Science and technology have vastly expanded the realm of medicine. The numbers of and knowledge about diseases has greatly increased, and we can help more people in many more ways than ever before. At the same time, the extensive expansion has also augmented harms, professional responsibility, and ethical concerns. While these challenges have been studied from a wide range of perspectives, the problems prevail. This article adds value to previous analyses by identifying how the moral imperative of medicine has expanded (...) in three ways: (1) from targeting experienced phenomena, such as pain and suffering, to non-experienced phenomena (paraclinical signs and indicators); (2) from addressing present pain to potential future suffering; and (3) from reducing negative wellbeing (pain and suffering) to promoting positive wellbeing. These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship. In order to find ways to manage the moral expansion of medicine, four traditional ways of setting limits are analyzed and dismissed. However, basic asymmetries in ethics suggest that it is more justified to address people’s negative wellbeing (pain and suffering) than their positive wellbeing. Moreover, differences in epistemology, indicate that it is less uncertain to address present pain and suffering than future wellbeing and happiness. Based on these insights the article concludes that the moral imperative of medicine has a gradient from pain and suffering to wellbeing and happiness, and from the present to the future. Hence, in general present pain and suffering have normative priority over future positive wellbeing. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is universally acknowledged as the prominent reference textbook for the diagnosis and assessment of psychiatric diseases. However, since the publication of its first version in 1952, controversies have been raised concerning its reliability and validity and the need for other novel clinical tools has emerged. Currently the DSM is in its fourth edition and a new fifth edition is expected for release in 2013, in an intense intellectual debate and in a (...) call for new proposals. (shrink)

This Editorial introduces the thematic series on 'Toward a New Psychiatry: Philosophical and Ethical Issues in Classification, Diagnosis and Care' http://www.biomedcentral.com/series/newpsychiatry.

Non è un caso che l’enhancement umano, cioè il potenziamento di capacità fisiche, cognitive ed emotive degli esseri umani con l’ausilio di tecnologie, sia diventato un tema centrale nei dibattiti etico-applicativi e nei tentativi contemporanei di arrivare a una comprensione più adeguata della natura umana. In esso si incontrano quesiti decisamente ricchi e complessi, sia dal punto di vista tecnoscientifico e medico sia da quello filosofico – e lo fanno in un modo che ci permette di vedere questi quesiti sotto (...) una nuova luce. Il numero raccoglie alcune voci italiane, tedesche, inglesi e statunitensi su diversi aspetti della problematica dell’enhancement umano. Tra le tematiche discusse troviamo il potenziamento genetico, le dimensioni etiche dell’enhancement, la relazione uomo-tecnologia, il cosiddetto enhancement morale, la relazione tra enhancement ed eugenetica, la distinzione tra potenziamento e terapia e la rilevanza delle neuroscienze per lo sviluppo futuro delle bio-tecnologie, della medicina e dell’etica. (shrink)

In light of the recent credibility crisis in psychology, this paper argues for a greater emphasis on theorizing in scientific research. Although reliable experimental evidence, preregistration, methodological rigor, and new computational frameworks for modeling are important, scientific progress also relies on properly functioning theories. However, the current understanding of the role of theorizing in psychology is lacking, which may lead to future crises. Theories should not be viewed as mere speculations or simple inductive generalizations. To address this issue, the author (...) introduces a framework called “cognitive metascience,” which studies the processes and results of evaluating scientific practice. This study should proceed both qualitatively, as in traditional science and technology studies and cognitive science, and quantitatively, by analyzing scientific discourse using language technology. By analyzing theories as cognitive artifacts that support cognitive tasks, this paper aims to shed more light on their nature. This perspective reveals that multiple distinct theories serve entirely different roles, and studying these roles, along with their epistemic vices and virtues, can provide insight into how theorizing should proceed. The author urges a change in research culture to appreciate the variety of distinct theories and to systematically advance scientific progress. . (shrink)