Christopher Boorse’s biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield’s harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze Boorse’s (...) central argument for the sufficiency claim, the “pathologist argument,” which takes pathologists’ intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion. (shrink)

Wakefield’s harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction and a value component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that dysfunctions (...) need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction’s harmfulness is best understood in dispositional terms. (shrink)

This target article presents a plausible evolutionary scenario for the emergence of the neural preconditions for language in the hominid lineage. In pleistocene primate lineages there was a paired evolutionary expansion of frontal and parietal neocortex (through certain well-documented adaptive changes associated with manipulative behaviors) resulting, in ancestral hominids, in an incipient Broca's region and in a configurationally unique junction of the parietal, occipital, and temporal lobes of the brain (the POT). On our view, the development of the POT in (...) our ancestors resulted in the neuroanatomical substrate consistent with the ability for representations in modality-neutral association cortex and, as a result of structure-imposing interaction with Broca's area, the hierarchically structured Evidence from paleoneurology and comparative primate neuroanatomy is used to argue that Homo habilis (2.5–2 million years ago) was the first hominid to have the appropriate gross neuroanatomical configuration to support conceptual structure. We thus suggest that the neural preconditions for language are met in H. habilis. Finally, we advocate a theory of language acquisition that uses conceptual structure as input to the learning procedures, thus bridging the gap between it and language. (shrink)

In ‘Rethinking Disease’, Powell and Scarffe1 propose what in effect is a modification of Jerome Wakefield’s2 3 harmful dysfunction analysis of medical disorder. The HDA maintains that ‘disorder’ is a hybrid factual and value concept requiring that a biological dysfunction, understood as a failure of some feature to perform a naturally selected function, causes harm to the individual as evaluated by social values. Powell and Scarffe accept both the HDA’s evolutionary biological function component and its incorporation of a value component. (...) Their proposed ‘new twist’ is to revise the value component: ‘Our proposed definition of disease is as follows: a biomedical state is a disease only if it implicates a biological dysfunction that is, or would be, properly disvalued’. So, they propose that a disorder is a ‘properly disvalued dysfunction’ rather than a ‘harmful dysfunction’, an approach they term ‘thickly normative’ in contrast to the thin normative approach of the HDA. There has been a surge of interest recently in better understanding the ‘harm’ component of the HDA. Powell and Scarffe’s analysis is a helpful contribution to this discussion. We focus here exclusively on their proposal regarding the analysis of the concept of disorder and ignore many important related issues that the authors address, ranging from prioritising resource allocation between disorders and non-disorders to whether the concept of disorder should be replaced by a generic welfarist concept. The resolution of these additional issues depends on first understanding ‘disorder’. The authors’ proposed changes to the HDA also deserve evaluation because the HDA, which has been endorsed by leading nosologists,4 plays an influential role in nosological debate across categories of disorder ranging, for example, from sexual paraphilias5 to psychopathy.6 A basic problem is that Powell and Scarffe misinterpret …. (shrink)

In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. In Part 1, I argued that, even if one accepts Lewis’s critique of the brain evidence presented for the brain-disease view, his arguments fail to establish that addiction is not a disorder. Relying on my harmful dysfunction analysis of disorder, I defended the view (...) that addiction is a medical disorder and a brain disorder. In Part 2, I consider some broader philosophical issues raised by Lewis’s arguments: I consider a larger puzzle, at the heart of the neo-Kraepelinian program in contemporary psychiatry, that is raised by Lewis’s argument that addiction is not a disorder because the brain displays no damage but only normal learning: must all mental disorders be brain disorders, or can mental disorders occur in normal brains? I argue that mental disorders can occur in normal brains. I critique Lewis’s response to the evolutionary “novel environment” approach to explaining why addiction is a disorder. Lewis agrees with brain-disease proponents that interpreting addiction as brain disorder relieves addicts of moral censure, but I argue that moral defect and brain disease are not exclusive. Finally, I consider Lewis’s “developmental-learning” account of addiction that encourages positive and empowering narrativizing of addiction, but I argue that the developmental-learning view is vacuous due to use of an overly broad notion of “development.”. (shrink)

In the first part of this article, I argue that Christopher Megone's natural-kind interpretation of Aristotle's argument that "the function of a human being is reason" does not resolve major puzzles about the argument, specifically the puzzles of why a human being has a function and why reason is that function. I attempt to resolve these puzzles by supplementing the natural-kind account with the doctrine that reason is the master regulatory natural function by which individuals enter into social life. In (...) the second half, I critique Megone's value account of function and argue for a nonevaluative, causal-explanatory account of function and teleological explanation. (shrink)

In clinical practice, evidence suggests that teaching ethics using normative ethical theory has little influence on the ethical actions of providers in practice. Thus, new training methods are needed that improve clinician response to ethical problems. A sensemaking approach to ethics training has demonstrated promise as an evidence-based pedagogical method to improve ethical reasoning and response. Project ECHO is theoretically linked to improved sensemaking. This study examines the effectiveness of ECHO and training in use of sensemaking approaches to ethical response (...) by clinicians. A quasi-experimental design study using univariate linear regression was used to examine the effect of the three types of ethics training on ethical response self-efficacy scores, while controlling for participant characteristics of years in practice, discipline and sex. We found evidence that training in sensemaking through participation in ECHO promotes improved ethical response self-efficacy of clinicians. However, results also suggest that a traditional ECHO format that does not explicitly introduce sensemaking strategies into the training does not result in the same learning outcomes as measured through an ethical response self-efficacy survey. This study found important preliminary results to support use of sensemaking approaches in clinical ethics training. (shrink)

The harmful dysfunction (HD) analysis of "disorder" holds that disorders are harmful failures of "designed" (that is, naturally selected) functions. Murphy and Woolfolk (2000) present a series of proposed counterexamples to the HD analysis to support their claim that it fails to provide a necessary condition for disorder. They argue that disorder can exist where there is no failed function, as in failed spandrels and inflamed vestigial organs, and that there can be disorders when everything is working as designed, as (...) in environment--design mismatches and disorders acquired through normal learning processes. They also argue that the HD analysis suffers from methodological problems, including value-ladenness of dysfunction judgments and unwarranted assumptions about the nature of internal mechanisms and their functions. -/- In this paper, each of these objections is critically evaluated. Reanalysis of the proposed counterexamples is argued to reveal strong support for the HD analysis. For example, failed spandrels are considered disorders when and only when they imply failures of designed functions; dysfunctions of vestigial organs involve failures of function at the tissue level, not the organ level; mechanism-environment mismatches are not considered disorders; and conditions acquired through normal learning processes can involve dysfunctions and are considered disordered only when they do. Murphy and Woolfolk's methodological objections are found to be based on a misinterpretation of the HD analysis. It is concluded that Murphy and Woolfolk fail to offer a cogent objection to the HD analysis. (shrink)

Pierre-Henri Castel provides a short but richly argued precis of his recently published two-volume 1,000-page masterwork on the history of obsessive-compulsive disorder. Having not read the as-yet-untranslated books, I write this commentary from Plato’s cave, trying to infer the reality of Castel’s analysis from expository shadows. I am unlikely to be more successful than Plato’s poor troglodytes, so I apologize ahead of time for any misunderstandings. Moreover, I cannot assess Castel’s detailed evidential case for his substantive theses.1 I thus focus (...) on some key philosophical issues that impinge on an area of my concern, the concept of mental disorder. Castel is a rare breed of French.. (shrink)

This volume addresses the intriguing issue of indirect reports from an interdisciplinary perspective. The contributors include philosophers, theoretical linguists, socio-pragmaticians, and cognitive scientists. The book is divided into four sections following the provenance of the authors. Combining the voices from leading and emerging authors in the field, it offers a detailed picture of indirect reports in the world’s languages and their significance for theoretical linguistics. Building on the previous book on indirect reports in this series, this volume adds an empirical (...) and cross-linguistic approach that covers an impressive range of languages, such as Cantonese, Japanese, Hebrew, Persian, Dutch, Spanish, Catalan, Armenian, Italian, English, Hungarian, German, Rumanian, and Basque. (shrink)

This book consists of a focused and systematic analysis of Freud’s implicit argument for unconscious mental states. The author employs the unique approach of applying contemporary philosophical methods, especially Kripke-Putnam essentialism, in analyzing Freud’s argument. The book elaborates how Freud transformed the intentionality theory of his Cartesian teacher Franz Brentano into what is essentially a sophisticated modern view of the mind. Indeed, Freud redirected Brentano's analysis of consciousness as intentionality into a view of consciousness-independent intentionalism about the mental that in (...) effect set the agenda for latter-twentieth-century philosophy of mind. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Makes a Mental Disorder Mental?Jerome C. Wakefield (bio)Keywordsharmful dysfunction, mental disorder, intentionality, mental dysfunction, mental functioning, phenomenality, somatic disorderWhat makes a medical disorder mental rather than (exclusively) somatic or physical? Psychiatry to some extent depends for its existence as a medical specialty on the distinction between mental and somatic disorders, yet the history of this distinction presents a bewildering array of puzzling judgments, radical shifts, and seemingly arbitrary (...) distinctions. The historical observation that putative mental disorders are often reclassified as physical disorders as soon as their physiologic basis is understood further confuses matters. Moreover, recent debates about such classifications often seem to reflect desires to protect professional turf or obtain optimal reimbursement for treatment more than they do the application of a coherent conceptual distinction. No wonder that Brülde and Radovic (2006) disarmingly admit at the outset of their exploration of this question that there is a case to be made that their topic is relatively unimportant or even meaningless intellectually, a rare way to start an inquiry!Could there nonetheless be a cogent conceptual distinction lurking here? Brülde and Radovic usefully invite us to reframe the question, in effect as follows: Suppose we pay attention to professional and lay judgments as evidence but at the same time try to avoid being ensnared by the distortions resulting from turf issues and other pragmatic motives and constraints. Can we then identify some principled distinction in this domain that is worth making and that interestingly corresponds to the distinction generally made between mental disorders and strictly somatic disorders? Brülde and Radovic do not come to any confident or compelling conclusion about this.My answer, based on my harmful dysfunction analysis of disorder (Wakefield, 1992a, 1992b, 1999a, 1999b), is that a mental disorder is a harmful mental dysfunction, where a mental dysfunction is a failure of the capacity of some mental mechanism to perform a function for which it was biologically designed. I argue that, owing to a series of logical missteps, Brülde and Radovic needlessly reject this view. After some preliminary comments and clarifications, I defend the internal dysfunction approach from the objections posed by Brülde and Radovic, and then conclude by elaborating this view in some new ways. Note that Brülde and Radovic critique something they call the "internal cause view" of what makes a disorder mental, and they name others who hold that view. However, my work figures prominently in their discussion, and for expository simplicity, I will presume to simply construe their arguments as aimed at the harmful dysfunction analysis. [End Page 123]Clarifying the QuestionIt is easy to misconstrue the question "What makes a mental disorder mental" as demanding a precise account of the mental, an error to which Brülde and Radovic succumb in their repeated complaints that various writers do not present principled accounts of the mental but rely on lists of prototypical mental states or tentative guidelines to fix the reference of mental. We would need a precise definition of mental if the problem were how to classify cases in which it is ambiguous whether some phenomenon is mental or physical. We might imagine, for example, someone being genuinely puzzled as to whether inability to sleep is failure of a mental function or process. But this sort of puzzle about the boundaries of the mental is not the problem with which Brülde and Radovic are concerned; anyway, ambiguous cases may just be inherently ambiguous. The problem, which a crisp definition of mental will not resolve, is what relation mental states or mechanisms must have to a disorder to make it a mental disorder; must there be mental symptoms, or mental dysfunctions, or either one, and so on? But, even if a precise resolution of the nature of the mental is not needed, some notion of the mental domain is essential in pursuing this discussion. We can pick out the mental ostensively, by pointing to lots of examples (e.g., perception, motivation, emotion, thought, and sensation) much more confidently than we can define it in a principled way. But because Brülde and Radovic find fault in such ostensive reference fixing, let me... (shrink)

In general, we know that gesture accompanying spoken instruction can help children learn. The present study was conducted to better understand how gesture can support children’s comprehension of spoken instruction and whether the benefit of teaching though speech and gesture over spoken instruction alone depends on differences in cognitive profile – prior knowledge children have that is related to a to-be-learned concept. To answer this question, we explored the impact of gesture instruction on children’s analogical reasoning ability. Children between the (...) ages of 4 and 11 years solved scene analogy problems before or after speech alone or speech and gesture instruction while their visual attention was monitored. Our behavioral results suggest a marginal benefit of gesture instruction over speech alone, but only 5-year-old children showed a distinct advantage from speech+gesture instruction when solving the post-instruction trial, suggesting that at this age, children have the cognitive profile in place to utilize the added support of gesture. Furthermore, while speech+gesture instruction facilitated effective visual attention during instruction, directing attention away from featural matches, and towards relational information, was pivotal for younger children’s success post instruction. We consider how these results contribute to the gesture-for-learning literature and consider how the nuanced impact of gesture is informative for educators teaching tasks of analogy in the classroom. (shrink)

An important application of cognitive architectures is to provide human performance models that capture psychological mechanisms in a form that can be “programmed” to predict task performance of human–machine system designs. Although many aspects of human performance have been successfully modeled in this approach, accounting for multitalker speech task performance is a novel problem. This article presents a model for performance in a two-talker task that incorporates concepts from psychoacoustics, in particular, masking effects and stream formation.

A major obstacle to formulating a broad-content intentional psychology is the occurrence of ''Frege cases'' - cases in which a person apparently believes or desires Fa but not Fb and acts accordingly, even though "a" and "b" have the same broad content. Frege cases seem to demand narrow-content distinctions to explain actions by the contents of beliefs and desires. Jerry Fodor ( The elm and the expert: Mentalese and its semantics , Cambridge, MA: MIT Press, 1994) argues that an explanatorily (...) adequate broad-content psychology is nonetheless possible because Frege cases rarely occur in intentional-explanatory contexts, and they are not systematically linked to intentional laws in a way that demands intentional explanation. Thus, he claims, behaviors associated with Frege cases can be considered ceteris-paribus exceptions to broad-content intentional laws without significantly decreasing the explanatory power of intentional psychology. I argue that Frege cases are plentiful and systematically linked to intentional laws in a way that requires intentional explanation, specifically in the explanation of why certain actions are not performed. Consequently, Frege-case behaviors cannot be construed as ceteris-paribus exceptions to intentional laws without significantly eroding the explanatory power of intentional psychology and reducing the rationality of the agent. Fodor thus fails to save broad-content psychology from the prima facie objections against it based on Frege cases. (shrink)

Protogaea, an ambitious account of terrestrial history, was central to the development of the earth sciences in the eighteenth century and provides key philosophical insights into the unity of Gottfried Wilhelm Leibniz’s thought and writings. In the book, Leibniz offers observations about the formation of the earth, the actions of fire and water, the genesis of rocks and minerals, the origins of salts and springs, the formation of fossils, and their identification as the remains of living organisms. Protogaea also includes (...) a series of engraved plates depicting the remains of animals—in particular the famous reconstruction of a “fossil unicorn”—together with a cross section of the cave in which some fossil objects were discovered. Though the works of Leibniz have been widely translated, Protogaea has languished in its original Latin for centuries. Now Claudine Cohen and Andre Wakefield offer the first English translation of this central text in natural philosophy and natural history. Written between 1691 and 1693, and first published after Leibniz’s death in 1749, Protogaea reemerges in this bilingual edition with an introduction that carefully situates the work within its historical context. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mental Disorder and Moral Responsibility:Disorders of Personhood as Harmful Dysfunctions, With Special Reference to AlcoholismJerome C. Wakefield (bio)Keywordsalcohol dependence, philosophy of psychiatry, mental disorder, harmful dysfunction, psychiatric diagnosis, person, moral responsibilityIn his paper, Ethical Decisions in the Classification of Mental Conditions as Mental Illness, Craig Edwards grapples with a profound problem: why is it that when we classify a mental condition as a mental disorder, that tends to take (...) the condition out of the sphere of moral responsibility or virtuousness of character? For example, it is not uncommon when someone commits suicide and the question is raised as to why he or she did it, that instead of a reason or character trait that would place the act within a moral calculus, one is offered the explanation "she was clinically depressed" or "he was bipolar," and this tends to terminate discussion and make reasons and moral evaluation superfluous. Why does such a comment have that effect?As Edwards notes, this can get complicated as the moral and the disordered interact. Certainly people are sometimes morally responsible for acting on their disordered impulses (as in pedophilia), and they are responsible for putting themselves in the way of disorder, as when someone imbibes in a way likely to lead to alcoholism. But at the normal/disorder divide, there seems to be a consistent lifting of some responsibility, reflecting the application of the sick role. For example, the rough equivalent of our current category of post-traumatic stress disorder (PTSD) was recognized as a disorder in earlier wars ("shell shock," "war neurosis"), but often considered an expression of cowardice; the cowardice was morally evaluable as a failure of virtue (even if, like many personality traits, being a coward is not within the person's direct voluntary control) and led to contempt for those with PTSD, but nonetheless—except in cases thought to be malingering—the PTSD that resulted constituted a disorder for which the individual was [End Page 91] not in the same direct sense blameworthy. This moral shift requires explanation.This topic also has important social ramifications. Relief from responsibility may sound like a good thing, and it is trumpeted by mental health advocates as a reason for supporting the classification of many conditions as disorders. But as Edwards is aware, it is a two-edged sword. Disordered status may allow escape from censure and offer the protections of the sick role, but it also changes the relationship of the agent to his or her own actions and imposes the responsibility of the sick role on the individual to attempt to change ("get better"). The sick role allows for no defense of an idiosyncrasy based on normal variation ("It takes all kinds…") or the individual's eccentric vision or steadfast integrity, for that vision or sense of integrity are now seen as pathological and not morally legitimate. The individual is subjected to endless entreaties to seek help and it is implied that not to do so is irresponsible, so that a decision to embrace one's nature and remain as one is becomes illegitimate. Moreover, the sick role allows for no explanation in terms of the individual's normal defensive response to unjust, deprived, or challenging social or environmental circumstances, thus weakening the motives for social change rather than individual intervention.In sum, there is an inevitable sense in which being placed in the sick role inherently stigmatizes the "sick" condition in virtue of the special moral attitudes extended to the disordered. Cultures can thus easily exploit the sick role and its much-touted relief from responsibility to extend the reach of social control processes. This is one reason why the distinction between disorder and non-disorder is so important, and why it is crucial to identify when non-disordered conditions are mislabeled as disorders—as when, for example, psychiatry gets it wrong about the distinction between normal and disordered sadness (Horwitz and Wakefield, 2007). Such overpathologization can redefine the boundaries of our moral universe on mistaken grounds.Edwards offers two provocative answers—not entirely at ease with each other—to the question of why mental disorders relieve the patient from moral responsibility: (1) mental disorders are... (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

Les critiques actuelles des diagnostics psychiatriques, qu’elles viennent des antipsychiatres, des béhavioristes, des constructionnistes sociaux, des szasziens et des foucaldiens, rejettent généralement l’idée que le concept de trouble mental est légitime du point de vue médical, ne laissant donc aucun argument solide à partir duquel il soit possible de mener une critique constructive et d’établir un dialogue avec la psychiatrie. Ces positions ne réussissent également pas à expliquer les fortes intuitions populaires qui permettent aux gens de distinguer les troubles psychologiques (...) des autres conditions psychologiques négatives. Selon l’analyse de la dysfonction préjudiciable présentée dans cet article, un trouble mental est une condition : 1) préjudiciable, un concept évaluatif basé sur des valeurs sociales ; et 2) causée par une dysfonction psychologique, un concept factuel se rapportant à un mécanisme psychologique qui accomplit une fonction pour laquelle il a été biologiquement conçu . L’analyse DP est ainsi une position hybride qui requiert à la fois que des critères évaluatifs et factuels soient satisfaits pour garantir l’attribution d’un trouble. Nous argumentons que l’analyse DP réussit admirablement à expliquer les jugements intuitifs quant à ce qui est un trouble et à ce qui en n’est pas. La composante factuelle permet également de critiquer le critère diagnostique du DSM, ce que nous ferons à l’aide de plusieurs exemples . Ces critiques déterminent où le DSM a dévié de ses propres hypothèses et ainsi considéré comme des troubles ce qui n’en est pas. Elles expliquent également pourquoi les tentatives du DSM de remédier au problème en introduisant le critère du « cliniquement significatif » échouent.Current antipsychiatric, behaviorist, social-constructivist, Szaszian, and Foucauldian critiques of psychiatric diagnosis generally reject mental disorder as a medically legitimate concept, thus allowing no place to stand from which to mount a constructive critique and dialogue with psychiatry. These views also fail to explain the robust folk intuitions by which people distinguish psychological disorders from other negative psychological conditions. According to the harmful dysfunction analysis presented in this paper, a mental disorder is condition that is harmful, a value concept judged by social values ; and caused by a psychological dysfunction, a factual concept referring to failure of a psychological mechanism to perform a function for which it is biologically designed . The HD analysis is thus a hybrid account that requires both value and factual criteria to be satisfied before attribution of disorder is warranted. It is argued that the HD analysis has considerable success in explaining intuitive judgments about disorder versus non-disorder. The factual component also allows for a critique of DSM diagnostic criteria for specific categories, with several examples discussed. These critiques identify where the DSM has deviated from its own deepest assumptions and labeled non-disorders as disorders, and why the DSM’s own attempts to fix the problem, as with the «clinical significance» criterion, do not succeed. (shrink)

The ArgumentJohann von Justi, the foremost literary cameralist of his generation, served as chief police commissioner in Göttingen between 1755 and 1757. While in Göttingen, Justi offered lectures at the university on the “œconomic, police and cameral sciences.” He also arrested vagrants, wrote on chemistry, disciplined unruly students, conducted chemical experiments, supervised the pricing of Göttingen's staple goods, engaged in a public controversy with a prominent Berlin chemist, edited and published a bi-weekly periodical (Göttingische Policey-Amts Nachrichien), and worked with the (...) university's curator to refashion the academic structure of the sciences. Taken together, these various activities reflected his broad vision for social and academic change, a vision with important implications for the form and content of the sciences. Drawing on archival material in Göttingen, on articles from thePolicey-Amts Nachrichten, and on Justi's other cameralist and chemical writings, I use his everyday experiences as a local police official to explore the meaning of his chemical work. I argue that Justi's chemistry was suffused with the cameralist dreams and ambitions of a small-town police commissioner. It is what I call police chemistry. (shrink)

Recent moral philosophers have had little to say about Giovanni Gentile's 'actual idealism’, which is widely dismissed as a kind of obscurantist Hegelianism used to conceal flimsy justifications for the state’s total impunity over questions of morality and truth. While Gentile is increasingly recognised as a major figure in twentieth-century Italian culture, actual idealism itself has yet to be given a full and impartial philosophical appraisal. Giovanni Gentile and the State of Contemporary Constructivism represents the first book-length treatment of actual (...) idealist moral theory. Part I describes and criticises Gentile’s stated view, showing that it includes several ambiguities that he exploits in order to align it with Fascist totalitarianism. Part II develops a modified version that is more consistent with the basic tenets of actual idealism. It is argued that Gentile’s theory is best understood as a radical constructivist doctrine according to which all thinking has a moral character. Rigorously conceived, it promotes not uncritical submission to the state, but free and self-regulating thought in the absence of a fully objective reality. Thus Gentile demonstrates both the plausibility and the limitations of any uncompromising form of anti-realist constructivism. (shrink)

: Jerry Fodor proposes a solution to Quine's inscrutability–of–reference problem for certain naturalized semantic theories, thereby defending such theories from charges that they cannot discriminate meanings finely enough. His proposal, combining elements of informational and inferential–role semantics, is to eliminate non–standard interpretations by testing predicate compatibility relations. I argue that Fodor's proposal, understood as primarily aimed at Mentalese, withstands Ray's and Gates's objections but nonetheless fails because of unwarranted assumptions about ontological homogeneity of target language predicates, and problems with Fodor's (...) reliance on predicate conjunction to resolve ambiguity. Naturalized semantics thus remains without an answer to the inscrutability objection. (shrink)

This response to continuing commentary addresses brain-hand relationships in Cebus apella (as introduced in West-ergaard's commentary), the evolutionary and acquisition parallels between music and language (suggested by Lynch), and the potential behavioral linguistic consequences of the evolutionary neurobiology in Australopithecus africanus and Homo habilis (discussed by Tobias). Finally, we reiterate the importance of well informed, multidisciplinary approaches to the study of the emergence of human species-specific cognition, especially linguistic capacity.

Politics and religion certainly ride together throughout the Dune saga. Rationales were given to support twentieth century dictator ships, whose citizens were encouraged to see their leaders as infallible. In this way, politics in a totalitarian state resembled a religion, with a community of faithful followers and its own special theology to justify the dictator's authority. This chapter, draws parallels between the religious dimensions of politics in Frank Herbert's Dune novels and some philosophers’ views on tyranny and justice here on (...) Earth. Even in democratic countries, leaders still tend to think of themselves as in service to some higher, impersonal standard, like a set of principles, a tradition, a flag, or a constitution. Plato's readers have sometimes described the relation between the higher plane of reality of universals and the world of everyday experience in terms of the relation between heaven and earth in the Abrahamic religions. (shrink)

Current symptom-based DSM and ICD diagnostic criteria for mental disorders are prone to yielding false positives because they ignore the context of symptoms. This is often seen as a benign flaw because problems of living and emotional suffering, even if not true disorders, may benefit from support and treatment. However, diagnosis of a disorder in our society has many ramifications not only for treatment choice but for broader social reactions to the diagnosed individual. In particular, mental disorders impose a sick (...) role on individuals and place a burden upon them to change; thus, disorders decrease the level of respect and acceptance generally accorded to those with even annoying normal variations in traits and features. Thus, minimizing false positives is important to a pluralistic society. The harmful dysfunction analysis of disorder is used to diagnose the sources of likely false positives, and propose potential remedies to the current weaknesses in the validity of diagnostic criteria. (shrink)

This book explores the intimate connections, conflicts and discontinuities between religion and philosophy in the Platonic and Neoplatonic traditions from Antiquity to the early Medieval period. It presents a broader comparative view of Platonism by examining the strong Platonist resonances among different philosophical/religious traditions, primarily Jewish, Christian, Islamic and Hindu, and suggests many new ways of thinking about the relation between these two fields or disciplines that have in modern times become such distinct and, at times, entirely separate domains.

The World Health Organization states that depression is the leading cause of disability worldwide, and predicts that by 2030 the epidemic of depression raging across the world will be the single biggest contributor to the overall burden of disease of all health conditions. Yet this gloomy picture masks a number of paradoxes concerning the diagnosis and cultural interpretation of depression that appear to challenge the claimed prevalence rates on which it is based. This book's essays by some of the world's (...) leading researchers and scholars on depression explores these anomalies in detail from multidisciplinary and multicultural perspectives, and in doing so reshapes the debate on the nature of depression that is currently under way in the US and abroad. At the book's core is the exploration from the multiple perspectives of a key dilemma: is the epidemic of depression real or is it just apparent? In particular, could it be the result of criteria laid down in the official American classification system of mental disorders, the DSM, interacting with cultural changes to reshape our view of melancholy, pathologizing what were formerly normal symptoms of grief or intense sadness? The debate over the DSM's conception of depression has an international relevance, with the WHO's upcoming revisions to its International Classification of Diseases requiring coordination with the DSM. This collection of perspectives has an unprecedented international dimension, as scholars from Europe and around the world join US academics to explore a central and controversial element of contemporary psychiatric diagnosis - and one that has enormous practical implications for the future of mental health care and how we view our emotions. The book's accessible essays will make it useful to scholars, practitioners, and students across a wide range of disciplines. (shrink)

The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

Guido de Ruggiero (1888-1948) was perhaps the greatest Italian intellectual historian in the twentieth century. He was a fierce champion of liberalism, an ardent opponent of Fascism, an insightful critic and interpreter of his contemporaries, and a formidable philosopher in his own right. Idealism & Experience: The Philosophy of Guido de Ruggiero comprises eight new critical essays, as well as English translations of five of de Ruggiero's most important shorter writings, which chart the development of his thought between 1914 and (...) 1946. Taken together, these essays reveal the range, richness and philosophical sophistication of de Ruggiero's ideas, enabling Anglophone readers to appreciate their enduring relevance in our own troubled times. (shrink)

The Italian author Giovanni Gentile occupied a radical position among philosophers of the first half of the twentieth century. He tried in earnest to revolutionize idealist theory, developing a doctrine that retained the idealist conception of the thinking subject as the centre and source of any intelligible reality, while eschewing many of the unwarranted abstractions that had pervaded earlier varieties of idealism and led their adherents astray. Given his great prominence during his lifetime, it is perhaps remarkable that Gentile is (...) so little discussed, and even then so poorly understood, in the English-speaking world. Few of his works have ever been translated into English, and these represent only a fraction of his great corpus and the many topics discussed therein. This neglect is partly explained by his close association with the Partito Nazionale Fascista, of which he remained a loyal member and supporter between 1923 and his assassination in 1944. The volume comprises eleven essays. Seven of these are new pieces written especially for Thought Thinking, and are intended both to contribute to ongoing debates about Gentile's philosophy and to indicate just a few of its many aspects that continue to draw the attention of philosophers, political theorists and intellectual historians. These are supplemented by new English translations of four of Gentile's shorter works, selected to offer some direct insight into his ideas and style of writing. (shrink)

This book explores the intimate connections, conflicts and discontinuities between religion and philosophy in the Platonic and Neoplatonic traditions from Antiquity to the early Medieval period. It presents a broader comparative view of Platonism by examining the strong Platonist resonances among different philosophical/religious traditions, primarily Jewish, Christian, Islamic and Hindu, and suggests many new ways of thinking about the relation between these two fields or disciplines that have in modern times become such distinct and, at times, entirely separate domains.

Speakers often use gesture to demonstrate how to perform actions—for example, they might show how to open the top of a jar by making a twisting motion above the jar. Yet it is unclear whether listeners learn as much from seeing such gestures as they learn from seeing actions that physically change the position of objects (i.e., actually opening the jar). Here, we examined participants' implicit and explicit understanding about a series of movements that demonstrated how to move a set (...) of objects. The movements were either shown with actions that physically relocated each object or with gestures that represented the relocation without touching the objects. Further, the end location that was indicated for each object covaried with whether the object was grasped with one or two hands. We found that memory for the end location of each object was better after seeing the physical relocation of the objects, that is, after seeing action, than after seeing gesture, regardless of whether speech was absent (Experiment 1) or present (Experiment 2). However, gesture and action built similar implicit understanding of how a particular handgrasp corresponded with a particular end location. Although gestures miss the benefit of showing the end state of objects that have been acted upon, the data show that gestures are as good as action in building knowledge of how to perform an action. (shrink)

Using Marcuse's theory of the total mobilization of advanced technology society along the lines of what he calls “the performance principle,” I attempt to describe the complex composition of class oppression in the classroom. Students conceive of themselves as economic units, customers pursuing neutral interests in a morally neutral, socio‐economic system of capitalist competition. The classic, unreflective conception of the classroom responds to this by implicitly endorsing individualism and ideals of humanist citizenship. While racism and cultural diversity have come to (...) count as elements of liberal intelligence in most college curricula, attempts to theorize these aspects of social and individual identity and place them in a broader content of class appear radical and inconsistent with the humanistic notion that we all have control over who we are and what we achieve. But tags such as “radical” and “unrealistic” mark a society based on the performance principle. Marcuse allows us to recognize a single author behind elements of psychology, metaphysics, and capitalism. The fact that bell hooks hits upon a similar notion suggests that we might use Marcuse's theory of the truly liberatory potential of imagination to transform and reconceive our classrooms so that the insidious effects of class, racism, and individualistic apathy might be subverted. Specifically, I outline and place into this theoretical context three concrete pedagogical practices: (a) the use of the physical space of the classroom; (b) the performance of community through group readings and short full‐class ceremonies, and (c) the symbolic modeling represented by interdisciplinary approaches to teaching. All three of these practices engage students in ways that co‐curricularly subvert class (and, incidentally, race divisions) and allow students to imagine, and so engage in, political action for justice as they see it. (shrink)

The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

BackgroundCritical public health measures implemented to mitigate the spread of the novel coronavirus disease (COVID-19) pandemic have disrupted health research worldwide, including HIV prevention research. While general guidance has been issued for the responsible conduct of research in these challenging circumstances, the contours of the dueling COVID-19 and HIV/aids pandemics raise some critical ethical issues for HIV prevention research. In this paper, we use the recently updated HIV Prevention Trials Network (HPTN) Ethics Guidance Document (EGD) to situate and analyze key (...) ethical challenges related to the conduct of HIV prevention research during the COVID-19 pandemic as well as identify potential areas for refinement of the guidance document based on this unprecedented state of affairs.Main bodyNecessary actions taken for HIV prevention research studies due to the COVID-19 pandemic involve an array of ethical issues including those related to: (1) risk mitigation; (2) behavior change; (3) compounding vulnerability; (4) community engagement; (5) trial reopening; and 6) shifting research priorities.ConclusionsIn the context of the dueling HIV and COVID-19 global pandemics, research teams and sponsors must be nimble in responding to the rapidly changing environment by being sensitive to the associated ethical issues. The HTPN EGD provides a rich set of tools to help identify, analyze and address many of these issues. At the same time, future refinements of the HPTN EGD and other research ethics guidance could be strengthened by providing explicit advice regarding the ethical issues associated with disrupted research and the reopening of studies. In addition, additional consideration should be given to appropriately balancing domains of risk (e.g., physical versus social), addressing the vulnerability of research staff and community partners, and responding to un-anticipatable ancillary care needs of participants and communities. Appropriately addressing these issues will necessitate conceptual work, which would benefit from the careful documentation of the actual ethical issues encountered in research, the strategies implemented to overcome them, and their success in doing so. Throughout all of these efforts, it is critical to remember that the HIV pandemic not be forgotten in the rush to deal with the COVID-19 pandemic. (shrink)