This chapter contains sections titled: The Case for Restricting the Civil Liberties of the Cognitively Disabled Two Conceptions of Competence Further Topics Editor's Note.

Ethical and legal discourse pertaining to the ability to consent to treatment and research in England operates within a dualist framework of “competence” and “capacity”. This is confusing, as while there exists in England two possible senses of legal capacity – “first person” legal capacity and “delegable” legal capacity, currently neither is formulated to bear a necessary relationship with decision-making competence. Notwithstanding this, judges and academic commentators frequently invoke competence to consent in discussions involving the validity of (...) offering or withholding consent as a synonym for legal capacity to consent. I argue that this gives rise to a conflation, jeopardising clarity and consistency in law. This is somewhat less problematic in instances of “first-person” legal capacity that are heavily informed by criteria for decision-making competence than in the second sense of legal capacity, which is qualitatively different from decision-making competence, or with first-person legal capacity when defined in different terms from competence. The paper concludes by proposing that the soundest resolution to this problem is by making decision-making competence a necessary and sufficient condition of first-person legal capacity, affording a more scrupulous distinction between the two different forms of legal capacity that exist. (shrink)

In this paper we develop a hermeneutic approach to the concept of competence. Patient competence, according to a hermeneutic approach, is not primarily a matter of being able to reason, but of being able to interpret the world and respond to it. Capacity should then not be seen as theoretical, but as practical. From the perspective of practical rationality, competence and capacity are two sides of the same coin. If a person has the capacity to understand the (...) world and give meaning to the situation, he or she is able to make decisions, and is thus competent. People can fail in the area of practical rationality. They can feel ill at ease, uncomfortable or not at home in the situation. Under such conditions, they appear as incompetent, and urge caregivers to respond in such a way that their competence can be raised. The issue is not how to measure their incompetence, but how to help them to become more competent, that is to get a practical grip on their situation and to be able to live out their lives in such a way that they develop their identity in relations with others. From a hermeneutic point of view, assessing a patient's capacity implies focusing on the patient's way of meaning making and regarding her behavior from the perspective of practical rationality. The focus should not be on the assessment as a matter of fact, but on improving capacity. This requires allowing the patient to experience the world meaningfully and affording her, in the context of a supportive and trustful institutional environment, the possibility of developing a personal narrative where her choices are expressed verbally or non-verbally. (shrink)

In this article some of the presuppositions that underly the current ideas about decision making capacity, autonomy and independence are critically examined. The focus is on chronic disorders, especially on chronic physical disorders. First, it is argued that the concepts of decision making competence and autonomy, as they are usually applied to the problem of legal (in)competence in the mentally ill, need to be modified and adapted to the situation of the chronically (physically) ill. Second, it is argued (...) that autonomy and dependence must not be considered as two mutually exclusive categories. It is suggested that decision making may take on the form of a more or less conscious decision not to be involved in making all kinds of explicit and deliberate decisions. Elaborating on Agich's distinction between ideal and actual autonomy, the concept of Socratic autonomy is introduced. (shrink)

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements (...) of capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

With the waves of reform occurring in mental health legislation in England and other jurisdictions, mental capacity is set to become a key medico-legal concept. The concept is central to the law of informed consent and is closely aligned to the philosophical concept of autonomy. It is also closely related to mental disorder. This paper explores the interdisciplinary terrain where mental capacity is located. Our aim is to identify core dilemmas and to suggest pathways for future (...) interdisciplinary research. The terrain can be separated into three types of discussion: philosophical, legal and psychiatric. Each discussion approaches mental capacity and judgmental autonomy from a different perspective yet each discussion struggles over two key dilemmas: whether mental capacity and autonomy is/should be a moral or a psychological notion and whether rationality is the key constitutive factor. We suggest that further theoretical work will have to be interdisciplinary and that this work offers an opportunity for the law to enrich its interpretation of mental capacity, for psychiatry to clarify the normative elements latent in its concepts and for philosophy to advance understanding of autonomy through the study of decisional dysfunction. The new pressures on medical and legal practice to be more explicit about mental capacity make this work a priority. (shrink)

We undertake to bring a phenomenological perspective to bear on a challenge of contemporary law and clinical practice. In a wide variety of contexts, legal and medical professionals are called upon to assess the competence or capacity of an individual to exercise her own judgement in making a decision for herself. We focus on decisions regarding consent to or refusal of medical treatment and contrast a widely recognised clinical instrument, the MacCAT-T, with a more phenomenologically informed approach. While the (...) MacCAT-T focuses attention on individual cognitive performance criteria, an approach oriented by second-person phenomenology brings into view the complex role of time, others and identity in constituting the capacity for individual autonomous judgement. Our phenomenological analysis has consequences both for the practice of capacity assessments and for further research in this arena. Good practice in capacity assessment must attend to decision communities, distributed capacity, and temporal competence, while research on mental capacity will miss the phenomenon if it trains its focus ‘between the ears.’ We illustrate our approach by considering two recent cases of contested capacity: one involving cognitive disability in a dysfunctional decision community, the second presenting the possibility of competent decision-making under conditions of paranoid schizophrenia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Pathology of the Mind: Disorder Versus DisabilityRichard G. T. Gipps (bio)Keywordsorder, disorder, ability, disability, mental illnessAlfredo Gaete (2008) describes mental disorders as impairments in intentionality, phenomenal consciousness, and intelligence that cause harm to the affected person. I found persuasive Gaete’s claim that the concept of ‘mental disorder’ is best understood as nontheoretical and nontechnical. I also find compelling his argument that a previous contribution of my (...) own—which relied in part on specifying different senses of ‘disorder’ in psychological, physiological, and social cases—was misguided. Further, his suggestion that we ought at least to attempt analysis in terms of necessary and sufficient conditions before we seek out less definitive characterizations (in terms of family resemblances) also persuades me, although I find myself less sanguine than he about the general possibility of achieving such analyses.One of Gaete’s principal claims is that mental disorder is helpfully understood in terms of an absence of a capacity—that is, as a disability. There are two related objections—or two aspects of the same objection—that I would like to offer the author with respect to this claim. These may well not be conclusive, but will I hope at least function as foils against which the author can usefully sharpen his argument. One objection suggests that there is a viable distinction between the concepts of mental disorder and mental disability, as commonly used in clinical contexts, which the account offered seems unable to respect. The second suggests that the account may not be able to theorize what is argued to be the essential contribution of the concepts of order and disorder (as opposed to ability and disability) to the everyday concept of mental disorder. Accordingly, it questions the power of a disability approach such as Gaete’s to capture the essential nature of mental disorder.In his paper, Gaete classifies mental retardation and developmental, or (what in the United Kingdom are known as) learning, disabilities (autism, etc.) as cases of mental disorder. I found this surprising because it is not common linguistic practice in the psychological circles in which I operate. It would also seem to make a nonsense of commonly accepted ideas like: “Mental disorders are more likely to occur in patients with developmental disabilities (e.g., in autism, Asperger, or Down syndrome) than in the general population.” (For an example, see Campbell and Malone [1991]). On Gaete’s classification, it would appear that people with autism eo ipso have a mental disorder, and [End Page 341] hence the commonly accepted idea would need to be interpreted as merely a statement about comorbidities of different disorders of the same general (i.e., mental) type. But that is not, I believe, how the term is commonly used, and Gaete’s suggestion must therefore be treated as revisionary rather than descriptively analytical.One way of reconstructing a rationale underlying the distinction between mental disabilities and mental disorders is as follows. A developmental disability involves a failure of (certain aspects of) the mind to grow and reach an expected level or type of organization. A mental disorder by contrast involves a disturbance or disorganization (not simply an impoverishment) within the mind at whichever level of organization it has reached. As the mind develops, and reaches new levels or types of organization, the forms which mental disorders may take accordingly change.Autism and schizophrenia provide helpful illustrations of this distinction. Autism represents a failure of (among other things) the social mind to develop in childhood. The person with moderate to severe autism may attain at best a very shaky grasp on the realities of other minds and social conventions. That is, the degree of mental structure they obtain—their social competencies or capacities—will likely remain limited. It is this fundamental deficit that marks out the disability, and not the social anxieties or other such disturbances that can beset the autistic person.Schizophrenia, by contrast, tends to occur at late adolescence, when the individual has developed higher levels of—albeit often fragile—mental structure. Yet it is not the fragility of such mental structure, but rather the disruptions that can occur within such structures as have developed, that mark them out... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Anorexia and the MacCAT-T Test for Mental Competence:Validity, Value, and EmotionLouis C. Charland (bio)Keywordsmental competence, decisional capacity, anorexia, value, emotionValidity of the MacCAT-THow does one scientifically verify a psychometric instrument designed to assess the mental competence of medical patients who are asked to consent to medical treatment? Aside from satisfying technical requirements like statistical reliability, results yielded by such a test must conform to (...) at least some accepted pretheoretical desiderata; for example, determinations of competence, as measured by the test, must capture a minimal core of accepted basic intuitions about what competence means and what a theory of competence is supposed to do. The concepts of "face validity" and "content validity" are both important here. Face validity "indicates that an instrument appears to test what it is supposed to and that it is a plausible method for doing so" (Portney and Watkins 2000, 82). Content validity "means that the test contains all the elements that reflect the variable being studied" (Portney and Watkins 2000, 83). An adequate instrument for measuring mental competence must at minimum satisfy both of these requirements.What Tan and her colleagues (2006) have shown is that the MacArthur Competence Assessment Tool—Treatment (MacCAT-T) test for mental competence may not be an empirically valid measure of mental competence for some cases of anorexia. The data they report show that "competence," as measured by the MacCAT-T, does not conform sufficiently well with what is wanted of a clinical medical theory of competence. More specifically, the MacCAT-T is deficient in both face and content validity. This result is extremely significant; previous challenges to the validity of the MacCAT-T have often been largely theoretical in nature. My own objection that the MacCAT is inadequate because it omits the influence of emotion is based on a combination of empirical theory (Charland 1998a) and philosophical argument (Charland 1998b). However, it is entirely theoretical in nature. So is my argument that in ignoring emotion the MacCAT misses a crucial contributing ingredient in competence, namely, value (Charland 2001, see especially 136 note 2). Tan's study provides valuable empirical evidence for the second of these challenges, which deals more specifically with value. On the one hand, the study clearly demonstrates that patients sometimes do [End Page 283] base their treatment decisions on reasons derived from values. And on the other hand, it also nicely illustrates the centrality of values—"utilities" or "preferences"—in the decision-making process generally; a basic assumption of standard decision theory for which, paradoxically, there appears to be no satisfactory counterpart in the MacCAT-T model of reasoning and decision making.Thus, values figure among the reasons that patients actually use in reasoning when they weigh the risks and benefits of proposed treatment options. The MacCAT-T must be amended to incorporate this fact if it is to be a satisfactory clinical medical tool. Without such a correction, the concept of mental competence it measures is empirically invalid. At the root of the problem is a clash of intuitions. Tan's data provide convincing evidence that some of the patients who are deemed to be mentally competent by MacCAT-T standards should not in fact be considered competent. Note that the language in which this clash is expressed—"should not in fact"—involves a combination of descriptive and prescriptive elements, reminding us that the concept of competence is dual in nature: it is both prescriptive and descriptive (Freedman 1981). These problems underscore the need for greater clarity about what pretheoretically we want a clinical theory and test of competence to capture. It is of course reasonable to say that such a test must be consistent with major tenets of the relevant case law (Appelbaum 1998). But a legally valid concept of competence of this sort is too thin and arbitrary a foundation on which to build a clinical medical theory of competence. An empirically valid theory and test of the latter sort must incorporate the role of values if it is be truly helpful in medical practice.Value and the MacCAT-TI agree with Tan and her colleagues that some notion of "pathological value" needs to be... (shrink)

BackgroundThe Mental Capacity Act was enacted in 2007 in England and Wales, but the assessment of mental capacity still remains an area of professional concern. Doctors’ compliance with legal and professional standards is inconsistent, but the reasons for poor compliance are not well understood. This preliminary study investigates doctors’ experiences of and attitudes toward mental capacity assessment.MethodsThis is a descriptive, cross-sectional study where a two-domain, study-specific structured questionnaire was developed, piloted and digitally disseminated to doctors at differing (...) career stages employed in a large, multi-site National Health Service Trust in London over 4 months in 2018. Descriptive statistics and frequency tables adjusted for missing data were generated and secondary analysis was conducted.ResultsParticipants were predominantly UK trained, female and between the ages of 30 and 44 years. Less than half of the participants reported receiving formal MCAx training. Only one-third of the participants self-rated themselves as very competent or extremely competent. Self-reported MCA confidence was significantly affected by career stage with Consultants with over 10 years of experience reporting lowest confidence.ConclusionsThis study describes significant variation in practice by doctors and low self-confidence in the practice of MCAx. These results raise concerns that MCAx continues to be inconsistently performed by doctors despite appropriate awareness of the law and professional guidance on best practice. (shrink)

Relativistic theories and arguments are fairly common in legal thinking. A case in point is Stanley Fish's theory of interpretation, which applies to statutes and constitutions as well as to novels and poems. Fish holds, inter alia, (i) that an interpretation of a statute, a poem, or some other text can be true or valid only in light of the interpretive strategies that define an interpretive community, and (ii) that no set of interpretive strategies (and therefore no interpretation) is truer (...) or more valid than any other. In this article, I discuss these claims critically and argue that the very idea of an interpretive community is more or less unintelligible, and that in any case Fish's theory is self-refuting. I begin with a few words about the methods and techniques of statutory interpretation(Section 2). I proceed by introducing Fish's theory of interpretation, giving special consideration to some difficulties in Fish's account of the concept of an interpretive community (Sections 3-4). I then introduce two types of relativism, cognitive and moral (Section 5), and argue that Fish's theory asserts cognitive relativism in the shape of conceptual relativism and relativism about truth (Section 6). Having done that, I consider Donald Davidson's well-known objection to alternative conceptual schemes (Section 7) as well as the popular charge that relativism about truth is self-refuting (Section 8). (shrink)

A RELATIVISTIC THEORY OF PHENOMENOLOCICAL CONSTITUTION: A SELF-REFERENTIAL, TRANSCENDENTAL APPROACH TO CONCEPTUAL PATHOLOGY. (Vol. I: French; Vol. II: English) -/- Steven James Bartlett -/- Doctoral dissertation director: Paul Ricoeur, Université de Paris Other doctoral committee members: Jean Ladrière and Alphonse de Waehlens, Université Catholique de Louvain Defended publically at the Université Catholique de Louvain, January, 1971. -/- Universite de Paris X (France), 1971. 797pp. -/- The principal objective of the work is to construct an analytically precise methodology which can serve (...) to identify, eliminate, and avoid a certain widespread _conceptual fault_ or _misconstruction_, called a "projective misconstruction" or "projection" by the author. It is argued that this variety of error in our thinking (i) infects a great number of our everyday, scientific, and philosophical concepts, claims, and theories, (ii) has largely been undetected, and (iii), when remedied, leads to a less controversial and more rigorous elucidation of the transcendental preconditions of human knowledge than has traditionally been possible. The dissertation identifies, perhaps for the first time, a _projective_ variety of self-referential inconsistency, and proposes an innovative, self-reflexive approach to transcendental argument in a logical and phenomenological context. The strength of the approach lies, it is claimed, in the fact that a rejection of the approach is possible only on pain of self-referential inconsistency. The argument is developed in the following stages: A general introduction identifies the central theme of the work, defines the scope of applicability of the results reached, and sketches the direction of the studies that follow. The preliminary discussion culminates in a recognition of the need for a _critique of impure reason_. The body of the work is divided into two parts: Section I seeks to develop a methodology, on a purely formal basis, which is, on the one hand, capable of being used to study the transcendental foundations of the special sciences, including its own proper transcendental foundation. On the other hand, the methodology proposed is intended as a diagnostic and therapeutic tool for dealing with _projective_ uses of concepts. The approach initiates an analysis of concepts from a perspective which views _knowledge as coordination_. Section I describes formal structures that possess the status of preconditions in such a coordinative account of knowledge. Special attention is given to the preconditions of _identifying reference_ to logical particulars. The first section attempts, then, to provide a self-referential, transcendental methodology which is essentially revisionary in that it is motivated by a concern for conceptual error-elimination. Phenomenology, considered in its unique capacity as a self-referential, transcendental discipline, is of special relevance to the study. Section II accordingly examines a group of concepts which come into question in connection with the central theme of _phenomenological constitution_. The "_de-projective methodology_" developed in Section I is applied to these concepts that have a foundational importance in transcendental phenomenology. A translation is, in effect, proposed from the language of consciousness to a language in which preconditions of referring are investigated. The result achieved is the elimination of self-defeating, projective concepts from a rigorous, phenomenological study of the constitutive foundations of science. The dissertation was presented in a two volume, double-language format for the convenience of French and English researchers. Each volume contains an analytical index. (shrink)

Mental competence, or decision‐making capacity, is an important concept in law, psychiatry, and bioethics. A major problem faced in the development and implementation of standards for assessing mental competence is the issue of objectivity. The problem is that objective standards are hard to formulate and apply. The aim here is to review the limited philosophical literature on the place of value in competence in an attempt to introduce the issues to a wider audience. The thesis (...) that the assessment of competence must incorporate elements of value and rationality is defended, and some tentative suggestions offered about how this might be achieved in a clinical setting. (shrink)

Psychiatrists are frequently called upon to make assessments of the rationality or irrationality of persons for a variety of medical-legal purposes. A key category is that of evaluations of a patient's capacity to grant informed consent for a medical procedure. A diagnosis of mental illness is neither a necessary nor a sufficient condition for a finding of incompetence. The notion of competency to grant consent, which is a mixed psychiatric-legal concept, shares some features with philosophical conceptions of rationality, (...) but differs from them in a number of important respects. This article describes the actual practice of psychiatrists when making such judgments, along with the standards of competency they employ. A comparison is made between those notions of competency and predominant philosophical conceptions of rationality. (shrink)

Recent legal developments challenge how valid the concept of mental capacity is in determining whether individuals with impairments can make decisions about their care and treatment. Kong defends a concept of mental capacity but argues that such assessments must consider how relationships and dialogue can enable or disable the decision-making abilities of these individuals. This is thoroughly investigated using an interdisciplinary approach that combines philosophy and legal analysis of the law in England and Wales, the European Court of (...) Human Rights, and the United Nations Convention on the Rights of Persons with Disabilities. By exploring key concepts underlying mental capacity, the investigation concludes that both primary relationships and capacity assessments themselves must display key competencies to ensure that autonomy skills are promoted and encouraged. This ultimately provides scope for justifiable interventions into disabling relationships and articulates the dialogical practices that help better situate, interpret, and understand the choices and actions of individuals with impairments. (shrink)

The author of “How Bioethics and Case Law Diverge in Assessments of Mental Capacity: An Argument for a Narrative Coherence Standard” (2020) arrives at a reasonable conclusion; however, it is far le...

According to John Rawls, the liberalism of John Stuart Mill is “comprehensive” and not “political” because it promotes the idea of individuality as a more or less universal conception of the good. Rawls’s political liberalism, in contrast, does not promote any one particular conception of the good over others. Instead, it aims to guarantee for citizens the capacity for a conception of the good. I argue, however, that Mill’s liberalism is “comprehensive” because power is ubiquitous, i.e., because there are social (...) and “nonpolitical” forms of power that political liberalism is not equipped to deal with. It is impossible to guarantee the capacity fora conception of the good without providing a point of resistance to the social and nonpolitical deployment of power. Thus, if liberalism is going to be able to guarantee the capacity for a conception of the good, it must become “political” in aim but “comprehensive” in scope. (shrink)

This chapter considers whether legal requirements can constitute reasons for action independently of the merits of the requirement at hand. While jurisprudential opinion on this question is far from uniform, sceptical views are becoming increasingly dominant. Such views typically contend that, while the law can be indicative of pre-existing reasons, or can trigger pre-existing reasons into operation, it cannot constitute new reasons. This chapter offers support to a somewhat less sceptical position, according to which the fact that a legal requirement (...) has been issued can be a reason for action, yet one that is underpinned by bedrock values which law is apt to serve. Notions discussed here include a value-based conception of reasons as facts ; a distinction between complete and incomplete reasons ; and David Enoch’s idea of triggering reason-giving. Following a discussion of criticism against the view adopted here, the chapter concludes by considering some more ‘robust’ conceptions of law’s reason-giving capacity. (shrink)

In the principles of informed consent we state that each person ought to be free to make his or her own decisions regarding his or her life and health — provided that he or she is mentally competent to do so. Here, the concept of competence plays a crucial role. Where one is competent our moral goal is to promote his or her freedom; if he or she is not, our priority must be to protect and help him or (...) her. In this paper I discuss three different notions of patient competence. The first, rational competence, concerns the basic ability to make a decision. The second, performance competence, concerns one's ability to make decisions and perform skills in ways that measure up to certain external standards. The third, reflective competence, concerns one's ability to identify and critically to scrutinize one's own values — one's ability, that is, to formulate and to evaluate one's own internal standards of decision and action. This richer analysis of the concept of competence enables us to formulate more precisely the moral difficulties we face when competence is impaired. (shrink)

Salafism is one of the most important issues of the last few centuries. There are intense discussions on the issues related to Salafism, its emergence, how it was first used by whom and in what sense. Discussions about Salafism are sometimes experienced in relation to whether this concept corresponds to a mentality or to a sect, and sometimes this phenomenon is brought up in relation to a number of important names that have taken place in the history of Islamic thought. (...) Ibn Taymiyya (d. 728/1328) emerges as the most frequently mentioned name in this context. Therefore, in this article, we have examined how Salafism/Salafiyya concept is used in the works of Ibn Taymiyya who is accepted as the theorist and the most powerful representative of Salafism. We have discussed the issue in a comprehensive manner by including the concept of Salaf, which is one of the most used concepts of Ibn Taymiyya. When we consider Ibn Taymiyya's use of the concepts of Salaf and Salafiyya, the concept of Salaf is seen to be used much more than the concept of Salafiyya. Thus, the concept of Salaf in the thought of Ibn Taymiyya refers to the Islamic society that lived in the early centuries and the conception of religion revealed by this society. The concept of Salafiyya, however, appears to have been used in a way that reflects a mentality and a way of thinking rather than a particular school or sect.Summary: Sects are human made structures that emerged with the institutionalization of differentiations in the conception of religion. The production of systematic theology and fiqh, the formation of its own literature, its dissemination and dissociation from other systems of thought are the most important turning points for the emergence of sects. One of the most important variables that determine the formation process of sects is the mentality of sect. It is known that the sects come into the realm of existence when the mindsets with the implicit reference system become visible. Therefore, there is a mentality on which every sect is based, but not every mentality has come to the point of being a sect. While some mentalities have influenced different sects in different shades, some of them have been confronted with only one sect.In fact, Salafism is one of the ways of thinking which is a mindset and it is a subject of important debates about whether it is a sect. Although the use of salafiyya is seen in the literature in the past, the fact that Salafism felt its existence as a kind of religion or mentality was realized in the 18th and 19th centuries. It is also known that the discussions about the definition of Salafism have started since these periods. From the second half of the 20th century, Salafism began to take a place in the agenda of both the Islamic world and the West. This has naturally led to efforts to define Salafism. Thus, Salafism is subjected to attempts to identify and associate with structures, such as denomination, ideology, religious understanding and mentality. In this direction, it is seen that Salafism is tried to be defined by establishing close link with the structures, such as Ahl al-Sunnah, Ahl-i Hadith, Hanbalism and Wahhabism or by reducing them directly to one of these structures. Thus, Salafism is sometimes backed up to the early stages of Islamic thought and sometimes associated with multilayered structures, such as the Ahl al-Sunnah, which embodies many political-mythic and fiqh structures.In line with the efforts of defining Salafism, it is also seen that many names that have had a say in classical Islamic thought or have been mentioned in modern times have been brought to the agenda. In addition to the names, such as Ahmad ibn Hanbal, Ibn Taymiyya, Ibn Qayyim al-Jawziyya, the names of Emir al-Saneyani, Muhammad ibn Abd al-Wahhab, Muhammad al-Shawkani, Shaykh Abdulaziz ibn Baz and Muhammad Nasir al-din al-Albani are frequently mentioned in this process. It should be noted that there is a special place of Ibn Taymiyya among these names. Ibn Taymiyya took the place of both in history of Islamic thought and Ahl al-Hadith-Hanbalite tradition and made a name for himself in the context of many subjects. It is claimed that Ibn Taymiyya, who was the theorist of the Hanbalite conception of religion, and the missionary of the New Hanbalism, was also the founding figure and the most important representative of Salafism. In modern times, most of those who declare ideas about Salafism place Ibn Taymiyya at the center of Salafism and present him as the founding name of this mentality. However, the question of what kind of relationship between the mentality called Salafism and Ibn Taymiyya's world of thought and religion is not the subject of academic studies. However, the works of Ibn Taymiyya, who is an author of a very velocity, should be analyzed from this point of view and all kinds of words about Ibn Taymiyya-Salafism relationship should be left behind this effort. Our study, which aims to fulfill this gap, was designed to explain topics, such as whether the concept of salafiyya was used in the works of Ibn Taymiyya, whether and how the past was used, and the extent to which the meaning attributed to the salafiyya coincided with the current Salafism. Understanding of the concept of the salafiyya in the works of Ibn Taymiyya depends on the explanation of how the term salaf was derived and used by Ibn Taymiyya. When the works of Ibn Taymiyya are scanned, it is seen that he used the word salaf much more than the word salafiyya. In fact, the word of salafiyya, which Ibn Taymiyya has rarely included, has been placed in some places in a way that refers to the meaning field of the word salaf. When we consider the use of the word salaf in the works of Ibn Taymiyya, we first see the generations who lived in the early historical periods of Islamic thought and the conception of religion which these generations have revealed. Other names that have taken place in the history of Islamic thought have similar opinions about the generation of the predecessors and the religious understanding of this generation. In other words, according to the general opinion of the predecessor, especially the first three centuries came to mind. However, it is seen that Ibn Taymiyya made some attempts to periodize both the generation of the predecessors and to define the understanding of religion of this generation. Nevertheless, Ibn Taymiyya could not provide a clear picture on this issue, and he occasionally contradicted his findings regarding his involvement in the predecessor generation. Nevertheless, he generally adopted generalizations and an attitude to limit the meaning of the predecessor to the first generations. The word salafiyya, which Ibn Taymiyya placed on the meaning of the word salaf, is used less compared to the word salaf and is given in more complete terms. This indicates that the main factor that influenced Ibn Taymiyya's salafi thought was salaf, not salafiyya as a systematic structure. These findings make it necessary to reconsider the claims of Salafism being a sect and it is being represented at the time of Ibn Taymiyya. (shrink)

The chapter outlines Nietzsche's view of decadence, its history and effects. The philosopher held decadence to be any condition, deceptively thought good, which limits what something or someone can be. This concept informs his critical and affirmative projects, acting as a versatile tool to identify and overcome his own decadence and to resist the decadence of Western culture. Decadence appears in five major areas of concern to Nietzsche: physiology; psychology; art and artists; politics; and philosophy. Physical and mental phenomena (...) provide the substrate of his understanding, but they manifest in cultural, political, and philosophical forms that, in turn, affect the body and mind. In each of the five areas, the concept of decadence for Nietzsche serves 1) to unmask valued cultural phenomena as corrupt, 2) to name and analyze degenerate effects, and 3) to spur reflection on how to respond. (shrink)

Psychologists debate whether mental attributes can be quantified or whether they admit only qualitative comparisons of more and less. Their disagreement is not merely terminological, for it bears upon the permissibility of various statistical techniques. This article contributes to the discussion in two stages. First it explains how temperature, which was originally a qualitative concept, came to occupy its position as an unquestionably quantitative concept (§§1–4). Specifically, it lays out the circumstances in which thermometers, which register quantitative (or cardinal) (...) differences, became distinguishable from thermoscopes, which register merely qualitative (or ordinal) differences. I argue that this distinction became possible thanks to the work of Joseph Black, ca. 1760. Second, the article contends that the model implicit in temperature’s quantitative status offers a better way for thinking about the quantitative status of mental attributes than models from measurement theory (§§5–6). (shrink)

Taking the title of his book from Isaiah Berlin's famous essay distinguishing a negative concept of liberty connoting lack of interference by others from a positive concept involving participation in the political realm, Samuel Fleischacker explores a third definition of liberty that lies between the first two. In Fleischacker's view, Kant and Adam Smith think of liberty as a matter of acting on our capacity for judgment, thereby differing both from those who tie it to the satisfaction of our desires (...) and those who translate it as action in accordance with reason or "will." Integrating the thought of Kant and Smith, and developing his own stand through readings of the Critique of Judgment and The Wealth of Nations, Fleischacker shows how different acting on one's best judgment is from acting on one's desires--how, in particular, good judgment, as opposed to mere desire, can flourish only in favorable social and political conditions. At the same time, exercising judgment is something every individual must do for him- or herself, hence not something that philosophers and politicians who reason better than the rest of us can do in our stead. For this reason advocates of a liberty based on judgment are likely to be more concerned than are libertarians to make sure that government provides people with conditions for the use of their liberty--for example, excellent standards of education, health care, and unemployment insurance--while at the same time promoting a less paternalistic view of government than most of the movements associated for the past thirty years with the political left. (shrink)

This article explores refusal of medical treatment by adult patients from ethical and legal perspectives. Initially, consequentialist and deontological ethical theory are outlined. The concepts of autonomy, paternalism and competence are described and an overview of Beauchamp and Childress’s principle-based approach to moral reasoning is given. Relevant common law is discussed and the provisions of the Mental Capacity Act 2005 in assessing competence is evaluated. In order to demonstrate the consideration of moral issues in clinical practice, ethical (...) theory is applied to two well-known incidents: the case of Re MB, where doubt over decision-making capacity led to a paternalistic act to override a patient’s choice; and the death of Emma Gough, a situation where respect for autonomy prevailed when healthcare staff acted lawfully in following a patient’s refusal of life-saving treatment. Finally, guidance from regulatory bodies on the roles and responsibilities of health professionals in relation to this topic are considered. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Appreciating Anorexia:Decisional Capacity and the Role of ValuesThomas Grisso (bio) and Paul S. Appelbaum (bio)Keywordscompetence, consent, anorexia, appreciation, decision makingTan and her colleagues (2006) reported that persons with anorexia nervosa typically manifest no difficulty satisfying the criteria for abilities associated with competence to consent to or refuse treatment. Their results led them to conclude that these patients generally had no problem grasping the nature of anorexia and its (...) possible consequences (understanding), typically did not have difficulty processing information when making treatment decisions (reasoning), and usually neither denied that they had a disorder nor manifested distorted beliefs about the potential consequences of treatment for the disorder.Nevertheless, these authors found, some anorexia patients said that they knew they might die and that they would rather die than suffer the alternative consequences (e.g., loss of identity, feeling of being disgusting). They point out that these beliefs, suggesting questionable competence, were not identified by the usual criteria for competence to consent to treatment. Therefore, they propose that we should consider a modification of the criteria for competence to consent to treatment. They argue for inclusion of "pathological values" as the basis for a finding of incompetence. Their notion of a pathological value (as we summarize it based on their Discussion) includes (a) a personal value (b) on which treatment refusal is based, that (c) is not authentic, and (d) is due to a mental disorder.Second, Tan and colleagues were concerned that the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), currently used widely to assess competence to consent to treatment, did not seem to take values into account when examining deficits related to lack of appreciation or reasoning. They point out that most patients with anorexia nervosa in their study had "pathological values" that influenced their thinking about treatment, yet they did not obtain poor scores on the instrument's appreciation scale, which assesses whether patients deny that they have the illness or offer reasons for accepting or refusing treatment that are based on delusional premises or a serious distortion of reality. Moreover, almost all of the anorexia patients in the study obtained adequate scores on reasoning, which examines the ability to process options and consequences when weighing a treatment decision. [End Page 293]Reasons for Caution in Altering Criteria for CompetenceA fundamental step in considering Tan and her co-worker's proposal is to examine whether it is necessary to add a concept of "pathological values" to the legal construct of competence to consent to treatment. Modifying the legal doctrine of consent is important if that is needed to improve its validity or reliability. But modifications of the doctrine would have considerable costs, including a long process of producing logical and empirical evidence for its necessity, developing methods to assess the new concept, and then a process of debate, persuasion, and education to change laws, ethical guidelines, and medical training. Moreover, principles of theory building urge parsimony. A theory should employ no more concepts or assumptions than are required to account for the phenomena that the theory seeks to organize or explain. So one must be sure that modifications are truly necessary before adding complexity to the theory of decisional competence.In addition, there is an inherent danger in altering a concept like competence to consent to treatment on the basis of the study of any one mental disorder. It is not at all clear how the modification might influence findings of competence when applied to other disorders. Using a study of patients with anorexia nervosa as the impetus for changing the competence concept runs this risk. For example, anorexia is one of a class of mental disorders that is characterized by a failure to abstain from behavior (here, limiting food intake and other behaviors designed to reduce weight) that has negative consequences for the person. Other conditions in this category might include substance abuse disorders and impulse control disorders (e.g., pathological gambling). Even if one concludes that revised criteria for competence would reduce false-positive findings of competence in this group of disorders, one would have to consider carefully its impact on the full range of disabling mental conditions.Moreover, the sensitivity... (shrink)

The mention of “self-control” calls up certain stock images: Saint Augustine struggling to renounce carnal pleasures; dispassionate Mr. Spock of Star Trek; the dieter faced with tempting desserts. In these stock images reason is almost always assigned the power and authority to govern passions, desires, and appetites. But what if the passions were given the power to rule—what if, instead of sovereign reason, there were sovereign sentiments? My dissertation examines three sentimentalist conceptions of self-control: David Hume’s conception of “strength (...) of mind”; Adam Smith’s conception of “self-command”; and Jane Austen’s examination of these conceptions. Hume divests reason of motivational power, and with this new moral psychology comes a new conception of self-control. Humean strength of mind is indirect, artificial, and social—a regulatory system that humans cannot develop until societal systems of government and regulations have been instituted. Smith accepts Hume’s anti-rationalist arguments, but he emphasizes that only certain sentiments are fit to rule. And he argues that self-control develops without the sophisticated external conditions posited by Hume. Smithian self-command is the capacity to modify one’s feelings in accordance with a regulative ideal: the sentiments of an imagined impartial spectator. Austen responds to these conceptions, illustrating and complicating them. Sense and Sensibility explores the difficulties of discerning the feelings of others, and Persuasion dramatizes the difficulties of distinguishing strength of mind in another, offering sets of characters for the reader’s scrutiny, each with a competing claim to strength of mind. Taken together, Austen’s novels offer a fuller and more delicately shaded depiction of the sort of self-control that Hume and Smith imagine in their philosophical works. (shrink)

When emotions are mentioned in the literature on mental competence, it is generally because they are thought to influence competence negatively; that is, they are thought to impede or compromise the cognitive capacities that are taken to underlie competence. The purpose of the present discussion is to explore the possibility that emotions might play a more positive role in the determination of competence. Using the MacArthur Treatment Competence Study as an example, it is argued (...) that appreciation, a central theoretical concept in many contemporary approaches to competence, has important emotive components that are seldom sufficiently recognized or acknowledged. If true, this means that some leading contemporary accounts of competence need to be revised in order to make more adequate provision for the positive contribution of emotion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.3 (2001) 445-446 [Access article in PDF] G. Felicitas Munzel. Kant's Conception of Moral Character: The "Critical" Link of Morality, Anthropology, and Reflective Judgment. Chicago: University of Chicago Press, 1999. Pp. xxii + 378. Cloth, $53.00. Paper, $24.00. Given the recent trend in Kant scholarship to seek a kinder, more caring philosopher behind the familiar rules and imperatives, a study focusing on the (...) place of "character" in Kant's thought is a timely contribution to a growing body of work. Indeed, G. Felicitas Munzel intends to go where no Kantian has gone before and show not only that Kant has a conception of character, but that it is "rich" (1) and "unique in the history of philosophy" (5). Considering his "corpus as a whole" (6), she sets out to demonstrate the "systematic importance" of the concept for Kant's thought (1) and reveal "a richer sense of familiar notions of his moral philosophy than is generally appreciated" (11).From the outset, however, high hopes prove hard to sustain. In Chapter 1, Munzel's exegetical efforts to link "character" with Denkungsart ("conduct of thought") and Gesinnung ("comportment of mind"), either delineate only familiar elements of Kant's thought or attribute to him views which philosopher and non-philosopher alike could hardly deny: in Kant's "rich" conception, character involves clear thinking and perfection, and is an "accomplished state" (67) presupposing sound reasoning and the capacity to think. In what becomes the dominant theme of the study, Munzel concludes that, for Kant, character is an activity in which the objective moral law is realized in subjects acting on maxims and from firm principles.In Chapter 2 the reader is subsequently led across a familiar terrain of causality, desire, and feeling, to learn that Kant is disinclined to inclination, but very much inclined to reason (71-2); and that character has a foot in both the empirical and intelligible orders of causality (74). The same goes for desire (95ff.) and aesthetic capacity (126ff.), where the "moral form" of character represents the union of reason and nature. A [End Page 445] similar story continues in Chapter 3 where Munzel considers Kant's view of religion and hopes to cast "new light" (142) upon and foster "fresh appreciation" (182) for "radical evil." Again, the reader spots comforting landmarks along the way and emerges into a world unchanged: for Kant, Munzel concludes, human conflict is a manifestation of evil with its roots in human nature; virtue involves progress or advance; and a well-established character brings inner and outer peace to human life (134-6).In the remainder of the book Munzel turns to the "structure and cultivation of character." Chapter 4 focuses on orientation, reflective principles, conscience, and discourse where, rambling through the Kantian landscape, one learns that common sense is a source of principles (198ff); maxims should be steadfastly adopted (208-9); and that morally upright persons should know their duty (210), tell the truth (246), and develop their capacities to the full (249). By this stage, that "character must be made subjectively rational" (252) has become a mantra, but lest the point remain unclear, Munzel expounds a metaphor (from Mendelssohn's Morgenstunden) of a traveler on life's journey, in order to emphasize that moral character involves being rational, competent, and accountable for one's actions (191ff.).In the final chapter, pedagogy becomes the main focus. It is a practice, Munzel contends, which determines the conditions under which character is formed (260). Mixed in the appropriate fashion, its elements combine to make "cultivation of moral judgment" the "essence of moral character" (259). Again, Munzel connects character to well-known Kantian doctrines, linking pedagogy to self-mastery (292) and a community of civic-minded citizens (258) in which the good of one promotes the well-being of all (288). In the world according to Kant, reason "grafts" virtue onto the stuff of nature to create an organic unity as—in Munzel's favorite metaphor (see 335-45... (shrink)

The Mental Capacity Act 2005 has put the assessment of mental capacity for decision-making at the forefront of psychiatric practice. This capacity is commonly linked within philosophy to autonomy, that is, to the idea, or ideal, of self-government. However, philosophers disagree deeply about what constitutes autonomy. This contribution brings out how the competing conceptions of autonomy would play out in psychiatric practice, taking anorexia nervosa as a test case. © 2009 Elsevier Ltd. All rights reserved.

V sklopu čedalje intenzivnejšega ukvarjanja z zgodovino hermenevtike v zadnjih letih se kaže Dilthej pogosto kot »klasik« tiste z Gadamerjem inkriminirane tradicionalne hermenevtike, s čimer je postavljen v pozicijo golega predhodnika filozofske hermenevtike oz. hermenevtične filozofije Heideggra in Gadamerja. Toda ta pogled, ki izhaja v glavnem iz Gadamerjeve koncepcije in se lahko zdi na prvi pogled povsem sprejemljiv, je problematičen in pomeni po mojem mnenju odločno prikrajšanje Diltheyevega filozofskega dosežka in njegovega prispevka hermenevtičnemu mišljenju.Within the context of the more and (...) more intensive research on the history of hermeneutics in recent years, Dilthey more and more often appears as a “classic” of the traditional hermeneutics incriminated by Gadamer, which puts him in the position of a mere predecessor of philosophical hermeneutics viz. hermeneutic philosophy of Heidegger and Gadamer. This view, however, stemming primarily from Gadamer’s conception and appearing to be quite acceptable at a first glance, is highly problematic and, in my opinion, contributes to a decisive diminution of Dilthey’s philosophical achievement and his contribution to hermeneutic thinking. (shrink)

It should be clear that Lyell's scientific contemporaries would hardly have agreed with Robert Munro's remark that Antiquity of Man created a full-fledged discipline. Only later historians have judged the work a synthesis; those closer to the discoveries and events saw it as a compilation — perhaps a “capital compilation,”95 but a compilation none the less. Its heterogeneity made it difficult to judge as a unity, and most reviewers, like Forbes, concentrated on the first part of Lyell's trilogy. The chapters (...) on glaciation were admired by Lyell's friends but had relatively little appeal to more general readers. His discussion of the species question hedged far too much to please those who accepted the cogency of Darwin's evidence and arguments. This last section of the book blatantly lacks originality or commitment and certainly has no claim to classical status in anthropology.We are left, then, with the first twelve chapters, for it was this portion that dictated the book's title and that amassed the available evidence favoring the antiquity of the human species. Did it do anything more than marshall the evidence that others had discovered? I think not. Lyell could write with style and verve. Principles of Geology is a remarkably readable book. But Antiquity is the work of a geologist, not of a systematic student of man. Despite its occasional touches of power, it never captures the freshness and immediacy of Lubbock's Pre-historic Times nor the theoretical brilliance of E. B. Tylor's Researches into the Early History of Mankind (1865).96 Antiquity utilizes little of the comparative method whereby Lyell's contemporaries used data from modern “savagery” to elaborate the possible social functions of the prehistoric remains being uncovered. It contains little social theory and has virtually no integrated framework. Even the first twelve chapters do not really hang together. As Hooker, commenting to Darwin on Lubbock's review, sadly wrote: “Lubbock in [the] N[atural] H[istory] Review, had in a note called attention to Lyell's ... ‘doing injustice’ to Prestwich & Falconer. I modified this expression ‘injustice’ in Lubbock's paper (which was friendly and apologetic). I am deeply sorry for it, but what can one do? I do think Lyell's first XII chapters a complete mess.”97 In another letter to Darwin, Hooker described this first portion of Antiquity as “confused and confusing.”98Part of the problem, of course, lay in the subject's novelty for Lyell and for most of his contemporaries. At a deeper level, however, I believe that the book accurately reflects Lyell's uncertainties about Darwin's work and its implications for man.99 Leonard Wilson's edition of Lyell's Scientific Journals provides a unique insight into Lyell's mind during the years just before he began to write Antiquity.100 Preoccupied with the human implications of evolutionary biology, Lyell was not clear how many of those implications were compatible with his deep convictions about the dignity of man's place in the cosmos. With a certain naiveté, Lyell complained in 1873 that many of his readers had failed to see the “natural connections” among the three portions of Antiquity.101 Connections could indeed be drawn between man's antiquity and his evolutionary origins; Lyell's private Scientific Journals movingly demonstrate that he was well aware of this fact. But he never fully made the connections in his published writings. Antiquity of Man is more appropriately seen as the last gasp of the heroic period in British geology than as the opening salvo in a new, post-Darwinian anthropological synthesis. Between the founding of the Geological Society of London in 1807 and the middle of the nineteenth century, geology was recognized as one of the most exciting and innovative scientific fields in Britain.102 Lyell himself had contributed much to that drama, and by the 1860's he was a public figure of venerable proportions. More then any other man he represented a geology that had extended the boundaries of process, time, and life. The fundamental achievements of Lyell and his colleagues had been assimilated into the wider Victorian consciousness, yet the earlier public debates about “genesis and geology” had left untouched in its essentials the concept of Man as a moral, responsible, created being.103Lyell never abandoned this view of his own species, and in 1863 it was a completely responsible creature which, under the weight of empirical evidence, Lyell admitted had lived on earth far longer than had previously been thought. Certainly this more generous allowance for human existence was constitutive to what Burrow calls the evolutionary social theory of midcentury Britain.104 Unlike Lyell, the younger representatives of this anthropology quietly accepted both man's antiquity and his aboriginal animality. Herbert Spencer's Principles of Psychology (1855), as well as the other volumes of his grand Synthetic Philosophy, presented as part of the cosmic process the development of human from prehuman beings.105 Tylor's discussion of what in his Researches (1865) he called the “gesture-language” presupposed the gradual and de novo origin of language in early human populations.106 Lubbock's young and polished mind was untroubled by the human implications of Darwin's work, and he cast his Prehistoric Times into such a perfect mold that it and its companionpiece (On the Origin of Civilization, 1870) went through seven editions each between 1865 and World War I, with their original theoretical structures intact. In a way that Lyell could not grasp, Lubbock was intrigued by questions concerning the origins of moral and religious beliefs and did not flinch at the thought of an amoral, atheistic creature as an ancestor.107 Indeed, as the German naturalist Carl Vogt pointed out in his Lectures on Man, translated into English the year after Antiquity, both Darwin's theories and the primitive flint knives of the Stone Age bore witness to a time beyond that imaginable from the condition of the lowest present-day “savage”:From such a low condition [little better than anthropomorphous apes], compared to which that of the so-called savages of the old and new world is a refined civilisation, has the human species gradually extricated itself, in a bitter struggle for existence, which it was well able to maintain, by being gifted with a larger amount of brain and intelligence than that possessed by the surrounding animal world.108The easy integration of biological and social themes was perhaps the distinguishing hallmark of Victorian anthropology of the 1850's and 1860's. After his fashion, Lyell got both themes into Antiquity, but he carefully separated them with a seven-chapter wall of glacial ice. Lyell's anthropology was not that of a thoroughgoing evolutionist like Lubbock, Tylor, or Spencer. For Lyell prehistoric man was not a product of biological evolution. Rude and superstitious he may have been, but he possessed ritual and a belief in a future state, and thus deserved “the epithet of ‘noble,’ which Dryden gave to what he seems to have pictured to himself as the primitive condition of our race: as Nature first made man/when wild in woods the noble savage ran.”109As a systematic argument, Lyell's book was at best a significant failure. As a popularization, it was a success — largely because of the personal stature of its author and the particular moment of its appearance. It helped establish the fact of man's antiquity with a wider Victorian audience, in itself no mean achievement. But Lyell was unable to exploit the fuller implications of his material in the service of a secular science of man. Ironically, he exploited only his colleagues' discoveries. Though the aging Lyell, with failing eyesight but unfailing mental powers, can still be seen as a man of considerable importance, his Antiquity belongs to the carefully circumscribed world of British geology rather than to the less disciplined world of Victorian anthropology. (shrink)

State statutes, case law, and professional codes of ethics in the mental health professions typically stress either a duty or the permissibility of disclosing confidential information in order to prevent clients from seriously harming themselves. These sources are intended to address cases where clients are deemed to be suffering from cognitive dysfunction for which paternalistic intervention, including involuntary hospitalization, is considered necessary to prevent self-destructive behavior.The counselor’s moral and legal responsibility is less apparent when mentally competent clients desire suicide (...) as release from irremediable suffering due to severe physical illness, and this desire is defensible within these clients’ value systems. This paper will explore moral and legal dimensions of a counselor’s decision not to intervene in such cases. The concept of permitted suicide will be introduced and defined, and guidelines for its application developed. (shrink)

Chapter 1 First Person Access to Mental States. Mind Science and Subjective Qualities -/- Abstract. The philosophy of mind as we know it today starts with Ryle. What defines and at the same time differentiates it from the previous tradition of study on mind is the persuasion that any rigorous approach to mental phenomena must conform to the criteria of scientificity applied by the natural sciences, i.e. its investigations and results must be intersubjectively and publicly controllable. In Ryle’s (...) view, philosophy of mind needs to adopt an antimentalist stance to achieve this aim. Antimentalism not only definitively rejects the idea that mind is a substance separated from the body, it also denies that mental phenomena radically differ from physical phenomena by virtue of several unique features. Most problematically, mental phenomena have a conscious character (mental states are related to specific qualitative feelings) and are accessible only to the first-person (only the subject knows directly what s/he is experiencing inside his/her mind). Ryle takes a strong stance on antimentalism going so far as to maintain that an approach to mind which aims to meet the criteria of scientificity set by the natural sciences must avoid any reference to internal, unobservable mental states. In his view (which is considered a specifically philosophical version of psychological behaviorism and also addresses questions put forward in psychological research), mental states can be redescribed in terms of behavioral dispositions. In this chapter, we address the historical roots of the antimentalist view and analyze its relation to the later tradition of research on mind. We show that, compared to the antimentalist stance, functionalism and cognitivism take a step back when they maintain that direct reference to mental states is necessary since mental states cause and therefore explain human behavior. This step backwards is often interpreted as a return to mentalism. However, this is only partially true. Indeed, we suggest that these later traditions retain one important element of Ryle’s antimentalism, i.e. the idea that mental states must be uniquely identified using external and publicly observable criteria, while excluding any reference to introspection and those qualitative dimensions of a mental state, which are accessible only to the first-person. According to the perspective we put forward, this epistemological stance has continued to influence contemporary research on mind and current philosophical and psychological theories which both tend to exclude the subjective qualities of human experience from their accounts of how the mind works. The issue we raise here is whether this is legitimate or whether subjective qualities do play a role with respect to the way our mind works. The conclusion of this chapter anticipates the argument the book makes in in favor of this latter position, starting from a particular angle, i.e. the problem of how we categorize concepts related to our internal states. -/- Chapter 2 The Misleading Aspects of the Mind/Computer Analogy. The Grounding Problem and the Thorny Issue of Propriosensitive Information -/- Abstract. After the crisis of behaviorism, cognitivism and functionalism became the predominant models in the field of psychology and of philosophy, respectively. Their success is mainly due to the new key they use for interpreting mental processes: the mind/computer analogy. On the basis of this analogy, mental operations are seen as cognitive processes based on computations, i.e. on manipulations of abstract symbols which are in turn understood as informational unities (representations). This chapter identifies two main problems with this model. The first is how these symbols can relate to and communicate with perception and thus allow us to identify and classify what we perceive through the senses. Here we limit ourselves to presenting this issue in relation to the classical symbol grounding problem originally put forward by Harnad on the basis of Searle’s Chinese room argument. An attempt to address the problem raised here will be made in chap. 3. The second point we discuss in relation to the mind/computer analogy concerns the idea of information it fosters. Indeed, following this analogy, information is something available in the external world which can be captured by the senses and transmitted to the central system without being influenced or modified by the procedures of transmission. This perspective does not take into account that – unlike computers – in living beings information is acquired by means of the body. As Ulric Neisser has already pointed out, the body is itself an informational source that provides us with additional sensory experience that influences (modifies or complements) the information extracted from the external world by the senses. To develop this line of analysis and to determine exactly what information is provided by the body and how this might influence cognition, we examine Sherrington’s and Gibson’s positions. Moving on from their views, we qualify bodily information in terms of ‘proprioception’. We use ‘proprioception’ in a broad sense to describe any kind of experience we have of our internal states (including postural information as well as sensations related to the general state of the body and its parts). Following Damasio’s and Craig’s studies, we further elaborate this position, arguing that living beings are equipped with an internal propriosensitive monitoring system which maps all the changes that constantly occur in our body and that give us perceptual (‘proprioceptive’ or propriosensitive) information about what happens inside us. Moreover, relying on Goldie’s and Ratcliffe’s view, we show that emotional information can also be considered as a form of ‘proprioception’ which contributes to determining everything we perceive. This analysis leads us to the second main thesis of this book: ‘proprioception’ is a form of internal perception and it is an essential component of the sensory information we can access and use for all cognitive purposes. -/- Chapter 3 Semantic Competence from the Inside: Conceptual Architecture and Composition -/- Abstract. Concepts are essential constituents of thought: they are the instruments we use to categorize our experience, i.e. to classify things and group them together in homogeneous sets. Here we define concepts as the internal mental information (representations) that allows us, among other things, to master words in natural language. By analyzing the way in which individuals master word meanings we explore a number of hypotheses regarding the nature of concepts. Following Diego Marconi’s research, we differentiate between two kind of abilities that underpin lexical competence – so-called ‘referential’ and ‘inferential competence’ – and we suggest that, in order to support these abilities, concepts must also include two corresponding kinds of information, i.e. inferential and referential information. We point out that the most widely used and acknowledged theories of concepts do not make this distinction, instead broadly characterizing the information used for categorization in terms of propositionally described feature lists. However, we show that while feature lists can explain inferential competence, they do not account for referential competence. To address the issue of referential competence we examine Ray Jackendoff’s hypothesis that to account for the possibility of linking perceptual and conceptual information we need to assume the existence of a (visual) representation that encodes the geometric and topological properties of objects and bridges the gap between the percept and the concept. Furthermore, we analyze the extension of this work by Jesse Prinz who introduced the notion of a proxytype, a perceptual representation of a class of objects that incorporates structural and parametric information related to their appearance. However, as we point out, proxytypes can only explain the relationship between perception and concepts with respect to instances that can be perceived through the senses and that belong to the same class by virtue of their physical similarity. We suggest that this notion be extended to include larger conceptual classes. To accomplish this, we further develop Mark Johnson, George Lakoff and Jean Mandler’s idea of a schematic image and argue that conceptual representations include a perceptual schema. Perceptual schemata are non-linguistic, structured experiential gestalts (patterns or maps) that make use of information taken from all sensory modalities, including body perception. They accomplish a quasi-conceptual function: they allow us to recognize and to classify different instances. In this work, we hypothesize that perceptual schemata are an essential component of concepts, but not identical to them. Instead, we suggest that concepts include both perceptual and propositional information with perceptual schemata providing the ‘perceptual core concept’ that grounds related propositional information. -/- Chapter 4 In the Beginning There Were Categories. The Bodily Origin of Prelinguistic Categorical Organization: The Example of Folkbiological Taxonomies -/- Abstract. Studies of categorization in psychology and the cognitive sciences have made use of the notions of ‘category’ and ‘concept’ without precisely defining what is meant by either; in fact, often these terms have been used as synonyms, making it difficult to address specific issues related to conceptual development. This chapter begins by discussing the definitions of, as well as the distinctions between, ‘categories’ and ‘concepts’ in the classical philosophical tradition (Aristotle, Kant and Husserl). We introduce our view of categories with reference to Husserl. Categorization is defined as the way in which our experience is originally (pre-linguistically) organized in a passive and fully unconscious manner on the basis of universal structuring principles. Conceptualization is explained as a later process in which the earlier categorical macro-classes are further subdivided into more specific and detailed sets; this later process also relies on linguistic learning and exposure to culture. On the basis of Ray Jackendoff, Jean Mandler, George Lakoff and Mark Johnson’s work, we hypothesize that categorization is a two-step process that begins with the formation of homogeneous sets of entities partitioned into regions that describe the ontological boundaries of the objects that humans perceive (categories) and continues at a later stage with the development of more specific classifications (concepts). In this chapter, we mainly address three related issues: Why should we assume that there is categorical organization which precedes the development of a conceptual system? How do categories and concepts relate to each other? Shall we hypothesize that categories are innate or that they are formed before concepts on the basis of information and organizational structure available at a very early developmental stage? We show that categorical partitions are necessary for categorization and, following Mandler, that the general categories we form at an early age do not match our adult superordinate concepts. As for the third issue, we argue that there might be no need to assume that categories are innately present in the human mind, since their formation can be explained – at least in certain cases – by basic mechanisms that work on body (propriosensitive) information. This hypothesis will not be discussed in general, but in relation to a particularly relevant example of categorical partition, i.e. the folk-biological dichotomy between ANIMATE/INANIMATE. This is compared with other dichotomies that derive from it, but are not directly categorical such as LIVING/NON-LIVING and BIOLOGICAL/NON-BIOLOGICAL. -/- Chapter 5 Internal States: From Headache to Anger. Conceptualization and Semantic Mastery -/- Abstract. Here we ask if we can also apply the distinction between referential and inferential competence we introduced in Chapter 3 to words that do not refer to things that are perceived using the external senses, especially to words/concepts that denote bodily experiences (such as pain, thirst, hunger, etc.) or emotions. We introduce and discuss the hypothesis that – even though such words/concepts do not refer to intersubjectively identifiable entities in the external world – they do have a kind of referent that can be accessed via direct perception, more specifically ‘proprioception’, as we have defined it in terms of all propriosensitive information we can consciously access. In the first part of the chapter, we specifically consider terms denoting bodily experiences such as ‘pain’ or ‘hunger’ and argue that their referents are identified and classified from a first-personal point of view on the basis of four main characteristics: their specific intensity, their localization in the body, their co-occurrence with other signals and above all their specific qualitative sensations. Emotions are addressed in the second part of the chapter. We suggest that there is a continuity between bodily experiences and emotions. In particular, we argue for a perceptual theory of emotions in line with that proposed by James and Lange at the end of the 19th century and developed more recently by authors such as Damasio (see also chap. 2§5, §6). The hypothesis we put forward is that the referential information that supports the categorization of emotions and therefore also our mastery of terms referring to emotions consists in the perception (i.e. the ‘proprioception’) of those bodily states and changes in bodily states which constitute our emotional experience. In the context of this discussion we examine some objections to this line of reasoning that arise from a cognitivist perspective and following authors such as Oatley, Johnson-Laird and Frijda, we distinguish between basic emotions that can be identified and classified solely on the basis on how they feel and complex emotions whose identification and classification additionally depends on cognitive factors. To describe how emotions are identified and classified on the basis of how they feel, we rely on Marcel and Lambie’s distinction between an ‘emotion state’ and an ‘emotion experience’. Both notions indicate kinds of feelings that we consciously experience. However, they describe first-order and second order emotion awareness respectively. The emotion state is the feeling we have of the bodily states and changes that occur when we are experiencing an emotion, while the emotion experience is the fully developed and integrated emotion we both experience and are, with reflection, aware of experiencing. On the basis of this differentiation, we also show that the same characteristics that aid in the identification and classification of bodily experiences (specific qualitative sensations; somatic localization; specific intensity; presence/absence of specific concomitant sensations) can also be used for the identification and classification of emotions – at least basic emotions. In the last two sections of the chapter we present some clinical evidence on the semantic competence of people who suffer from Alexithymia and Autism Spectrum Disorder which supports the conclusions of our preceding analyses. -/- Chapter 6 The ‘Proprioceptive’ Component of Abstract Concepts -/- Abstract. In this chapter, we address the issue of whether the mastery of abstract words requires only inferential knowledge and thus, if the concepts that support the mastery of abstract words include only linguistic information. We start by differentiating the notions of ‘abstract’ and ‘general’ which are often erroneously confused. We then identify a strict definition of abstract, as contrasted with ‘concrete’, that applies to words or concepts whose referent cannot be experienced by the senses. We argue that abstract words/concepts would be better described as theoretical, because they are usually conceived as structured sets of inferential knowledge expressed linguistically; that is, as small theories. Pointing out parallels with Carnap’s analysis of this issue in philosophy of science, we hypothesize that words/concepts denoting non-observable entities are not all ‘equally theoretical’, because their link to sensory experience can be stronger or weaker. We revive the distinction, inspired by Quine, between theoretical and intertheoretical concepts/words. This distinction relies on the fact that the former – unlike the latter – retains a strong, although indirect, connection with perception. In Quine’s discussion, perception is understood uniquely in terms of observability, i.e. of external sensory experience. Here we argue, however, that bodily, ‘proprioceptive’ (i.e. propriosensitive) experience can also serve to referentially ground theoretical (i.e. abstract) concepts/words. We frame this issue using the example of the theoretical concept ‘freedom’ and Lakoff’s hypothesis that this concept is developed on the basis of bodily information. We contrast this with the example of ‘democracy’ which more closely resembles an intertheoretical concept/word. Furthermore, we show that one of the classical views put forward in psycholinguistic research to explain how abstract concepts are mentally represented – i.e. Paivio’s Dual Coding Theory – points in the same direction as our analysis. The same is true of Barsalou’s work suggesting that we use internal information to understand at least some abstract words. To sustain this position, we put forward two lines of evidence: the first comes from psycholinguistic studies while the second examines deficits of semantic competence exhibited by people with Autism Spectrum Disorder. On the basis of our analysis, we put forward a classification that distinguishes between different kinds of concreteness and different degrees of abstraction: concepts/words referring to body experiences and basic emotions are described as analogous to concrete concepts/words because they are grounded in perceptual (i.e. propriosensitive) experience, while abstract concepts/words are considered more or less abstract depending on whether they are intratheoretical (and rely entirely on inferential information) or theoretical (and are partially grounded in perceptual – or more often in propriosensitive perceptual – information). In the last section of the chapter we consider two scales that have been used in psycholinguistic research to measure the degree of concreteness vs. abstractness of words and we show that – used conjointly – they can provide a measure of the internal vs. external grounding of specific words. (shrink)

Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to do with what (...) is commonly called “decisional capacity”, a central concept in health care law and ethics, and increasingly an independent topic of philosophical inquiry. -/- Decisional capacity can be defined as the ability of subjects to make their own medical decisions. Somewhat similar questions of capacity arise in other contexts, such as capacity to stand trial in a court of law and the ability to make decisions that relate to personal care and finances. However, the history behind the more general legal notions of capacity to stand trial and capacity to manage one’s life is different and operates somewhat differently in law (Roth, Meisel, & Litz 1977; Zapf & Roesch 2005). For the purposes of this discussion the notion of decisional capacity will be limited to medical contexts only; most notably, those where decisions to consent or to refuse treatment or participation in clinical research are concerned. (shrink)

Governing nursing conduct: the rise of evidence‐based practice Drawing on the Foucauldian concept of ‘governmentality’ to analyse the evidence‐based movement in nursing, we argue that it is possible to identify the governance of nursing practice and hence nurses across two distinct axes; that of the political (governance through political and economic means) and the personal (governance of the self through the cultivation of the practices required by nurses to put evidence into practice). The evaluation of nursing work through evidence‐based reviews (...) provides detailed information that may enable governments to target and instruct nurses regarding their work in the interest of preserving the health of the population as a whole. Political governance of the nursing population becomes possible through centralised discursive mechanisms, such as evidence‐based reviews that present nursing practice as an intelligible field whose elements are connected in a more or less systematic manner. The identity of the evidence‐based nurse requires the modern nurse to develop new skills and attitudes. Evidence‐based nursing is an emerging technology of government that judges nursing research and knowledge and has the capacity to direct nursing practice at both the political and personal level. (shrink)

Some relativists deny that moral discourse is factual. According to them, our ethical commitments are to be explained by appealing to noncognitive mental states like desires, rather than to beliefs in some independent moral facts. Indeed, the package antirealism (there are no moral properties) & noncognitivism (the source of moral commitments is noncognitive) seems to be implicit in Lewis’s and Harman’s relativism. But to many philosophers this package seems to be unattractive. Our task in this paper is to construe (...) and defend a less committal and hence more attractive version of relativism. Our thesis has two elements. First, we shall present a version of relativism that combines, on the one hand, realism with regard to thick ethical properties, and, on the other, antirealism with regard to thin ethical properties. Secondly, we shall argue that this version of relativism can be defended through the skeptical theory of meaning Kripke attributes to the later Wittgenstein. The paper comprises three parts: the first sketches in very broad lines a version of standard moral relativism. In the second part we construe an alternative version that we call ‘cultural relativism.’ By appealing to the thick-thin distinction, cultural relativists explain what it means to say of forms of life that they are in conflict. In the third part we shall elaborate an argument whose conclusion is that in ranking conflicting ethical outlooks, people make an error, that is, they attribute to these outlooks moral properties that do not exist. (shrink)

In the pair of articles of which this is the second, I present a set of problems and philosophical proposals that have in recent years been associated with the term “relativism”. These problems are related to the question of how we should represent thought and speech about certain topics. The main issue is whether we should model such mental states or linguistic acts as involving representational contents that are absolutely correct or incorrect, or whether, alternatively, their correctness should be (...) thought of as varying with some (more or less surprising) factor. In the first article, “Relativism 1: Representational Content”, I discussed the general issue of relativism about representational content. I argued for the conciliatory view that both relativist and absoutist conceptions of representational content can be legitimate. In the present continuation, I look in more detail at a special case of the general issue, namely the question of whether semantic contents, i.e. the contents assigned to linguistic utterances in the semantics of natural language, should be construed in an absolutist or in a relativist way. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants (...) report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Finding PartnershipThe Benefit of Sharing and the Capacity for ComplexityMichaela Amering (bio)Keywordsrecovery, empowerment, trialog, user involvement, schizophreniaIs There Ignorance and Arrogance? In Psychiatry? In Medicine?Adding insight to injury' is the paraphrase psychiatrist Pat McGorry (1992) coined for his reproach of 'pushing for "insight" or "acceptance of diagnosis"' without carefully taking into account the complexities of the individual situation, context, and needs. That must be about the kind of behavior (...) Marga Reimer has in mind in her paper on treatment adherence in the absence of insight, which depicts mental health professionals characterized by arrogance against the common sense of motivating compliance by perceived or anticipated benefits on different everyday life levels, but instead trying to get people to believe in a mental illness such as schizophrenia and wishing them to want treatment for that in the form of medication.In addition, Reimer presents examples from general medicine to make her point that adherence follows perceived or anticipated benefits instead of being a result of insight into a medical model of illness and McGorry (1992) also suggests that disregard for the active role that patients may play as reflected in psychiatry in terms such as 'case management' and 'compliance' "is a failing which extends to mainstream medicine and probably to most systems of human service delivery." On the other hand, Bill Anthony (2006), one of the most eminent experts on psychiatric rehabilitation and recovery in a personal report on his own medical illness, multiple sclerosis—MS, and the assistance he has been receiving in connection with it, describes the 'MS-Community' as exemplary with respect to instilling courage and hope, continually providing information and opportunities for exchange, and for never questioning a person's ultimate freedom of choice. In contrary, in mental health care he does not experience the medical profession as acting with full respect and support for its patients and suggests a great deal more work and transformation—especially concerning coercive treatments—ahead to follow this example. Similarly, it has been suggested that psychiatry should be better integrated into medicine to overcome stigma and discrimination of psychiatric health problems and interventions. A pertinent example of an initiative in this direction is the proposal of a fusion of mental health and incapacity legislation to arrive at ethically consistent legal situations with regard to involuntary [End Page 77] treatment across medicine (Dawson and Szmukler 2006).Is There Something Called Schizophrenia? and How Much Longer?Reimer's main example—schizophrenia—is the diagnosis that poses some of the greatest problems to the field and to the recognition of psychiatry as a scientific medical discipline. The current concept as well as the term 'schizophrenia' will probably not be around much longer; 'a century of schizophrenia is enough' (Kelly and Murray 2002). Suggested solutions for the problems of the diagnosis of schizophrenia concern the urgent complement of the categorical with a dimensional approach (Allardyce et al. 2007), a change also put forward as one of the essential remedies to undermine the stigma of mental illness that is often exacerbated by clinical diagnosis (Corrigan 2007). Such a move would also clearly help against the still prevalent experiences of users of services and their families and friends, whose hopes and dreams have been crushed and whose resilience has been undermined by clinical situations, which in times of psychotic crises, not only forced diagnoses but also prognoses—often scientifically unfounded—on them (Amering and Schmolke 2009).Is There a Solution? Can We Use Our Talents? And Those of People With a Lived Experience of Mental Health Problems and Care?Clinicians as well as scientists know that health, illness, and recovery occur in complex ways and contexts. People faced with mental health problems clearly realize the complexities of their situation and are especially motivated to appreciate the variety of factors and interactions that need to be integrated to arrive at a valid assessment. Ideally, the therapeutic relationship—essentially a partnership—holds a formidable chance of sharing efforts and creating the wisdom for finding and facing the truths necessary to develop solutions that can uphold and work in line with the complexities of human life.I would argue that psychiatric professionals are certainly part... (shrink)

The philosophical-psychological Lvov-Warsaw School, derived from the philosophical tradition of Franz Brentano, developed his concept of intentionality for many years in an original way. This is particularly evident in Kazimierz Twardowski’s theory of actions and products and Tadeusz Tomaszewski’s theory of action. Kazimierz Ajdukiewicz’s semantic epistemology is also an important yet unfinished achievement (though less related to the issue of intentionality), in the light of which cognitive processes are organically embedded in cultural artefacts and, more specifically, in language. Despite the (...) extraordinary wealth of the Lvov-Warsaw School’s achievements, the theoretical findings of Twardowski and his disciples allow for the extraction of relatively consistent conclusions regarding the specifics of human cognition. Achievements of the Polish school of psychology seem to be important in the long ongoing discussion on the topic of the nature of cognitive processes and the mind. (shrink)

The paper develops a framework for discussing concepts of health and disease along two dimensions. The first is the role of values in our disease concepts, and the second is the relationship between science and folk psychology. This framework is then applied to the concept of mental disorder. I argue that existing treatments of the concept yield too much authority to common sense, which produces a tension within the program of finding a scientific basis for our ascriptions of (...) class='Hi'>mental disorder. The science should be given more authority, even if this leads to counterintuitive results. I conclude by identifying several smaller scale conceptual problems within the application of science to mental illness, and argue that the debate needs to shift towards dealing with such problems in an empirically informed way, rather than remaining at the level of conceptual analysis. 2012 APA, all rights reserved). (shrink)

Mentalization is the capacity to perceive and interpret behavior in terms of intentional mental states, to imagine what others are thinking and feeling, and is a concept that has taken the psychological and psychoanalytic worlds by storm. This collection of papers, carefully edited by Fredric Busch, clarifies its import as an essential perspective for understanding the human psyche and interpersonal relationships. The book is divided into theoretical, research and clinical papers, reflecting how the investigators thoughtfully and purposefully pursued each (...) of these goals. Those involved in identifying mentalization have also made consistent efforts to measure and research the concept. Thus, in addition to expanding the theoretical bases and implications of mentalization and identifying clinically useful applications, the authors describe research that scientifically grounds the concept. _Mentalization _addresses and expands upon a number of implications of mentalization. These include: What are the broader implications for mentalization with regard to social and evolutionary development? How does mentalization interdigitate with other psychoanalytic models? How is mentalization systematically assessed? What clinical correlates have been found? How do we understand variations in the capacity for mentalization, even within a given individual? What are the applications of mentalization in the clinical arena, including specific disorders? Readers of this volume will find their clinical work to be more productive and their view of the human psyche broadened. (shrink)

Consider people’s ordinary concept of belief. This concept seems to pick out a particular psychological state. Indeed, one natural view would be that the concept of belief works much like the concepts one finds in cognitive science – not quite as rigorous or precise, perhaps, but still the same basic type of notion. But now suppose we turn to other concepts that people ordinarily use to understand the mind. Suppose we consider the concept happiness. Or the concept love. How are (...) these concepts to be understood? One obvious hypothesis would be that they are best understood as being more or less like the concept of belief. Maybe these concepts, too, pick out a particular mental state and thereby enable people to predict, explain and understand others’ behavior. We will argue that this hypothesis is mistaken. Instead, we suggest that the different concepts people use to understand the mind are fundamentally different from each other. Some of these concepts do indeed serve simply to pick out a particular mental state, but others allow a role for evaluative judgments. So, for example, our claim will be that when people are wondering whether a given agent is truly ‘happy’ or ‘in love,’ they are not merely trying to figure out whether this agent has a particular sort of mental state. They are also concerned in a central way with evaluating the agent herself. In short, our aim is to point to a striking sort of difference between the different concepts that people use to pick out psychological attitudes. We will be.. (shrink)

(1)In this necessarily condensed account there have been presented the personality systems of James, Freud, and McDougall, the first and the last of these exhibiting certain common factors, with certain extensions peculiar to each system. With the Freudian system these factors vaguely appear, but their form is badlydefined and their delineation incomplete. The criticism of the three systems may be summarised as follows:—that of James is lacking in content, i.e. of the sentiments, while that of McDougall is more in line (...) with a simple self concept than that of a complete personality system and hence is lacking in organisation. That of Freud, while possessing some features in common with that of McDougall appears naive and undeveloped. By combining the systems of the first-mentioned pair, a final system may be obtained, whichmore completely explains personality than any one of them. (2)According to this final system the main features of personality consist of:— (a)A basic system of instincts which tends to operate independently as personality phases; among these first fear, and later, submission and self assertion act as regulative factors. The former of this pair is inhibitive in its general effect on conduct, the latter accentuating it. (b)From a combination of instinctive tendencies focussed upon mental objects the sentiments develop. Like sentiments are grouped into a more or less defined entity styled a social self,this self being a product primarily of a particular environment. More than one social self tends to exist side by side in the same personality, each self retaining a specific set of moral sanctions of its own. Social selves may be independent and contradictory in their “mores” if there exist no overlap of common factors in apperception systems, sentiments and will attitudes. (c)At adolescence a rational process begins. Abstract sentiments and ideal personalities develope, and in place of social authority there is substituted the approbation or disfavour of anideal community existent in the mind of the subject; this forms the background of the promptings of conscience. An ethical code finally emerges whichis more or less universal in its applications. This development may be designated a rational, spiritual, or ethical self, and it acts as a unifying influence upon the social selves by legislating for opposed sanctions, and thus affording a final court of appeal in the case of conflict. Hence it becomes the crowning development of a unified personality. A clarification of the terms “self” and “personality” is thus afforded, whereby the term “self” is regarded as a phase of the latter. (shrink)

Alzheimer's disease and other forms of dementia are among the fastest growing health problems in America. Dementia incidence tends to increase with age, and the elderly are the fastest growing segment of the population. Medical and social sciences research on dementia involving demented patients is both ongoing and necessary. However, as noted in a report of the Office for Human Subjects Research, “while research with intellectually impaired people generates valuable … data, it also provides significant ethical challenges.

We approach the virtual reality phenomenon by studying its relationship to set theory. This approach offers a characterization of virtual reality in set theoretic terms, and we investigate the case where this is done using the wellfoundedness property. Our hypothesis is that non-wellfounded sets (so-called hypersets) give rise to a different quality of virtual reality than do familiar wellfounded sets. To elaborate this hypothesis, we describe virtual reality through Sommerhoff’s categories of first- and second-order self-awareness; introduced as necessary conditions for (...) consciousness in terms of higher cognitive functions. We then propose a representation of first- and second-order self-awareness through sets, and assume that these sets, which we call events, originally form a collection of wellfounded sets. Strong virtual reality characterizes virtual reality environments which have the limited capacity to create only events associated with wellfounded sets. In contrast, the logically weaker and more general concept of weak virtual reality characterizes collections of virtual reality mediated events altogether forming an entirety larger than any collection of wellfounded sets. By giving reference to Aczel’s hyperset theory we indicate that this definition is not empty because hypersets encompass wellfounded sets already. Moreover, we argue that weak virtual reality could be realized in human history through continued progress in computer technology. Finally, within a more general framework, we use Baltag’s structural theory of sets (STS) to show that within this hyperset theory Sommerhoff’s first- and second-order self-awareness as well as both concepts of virtual reality admit a consistent mathematical representation. To illustrate our ideas, several examples and heuristic arguments are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Keeping Philosophy in Mind:Shadworth H. Hodgson's Articulation of the Boundaries of Philosophy and ScienceThomas W. StaleyIntroductionShadworth H. Hodgson's (1832–1912) contributions to Victorian intellectual discourse have faded from prominence over the past century. However, despite his current anonymity, Hodgson's case is important to an understanding of the historical split between philosophy and science in late nineteenth century Britain. In particular, his example illuminates the specific role played by developing concepts (...) of the mind in a period of deep transition in the British intellectual community. His virtual disappearance from the record, I contend, is indicative also of the disappearance of his form of philosophy as a vital social project. His ideas, rather than being rejected, were instead largely neglected—they became lost as philosophical discussion moved elsewhere, both conceptually and institutionally. However, in the inaugural volume of Mind in 1876, Hodgson's ideas initially found a prominent place in a central dialogue over the position of philosophy with respect to science. There, and throughout his career, Hodgson engaged in the defense of an intellectual tradition he regarded as under threat from psychological science. Both his particular formulation of an ongoing role for philosophy and his own uneasy position in the intellectual environment of late Victorian Britain shed significant light on an under-examined issue [End Page 289] of the period: the fraught relationship between philosophy and science as competing enterprises engaged in the study of the human mind."Philosophy" and "science" are easily construed as partnered intellectual complexes in modern Western society. However, closer scrutiny of the historical record shows that the two terms—whether as theoretical referents or actors' categories—have often reflected divergent priorities and that transitions from "philosophical" to "scientific" terms have been contentious. In examining the birth of natural science out of natural philosophy during the Enlightenment, the historian Andrew Cunningham has emphasized how the reordering of intellectual fields created new conflictive relationships between philosophy, science, and religion.1 He reminds us that the process of scientific secularization was but one of a set of constitutive shifts among these human activities, and that the earlier natural philosophy thus played by fundamentally different rules than its successor. A similar story can be told about the late nineteenth-century transition I am considering: in a nutshell, to borrow a phrase from Cunningham, men did not start doing mental science until they stopped doing moral philosophy. However, this time, philosophy already stood in competition with existing scientific institutions, sparking a more severe contest for authority. As mental science began to develop along the lines of the natural disciplines, Hodgson and others feared little would remain as a distinctive domain for philosophy as such, moral or otherwise. His efforts on the part of philosophy thus represent one front in an intellectual "turf war"—what recent scholars have called "boundary work," shoring up the institutional positions of different intellectual enterprises competing for authority in the world.2 Gieryn's formative analysis of boundary work was based on the contemporaneous example of John Tyndall's campaign to promote scientific over religious authority in Victorian Britain, but this was much more than a two-way struggle. The early career of Mind bears witness to a closely related, but less discussed, battle for influence between philosophy and science, in which the journal itself served as a critical "boundary object," a medium for enforcement of the distinctions between these two intellectual fields.3 [End Page 290]Thomas Dixon has recently surveyed the origins of this shift. Like Cunningham, Dixon emphasizes the constitutive differences in scope and orientation of the two intellectual enterprises, salient among them the secularization of the new human sciences.4 This process—begun tentatively by Thomas Brown and brought to fruition by Bain, Spencer, and Darwin—involved wholesale shifts in the scholarly linguistic complex, from a set of several mental categories rooted in Christian philosophical categories—affections, passions, sentiments, etc.—to a novel, explicitly "scientific," and singular grouping of emotions. While the older tradition dominant until mid-century had understood the broad range of mental phenomena as largely rational and voluntary, the new emotions were formulated as more circumscribed in purview, subconscious or autonomic in action... (shrink)

Does respect for autonomy imply respect for precedent autonomy? The principle of respect for autonomy requires us to respect a competent patient’s treatment preference, but not everyone agrees that it requires us to respect preferences formed earlier by a now‐incapacitated patient, such as those expressed in an advance directive. The concept of precedent autonomy, which concerns just such preferences, is problematic because it is not clear that we can still attribute to a now‐incapacitated patient a preference which that patient never (...) disaffirmed but can no longer understand. If we cannot make that attribution, then perhaps we should not respect precedent autonomy – after all, how can you respect patient autonomy by giving patients what they no longer want, even if they never disaffirmed those wants? I argue that whether an earlier preference can still be attributed to a now‐incapacitated patient depends on the reasons behind the preference, for a preference includes (and is not merely supported by) the reasons behind it. When the considerations that served as reasons no longer exist, neither does the preference which included those reasons. In particular, if the considerations that served as reasons for the patient exist only under conditions where the patient retains full mental capacity, then once that capacity is lost, so are those reasons and the preference based upon them. I use this analysis of precedent autonomy to ascertain the merits of various approaches to advance medical decisionmaking, including Nancy Rhoden’s approach, approaches based on a Parfitian personal identity analysis, approaches based on soft paternalism, and approaches based on the stability and longevity of preferences. Despite the apparent absurdity of respecting patient autonomy by giving patients what they no longer prefer but have never disaffirmed, I conclude with some programmatic remarks on when and why respect for (precedent) autonomy nonetheless requires us to respect former preferences. (shrink)