Political theory and philosophy need to widen their view of the space in which what matters politically takes place, and I suggest that integrating the conditions of sustainability of all affected—that is, all participants in nature's relations—is a necessary first step in this direction. New materialists and posthumanists have challenged how nature and politics have traditionally been construed. While acknowledging the significance of their contributions, I critically examine the ethical and political implications of their ontological project. I focus particularly on (...) how the decentering of human agency that they advocate for raises a set of concerns that need to be addressed in developing an appropriate ecological ethics. I argue that the latter must be attuned to the vulnerability of living beings who participate in relationships that sustain life on earth. This brings me to conclude that qualitative distinctions between the worlds ofbiosandtechneare necessary. This is because we need to think critically about ways of evaluating types of relationships so that we can assess them and establish which are worth nurturing and protecting and which are not. (shrink)

Technological advances are making devices that functionally replace body parts—artificial organs and limbs—more widely used, and more capable of providing patients with lives that are close to “normal.” Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies—which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with (...) artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects. The paper argues that bodies’ normative status relies on the relation of a body to a person and shows that persons could have similar relations to prostheses. This suggests that in approaching ethical issues surrounding prostheses, it is appropriate to regard them as more like body parts than like objects. (shrink)

Artificial devices that functionally replace internal organs are likely to be more common in the future. They are becoming more and more technologically feasible, increases in chronic diseases that can compromise various organs are anticipated, and donor organs will remain necessarily limited. More people in the future may have bodies that are partly nonorganic. How might artificial organs affect how we experience and conceptualize our bodies and how we understand the relation of the body to the experiencing, acting subject, or (...) self? Here, I focus on artificial heart devices (AHDs), including total artificial hearts (TAHs) and ventricular assist devices (VADs). While other devices, such as pacemakers and implantable cardiac defibrillators, assist the heart, I focus on devices that replace rather than assist organic function. AHDs, I argue, may have two opposing effects. On the one hand, having an AHD could alter experience, seemingly confirming that selves are shaped by the specifics of embodiment. On the other hand, AHDs are likely to encourage people to regard bodies as machines that are separable from the self. AHDs thus both confirm and undermine a body-self dualism. People with these devices may come to regard their bodies as machinelike even while having an artificial part alters their subjective experience. (shrink)

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions of knowledge. Hence, (...) there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good. (shrink)

We argue that contemporary conceptualizations of “persons” have failed to achieve the moral goals of “person-centred care” (PCC, a model of dementia care developed by Tom Kitwood) and that they are detrimental to those receiving care, their families, and practitioners of care. We draw a distinction between personhood and selfhood, pointing out that continuity or maintenance of the latter is what is really at stake in dementia care. We then demonstrate how our conceptualization, which is one that privileges the lived (...) experiences of people with dementia, and understands selfhood as formed relationally in connection with carers and the care environment, best captures Kitwood’s original idea. This conceptualization is also flexible enough to be applicable to the practice of caring for people at different stages of their dementia. Application of this conceptualization into PCC will best promote the well-being of people with dementia, while also encouraging respect and dignity in the care environment. (shrink)

The phrase ‘person‐centred care’ (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood. However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in which (...) a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC. (shrink)

This article critical examines Gilbert and colleagues’ study (Gilbert et al. 2017) claims on how deep brain stimulation (DBS) as a treatment for Parkinson’s disease (PD) can influence people’s self-concept.

One of major branches of philosophical research is the self, which, in particular, tries to find out how a subject creates her identity. In this work, I will just focus on two kinds of identity approaches: the narrative self-concept and the dramatic self-concept. I will argue that, although the Narrative identity approach especially helpful for the subject being able to give continuity to her actions, the Dramatic identity is which achieves to give meaning to the subject’s actions as soon as (...) they are happened, and also to herself. Hence, although both approaches might be useful for the self-concept of a subject because maintain a bidirectional relationship, it is the Dramatic identity theory which manages to resolve certain problems facing Narrative identity theory. To explain this, I will claim that agent is dramatized herself by acting in different situations. Following Erving Goffman and J. David Velleman, what it is posed in this essay is that the subject develops a Dramatic identity, in a similar way to the performer who represents her character, when she enacts herself in concrete contexts. That is, the agent dramatizes herself in a situation in a manner similar as an actor represents a character on stage. Consequently, my main goal is to answer to how an agent makes her identity by acting in social contexts. (shrink)

Recent works on narrative self-concept still do not pay enough attention to how a person’s actions influence her narration. Narrative structures may enable the subject to give meaning and continuity over time to her experience. But also, a person’s behavior can make sense of her self-concept. From this perspective, the Narrative Identity Theory might be insufficient for addressing the challenge of making sense of the subject’s actions during the interaction itself. The Dramatic Identity Theory's proposal can complement the Narrative Theory (...) on such points. Accordingly, this work will explore the relationship between these two theories in order to explain how the Dramatic Identity Theory can solve these problems, with a proposal based on the analogy between a theater actor’s performance and the subject's actions. (shrink)

Narrative views of the self argue that we constitute our self in self-narratives. Embodied views hold that our self is shaped through embodied experiences. In that case, what is the relation between embodiment and narrativity in the process of self-constitution? The question demands a clear definition of embodiment, but existing studies remains unclear on this point (section 2). We offer a correction to this situation by drawing on Merleau-Ponty’s analysis of the body that highlights its habituality. On this account, the (...) body has an inherent tendency to cultivate an organization of habits through its history of engagement with the world (section 3). Next, we explore its role in narrative self-constitution by distinguishing between two aspects of the narrative self, the narrated I and the narrating I (section 4). We argue on phenomenological grounds that self-narratives are informed by bodily perspectives in both respects. Furthermore, a focus on the habituality of the body allows for a better explanation of self-constitution than those based on implicit self-narratives (section 5). For these phenomenological and theoretical reasons, we conclude that narrative self-constitution is an embodied and embedded practice (section 6). (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)

Theories of collective intentionality and theories of relational autonomy share a common interest in analyzing the social dynamics of agency. However, whereas theories of collective intentionality conceive of social groups primarily as intentional and voluntarily willed, theories of relational autonomy claim that autonomous agency is both scaffolded and constrained by social forces and structures, including the constraints imposed by nonvoluntary group membership. The question raised by this difference in view is whether social theorizing that overlooks the effects of nonvoluntary social (...) group membership on individual and joint agency overlooks crucial aspects of the social dynamics of agency. To explore this question, this article first evaluates Michael Bratman's planning analysis of individual agency from the perspective of relational autonomy theory and compares it with a narrative self‐constitution account of temporally extended agency. It then evaluates Bratman's analysis of shared agency and discusses Shaun Gallagher and Deborah Tollefsen's concept of we‐narratives, which extends the notion of narrative construction to shared agency. Overall, the argument aims to show that if we are interested in understanding the social dynamics of agency, it is critical to attend to the way that agents exercise their intentional agency in relation to internalized and external social constraints. (shrink)

In this paper I present a critical analysis of the English law relating to the safeguarding of vulnerable adults, in particular how the law impacts on the sexual lives of adult women with mental disabilities. I consider the discourses of vulnerability that surround the different legal regimes and whether the emerging theoretical vulnerability literature can assist in developing more nuanced legal responses. I argue that the inherent jurisdiction and Care Act 2014 provide an opportunity to move away from the focus (...) on inherent features of vulnerability such as mental disability towards a more nuanced, situational and embodied account of what it means to safeguard ‘vulnerable adults’. This has the potential to be developed in England through the new legal framework of the Care Act and can be achieved through targeting interventions against the situational causes of vulnerability, for example the perpetrators of sexual violence. (shrink)

Recent work on the relation between narrative and selfhood has emphasized embodiment as an indispensable foundation for selfhood. This has occasioned an interesting debate on the relation between embodiment and narrative. In this paper, I attempt to mediate the range of conflicting intuitions within the debate by proposing a scalar approach to narrative and an accompanying concept of a split-self. Drawing on theoretical developments from contemporary narratology, I argue that we need to move away from a binary understanding of narrative (...) as something an entity strictly is or is not; rather, we need to see narrative as an attribute admitting of degrees. I suggest that the relation between narrative and embodiment should be seen along these lines, proposing three levels of the narrativity of embodied experiencing: 1) the unnarratable, 2) the narratable and 3) the narrative. Finally, I discuss the implications this framework has for the general question of the narrative constitution of selfhood. (shrink)

Narrative theories currently dominate our understanding of how selfhood is constituted and concretely individuated throughout personal history. Despite this success, the narrative perspective has recently been exposed to a range of critiques. Whilst these critiques have been effective in pointing out the shortcomings of narrative theories of selfhood, they have been less willing and able to suggest alternative ways of understanding personal history. In this article, I assess the criticisms and argue that an adequate phenomenology of personal history must also (...) go beyond narrative. Drawing on a distinction between history and narrative, I outline an account of historical becoming through a process of sedimentation and a rich notion of what I call historical selfhood on an embodied level. Five embodied existentials are suggested, sketching a preliminary understanding of how selves are concretely individuated on a pre-narrative level. (shrink)

The standard reply to the critique that narrative theories of the self are either chauvinistic or trivial is to “go implicit”. Implicit narratives, it is argued, are necessary for diachronically structured self-experience, but do not require that such narratives should be wholly articulable life stories. In this paper I argue that the standard approach, which puts forward a phenomenological conception of implicit narratives, is ultimately unable to get out of the clutches of the dilemma. In its place, I offer an (...) alternative approach that does avoid the dilemma, by construing implicit narrativity as an enabling condition for experiences, rather than as something that is itself present in experience. According to this constitutive account, the coherence and intelligibility of our experiences is due to the fact that they are anchored in a larger, diachronic context. This context, I argue, takes a fundamentally embodied and narrative dimension. (shrink)

Psychiatric patients sometimes ask where to draw the line between who they are – their selves – and their mental illness. This problem is referred to as the self-illness ambiguity in the literature; it has been argued that solving said ambiguity is a crucial part of psychiatric treatment. I distinguish a Realist Solution from a Constructivist one. The former requires finding a supposedly pre-existing border, in the psychiatric patient’s mental life, between that which belongs to the self and that which (...) belongs to the mental illness. I argue that no such border exists, and that attempts to find it might even render the felt ambiguity worse. Instead, any solution must be constructivist; the patient (and others) should deliberate and discuss what to identify with or not. I further argue that psychiatric patients need not see their mental illness as wholly distinct from themselves to avoid ‘identifying with their diagnoses' in a problematic way. Finally, we can excuse problematic behaviour by mentally ill people – in fact, we can do so in a more nuanced and constructive way – while rejecting the view that the mental illness is wholly distinct from the patient’s self. (shrink)

In this article, I outline various ways in which artifacts are interwoven with autobiographical memory systems and conceptualize what this implies for the self. I first sketch the narrative approach to the self, arguing that who we are as persons is essentially our (unfolding) life story, which, in turn, determines our present beliefs and desires, but also directs our future goals and actions. I then argue that our autobiographical memory is partly anchored in our embodied interactions with an ecology of (...) artifacts in our environment. Lifelogs, photos, videos, journals, diaries, souvenirs, jewelry, books, works of art, and many other meaningful objects trigger and sometimes constitute emotionally-laden autobiographical memories. Autobiographical memory is thus distributed across embodied agents and various environmental structures. To defend this claim, I draw on and integrate distributed cognition theory and empirical research in human-technology interaction. Based on this, I conclude that the self is neither defined by psychological states realized by the brain nor by biological states realized by the organism, but should be seen as a distributed and relational construct. (shrink)

In this article, I outline various ways in which artifacts are interwoven with autobiographical memory systems and conceptualize what this implies for the self. I first sketch the narrative approach to the self, arguing that who we are as persons is essentially our life story, which, in turn, determines our present beliefs and desires, but also directs our future goals and actions. I then argue that our autobiographical memory is partly anchored in our embodied interactions with an ecology of artifacts (...) in our environment. Lifelogs, photos, videos, journals, diaries, souvenirs, jewelry, books, works of art, and many other meaningful objects trigger and sometimes constitute emotionally laden autobiographical memories. Autobiographical memory is thus distributed across embodied agents and various environmental structures. To defend this claim, I draw on and integrate distributed cognition theory and empirical research in human-technology interaction. Based on this, I conclude that the self is neither defined by psychological states realized by the brain nor by biological states realized by the organism, but should be seen as a distributed and relational construct. (shrink)

Psychologists and philosophers agree that personal narratives are a central component of one’s identity. The concept of narrative self has been proposed to capture this aspect of selfhood. In recent times, it has been a matter of debate how the narrative self relates to the embodied and experiential dimension of the self. In this debate, the role attributed to inner speech is that of constructing and maintaining personal narratives. Indeed, evidence suggests that inner speech episodes are involved in self-reflection and (...) autobiographical reasoning. That is, previous works have focused mostly, if not solely, on the role of inner speech for narrative self-understanding. However, inner speech is also involved in enacting personal narratives. In such cases, the content of the inner speech episodes is not in the service of the construction of narratives, rather it implies the identification with the character of the personal narratives. I introduce two instances of the use of inner speech for narrative self-enactment: positive self-talk and stereotype threat. I conclude by considering the implications of the examples introduced for the debate regarding the relation between the narrative and the embodied dimensions of selfhood. (shrink)

Richard Heersmink argues that self‐narratives are distributed across embodied organisms and their environment, given that their building blocks, autobiographical memories, are distributed. This argument faces two problems. First, it commits a fallacy of composition. Second, it relies on Marya Schechtman's narrative self‐constitution view, which is incompatible with the distributed cognition framework. To solve these problems, this article develops an alternative account of self‐narratives. On this account, we actively connect distributed autobiographical memories through distributed conversational and textual self‐narrative practices. This account (...) enhances our understanding of the memory–narrative nexus and has implications for philosophical conceptions of self. (shrink)

In recent years, philosophers of mind have explored the relationship between lived embodied experiences and self-narratives in bringing about a sense of self. This relationship has been vividly debated, with no consensus in the field. While some have argued that lived embodied experiences influence, but are not influenced by, self-narratives, others have maintained that lived embodied experiences and self-narratives influence each other across time. However, the very concept of ‘self-narrative’ and its scope of application has remained underspecified. The debate, I (...) will argue, can only be resolved if we arrive at a better theoretical understanding of self-narrative. Therefore, the purpose of this paper is to develop a conceptual account of the notion of ‘self-narrative’ and a descriptive account of its scope of application. It will then be shown how these accounts can pave the way towards resolving the debate on the experience-narrative nexus. (shrink)

Are interpersonal affordances a distinct type of affordance, and if so, what is it that differentiates them from other kinds of affordances? In this paper, I show that a hard distinction between interpersonal affordances and other affordances is warranted and ethically important. The enactivist theory of participatory sense-making demonstrates that there is a difference in coupling between agent-environment and agent-agent interactions, and these differences in coupling provide a basis for distinguishing between the perception of environmental and interpersonal affordances. Building further (...) on this foundation for understanding interpersonal affordances, I argue that in line with some enactivist work on social cognition, interpersonal affordances ought to be considered as those that are afforded by agents and are recognized as such. Given this distinction, I also make the point that because our social conventions establish persons as more than mere agents, the direct perception of interpersonal affordances may also involve seeing others as embodied selves. Distinguishing between types of affordances thus also matters ethically: there can be harms done when an agent is not perceived as an agent, and there can be harms done when an agent is not perceived as a self. (shrink)