as being difficult to establish as an axiom of therapy. The linguistic structure of the conscious and unconscious mind is, on this account, a conceptual implication of the role of the symbolic register in thought and not a thesis that requires verification (a Wittgensteinian thesis espoused by a number of contemporary philosophers, including Dummett and Davidson).As it happens, cognitive science has found linguistic structure to be important in operations of the cognitive unconscious (arguably different from the dynamic unconscious due to the former's dependence on scientific experiment and the latter's connections to life history rather than mere psychological or cognitive traits [see Gillett and McConnell 2005]). Given that language and problem solving are so closely intertwined, it would suggest that cognitive science was overlooking something important rather than damaging Lacanian theory if linguistic structure did not appear on cognitive science's "radar." So, how does language logically (in the sense defended by Husserl and Frege, that is, to do with the sense or content of thoughts not merely the processes underpinning one's contingently evolving stream... (shrink)

Lacan, despite being largely ignored and misunderstood in Anglo-American analytic philosophy, brings psychoanalytic theory into close contact with the philosophy of mind and psychiatry as illuminated by the continental tradition. He draws on Freud, phenomenology, existentialism, and structuralism to construct a subtle theoretical approach to the psyche according to which our engagement in discourse and our existence in the world combine to generate a many layered structure of meanings and influences that forms us. This allows him to focus on the (...) nature and role of language and our discursively constructed self-conceptions both in the therapeutic encounter and in the maladies of the psyche. The relevance of Lacan's thought for analytic philosophy of psychiatry can be explored by pursuing his links to Freud, his complex treatment of issues in the philosophy of language, and a subtle blend of existentialism and continentally inspired naturalism that paints the contours of the unconscious mind in operationally compelling terms. (shrink)

In this paper, we explicate the method of Investigative Ordinary Language Philosophy (IOLP). The term was coined by John Cook to describe the unique philosophical approach of Frank Ebersole. We argue that (i) IOLP is an overlooked yet valuable philosophical method grounded in our everyday experiences and concerns; and (ii) as such, Frank Ebersole is an important but neglected figure in the history of ordinary language philosophy.

On one hand, it is commonly accepted that clinicians should not deceive their patients, yet on the other there are many instances in which deception could be in a patient’s best interest. In this paper, I propose that this conflict is in part driven by a narrow conception of deception as contingent on belief. I argue that we cannot equate non-deceptive care solely with introducing or sustaining a patient’s true belief about their condition or treatment, because there are many instances (...) of clinical care which are non-doxastic and non-deceptive. Inasmuch as this is true, better understanding of non-doxastic attitudes, such as hope and pretence, could improve our understanding of deception in clinical practice. (shrink)

I argue that Aristotle believes that virtue comes in degrees. After dispatching with initial concerns for the view, I argue that we should accept it because Aristotle conceives of heroic virtue as the highest degree of virtue. I support this interpretation of heroic virtue by considering and rejecting alternative readings, then showing that heroic virtue characterized as the highest degree of virtue is consistent with the doctrine of the mean.

Many different versions of cultural studies have emerged in the past decades. While during its dramatic period of global expansion in the 1980s and 1990s, cultural studies was often identified with...