Jerry Fodor has argued that a modular mind must include central systems responsible for updating beliefs, and has defended this position by appealing to shared properties of belief fixation and scientific confirmation. Peter Carruthers and Stephen Pinker have attacked this analogy between science and ordinary inference. I examine their arguments and show that they fail. This does not show that Fodor's more general position is correct.

Jerry Fodor has argued that a modular mind must include central systems responsible for updating beliefs, and has defended this position by appealing to shared properties of belief fixation and scientific confirmation. Peter Carruthers and Stephen Pinker have attacked this analogy between science and ordinary inference. I examine their arguments and show that they fail. This does not show that Fodor’s more general position is correct.

Lisa Bortolotti argues convincingly that opponents of the doxastic view of delusion are committed to unnecessarily stringent standards for belief attribution. Folk psychology recognises many non-rational ways in which beliefs can be caused, and our attributions of delusions may be guided by a sense that delusions are beliefs that we cannot explain in any folk psychological terms.

This paper is a critical analysis of the concept of mental disorder recently advanced by Jerome Wakefield. Wakefield suggests that mental disorders are most aptly conceived as "harmful dysfunctions" involving two distinct and separable components: the failure of the mechanism in the person to perform a natural function for which the mechanism was designed by natural selection, and a value judgment that the dysfunction is undesirable.

Jennifer Radden argues that delusions play an important role in modernist epistemology, which is preoccupied with the justification and evaluation of beliefs. Another theme running through the book is the importance of culture for attribution of delusion. Beliefs that look delusional will not be treated as pathological if they are expressions of religious views or other culturally acceptable forms of life. It is hard to see why cultural acceptability should play a role in the modernist project of justification. I suggest (...) that we think less about a philosophical project of justification and turn our attention instead to commonsense judgements of the circumstances in which we see a belief as evidence of underlying pathology. I discuss cases in which unjustified beliefs are nonetheless treated as phenomena that are consistent with our views of how healthy human beings act, and suggest that alongside folk psychology we should acknowledge a folk epistemology that embraces such instances. I suggest that delusions are beliefs that folk epistemology treats as inexplicable, and that this approach solves some of the puzzles that Radden identifies as growing out of the modernist epistemic project. (shrink)

This chapter begins by sketching an account of morally responsible agency and the general conditions under which it may fail. We discuss how far individuals with psychiatric diagnoses may be exempt from morally responsible agency in the way that infants are, with examples drawn from a sample of diagnoses intended to make dierent issues salient. We further discuss a recent proposal that clinicians may hold patients responsible without blaming them for their acts. We also consider cognitively impaired subjects in the (...) light of related issues in moral and political theory, asking whether they have been unjustly excluded from liberal conceptions of political community due to their presumed lack of agency. (shrink)

Cooperation towards public goods relies on credible threats of punishment to deter cheats. However, punishing is costly, so it remains unclear who incurred the costs of enforcement in our evolutionary past. Theoretical work suggests that human cooperation may be promoted if people believe in supernatural punishment for moral transgressions. This theory is supported by new work in cognitive psychology and by anecdotal ethnographic evidence, but formal quantitative tests remain to be done. Using data from 186 societies around the globe, (...) I test whether the likelihood of supernatural punishment—indexed by the importance of moralizing “high gods”—is associated with cooperation. (shrink)

Representational theories of mind cannot individuate the sense modalities in a principled manner. According to representationalism, the phenomenal character of experiences is determined by their contents. The usual objection is that inverted qualia are possible, so the phenomenal character of experiences may vary independently of their contents. But the objection is inconclusive. It raises difficult questions about the metaphysics of secondary qualities and it is difficult to see whether or not inverted qualia are possible. This paper proposes an alternative test (...) of representationalism. Do experiences in different sense modalities have the same phenomenal character when they share content? Psychological work on the perception of shape through vision and spatial hearing is discussed. This work shows that visual and auditory experiences differ in phenomenal character even in so far as they represent similar properties. This objection to representationalism does not invite questions about secondary qualities or depend on establishing metaphysical possibilities. (shrink)

Wakefield's (2000) responses to our paper herein (Murphy and Woolfolk 2000) are not only unsuccessful, they force him into a position that leaves him unable to preserve any distinction between disorders and other problems. They also conflate distinct scientific concepts of function. Further, Wakefield fails to show that ascriptions of human dysfunction do not ineliminably involve values. -/- We suggest Wakefield is analyzing a concept that plays a role in commonsense thought and arguing that the task of science is to (...) identify the natural processes that accord with that commonsense concept. We argue that this represents an attempt to use conceptual analysis to legislate what should be acceptable science. We conclude that this constraint on science is unacceptable and that therefore Wakefield's overall position should be rejected. (shrink)

An examination of Ian Parker's definitions of discourse reveals them to be non-distinctive and of limited utility. It is argued that discourse analysis should be integrated with, rather than set against, social psychology. Discourse analysts should attend to the issues of the representativeness and generality of their evidence, should be wary of attributing causality to discourse, and should consider the advantages of systematically investigating, rather than asserting, the social consequences of the use of different discourses.

Through a collection of original essays from leading philosophical scholars, _Stich and His Critics_ provides a thorough assessment of the key themes in the career of philosopher Stephen Stich. Provides a collection of original essays from some of the world's most distinguished philosophers Explores some of philosophy's most hotly-debated contemporary topics, including mental representation, theory of mind, nativism, moral philosophy, and naturalized epistemology.

I distinguish three evolutionary explanations of mental illness: first, breakdowns in evolved computational systems; second, evolved systems performing their evolutionary function in a novel environment; third, evolved personality structures. I concentrate on the second and third explanations, as these are distinctive of an evolutionary psychopathology, with progressively less credulity in the light of the empirical evidence. General morals are drawn for evolutionary psychiatry.

This book is about the processing of information in face-to-face communication when a speaker makes both audible and visible information available to a perceiver. Both auditory and visual sources of information are evaluated and integrated to achieve speech perception. The evaluation of the information source provides information about the strength of alternative interpretations, rather than just all-or-none categorical information, as claimed by “categorical perception” theory. Information sources are evaluated independently; the integration process insures that the least ambiguous sources have the (...) most influences on the judgment. Similar processes occur in a variety of other behaviors, ranging from personality judgments and categorization to sentence interpretation and decision making. The experimental results are consistent with a fuzzy logical model of perception, positing three operations in perceptual (primary) recognition: feature evaluation, feature integration, and pattern classification. Continuously valued features are first evaluated, then integrated and matched against prototype descriptions in memory; finally, an identification decision is made on the basis of the relative goodness-of-match of the stimulus information with the relevant prototype descriptions. (shrink)

Empirical research on aesthetic response poses two challenges to philosophy. The more familiar challenge is that scientific explanations of aesthetic responses debunk what we take to be our reasons for those responses. One reaction to this challenge is an accommodation strategy that seeks to reconcile the scientific findings with an improved understanding of our normative reasons. This paper presents a more fundamental challenge: a well-established body of research in social psychology indicates that we routinely confabulate the reasons we give (...) for our aesthetic response. This challenges the accommodation strategy and suggests that philosophy should adopt a more radical naturalism about aesthetic response. (shrink)

It is widely assumed that the art media can be individuated with reference to the sense modalities. Different art media are perceived by means of different sense modalities, and this tells us what properties of each medium are aesthetically relevant. The case of pictures appears to fit this principle well, for pictures are deemed purely and paradigmatically visual representations. However, recent psychological studies show that congenitally and early blind people have the ability to interpret and make raised‐line drawings through touch. (...) This shows that pictures are not essentially visual representations. The view that pictures are essentially visual follows from influential views of the nature of depiction and of the nature of vision that are mistaken. By rooting out the mistake, we learn something about pictures, something about vision, and something about the doctrine that art media are individuated by the sense modalities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Is Psychiatry About?Dominic Murphy, PhD (bio)There are no such things as minds, but there are animate objects who behave differently from other types of natural entity. They move around under their own power, and some of their activity seems to be very different from that of other natural objects. Furthermore, some of our predictions about these objects are disproved in interesting ways; if we make a false prediction (...) we do not revise our best theory about how such things generally behave, but we instead conclude that there is something wrong with the object of the prediction. These intelligent unpredictable things need a special vocabulary, and mental talk has arisen to serve as that vocabulary. But since a mind is not a thing in nature we face the problem of saying what the sciences of the mind are actually about.There are, then, intelligent systems that can be judged pathological, and some of them are our conspecifics. It is fair to say that there is no agreement about how such judgments are made or should be made. The question of what a mental illness is part of this larger picture, and it raises several different issues.First, how should we think about our practices of judging deviance? It would be contrary to accepted practice to wear a swimsuit to a state funeral, but what sort of norms would it violate and what state of mind would we ascribe to somebody who did it? Second, what is the difference between a judgment of deviance and a judgment of pathology? We have many ways of distinguishing between types of deviance, and the lines between criminality, immorality and pathology, to take three examples, are not always easy to discern. Third, what makes an illness a mental illness? This is Gough's topic, and I will get to it in a moment, but it worth situating it within this broader framework which asks what we are doing when we make these judgments of norm-violation.Gough begins by quite correctly pointing out that if we look at the domain of psychiatry as currently understood, we would have a hard time seeing what it is supposed to be the science of. It is customary to see psychiatry as dealing with the mental but, as Gough notes, there are some mental processes that psychiatry does not deal with, and some processes that psychiatry deals with that are not mental. Gough's response to this problem is a very interesting one, which starts from the idea that the point of psychiatry is to help those who need it; how different do things look if we start from this position? Conley and Glackin (2021) argues that the practical and therapeutic aspirations of psychiatry should constrain our understanding of mental illness. Glackin argues that we should [End Page 41] see this 'norms-first' view, as I will call it, as part of a broader liberal-democratic conversation about the ways in which we should live togetherA view that starts with norms is typically opposed to the 'naturalist' position. A naturalist begins with positive facts as the basis for diagnostic concepts, on the grounds that our concepts of disease and health are supposed to answer to facts about the physical and mental constitution of human beings. Gough's view is neither a norms-first view or a naturalist's view. We could call it an institutionalist view, or, if we were being a bit less kind, an ostensive one—"these things here, that's mental illness."David Hull (1988) taught us that every science (indeed, every intellectual formation or tradition) needs to be understood in two ways. First, we have the theoretical commitments that are taken to define it. Second, there are the practices and institutions that separate its practitioners off from others. Contemporary evolutionary biology, for instance, is built on the twin foundations of the modern synthesis—Darwinian natural selection and Mendelian genetics. These two theoretical commitments have been transformed and adapted and supplemented in diverse ways so that their modern forms no longer resemble their originals very closely. Still, they continue as the central undertakings about the nature of the living world that modern... (shrink)

A study of culturally-embedded perceptual responses to aesthetic value indicates that learned perceptual capacities can secure compliance with social norms. We should therefore resist the temptation to draw a line between cognitive processes, such as perception, that can adapt to differences in physical environments, and cognitive processes, such as economic decision-making, that are shaped by social norms. Compliance with social norms is a result of perceptual learning when that same compliance modifies perceptible features of the physical environment.

Several recent books indicate that the philosophy of art has embarked upon a new alliance with cognitive science. One impetus for this is the move, beginning in the 70s and 80s, away from general aesthetics to a greater concern with the philosophies of the individual arts. Questions about the nature of art, expression, aesthetic experience and aesthetic properties as generic phenomena are still with us but many philosophers now approach them by means of specialized studies of music, literature, film, the (...) visual arts or the performing arts. Some claim that these questions can only be answered, or can best be answered, by studying the individual art forms. This has brought aesthetics into alignment with empirical research, which has always been concerned with individual art forms, for reasons having to do both with experimental design and with views of the mind as functionally differentiated. There is no psychological work on the perception of beauty, for example, but only on the perception of visual beauty, beauty in music and the like. Now that aesthetics is equally specialized, empirical research on the individual arts can be brought to bear upon familiar problems in aesthetics. (shrink)

What you see can shape how you feel, and the route from seeing to feeling sometimes involves empathy – as you might empathize with a woman you see grieving the death of her child. But empathy also comes from what you see in pictures. Bellini's Pieta? is one among many paintings, drawings, prints, and photographs that evoke empathy – and are designed to do so. Going further, it seems that episodes of empathy triggered by pictures can help build up a (...) person's capacity for empathic response. Indeed, they do so by fortifying the link between seeing and empathy in a distinctive way. To establish this thesis, we need a broad conception of empathic response and also the right conception of what we see in pictures. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Autonomy, Experience, and TherapyDominic Murphy (bio)The contemporary philosophical idea of autonomy has a psychological implication, to wit, that there exists a comprehensive set of ideal competences, realized in our mind/brain, that enable a person to be self-governing. Autonomy is normally accorded individuals who enjoy a certain kind of psychological functioning and, perhaps, a certain sort of psychological history (Christman 1991). We think that autonomous individuals critically evaluate their life (...) and actions, endorse them as self-determined rather than imposed from without, and guide their own lives in accordance with the plans and values they have worked out for themselves. Such self-government has to depend on some psychological structures, but philosophers have tended to theorize about what these structures might be at a considerable distance from what the behavioral sciences can tell us. Anderson and Lux's paper is a welcome contribution to the growing literature that tries to connect issues in ethics with empirical considerations. This sort of methodological, as opposed to merely metaphysical, naturalism, is only just coming into vogue in ethics, even in moral psychology.1 Anderson and Lux are, as far as I am aware, the first people to reflect seriously on what we can learn about autonomy from clinical experience. Theirs is a very suggestive and fruitful paper that looks at real-life cases of loss of autonomy and tries to reach conclusions about what the deficits in performance tell us about the psychological preconditions of autonomy. Their paper also opens the way for an investigation into the precise neurologic and computational underpinnings of these capacities, which is essential if we are to get a serious moral psychology underway.I find little to quarrel with in the story that Anderson and Lux tell, but I will try to modify it slightly to bring out what I think is the important psychological point they make and explore some ramifications. I begin by claiming that they have scored a decisive point in favor of an external conception of autonomy. Second, I suggest that what Anderson and Lux have really put their finger on is less a requirement of accurate self-assessment than a requirement of sensitivity to feedback from the environment. I conclude by raising some of these issues about the relations between autonomy and assessments of psychological function when the deficit responsible is less amenable to clear cut neurologic identification.The External Perspective on AutonomyOne way of taking the paper (although this goes beyond anything that Anderson and Lux suggest) is that there is a smooth naturalistic picture of the cognitive basis of autonomy. When people have a normally functioning neurocomputational setup in their heads, we should assume that they are autonomous, and vice versa. However, autonomy cannot simply be identifiable with a mind that is working as some scientific theory says it should, because a mind that is [End Page 303] in that sense working correctly could, nonetheless, be directed by forces other than the agent. Servile or deluded individuals might endorse their lives even if those lives are the product of indoctrination, self-deception, or internalized oppression (Mackinnon 1997; Mele 1995). Normal mechanisms of belief fixation, for example, may not foster one's autonomy if the only context in which they are exercised is one in which many possible ways of life are simply unavailable for consideration, having been excluded from consideration by the dominant forces around one. We might, then, think of full autonomy as depending on relational rather than intrinsic properties. Perhaps autonomy requires a subject to have both normal psychological capacities and the right sort of environment in which to exercise them. I do not follow-up on this suggestion, but I mention it because it introduces two dimensions, within the subject and around the subject, where the externalist perspective on autonomy can get a grip. I discuss the former, but I do not mean to suggest that the latter is not important. A full account must deal with both. But even the psychological structures that foster autonomy cannot be identified with a mind working according to some scientific theory, as we shall see.Many writers on autonomy argue that we must recognize appropriate, objective constraints... (shrink)

While nothing justifies atrocity, many perpetrators manifest cognitive impairments that profoundly degrade their capacity for moral judgment, and such impairments, we shall argue, preclude the attribution of moral responsibility.

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 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)

The representation of color by pictures raises worthwhile questions for philosophers and psychologists. Moreover, philosophers and psychologists interested in answering these questions will benefit by paying attention to each other's work. Failure to recognize the potential for interdisciplinary cooperation can be attributed to tacit acceptance of the resemblance theory of pictorial color. I argue that this theory is inadequate, so philosophers of art have work to do devising an alternative. At the same time, if the resemblance theory is false, then (...) color depiction has interesting implications for color science. Empirical researchers must rethink the widespread assumption that color recognition requires color constancy. I suggest that a neuropsychological account of color recognition will be instrumental to completing the philosophical task, but by the same token scientists might do well not to proceed without casting an eye to the work of philosophers of art. (shrink)

In theOrigin of the work of art, Heidegger claimed that the work of art opens to us thetruth of Being, the opening of the world. Two problematics arise from this. First, his idea of “world-disclosure” evoked a sense ofeverydayness(which captures, for me, the idea of credulism in perception). Second, the senses oftruth,Being, andworldare metaphysically condensed. Hence the question: how then could the “truth of Being” or the “world” that artworks reveal be experienced? Among other ways (mimesis, imagination, perception, etc.) by (...) which artworks are experienced, I choose to examine perception since it confirms this idea ofeverydayness. The questions that confront us to this effect are: can perception lead us into, to encounter, this world opened by artworks? Does the nervous/visual system suffice to enter into that world in which the artist invites us? This is where Richir becomes important. In response to the first problem, he shows that the “perception” (experience) of artworks is beyond mereeverydaynesssince artworks open for us a world that “never was” and “never will be” (i.e., “virtuality” and not a veridical sense ofeverydaynessas captured in the perceptive act that is object-related). This is because the material stuff or object given in perception is neutralized by thephantasiato become what Richir callsSache. ThisSacheis in itself a phenomenon that is disclosed in artworks. In response to the second problem, Richir shows how artworks cannot disclose just metaphysical categories ofBeing, truth, or world. The disclosure has to be phenomenological, corporeal, and affective. He therefore proposes another mode of “perception” beyondmere perceptionin a revolutionary interpretation of the husserlian “perceptive”phantasia.With this, he shows how the aforementioned metaphysical condensations are liveable in experience. I concretize this with an illustration from the theater. Finally, I suggest participation as a phenomenological approach that can make both Heidegger’s and Richir’s intuitions meaningful. (shrink)

Kendler and Schaffner have written an exemplary case study of the rise of the dopamine hypothesis and, if not its fall, at least its stagnation and transmutation. They bring out well both the state of the science and the opportunities offered by the theory to consider some famous philosophical theories of scientific progress. So well, in fact, have they done this, that I do not have a lot to say about it. I will just mention one or two points that (...) I found interesting, and then say a little about what looks to me like an omission from the story that the two Kens recount.One point they raise is the importance of competitor theories: now, there is supposed to be an old story about a quack who was apprehended during .. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Section on Psychedelics Research and TreatmentDominic SistiAgainst a backdrop of post-pandemic malaise, diseases of despair, and a fragmented mental health care system, psychedelics have enjoyed a resurgence of interest as powerful psychotherapeutic agents and as catalysts of personal growth. The true power of these substances—some of which are considered sacramental by Indigenous peoples—has been shrouded for half a century by cultural mythology, political propaganda, and (...) misuse. From about 1940 to 1970, psychedelics including psilocybin and LSD were studied and used by clinicians to treat a range of psychiatric disorders from alcoholism and depression in adults to "autistic schizophrenia" in children.In June 1971, the Nixon administration's racist and illiberal War on Drugs inaugurated what was essentially a total ban on psychedelics. Society was robbed of half a century of scientific progress, and one can only speculate how differently our society might now function, and how many people might have been spared the trauma of mental illness and incarceration. Thankfully, it appears the time has arrived for psychedelic medicines to be decriminalized and included again in the pharmacopeia.In June 2023, a group of psychedelic researchers, therapists, bioethicists, Indigenous scholars, and advocates met at the Banbury Conference Center at Cold Spring Harbor Laboratory. There, this interdisciplinary group discussed several pressing ethical issues in psychedelics research and treatment that continue to [End Page 114] challenge the field. The aim of this meeting was to develop a bioethical framework for the use of psychedelics in mainstream medical settings. That is, how should psychedelics be employed responsibly by everyday clinicians, including psychiatrists, psychologists, social workers, and other behavioral health-care providers? This special section offers a sampling of three topics in psychedelic bioethics raised by the Banbury group, several of whom appear as coauthors.In our first paper, Logan Neitzke-Spruill and colleagues offer an overview of explanatory models describing the therapeutic mechanisms of psychedelic substances and how each of these models generates unique ethical quandaries. Starting from molecular biology and moving to neural circuitry and networks, neurobiological models now propel contemporary scientific research into psychedelics. Knowing how these substances work on a molecular level may offer promising ways forward in the development of new molecules designed to treat serious mental illnesses and other neurologic conditions. Perhaps neuroplastic mechanisms will be harnessed to develop new therapies without necessitating a psychedelic trip—a controversial premise discussed in our third paper, by Katherine Cheung, Brian Earp, and David Yaden.Such "neuroreductionism" risks ignoring the subjective psychological and spiritual experiences of patients that appear to be pivotal in psychedelic-assisted therapy, often described as mystical and utterly transformative. At the psychological level, these substances engender a kind of vulnerability and suggestibility requiring clear ethical standards to ensure patients' psychological and physical safety. And so too, practitioners will need structural and cultural competency to recognize the spiritual or moral values that inspire patient reactions during and after their psychedelic experiences. Ethically informed psychedelic practitioners will have to navigate between disciplinary silos and explanatory models. One practical upshot is the open question of how best to train psychedelic practitioners who hold this broad set of competencies.To that end, well-trained practitioners will need to be able to disclose in some way the transformative properties of psychedelics to prepare patients for their experiences. But how does one describe the ineffable? This raises the question of how or if it is possible for patients to truly consent to the transformative experience elicited by psychedelics, often described as one of the most important experiences of a person's life. The experience might stimulate significant emotional healing, or it might be horrifying. This sounds like a problem uniquely attached to psychedelics: after all, most pharmaceuticals don't trigger changes in one's fundamental moral values, life choices, and commitments, nor are they intended to. Yet, Brent Kious, Andrew Peterson, and Amy McGuire challenge the view that the psychedelic experience is uniquely transformative and impervious to the disclosure requirements of informed consent, a bedrock of bioethics. Ultimately, the writers show how consent is possible even if the experiences are dramatically different from most medical interventions, endorsing a practical view of consent [End... (shrink)

Can metaphysics yield the consolations of philosophy? One possibility, defended by Derek Parfit, is that reflection on the nature of identity and time could diminish both fear of death and grief. In this paper, I assess the prospect of such consolation, focussing especially on attempts to console a grieving third party. A shift to a reductionist view of personal identity might mean that death is less threatening. However, there is some evidence to suggest that such a shift does not necessarily (...) translate into less death anxiety. Moreover, applied to grief at loss of another, such a perspective may be misdirected. A temporally neutral perspective offers a theoretically powerful way of reducing the sense of loss at being separated in time from a loved one. However, it is unclear whether it is psychologically possible to achieve. Even if it were possible, it may not diminish the pain of separation.I identify a serious challenge to philosophical consolation for grief. The greater the consolation that is offered, the greater the risk of losing important attachments and the less it may be psychologically accessible. (shrink)

Why do we understand media the way we do? Sometimes we think about media simply as means of communication and instruments of human creativity. At other times we understand media as powerful technologies that influence human culture and that can even govern how we think and act. Dominic Boyer grapples with these complexities in Understanding Media, where he questions what our different strategies of engaging media actually tell us about media, their messages and powers." "Understanding Media explores, in a serious (...) yet entertaining way, our common habits of thinking about the presence and significance of media in our lives. Offering analysis of the philosophical and social foundations of contemporary media theory as well as everyday strategies of knowing media, it addresses the advantages and limitations of different ways of understanding media. Boyer also reflects on the practical issue of how we can know media better than we do."--Jacket. (shrink)

Roger Shepard's creativity and scientific contributions have left an indelible mark on Psychology and Cognitive Science. In this tribute, I acknowledge and show how his approach to universal laws helped Oden and me shape and develop our universal law of pattern recognition, as formulated in the Fuzzy Logical Model of Perception (FLMP). [Shepard; Tenenbaum & Griffiths].

BackgroundThe experiences of UK ethnic minority healthcare workers are crucial to ameliorating the disproportionate COVID-19 infection rate and outcomes in the UKEM community. We conducted a qualitative study on UKEM healthcare workers’ perspectives on COVID-19 vaccine hesitancy in the UKEM community.MethodsParticipants were 15 UKEM healthcare workers. Data were collected using individual and joint interviews, and a focus group, and analyzed using thematic analysis.ResultsWe generated three themes: heterogeneity, mistrust, and mitigating. Therein, participants distinguished CVH in the UKEM community in educational attainment (...) and ethnicity. They pointed to the role of mistrust in CVH in the UKEM community. They opined that the mistrust underlying CVH in the UKEM community is rooted in history and religion, conspiracy theories, the speedy development and novelty of the vaccines, post-vaccination complications/side effects, false positive test results, and social media and social support/influence. Participants recommended that interventions targeted at mitigating CVH in the UKEM community need to, in a non-judgmental way, tackle dis/misinformation and provide education, and incorporate UKEM healthcare worker endorsement. They also suggested such interventions be community-oriented, enhance the convenience of vaccination centers and the possibility of vaccine choice, and appreciate that overcoming CVH and accepting vaccination is a gradual process involving personal assessment of risks and benefits.ConclusionCVH in the UKEM community is a multifaceted phenomenon requiring multicomponent interventions. (shrink)