Property dualism is enjoying a slight resurgence in popularity, these days; substance dualism, not so much. But it is not as easy as one might think to be a property dualist and a substance materialist. The reasons for being a property dualist support the idea that some phenomenal properties (or qualia) are as fundamental as the most basic physical properties; but what material objects could be the bearers of the qualia? If even some qualia require an adverbial construal (if they (...) are modifications of the thing that is conscious because of them, not properties of something else to which the subject of consciousness is related), then the property dualist can be driven to speculative forms of materialism none of which, at this point, looks more likely to be true than the more modest versions of emergent dualism defended by contemporary substance dualists. (shrink)

Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. (...) -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy's Role in Psychopathology Back to Jaspers and an Appeal to Grow PracticalThe author reports no conflicts of interest.In "Philosophy's role in theorizing psychopathology," Gibson presents a defense of the continued relevance of philosophy to psychopathology, and a non-exhaustive framework for the role of philosophy in this domain (Gibson, 2024). I find it hard to disagree that psychopathology is soaked in philosophy from its origins, and that to try (...) and dry it out would be both unwise and impossible.In this commentary, I go back to Karl Jaspers' account of the role of philosophy in his General Psychopathology. In doing so, I do not find that Gibson adds anything new, but instead gives us a well-illustrated reminder that philosophy "is operative within every living science" (Jaspers, 1997, p. 770).Situated Psychopathological TheorizingGibson addresses a broad 'we' who might be engaged with psychopathological theorizing. This seems to encompass three main settings, from which examples are drawn.1. Everyday and regulative social practices (ordinary and legal setting).2. Empirically driven disciplines which work with psychopathological constructs (academic setting).3. Psychiatry and psychotherapy (clinical setting).In my view, it is a mistake not to map the terrain where psychopathological theorizing is situated. In each setting psychopathological theorizing has its own set of aims and constraints. In the ordinary setting, the aim might be to know whether to blame a loved one for their action. In the legal setting it might be to decide whether treatment or punishment is appropriate. In the clinical setting, the aim is usually a therapeutic assessment, and moral stance taking is often best kept at bay. In the academic setting, we might want to ensure our concepts are reliable and valid, opening them up to investigation using objective scientific methods. [End Page 13]Beyond what can be said in the most general terms, the role of philosophy will look different in these different situations.Understanding Is Not (Just) a Philosophical ToolUnderstanding is a mode of knowing that is concerned with the particular, rather than the general, and accessed inter-relationally, relying on tacit knowledge and empathetic imagination. Gibson introduces the concept as an elementary form of social intuition, used in ordinary life to make sense of social relations and other people's behaviors and reactions. I agree with Gibson, drawing on Strawson, that Understanding is a mode of knowledge that involves the subject of enquiry as a participant (Strawson, 1982). There is a moral imperative to take this stance, which drives us to value the expansion of what we are able to understand of other people's mental states. This at least partly motivates the agenda when we theorize about psychopathology.At times throughout his argument, Gibson seems to be arguing for the role of Understanding in psychopathological theorizing, in place of his explicit aim of arguing for the role of philosophy. However it is not at all clear that this replacement can be made. Accepting the picture drawn, Understanding is not any more the expertise or domain of the philosopher than the author, police officer, or sociologist. We are surely not meant to take Understanding as a uniquely philosophical tool, but rather a mode of knowing available to all social agents, integral to social reasoning in ordinary life and in the human studies.What philosophy can distinctively do is point to and defend the existence of forms of intersubjective and tacit knowledge within human studies such as psychopathology. For Jaspers, Understanding can be a scientific tool, albeit one that reminds us that knowledge in psychopathology is not all of one kind. One role for philosophy therefore is to help us to "distinguish the different modes of knowing," so that we might "order knowledge into a comprehensive whole" (Jaspers, 1997, p. 769). This is akin to the 'synthetic' role that Gibson proposes.Philosophy and ScienceJaspers defines scientific knowledge broadly as knowledge with "general validity, convincing insights (which can be proved), clarity of method, and the possibility for a meaningful discussion" (Jaspers, 1997, p. 768).We do not get such a definition from Gibson, but in the sections of... (shrink)

Every choice we make is set against a background of massive ignorance about our past, our future, our circumstances, and ourselves. Philosophers are divided on the moral significance of such ignorance. Some say that it has a direct impact on how we ought to behave - the question of what our moral obligations are; others deny this, claiming that it only affects how we ought to be judged in light of the behaviour in which we choose to engage - the (...) question of what responsibility we bear for our choices. Michael Zimmerman claims that our ignorance has an important bearing on both questions, and offers an account of moral obligation and moral responsibility that is sharply at odds with the prevailing wisdom. His book will be of interest to a wide range of readers in ethics. (shrink)

Michael J. Zimmerman offers a conceptual analysis of the moral ‘ought’ that focuses on moral decision-making under uncertainty. His central case, originally presented by Frank Jackson, concerns a doctor who must choose among three treatments for a minor ailment. Her evidence suggests that drug B will partially cure her patient, that one of either drug A or C would cure him completely, but that the other drug would kill him. Accepting the intuition that the doctor ought to choose drug (...) B, Zimmerman argues that moral obligation consists in performing the action that is ‘prospectively best,’ that is ‘that which, from the moral point of view, it is most reasonable for the agent to choose’ given the evidence available to her at the time.Zimmerman defends his Prospective View of moral obligation against two main competitors in the long, first chapter of the book. According to the Objective View, a person ought to choose what is, in fact, the best option. The doctor ought to give her patient whichever drug will actually cure him. The fact that the doctor cannot know whether this is drug …. (shrink)

This paper begins with a recognition that questions of climate change, environmental degradation, and our relations to the natural world are increasingly significant and requiring of a response not only as philosophers of education but also as citizens of the planet. As such the paper explores five of the key journals in philosophy of education in order to identify the extent, range, and content of current discussions related to the environment. It then organizes and summaries the articles that were located (...) while seeking to identify the extent, possibilities, and limitations of current discussions relating to the environment in the philosophy of education community. The hope is that ultimately this work is an invitation to anyone, regardless of tradition, orientation, and expertise, to contribute to the expansion and deepening of both theory and practice in the face of this most serious of challenges. (shrink)

Michael J. Zimmerman explores whether and how our ignorance about ourselves and our circumstances affects what our moral obligations and moral rights are. He rejects objective and subjective views of the nature of moral obligation, and presents a new case for a 'prospective' view.

The principal aim of this book is to develop and defend an analysis of the concept of moral obligation. The analysis is neutral regarding competing substantive theories of obligation, whether consequentialist or deontological in character. What it seeks to do is generate solutions to a range of philosophical problems concerning obligation and its application. Amongst these problems are deontic paradoxes, the supersession of obligation, conditional obligation, prima facie obligation, actualism and possibilism, dilemmas, supererogation, and cooperation. By virtue of its normative (...) neutrality, the analysis provides a theoretical framework within which competing theories of obligation can be developed and assessed. This study is a major contribution to metaethics that will be of particular interest to all philosophers concerned with normative ethical theory. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses of (...) the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

Radical ecology typically brings to mind media images of ecological activists standing before loggers' saws, staging anti-nuclear marches, and confronting polluters on the high seas. Yet for more than twenty years, the activities of organizations such as the Greens and Earth First! have been influenced by a diverse, less-publicized group of radical ecological philosophers. It is their work—the philosophical underpinnings of the radical ecological movement—that is the subject of _Contesting Earth's Future_. The book offers a much-needed, balanced appraisal of radical (...) ecology's principles, goals, and limitations. Michael Zimmerman critically examines the movement's three major branches—deep ecology, social ecology, and ecofeminism. He also situates radical ecology within the complex cultural and political terrain of the late twentieth century, showing its relation to Martin Heidegger's anti-technological thought, 1960s counterculturalism, and contemporary theories of poststructuralism and postmodernity. An early and influential ecological thinker, Zimmerman is uniquely qualified to provide a broad overview of radical environmentalism and delineate its various schools of thought. He clearly describes their defining arguments and internecine disputes, among them the charge that deep ecology is an anti-modern, proto-fascist ideology. Reflecting both the movement's promise and its dangers, this book is essential reading for all those concerned with the worldwide ecological crisis. (shrink)

The idea that immoral behaviour can sometimes be admirable, and that moral behaviour can sometimes be less than admirable, has led several of its supporters to infer that moral considerations are not always overriding, contrary to what has been traditionally maintained. In this paper I shall challenge this inference. My purpose in doing so is to expose and acknowledge something that has been inadequately appreciated, namely, the moral aspect of nonmoral goods and evils. I hope thereby to show that, even (...) if immorality can be admirable, this poses no threat to morality. (shrink)

Aaron Zimmerman presents a new pragmatist account of belief, in terms of information poised to guide our more attentive, controlled actions. And he explores the consequences of this account for our understanding of the relation between psychology and philosophy, the mind and brain, the nature of delusion, faith, pretence, racism, and more.

The system of free expression John Milton defends in Areopagitica, a pamphlet against prior restraint in publishing, is often characterized as merely a proto-liberal, truth-based marketplace of ideas theory. But this represents a misunderstanding of Milton’s views on the freedoms of conscience, speech, and the press. The tendency in political theory, philosophy, and law to reduce the “free speech Milton” to Areopagitica, and the reduction of that essay to several soundbites, has meant sidelining both the significant exceptions to expressive liberties (...) that Milton calls for and also the role of the social in his theory. This incomplete characterization has enabled Milton’s misuse in First Amendment discourse and jurisprudence, where he is made to support hierarchical approaches to free speech that privilege public political speech and are therefore ill-equipped to address the full range of communicative experiences. More comprehensive readings of Milton, however, reveal both certain limits to free expression, and also deep consideration for a wide range of speech acts. By reading Milton’s theory of expressive liberties in light of the justifications he provides for those freedoms—i.e., virtue-building and Truth-seeking—this essay provides a fuller account of his views. What emerges is a distinctly Miltonian, virtue-driven “political theory of everyday talk” that locates value in even the most ordinary communicative acts. This theory—embracing both verbal and nonverbal expression—not only complements existing political theories of the everyday but can also help illuminate contemporary free speech concerns, many of which stem from the libertarian approach to expressive liberties that Milton helped inspire. (shrink)

Psychiatric diagnoses are increasingly seen as viable categories around which self and social identities might be drawn. This introduces a new pressure on the “boundary problem” for psychiatry: when members of the public request diagnoses to affirm their self-identities how should we draw the line between mental disorder and normality? If psychiatrists have the authority to recognize and diagnose mental disorder, how can roles as diagnosers and gate-keepers be balanced in a post-stigma era of mental health care? Focusing on the (...) disorder identified would-be patient who would not attract the diagnosis they seek were they not to seek it, this essay explores what it means to have an identity bound to a psychiatric diagnosis and considers a framework for psychiatrists to negotiate clinical encounters that involve the seeking of identity affirming diagnoses. (shrink)

This commentary argues the case for developmental psychopathology in understanding social learning. Informed by work on “epistemic disruption,” we have described difficulties with social learning associated with many forms of psychopathology. Epistemic disruption manifests in an inability to move between innovation and conformity, and arises from poor mentalizing, which generates difficulties in identifying social cues that trigger the correct stance.

There has long been interest in why languages are shaped the way they are, and in the relationship between sign language and gesture. In sign languages, entity classifiers are handshapes that encode how objects move, how they are located relative to one another, and how multiple objects of the same type are distributed in space. Previous studies have shown that hearing adults who are asked to use only manual gestures to describe how objects move in space will use gestures that (...) bear some similarities to classifiers. We investigated how accurately hearing adults, who had been learning British Sign Language for 1–3 years, produce and comprehend classifiers in locative and distributive constructions. In a production task, learners of BSL knew that they could use their hands to represent objects, but they had difficulty choosing the same, conventionalized, handshapes as native signers. They were, however, highly accurate at encoding location and orientation information. Learners therefore show the same pattern found in sign-naïve gesturers. In contrast, handshape, orientation, and location were comprehended with equal accuracy, and testing a group of sign-naïve adults showed that they too were able to understand classifiers with higher than chance accuracy. We conclude that adult learners of BSL bring their visuo-spatial knowledge and gestural abilities to the tasks of understanding and producing constructions that contain entity classifiers. We speculate that investigating the time course of adult sign language acquisition might shed light on how gesture became conventionalized during the genesis of sign languages. (shrink)

An overview of the philosophical and bioethics literature on conscientious refusals by health care professionals to provide abortion and contraceptive services.

Cet article propose le repérage et l’analyse de trois manières distinctes de conceptualiser la prière dans les travaux de sciences humaines et sociales qui la prennent pour objet à compter de la publication de l’essai de Marcel Mauss (1909). Ces trois conceptualisations de prière mises en débat dès le XXe siècle sont déterminées par une variation des stratégies discursives et des rapports au théologico-religieux. Normalisée, la prière est définie selon sa forme jugée idéale. Enchantée, elle est mise au service des (...) théories de l’homo religiosus. Désenchantée, elle est ramenée à une construction socio-psychologique. En relevant les intérêts comme les limites analytiques de chacune de ces options théoriques, l’objectif est de faire apparaître leur complémentarité afin d’esquisser les traits d’une nouvelle manière possible d’étudier la prière. (shrink)

In 2017 and 2019, two research teams claimed ‘proof of principle’ for artificial womb technology (AWT). AWT has long been a subject of speculation in bioethical literature, with broad consensus that it is a welcome development. Despite this, little attention is afforded to more immediate ethical problems in the development of AWT, particularly as an alternative to neonatal intensive care. To start this conversation, I consider whether experimental AWT is innovative treatment or medical research. The research–treatment distinction, pervasive in regulation (...) worldwide, is intended to isolate research activities and subject them to a greater degree of oversight. I argue that there is a tendency in the literature to conceptualize AWT for partial ectogenesis as innovative treatment. However, there are sufficiently serious ethical concerns with experimental AWT that mean that it must not be first used on humans on the basis that it is a ‘beneficial treatment’. First, I outline the prospects for translation of AWT animal studies into treatment for human preterms. Second, I challenge the conceptualizations of experimental AWT as innovative treatment. It must be considered medical research to reflect the investigatory nature of the process and guarantee sufficient protections for subjects. Identifying that AWT is research is crucial in formulating further ethico‐legal questions regarding the experimental use of AWT. Third, I demonstrate that clinical trials will be a necessary part of the clinical translation of AWT because of requirements laid out by regulators. I consider the justification for clinical trials and highlight some of the crucial ethical questions about the conditions under which they should proceed. (shrink)

Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised (...) exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings. (shrink)

Drawing on the work of Foucault and Western confessional writings, this book challenges the transhistorical and commonsense views of confession as an innate impulse resulting in the psychological liberation of the confessing subject. Instead, confessional desire is argued to be contingent and constraining, and alternatives to confessional subjectivity are explored.

In a 1983 interview, Michel Foucault contrasts our contemporary interest in sexual identity with the ancient Greek preoccupation with diet, arguing that sex has replaced food as the privileged medium of self-constitution in the modern West. In the same interview, Foucault argues that modern liberation movements should return to the ancient model of ethics, of which diet was a prime example, as aesthetics or self-transformative practice. In this paper I take up Foucault's argument with respect to the Animal Liberation Movement (...) and the dietetics of ethical vegetarianism. Contra Foucault, I suggest that diet has not been replaced by sexuality in the modern West, and that food choices, along with and intertwined with sexuality, continue to function as practices of self-constitution in both disciplinary and aesthetic fashions. I then consider the implications of this argument for the Animal Liberation Movement, exploring ways in which it might (and to some degree already does) take on aesthetic rather than moral strategies in order to pursue what Foucault once described as “an ethics of acts and their pleasures which would be able to take into account the pleasure of the other.”. (shrink)

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some community (...) miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

This paper provides an overview of Michel Foucault's continually changing observations on familial power, as well as the feminist-Foucauldian literature on the family. It suggests that these accounts offer fragments of a genealogy of the family that undermine any all-encompassing or transhistorical account of the institution. Approaching the family genealogically, rather than seeking a single model of power that can explain it, shows that far from this institution being a quasi-natural formation or a bedrock of unassailable values, it is in (...) fact a continually contested fiction that masks its own histories of becoming. (shrink)

The idea of philosophy as a way of living is explicitly introduced by Plato, who illustrates it through the story of his teacher’s life and death. A most striking aspect of Plato’s account of philosophy as a way of living is that it also appears to involve the idea of philosophy as a preparation for, or even a pursuit of, dying: they that strive unceasingly for this release [sc. the release of soul from body] are, so we maintain, none other (...) than those that pursue philosophy aright; indeed this and nothing else is the philosopher’s concern, the release and separation of soul from body The soul of the philosopher trains itself to die readily, by achieving, already during life, a state of purity: which is precisely what true philosophy consists in 80-81a. (shrink)