During the Italian campaigns of the French Revolutionary Wars (1796–1801), several epidemic outbreaks sparked acrimonious aetiological debates: were the fevers spread by soldiers and prisoners of war, or produced by environmental factors? This debate was not only a scientific issue, but also a political one, for causation was linked to accountability. Looking at a series of medical investigations written by French military practitioners, this paper argues that theories of contagion were used by civilians to accuse the army of spreading disease, (...) in what I describe as an “aetiology of blame.” Likewise, military officials attempted to absolve themselves of responsibility for the spread of disease by focusing on unwholesome environments, depicting diseases as unavoidable fatalities. Military doctors thus supported French imperial endeavours by obscuring the army's responsibility for the spread of diseases, putting forward aetiologies of fate and blaming individual behaviour. Even when they did not radically dismiss contagionist perspectives, military practitioners insisted on a wide range of pathogenic causes. Their discourses were in line with medical theories of the time, but they downplayed the responsibility of the army for the spread of diseases, which they depicted as a factor among others. Military doctors were thus not always involved in the direct and deliberate production of ignorance, but they did sustain controversies and uncertainty. (shrink)

This chapter explores the suggestion that early attachment underpins the human capacity for empathy, and that empathy, in turn, is a condition of moral competence. We are disposed by nature to seek intimacy with our human conspecifics: the securely attached child learns that, whatever perils the world may hold, his well-being is shielded within the private sphere of personal intimacy. But why should secure attachment also favour—as it does—recognition of moral obligations towards those with whom we have no special standing (...) and share no personal destiny—recognition that the claims of persons as such merit our attention and regard? One answer to this question looks beyond the fact of secure attachment to a further psychological capacity, our capacity for empathy: secure attachment promotes susceptibility to empathy, and an appropriate susceptibility to empathy is a condition of basic moral competence. The chapter proposes that the deeper and more persisting significance of empathy to morality can be understood from a developmental perspective. Looking to mentalization-based attachment theory allows us to understand how empathic mirroring enters into our earliest intimate, interactions with other persons, securing our default commitment to recognizing their reality as bound up with our own. In this way, empathy constitutes one of the natural foundations on which the more complex architecture of moral experience is constructed. Attachment theory helps us to understand the indispensable role empathy plays at the beginning of the circuitous road to virtue. (shrink)

Uncertainty in the field of child psychiatry may at times lead to groundless assumptions about the aetiology and pathology of psychiatric disorders of childhood. Treatment based on non-validated assumptions may be ineffective and may cause more harm than good. The case is presented of infantile autism which was at first attributed by clinicians to a specific negative effect of parents on their children. Evidence grounded on research did subsequently refute the assumption implicating the parents in the aetiology of (...) this disorder. An explanatory assumption can become evidence if it is tested and found valid. To avoid serious errors in the understanding and treatment of child psychiatric disorders, the clinician should always consider critically assumptions and opinion, provided in lieu of evidence. (shrink)

The common autoimmune disease type 1 diabetes provides a paradigm for the genetic analysis of multifactorial disease. Disease occurrence is attributable to the interaction with the environment of alleles at many loci interspersed throughout the genome. Their mapping and identification is difficult because the disease-associated alleles occur almost as commonly in patients as in healthy individuals; even the highest-risk genotypes bestow only modest risks of disease. The identification of common quantitative trait loci (QTL) in autoimmune disease and in other common (...) disorders, therefore,requires a very close marriage of genetics and biology. Two QTLs have been identified in human type 1 diabetes: the major histocompatibility complex HLA class II loci and a promoter polymorphism of the insulin gene. The evidence for their primary roles in disease aetiology demonstrates the necessity of combined studies of genetics and biology. Their functions and interaction underpin an emerging picture of the basic causes of the disease and direct analyses towards other candidate genes and pathways. The genetic tools used for QTL identification include transgenesis and gene knockouts, whole genome scanning for linkage, mouse congenic strains, linkage disequilibrium mapping, and the establishment of ancestral haplotypes among disease-associated chromosomes. BioEssays 1999;21:164–174. © 1999 John Wiley & Sons, Inc. (shrink)

Roughly half way through the fourthGeorgic, Virgil confronts a sad reality: on occasion the entire population of a hive can perish without warning and leave the bee-keeping farmer bee-less. In response to such a devastating loss, the poet describes an Egyptian procedure, to which modern critics have given the namebugonia, whereby the farmer acquires a new swarm of bees from the putrefying carcass of a dead ox (4.281–314). After the account ofbugonia, the poem takes a notoriously unexpected turn. Virgil asks (...) the Muses about the origins of this practice and then recounts the exploits of Aristaeus, an inhabitant of the georgic world whose own bees once succumbed to famine and disease. In the narrative that follows, Aristaeus consults his mother Cyrene and the seer Proteus, who tells him about Orpheus’ descent to the underworld. The narrative ends when Aristaeus, thanks to the teaching of his mother, performs a series of activities that culminates in a new swarm of bees bursting forth from the putrefying carcass of a dead ox (4.315–558). The aetiological character of the Aristaeus narrative is clear—Virgil promises to trace the Egyptian procedure back to its firstorigo(4.286), and when he addresses the Muses, he specifically asks what god discovered the practice and whence it took its first beginnings (4.315–16). But for what activity does the story actually offer anaition? (shrink)

In this paper, I utilise the tools of analytic philosophy to amalgamate mono-causal and multi-causal theories of disease. My aim is to better integrate viral and socio-economic explanations of AIDS in particular, and to consider how the perceived divide between mono-causal and multi-causal theories played a role in the tragedy of AIDS denialism in South Africa in the early 2000s. Currently, there is conceptual ambiguity surrounding the relationship between mono-causal and multi-causal theories in biomedicine and epidemiology. Mono-causal theories focus on (...) single, typically microbial, sources of illness and are most concerned with infectious diseases. By contrast, multi-causal theories allow for multiple factors to underpin a disease’s aetiology, including socio-economic and behavioural factors, and they usually focus on chronic non-communicable diseases. However, if these theories are taken to be strictly distinct, this prevents the inclusion of both microbial and socio-economic factors in a single explanation of any particular disease. This strict distinction became a problem when trying to explain the disproportionate prevalence of AIDS in southern Africa and ultimately contributed to the tragedy of AIDS denialism in South Africa. In tandem with viewing how the perceived divide between multi-causal and mono-causal theories underpinned AIDS denialism, I examine Thabo Mbeki’s specific role, while acknowledging that AIDS is being deprioritised on a broader international level. Overall, I will demonstrate that any long-term plan to eliminate AIDS will require viral and socio-economic factors to be considered simultaneously and that such a theoretical approach requires a clearer understanding of the underlying concepts of disease aetiology. (shrink)

Medically unexplained symptoms (MUS) remain recalcitrant to the medical profession, proving less suitable for homogenic treatment with respect to their aetiology, taxonomy and diagnosis. While the majority of existing medical research methods are designed for large scale population data and sufficiently homogenous groups, MUS are characterised by their heterogenic and complex nature. As a result, MUS seem to resist medical scrutiny in a way that other conditions do not. This paper approaches the problem of MUS from a philosophical point (...) of view. The aim is to first consider the epistemological problem of MUS in a wider ontological and phenomenological context, particularly in relation to causation. Second, the paper links current medical practice to certain ontological assumptions. Finally, the outlines of an alternative ontology of causation are offered which place characteristic features of MUS, such as genuine complexity, context-sensitivity, holism and medical uniqueness at the centre of any causal set-up, and not only for MUS. This alternative ontology provides a framework in which to better understand complex medical conditions in relation to both their nature and their associated research activity. (shrink)

Despite the diagnostic relevance of thought insertion for disorders such as schizophrenia, the debates about its aetiology are far from resolved. This paper claims that in paying exclusive attention to the perceptual and cognitive impairments leading to delusional experiences in general, current deficit approaches overlook the role that affective disturbances might play in giving rise to cases of thought insertion. In the context of psychosis, affective impairments are often characterized as a consequence of the stress and anxiety caused by (...) delusional episodes. However, here I explore some of the conceptual and empirical reasons to think that affective problems might in fact play a crucial doxastic role in the aetiology of thought insertion. Finally, I conclude by proposing a way of integrating the main insights of my analysis with the current ‘two-factor’ deficit approach to thought insertion and I explore the potential adaptive role that some delusions might have within this framework. (shrink)

Heart disease is a complex condition that is a leading cause of death worldwide. It is often seen as a disease of affluence, yet is strongly associated with a gradient in socio-economic status. Its highly complex causality means that many different facets of social and economic life are implicated in its aetiology, including factors such as workplace hierarchy and agricultural policy, together with other well-known factors such as what passes for individual 'lifestyle'. The very untangling of causes for heart (...) disease thus inevitably raises social, moral and political issues. These include the proper role of the individual and of larger social forces in its aetiology, prevention and treatment. The construction of risk factors for heart disease likewise is enmeshed with questions of distributive justice in the responsible targeting of those at risk for heart disease, a debate which has received much overt attention in the medical literature, but less attention within the ethical literature. Strategies for addressing a condition of such complex causality can be highly diverse, from pharmaceutical to social interventions, and value issues attach to the choice and presentation of such strategies. For example, prevention strategies may raise complex issues of responsibility and of judgements of what it is to 'live well'. Further ethical debate on this highly political disease would be welcome. (shrink)

The interactions between genetic and environmental risk factors contribute to the aetiology of complex human diseases. Genome‐wide association studies (GWAS) have revealed that most of the genetic variants associated with complex diseases are located in the non‐coding part of the genome, preferentially within enhancers. Enhancers are distal cis‐regulatory elements composed of clusters of transcription factors binding sites that positively regulate the expression of their target genes. The generation of genome‐wide maps for histone marks (e.g., H3K27ac), chromatin accessibility and transcription (...) factor and coactivator (e.g., p300) binding profiles have enabled the identification of enhancers across many human cell types and tissues. Nonetheless, the functional and pathological consequences of the majority of disease‐associated genetic variants located within enhancers seem to be rather minor under normal conditions, thus questioning their medical relevance. Here we propose that, due to the prevalence of enhancer redundancy, the pathological effects of many disease‐associated non‐coding genetic variants might be preferentially (or even only) manifested under environmental stress. (shrink)

The book investigates how Avicenna's doctrine of efficient causality relates to his general ontology, as well as how the two are interpreted, defended, and challenged in the early phase of Avicenna's Islamic reception (the eleventh and twelfth centuries).

Our understanding of the complexity of the oral biome and of the role of the various constituent bacteria in the aetiology of dental disease is growing. Probiotics and their relationship with prebiotics, as well as other microbiome‐based interventions, could be useful in preventing and treating dental disease and in promoting oral health. However, given the promise and early stage of this treatment approach, there are also a number of ethical, social and regulatory issues associated with innovative probiotic therapy. In (...) this article, a brief update is given on contemporary theories of the aetiology and management of the two commonest dental diseases, and on the roles of pre‐ and probiotics and oral biome transplant in the management of these diseases. The focus is primarily on four core issues: informed consent, risk–benefit assessment, how to determine suitable healthy donors, and commercialization and regulation. We discuss the safety and benefits of oral probiotics, not only concerning the products and quality control during their manufacture, but also regarding the depth of public knowledge about this topic. We point out that the requirement of listing ingredients honestly might be insufficient, and that the prevalent rhetoric of ‘natural’ and ‘organic’ as well as some health claims in the translational, innovative probiotic industry and markets are themselves misleading and should be carefully scrutinized. Finally, we suggest an ethical imperative to find a balance between scientific research and industry, and public health in the regulation of probiotics. (shrink)

What is the significance of empirical work on moral judgement for moral philosophy? Although the more radical conclusions that some writers have attempted to draw from this work are overstated, few areas of moral philosophy can remain unaffected by it. The most important question it raises is in moral epistemology. Given the explanation of our moral experience, how far can we trust it? Responding to this, the view defended here emphasizes the interrelatedness of moral psychology and moral epistemology. On this (...) view, the empirical study of moral judgement does have important implications for moral philosophy. But moral philosophy also has important implications for the empirical study of moral judgement. (shrink)

Gettier's reminder that knowledge cannot be identified with justified true belief started a heated debate about what knowledge really is.

I begin by examining how genetics drivesschizophrenia research, and raise both familiar andrelatively novel criticisms of the evidence putativelysupporting the genetic basis of schizophrenia. Inparticular, I call attention to a set of concernsabout the effects of placentation on concordance ratesof schizophrenia in monozygotic twins, which furtherweakens the case for schizophrenia''s so-called stronggenetic component. I then underscore two criticalpoints. First, I emphasize the importance of takingseriously considerations about the complexity of bothontogenesis and the development of hereditarydiseases. The recognition of developmentalconstraints and (...) supports is crucial, for attention todevelopment exposes the naivete of too many models ofgene action in the aetiology of disease. Secondly, Iattend to those schizophreniologists who ignoremethodological criticisms and thus presume a geneticbasis for schizophrenia, and then seek the schizophrenic genotype lacking an adequatephenotype. In response I attempt to demonstrate thenecessity of a sustained effort at characterizing thephenotype of schizophrenia as an enabling conditionfor the whole enterprise of psychiatric genetics – andfor psychiatry itself. Without the organism-levelphenotype, research at the level of genes will remainunproductive – assuming of course that research at thegenetic level is appropriate at all. (shrink)

Standard accounts of the senses attempt to answer the question how and why we count five senses (the counting question); none of the standard accounts is satisfactory. Any adequate account of the senses must explain the significance of the senses, that is, why distinguishing different senses matters. I provide such an explanation, and then use it as the basis for providing an account of the senses and answering the counting question.

Philosophical Papers Vol.32(2) 2003: 149-155.

Aetiological poetry tends to be mature poetry in both a literary and a political sense. Interest in antiquarian lore belongs in general to a poet's middle and later years when youthful and audacious quests for what is avant-garde and anti-establishment have yielded to conservatism and a desire to preserve the past. Propertius and Ovid both turned to aetiological poetry after a long apprenticeship in amatory ‘nugae’ which enabled them, like their predecessor, Callimachus, to embellish their work with a diversity of (...) artistic devices founded on considerable poetic skill and literary experience. With this, a vital ploy to engage the sympathy of a sophisticated audience, went the poise and urbanity with which the aetiological poet found humour in the pose of earnest researcher, in the naivety of primitive cult and in clever literary adaptations. Moreover, dedication to a form of writing essentially nationalist and conservative encouraged a tone of patriotic pride and allusions, even compliments, to the ruling powers. In the light of such considerations we may examine Ovid's account of the ‘Ludi Megalenses’. The ‘Megalensia’ furnished Ovid with a goddess who had enjoyed fame and even notoriety in the pages of Roman literature. In addition to showing a poetic and neoteric interest in the orgiastic elements of her cult and the alien music of her retinue Roman poetry could reflect too the awe and reverence inspired of old by the Great Mother and expressed in the Greek poets, whom Lucretius claimed as his sources in his powerfully beautiful excursus on Cybele worship. Again, Cybele's importance in Rome had been augmented by her Trojan origins, concerning which a canonical Augustan theology had been established by Vergil in the Aeneid. (shrink)

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the (...) book is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals. (shrink)

Journal Name: Philologus Issue: Ahead of print.

ABSTRACT Cognitive penetrability refers to the possibility that perceptual experiences are influenced by our beliefs, expectations, emotions, or other personal-level mental states. In this paper, I focus on the epistemological implication of cognitive penetration, and examine how, exactly, aetiologies matter to the justificatory power of perceptual experiences. I examine a prominent theory, according to which some cognitively penetrated perceptual experiences are like conclusions of bad inferences. Whereas one version of this theory is psychologically implausible, the other version has sceptical consequences. (...) In the second half of the paper, I suggest an alternative theory, drawing on recent empirical research on imagining-perception interaction and the epistemology of imagining. (shrink)

We provide a battery of examples of delusions against which theoretical accounts can be tested. Then, we identify neuropsychological anomalies that could produce the unusual experiences that may lead, in turn, to the delusions in our battery. However, we argue against Maher’s view that delusions are false beliefs that arise as normal responses to anomalous experiences. We propose, instead, that a second factor is required to account for the transition from unusual experience to delusional belief. The second factor in the (...) aetiology of delusions can be described superficially as a loss of the ability to reject a candidate for belief on the grounds of its implausibility and its inconsistency with everything else that the patient knows. But we point out some problems that confront any attempt to say more about the nature of this second factor. (shrink)

The literature on the aetiology of serial killing has benefited from analyses which offer an alternative perspective to individual/psychological approaches and consider serial murder as a sociological phenomenon. The main argument brought to bear within this body of work identifies the socio-economic and cultural conditions of modernity as enabling and legitimating the motivations and actions of the serial killer. This article interrogates this work from the standpoint of a gendered reading of modernity. Using the Yorkshire Ripper case, it emphasizes (...) how in addition to the political economy, gender relations and masculinity shape the dynamics of serial murder and its representation. (shrink)

Theories of Theories of Mind brings together contributions by a distinguished international team of philosophers, psychologists, and primatologists, who between them address such questions as: what is it to understand the thoughts, feelings, and intentions of other people? How does such an understanding develop in the normal child? Why, unusually, does it fail to develop? And is any such mentalistic understanding shared by members of other species? The volume's four parts together offer a state of the art survey of the (...) major topics in the theory-theory/simulationism debate within philosophy of mind, developmental psychology, the aetiology of autism and primatology. The volume will be of great interest to researchers and students in all areas interested in the 'theory of mind' debate. (shrink)

How many factors, i.e. departures from normality, are necessary to explain a delusion? Maher’s classic one-factor theory argues that the only factor is the patient’s anomalous experience, and a delusion arises as a normal explanation of this experience. The more recent two-factor theory, on the other hand, contends that a second factor is also needed, with reasoning abnormality being a potential candidate, and a delusion arises as an abnormal explanation of the anomalous experience. In the past few years, although there (...) has been an increasing number of scholars offering a variety of arguments in defence of Maher’s one-factor theory, these arguments have not been adequately addressed by two-factor theorists. This paper aims to address this gap by critically examining the arguments on three crucial issues: the intelligibility of delusions, the dissociation between anomalous experiences and delusions, and the empirical evidence of a second factor. I will argue that the Maherian notion of anomalous experience is not sufficient for explaining delusions and the two-factor theory is on the right track in its search for the missing factor in the aetiology of delusions. (shrink)

According to the distinguished philosopher Richard Wollheim, an emotion is an extended mental episode that originates when events in the world frustrate or satisfy a pre-existing desire (Wollheim, 1999). This leads the subject to form an attitude to the world which colours their future experience, leading them to attend to one aspect of things rather than another, and to view the things they attend to in one light rather than another. The idea that emotions arise from the satisfaction or frustration (...) of desires—the ‘match-mismatch’ view of emotion aetiology—has had several earlier incarnations in the psychology of emotion. Early versions of this proposal were associated with the attempt to replace the typology of emotion found in ordinary language with a simpler theory of drives and to define new emotion types in terms of general properties such as the frustration of a drive. The match-mismatch view survived the demise of that revisionist project and is found today in theories that accept a folk-psychological-style taxonomy of emotion types based on the meaning ascribed by the subject to the stimulus situation. For example, the match-mismatch view forms part of the subtle and complex model of emotion episodes developed over many years by Nico Frijda (Frijda, 1986). According to Frijda, information about the ‘situational antecedents’ of an emotion—the stimulus in its context, including the ongoing goals of the organism—is evaluated for its relevance to the multiple concerns of the organism. Evaluation of match-mismatch—the degree of compatibility between the situation and the subject's goals—forms part of this process. (shrink)

It is a philosophical truism that we must think of others as moral agents, not merely as causal or statistical objects. But why? I argue that this follows from the best resolution of an antinomy between our experience of morality as necessarily binding on the will and our knowledge that all moral beliefs originate in contingent histories. We can address this antinomy only by understanding moral deliberation via interpersonal relationships, which simultaneously vindicate and constrains morality’s bind on the will. This (...) means that moral agency is fundamentally social. I model an attitude toward our causal nature on sociologist Erving Goffman’s concept of ‘civil inattention’; our social practice of agency requires that we give minimal attention to the contingent origins of moral judgments in ourselves and others. Understood this way, seeing ourselves as moral agents requires avoiding appeal to causal aetiology to settle substantive moral disagreement. (shrink)

Sensuous imaginative content presents a problem for unitary accounts of phenomenal character (or content) such as relationism, representationalism or qualia theory. Four features of imaginative content are at the heat of the issue: its perspectival nature, the similarity with corresponding perceptual experiences, the multiple use thesis, and its non-presentational character. I reject appeals to the dependency thesis to account for these features and explain how a representationalist approach can be developed to accommodate them. I defend the multiple use thesis against (...) Kathleen Stock’s objections but separate the putative non-presentational character of imaginative content into two elements. Loss of presentation is accounted for by the reduced representations involved in imagination and lack of potential response-dependent representational properties. Absence of commitment to reality is accounted for by representational properties characterised in terms of the absence of a certain kind of aetiology. (shrink)

This paper argues that the DSM diagnostic category 'major depression' is so permissive that it fails to distinguish the phenomenology of depression from a general 'feeling of being ill' that is associated with a range of somatic illnesses. We start by emphasizing that altered bodily experience is a conspicuous and commonplace symptom of depression. We add that the experience of somatic illness is not exclusively bodily; it can involve more pervasive experiential changes that are not dissimilar to those associated with (...) depression. Then we consider some recent work on inflammation and depression, which suggests that the experience of depression and the 'feeling of being ill' are, in some cases at least, much the same . However, we add that the phenomenology of depression is heterogeneous and that many cases involve additional or different symptoms. We conclude that 'major depression' is a placeholder for a range of different experiences, which are almost certainly aetiologically diverse too. (shrink)

There is no satisfactory account for the general phenomenon of confabulation, for the following reasons: (1) confabulation occurs in a number of pathological and non-pathological conditions; (2) impairments giving rise to confabulation are likely to have different neural bases; and (3) there is no unique theory explaining the aetiology of confabulations. An epistemic approach to defining confabulation could solve all of these issues, by focusing on the surface features of the phenomenon. However, existing epistemic accounts are unable to offer (...) sufficient conditions for confabulation and tend to emphasise only its epistemic disadvantages. In this paper, we argue that a satisfactory epistemic account of confabulation should also acknowledge those features which are (potentially) epistemically advantageous. For example, confabulation may allow subjects to exercise some control over their own cognitive life which is instrumental to the construction or preservation of their sense of self. (shrink)

I introduce and discuss an underappreciated form of motivated cognition: motivational pessimism, which involves the biasing of beliefs for the sake of self-motivation. I illustrate how motivational pessimism avoids explanatory issues that plague other (putative) forms of motivated cognition and discuss distinctions within the category, related to awareness, aetiology, and proximal goals.