Wittgenstein’s concepts shed light on the phenomenon of schizophrenia in at least three different ways: with a view to empathy, scientific explanation, or philosophical clarification. I consider two different “positive” wittgensteinian accounts―Campbell’s idea that delusions involve a mechanism of which different framework propositions are parts, Sass’ proposal that the schizophrenic patient can be described as a solipsist, and a Rhodes’ and Gipp’s account, where epistemic aspects of schizophrenia are explained as failures in the ordinary background of certainties. I argue that (...) none of them amounts to empathic-phenomenological understanding, but they provide examples of how philosophical concepts can contribute to scientific explanation, and to philosophical clarification respectively. (shrink)

Recently, there has been increasing interest in methodological aspects of advanced imaging, including the role of guidelines, recommendations, and experts’ consensus, the practice of self-referral, and the risk of diagnostic procedure overuse. In a recent Delphi study of the European Association for Nuclear Medicine (EANM), panelists were asked to give their opinion on 47 scientific questions about imaging in prostate cancer. Nine additional questions exploring the experts’ attitudes and opinions relating to the procedure of consensus building itself were also included. (...) The purpose was to provide insights into the mechanism of recommendation choice and consensus building as seen from the experts’ point of view. Results: Regarding the factors likely to influence the willingness to refer a patient for imaging, the most voted were incorporation into guidelines and data from scientific literature, while personal experience and personal relationship were chosen by a small minority. Regarding the recommendations more relevant to prescribe an imaging procedure, it resulted the incorporation into guidelines promoted by scientific societies (59% of votes); these guidelines also resulted the more trusted. With respect to patients’ preferences considered when prescribing an imaging procedure, the most voted was accuracy, resulted more important than easy access and time to access to the procedure. The majority of the experts expressed the opinion that there is a scarce use of imaging procedures in prostate cancer. With respect to the most relevant factor to build consensus, it resulted the transparency of the process (52% of votes), followed by multidisciplinarity of contributors. The main obstacle to incorporation of modern imaging procedures into guidelines resulted the lack of primary literature on clinical impact. Conclusions: Firstly, the panelists portray themselves as having Evidence-Based Medicine oriented and scientifically inclined attitudes and preferences. Secondly, guidelines and recommendations from scientific societies, especially clinical ones, are positively taken into account as factors influencing decisions, but panelists tend to consider their own appraisal of the scientific literature as more relevant. Thirdly, in respect of overuse, panelists do not think that advanced diagnostic procedures are overutilized in the specific case of Prostate Cancer, but rather they are underutilized. (shrink)

Classical philosophical notions, such as conceptual truth, analyticity, and a priori knowledge, have recently re-entered the mainstream philosophical debate, after fifty years of depreciation. This paper illustrates how such notions are reintroduced and discussed in a current debate on the nature of concepts, along with the idea that a concept is individuated by an implicit definition. This traditional Neopositivist device has recently been redeployed by writers such as Peacocke, Horwich, and Boghossian. Implicit definitions raise a variety of interesting issues, from (...) semantics to epistemology: how can they succeed in fixing a concept’s semantic property, if not by convention? are they analytic, in the Quinean sense? Do they provide with a priori knowledge? Which constraints are appropriate, for some formulation genuinely to pick up the semantic property of a concept?. (shrink)

This paper explores the possibility of resisting meaning scepticism – the thesis that there are many alternative incompatible assignments of reference to each of our terms - by appealing to the idea that the nature of reference is to maximize knowledge. If the reference relation is a knowledge maximizing-relation, then some candidate referents are privileged among the others - i.e., those referents we are in a position to know about – and a positive reason against meaning scepticism is thus individuated. (...) A knowledge-maximizing principle on the nature of reference was proposed by Williamson in a recent paper (Williamson 2005). According to Williamson, such a principle would count as a defeasible reason for thinking that most of our beliefs tend to be true. My paper reverses Williamson’s dialectic, and argues that reference is knowledge-maximizing from the premise that most of our beliefs tend to be true. (shrink)

Una sintetica introduzione alle principali questioni etiche e filosofiche riguardanti la comunicazione sanitaria: la comunicazione fra medico e paziente e quella fra istituzioni, sanitari e cittadini. In uno scenario in cui autonomia e consenso della persona sono sempre più rilevanti nelle scelte di cura e di tutela della salute, l’autrice delinea un quadro concettuale aggiornato per affrontare temi problematici come la comunicazione della diagnosi, l’impostazione delle campagne di prevenzione e salute pubblica, il ruolo dei medici come esperti nei media. -/- (...) Indice del volume: Introduzione. - I. Concetti per la bioetica. - II. La comunicazione tra medico e paziente. - 3. La comunicazione delle istituzioni sanitarie. - IV. Gli esperti e i media nella comunicazione della salute. - Riferimenti bibliografici. - Indice analitico. -/- . (shrink)

At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a certain extent, for diagnosis, is the DSM, now at its fifth edition. The main reasons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative failure of the project of finding biomarkers for most mental disorders. Descriptivism has also the advantage of (...) capturing the phenomenology of mental disorders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descriptive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

Le controversie nosologiche in psichiatria siano orientate da ragioni sia epistemiche che non epistemiche, da questioni di evidenza ma anche di etica e sociologia della scienza, data la presenza di vari programmi di ricerca, di metodologie e anche di agenti differenti che si focalizzano sul problema del disturbo mentale. I due casi qui brevemente considerati, quello della Disposofobia e quello del Disturbo di personalità narcisistica mostrano, assieme al ruolo dell’evidenza empirica, da un lato il peso delle ragioni etiche dei gruppi (...) di pazienti e di quelle culturali della società allargata, dall’altro le dinamiche del consenso tra esperti. Che i disturbi mentali siano o non siano generi naturali, la loro classificazione è un processo razionale complesso che comprende norme e deviazioni dalle norme di diverso tipo. (shrink)

Abstract: At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a cer- tain extent, for diagnosis, is the DSM, now at its fifth edition. The main rea- sons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative fail- ure of the project of finding biomarkers for most mental disorders. Descrip- tivism (...) has also the advantage of capturing the phenomenology of mental dis- orders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descrip- tive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders included the Social Communication Disorder as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of Autism Spectrum Disorder. This (...) opens up the possibility that individuals with very similar symptoms can be diagnosed differently and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography. (shrink)

Riassunto: In questo contributo analizzeremo il criterio del danno, presente nella definizione generale di disturbo mentale del DSM. La questione ha rilevanza sia da un punto di vista filosofico, perché il danno è una componente normativa e valoriale, non oggettiva, sia da un punto di vista clinico, perché chi ha difeso il criterio del danno ha spesso sostenuto che in sua assenza avremmo troppi falsi positivi. Infine, ha importanza dal punto di vista socio-sanitario in relazione al rapporto tra la psichiatria (...) e la medicina non psichiatrica, nello specifico tra il DSM e l’ICD. Sosterremo che ci sono buone ragioni per non mantenere il danno come criterio necessario nella definizione generale del disturbo mentale. Dopo una breve introduzione, forniremo una panoramica storica sul ruolo del criterio del danno nelle varie edizioni del DSM. Successivamente si illustrerà la principale obiezione contro l’inclusione del criterio del danno nella definizione generale di disturbo mentale, ossia il problema dei falsi negativi, per poi presentare e discutere ulteriori ragioni – medico-pratiche e concettuali – che depongono a sfavore dell’attribuzione di un forte peso al criterio del danno. In sede conclusiva ribadiamo come la decisione presa dalla task force del DSM-5 di escludere il criterio del danno dalla definizione generale di disturbo mentale debba essere sostenuta. Parole chiave: Danno; Disabilità; Disagio; Disturbo mentale; DSM “Harm” as Criterion for the Definition of Mental Disease in DSM. Some Epistemological Reflections: In this paper, we analyse the harm requirement in the general definition of mental disorder in the Diagnostic and Statistical Manual for Mental Disorders. This issue has both philosophical and clinical relevance: on the one hand the harm requirement is a normative, value-laden, non-objective component in the definition of mental disorder; on the other hand, the harm requirement has often been defended on the grounds that it prevents an increase in false positives. The issue is also important in assessing the relationship between psychiatry and somatic medicine, more precisely, between the DSM and the International Classification of Diseases. We argue that there are good reasons not to maintain the harm requirement in the general definition of mental disorder. After a brief introduction, we overview the history of the harm requirement across the various editions of the DSM. Then, we examine the main objection to the inclusion of the harm requirement in the general definition of mental disorder, that is, the problem of false negatives, and also present several other points – both practical and conceptual – that help demonstrate why the harm requirement is inadequate as a definiens of mental disorder. To conclude, we stress that the decision of the DSM-5 task force not to regard the harm requirement as a necessary component of mental disorder should be endorsed. Keywords: Harm; Disability, Distress; Mental Disorder; DSM. (shrink)

This is the first comprehensive translation of the expanded French version of E.F.F. Chladni's Traité d'Acoustique, using Chladni's 1802 Die Akustik for reference and clarification. Chladni's experiments and observations with sound and vibrations profoundly influenced the development of the field of Acoustics. The famous Chladni diagrams along with other observations are contained in Die Akustik, published in German in 1802 and Traité d'Acoustique, a greatly expanded version, published in French in 1809. The present translation was undertaken by Robert T. Beyer, (...) PhD (1920-2008), noted acoustician, Professor of Physics at Brown University, and Gold Medal recipient of the Acoustical Society of America. Along with many other projects completed over the course of his career, Dr. Beyer translated Von Neumann's seminal work, Mathematical Foundations of Quantum Mechanics from the original German, spent 30 years translating Russian physics treatises and journals, served as editor of the English translation of the Soviet Journal of Experimental and Theoretical Physics, and also authored Sounds of our Times: Two Hundred Years of Acoustics. Represents the first comprehensive English translation of a seminal work in acoustics Translated by a prominent acoustician, and former Gold Medal recipient of the Acoustical Society of America In addition to the classic experiments with glass plates and violin bows, covers topics in music, architecture, and anatomy of human and animal hearing Appeals to a wide audience in physics, acoustics, and history of science. (shrink)

A critical study of McPeck's recent book, in which he strengthens and develops his arguments against teaching critical thinking (CT). Accepting McPeck's basic claim that there is no unitary skill of reasoning or thinking, I argue that his strictures on CT courses or programs do not follow. I set out what I consider the proper justification that programs in CT have to meet, and argue both that McPeck demands much more than is required, and also that it is plausible that (...) this deflated justification can be met. Specitically, I argue that it is reasonable to expect transfer of learning for basic logical skills. Additional topics covered include: the relation ofliberal education to critical thinking, argument analysis, testing for CT, and the value of conceptual or linguistic analysis. (shrink)

In R. C. Flickinger's (3rd ed. second impression 1929) we read on pp. 171In the iambic trimeters written by Aeschylus a trisyllabic substitution (tribrach, anapaest or dactyl) for the pure disyllabic iambus occurs only once in about twenty-five verses.Tragic Drama of the Greekstrimeters’ lines like.

M. Tullius Cicero was the first among the Roman thinkers, who made the pro_blematic of culture and civilization his serious concern. His investigations led him to the belief that the culture, seen as a whole of traditions, norms and values, is in_separable from artes, i. e. the spiritual phenomena in science and art. From his awarness of the necesssity to create the Roman culture in this sense of inseparability resulted his ambitious philosophical project: the Romans should accept the spiritual experience (...) of the Greeks and develop it in philosophical writings in Latin language. To all doubts and prejudices hostile to this intention he thus responded by philosophical and linguistic writings based on his conviction, that the Latin language is able to express even the most complicated philosophical ideas and concepts and that the human interaction is possible. (shrink)

While restating the correct interpretation of the prologue to the Hecyra of Terence in CQ 32 , 134 F. H. Sandbach has this to say: ‘Possibly the widespread view which the translators and I reject has been encouraged by disbelief that the theatre could be used for gladiatorial combat. It is true that there is no reliable evidence for such use at Rome, for Donatus' statement “hoc abhorret a nostra consuetudine uerumtamen apud antiquos gladiatores in theatro spectabantur” may be no (...) more than inference from Terence's text.’ There is, in fact, a certain amount of evidence for gladiatorial combats in the theatres at Rome, that is at venues where ludi scaenici were performed, which it is difficult to regard as unreliable and which is consistent with what we know of the relationship between the theatre and gladiatorial games. (shrink)