In order to enhance the “structural competency” of medicine—the capability of clinicians to address social and institutional determinants of their patients’ health—physicians need a theoretical lens to see how social conditions influence health and how they might address them. We consider one such theoretical lens, fundamental cause theory, and propose how it might contribute to a more structurally competent medical profession. We first describe fundamental cause theory and how it makes the social causes of disease and health visible. We then (...) outline the sorts of “fundamental interventions” that physicians might make in order to address the fundamental causes. (shrink)

This paper traces the unspoken, implicit white racial logic of the brain disease model of addiction, which is based on seemingly universal, disembodied brains devoid of social or environmental influences. In the United States, this implicit white logic led to “context-free” neuroscience that made the social hierarchies of addiction and its consequences invisible to, and thus exacerbated by, national policies on opioids. The brain disease model of addiction was selectively deployed among the white middle-class population that had long accessed narcotics (...) and pharmaceutical treatments for narcotics disorders from biomedical clinics, as opposed to from illegal sources subject to law enforcement. In turn, new treatments for opioid addiction were racially marketed to the same white clientele to which newly patented opioid analgesics were marketed, tapping into a circumscribed but highly lucrative consumer base that has long benefited from a legally protected, racially segregated safe space for white narcotics consumption. The connecting thread for the contemporary white opioid “crisis,” therefore, is white race as a ghost variable in addiction neuroscience and in its pharmaceutical and biotechnological translation. (shrink)

Problem: Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Approach: Beginning in 2001, Yale School of Medicine has held annual “Power Day” workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within (...) the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Outcome: Emerging narrative themes included the potential impact of small acts and students feeling “mute” and “complicit” in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. Next Steps: The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word “power” due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

The aim of this essay is to reflect on the place and importance of the question of address and to show how it comes to the fore in Søren Kierkegaard’s writings. What shall be attempted, with regard to Kierkegaard’s already widely recognized renown as an existential thinker, is to catch a glimpse of issues that make up the larger background in which the question of address is embedded. In doing so, the essay explores several features of Kierkegaard’s inquiry into the (...) question of existence in the Concluding Unscientific Postscript and connect them with the notion of the reader. This latter notion provides a way of understanding the singularity of voice, while offering an account of the testimony to existence. After a brief recapitulation, the essay identifies in conclusion unresolved issues relating to speech, silence, confidentiality, and listening. (shrink)

An anthology of the most important historical sources, classical and modern, on the subjects of presumptions and burdens of proof In the last fifty years, the study of argumentation has become one of the most exciting intellectual crossroads in the modern academy. Two of the most central concepts of argumentation theory are presumptions and burdens of proof. Their functions have been explicitly recognized in legal theory since the middle ages, but their pervasive presence in all forms of argumentation and in (...) inquiries beyond the law--including politics, science, religion, philosophy, and interpersonal communication--have been the object of study since the nineteenth century. However, the documents and essays central to any discussion of presumptions and burdens of proof as devices of argumentation are scattered across a variety of remote sources in rhetoric, law, and philosophy. Presumptions and Burdens of Proof: An Anthology of Argumentation and the Law brings together for the first time key texts relating to the history of the theory of presumptions along with contemporary studies that identify and give insight into the issues facing students and scholars today. The collection's first half contains historical sources and begins with excerpts from Aristotle's Topics and goes on to include the locus classicus chapter from Bishop Whately's crucial Elements of Rhetoric as well as later reactions to Whately's views. The second half of the collection contains contemporary essays by contributors from the fields of law, philosophy, rhetoric, and argumentation and communication theory. These essays explore contemporary understandings of presumptions and burdens of proof and their role in numerous contexts today. This anthology is the definitive resource on the subject of these crucial rhetorical modes and will be a vital resource to all scholars of communication and rhetoric, as well as legal scholars and practicing jurists. (shrink)

This essay aims to outline in what ways Kierkegaard’s thinking of existence not only brings into view a concept of existence, but, more fundamentally, enables one to locate an opening to questioning anew the relation of thinking and existence. This thinking of existence does not seek to dissolve existence into knowledge but aims at intensifying the question of a thinking grounded not in the conclusion made in “an external relation between a knower and a non-knower” of which non-knowledge is the (...) negative determination of knowledge, but rather of a thinking grounded in existence. (shrink)

Two core motivational systems have been conceptualized as underlying emotion and behavior. The approach system drives the organism toward stimuli or events in the environment, and the avoidance system instead deters the organism away from these stimuli or events. This approach—avoidance dichotomy has been central to theories of emotion. Advances in neuroscience complementing well-designed behavioral experiments have begun to elucidate the neural mechanisms underlying approach—avoidance motivation, suggesting that these two systems exist in parallel and are lateralized in the brain. This (...) review explores the notion of approach—avoidance and the cerebral lateralization of these motivational tendencies. (shrink)

[1]. [no special title] -- 2. [no special title].

A careful reading of Plato's works show that Thrasymachus and Callicles, his famous immoralists, are unselfconsciously devoted to virtue as they see it. They thereby offer surprising support for the view that people are not simply self-interested, and they cast light on the beliefs and hopes we all have of justice.

In this essay I will examine the various ways in which the concept of decision emerges in the writings of Kierkegaard focusing mainly on the Philosophical Fragments and the Postscript. This prepares the way for revisiting Kierkegaard’s concept of decision. Doing so indicates the radical way in which Kierkegaard connects the concept of decision to an aporia. The crucial existential concept of decision not only concerns the difficulty, or even the impasse, pertaining to knowledge, but also relates to the question (...) of how the singular finds his or her own way through existence. (shrink)

Although written more than 2,500 years ago and within a radically different culture, the Tao Te Ching's concepts and teachings have become more influential in the West than ever before. Laozi, the Chinese sage and founder of Taoism, sets out a path (tao) that allows us to tune in to the nature of the universe. His axioms are intended to help us achieve transcendence and a life of integrity and balance: they explore the importance of male and female complementary qualities (...) while praising self-knowledge and criticizing rational understanding. Among his insights are the beliefs that flexibility and suppleness are superior to rigidity and strength, and that self-absorption and self-importance are vain and destructive. This illustrated edition of a classic work is an essential addition to any home library of the world's classic philosophical texts. (shrink)

The social construction of space -- The anatomy of taste -- Towards a theory of cultural practice --Fields of cultural production -- Cultural practice, reflexivity and political action.

Gilles de la Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterised by the presence of motor and vocal tics. Patients with malignant TS experience severe disease sequelae; risking morbidity and mortality due to tics, self-harm, psychiatric comorbidities and suicide. By definition, those cases termed ‘malignant’ are refractory to all conventional psychiatric and pharmacological regimens. In these instances, deep brain stimulation (DBS) may be efficacious. Current 2015 guidelines recommend a 6-month period absent of suicidal ideation before DBS is offered to (...) patients with TS. We therefore wondered whether it may be ethically justifiable to offer DBS to a minor with malignant TS. We begin with a discussion of non-maleficence and beneficence. New evidence suggests that suicide risk in young patients with TS has been underestimated. In turn, DBS may represent an invaluable opportunity for children with malignant TS to secure future safety, independence and fulfilment. Postponing treatment is associated with additional risks. Ultimately, we assert this unique risk-benefit calculus justifies offering DBS to paediatric patients with malignant TS. A multidisciplinary team of clinicians must determine whether DBS is in the best interest of their individual patients. We conclude with a suggestion for future TS-DBS guidelines regarding suicidal ideation. The importance of informed consent and assent is underscored. (shrink)

Provability, Computability and Reflection.

La science du bien et du mal n'a jamais existé, et si Platon s'en désolait, nous avons cessé, nous, les Modernes, de nous en offusquer. Et pourtant, des questions d'ordre éthique nous sont incessamment posées aujourd'hui, ni plus ni moins que par le passé: quelles valeurs morales devons-nous promouvoir à l'école? Est-il acceptable d'abandonner à leur sort les familles de migrants fuyant la guerre? Notre pays, la France, doit-il intervenir militairement contre tel ou tel État dit "terroriste"?, etc. Face à (...) de telles interrogations, nous ne pouvons nous contenter de suspendre notre jugement sous couvert de relativisme ("À chacun sa conception du bien et du mal"). Prenant appui sur les réflexions de grands philosophes et théologiens face au défi du mal, tout en interrogeant la montée de nouvelles formes de violences au XXIe siècle, Laurence Hansen-Love pose la question: le bien et le mal sont-ils vraiment des notions obsolètes? Une fois récusée la fausse évidence d'une symétrie entre le bien et le mal, il est possible de prendre acte de la préséance du mal sur le bien. Dès lors, la certitude du mal, posée comme un fait, cesse de contredire l'incertitude du bien, à laquelle il apparaît sage de se résoudre."--Page 4 of cover. (shrink)

Yoga is the exercise of choice for so many because it makes you feel great in body and mind. But modern images of yoga have long featured the same kinds of bodies--white, slim, young, cis-gendered, able. Harmony Willow Hansen knows that a celebration of every kind of body brings more joy and inclusivity to all of us. She has been drawing joyful people in practice for years, creating a presence on Instagram that reaches hundreds of thousands of yoga lovers. (...) Her figures include older people, trans people, differently-abled people, people in different body types and weights. Harmony's art is all about bodies where anyone can find themselves and feel seen. Here are an array of positions including beginner poses, seated and low poses, lying down poses, standing poses, and partner poses, as well as prenatal and children's poses and flow. Readers will share in the ease and confidence that radiate from these yogis. An ideal gift for any yoga lover."--Amazon. (shrink)

Studie je zaměřena na proces interpretace textu, přičemž sleduje jev nazvaný „iracionální interpretace“. Protiklad racionální – iracionální chápe na základě konceptu Donalda Davidsona, a vychází tedy více z filosofie jazyka a mysli nežli z psychologie. Iracionalita interpretace spočívá v nesoudržnosti přesvědčení interpreta, tedy v narušení logických vazeb mezi jeho jednotlivými přesvědčeními. Na konkrétních příkladech je ukázáno, jak k takovému stavu mysli interpretujícího subjektu může dojít a jaký vliv má na porozumění celému textu. Pojem iracionální interpretace je uvažován na pozadí celé (...) sítě vztahů – interpreta k textu, k autorovi, ke kontextu a k tradici. Tyto vztahy jsou zachyceny pomocí několika schémat zakládajících se na Davidsonových modelech triangulace. Tyto modely ovšem podstatným způsobem modifikuje. Klíčová slova: interpretace – iracionalita – přesvědčení – vnitřní nesoudržnost – triangulace. (shrink)

Worin liegt die Bedeutung randständiger Dinge für kulturbildende Prozesse? Der Band untersucht ästhetische Entwürfe und theoretische Konzeptualisierungen materieller Peripherien vom 19. Jahrhundert bis in die Gegenwart. Diese werden anhand spezifischer Objekt- und Materialkategorien wie Plunder, Lumpen, Müll oder Makulatur verhandelt und differenziert. Indem literatur-, sozial- und kulturwissenschaftliche Perspektiven miteinander verbunden werden, findet eine interdisziplinäre Bearbeitung des Themas statt. Erörtert werden historisch variable Funktionen, die randständige Materialitäten in poetologischen, soziologischen und politischen Kontexten durch kulturell forcierte Auf- und Abwertungsakte übernehmen. Das Ausloten (...) von Darstellungsmöglichkeiten und -grenzen gesellschaftlich marginalisierter Dinge legt zudem ihr besonderes ästhetisches Potenzial frei."--Back cover. (shrink)

Meaning systems and psychological suffering -- Conceptualizations of meaning system -- Meaning systems and mental health culture -- Contemporary culture and objectification -- Training for talk therapists.

The book consists of three problem areas which are all connected with the question of creativity, esp. in gthe arts and poetry: It is about the ancient mythopoetic concept of the muses and their collision with the beloved of the poet, about the authority crisis of authorship and the dominance of the author over his creatures and fictional characters as well as their revolt against the father of the text and about a typ of creating and writing which acts against (...) all genetic traditions of authorship in the form of conception and birth, genealogical derivation. In this sense the, anti-generic' creativity doesn't originate and invent a work of art or a cultural phenomenon: the anti-generic product is something made, something constructed and not fgenerated, manufactured and not breed. This anti-oedupus-concept workts in a widespread tradition of the arts and literature, starting from our heroes of deconstructed narrative as Sterne's or Diderot's, over the classics of european realism Dostoevski or Flaubert until Nabokov and his, pregnant muse' Lolita. Wenn es ums Schaffen geht oder gar ums Schöpferische, liegt nichts so nahe wie das scheinbar unerschöpfliche Feld der Geburtsmetaphern, das Reden vom Zeugen und Empfangen, vom Austragen und Gebären eines Werkes, das für das Kind steht - ja dieses gar ersetzen soll. Die in diesem Band versammelten Überlegungen verknüpfen drei Problemkreise: Es geht um die Projektionsfigur der Musen und ihrer Kollision mit der Dichtergeliebten, um die permanente Autoritätskrise im Verhältnis des Autors zu seinen eigenen Geschöpfen und um die Entdeckung eines Kunstschaffens und Schreibens, das alle genetischen wie generischen Modi der Hervorbringung gegen den Strich dichtet und also konsequent antigenerisch verfährt. Vorgeführt werden diese drei Problemkreise an klassischen Texten des antigenerischen. Zuletzt bleibt die Frage nach den Musen der Musen und den Paradoxa der Dame Dichterin mit Blick auf ihre Inspirationsquellen. (shrink)

This book explores how a sense of wonder and the musicality of silence can be a rehumanizing force in education, health and welfare, countering overly anthropocentric and instrumental worldviews. Wonder - in an aesthetic, philosophical, and spiritual sense - brings human beings in resonance with the world again.

The purpose of the research is to explicate the Buddhist principles of ethical analysis of premeditated murder as an immoral act. The author solves this problem through the method of case study of exegetical treatises of outstanding Buddhist thinkers Vasubandhu (4th-5th centuries) and Yašomitra (8th century). It is shown that the ethical analysis of premeditated murder is based on a religious anthropological concept (the Buddhist doctrine of human action producing karmic retribution). Sinful intent is interpreted as an immoral mental urge (...) that generated a verbal intention to take the life of a certain person or a certain animal. According to the canonical point of view, there are three mental roots of immoral acts - greed, hatred, ignorance. The ethnical analysis of sinful intent is aimed at determining the connection of intent with any of these three mental phenomena. In accordance with this principle, Buddhist thinkers have identified three types of premeditated murder. All of them produce a “black” (unfavorable) karmic fruit, i.e. an unfortunate form of rebirth, exacerbating physical suffering. Great attention is paid by the author to the problem of the karmic responsibility of individuals ordering murders and the executors of such orders. In the considered sources, the verbal order to kill and its physical execution are interpreted as equally immoral actions that produce collective karmic responsibility. The author of the research examines in detail a special class of premeditated murder, fraught with inevitable infernal retribution. This class includes murders of benefactors (mother, father, arhat) and Buddhist ascetics practicing asceticism. These malicious sins were interpreted as an insurmountable obstacle to achieving a soteriological goal, even in the distant transcendental future. It is shown that Buddhist exegetes have developed principles for diagnosing these sins and characterized the immoral personal characteristics of sinners (disrespect towards parents, Buddhist preachers and religious ascetics, heretical denial of spiritual values, shamelessness, arrogance, ignorant self-will, misanthropy). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 57-62 [Access article in PDF] Listening to People Or Listening to Prozac?Another Consideration of Causal Classifications Jennifer Hansen Keywords causal classification, descriptivism, melancholia, neurasthenia, depression, cultural relativism. The shape and detail of depression have gone through a thousand cartwheels, and the treatment of depression has alternated between the ridiculous and the sublime, but the excessive sleeping, inadequate eating, suicidiality, withdrawal from social (...) interaction, and relentless despair are all as old as the hill tribes, if not as old as the hills. In the years since man achieved the capacity for self-reference, shame has come and gone; treatments for bodily complaints have alternated and crossed with treatments for spiritual ones; pleas to external gods have echoed pleas to internal demons. To understand the history of depression is to understand the invention of human being as we now know and are him. Our Prozac-popping, cognitively focused, semi-alienated postmodernity is only a stage in the ongoing understanding and control of mood and character. (Solomon 2001, 286) ALTHOUGH ANDREW SOLOMON clearly believes that "the shape and detail of depression have gone through a thousand cartwheels," Jennifer Radden gives us pause before assuming that depression is just another name for Dame Melancholy. Solomon's claim depends on a deeper metaphysical claim about the nature of depression and its causes. The current method of psychiatric nosology, descriptivism, does not necessarily support equating melancholia and depression. Furthermore, it appears that adopting descriptivism as the sole method of classifying mental disorders commits us to cultural relativist psychiatry. Below I reconsider whether we want to rule out causal classifications and suggest that embracing both descriptivism and causal classifications offer us greater possibilities in understanding human illness and culture.Although the occasion for Jennifer Radden's essay is to investigate whether or not melancholia and depression refer to the same thing, her essay detours into a consideration of extra-descriptivist models of psychiatric illness versus the descriptivism of current psychiatric nosology. This detour turns out to be warranted; her purely academic question yields to a timelier question concerning the proper methodology for classifying mental disorders. Whereas debates about psychiatric nosology are perennial, the recent success of the new generation of antidepressants [End Page 57] is reviving biological psychiatry and its search for the neurochemical origins of depression. Hence, embedded in Radden's question concerning whether or not melancholia is the same thing as clinical depression, is another important question concerning the causes of mental illness, particularly depression.Currently, with its descriptivist approach, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not classify mental illness, such as clinical depression, based on underlying causes. The cluster of symptoms and behavioral signs that lead a clinician to diagnose one as depressed that are contained in either the DSM or the International Classification of Diseases (ICD) may be too fuzzy or elusive to give any clear distinction between major depression, mild depression, and the blues. For example, one group of epidemiologists points out that [t]he DSM-III, DSM-III-R, and DSM-IV acknowledge that depression, like many mental disorders, has no currently obvious natural classes... If natural classes of depression exist, then their nosology awaits the discovery of distinct and reliable genetic, biological, clinical, or other predictors of risk, severity, or clinical course. Clinicians have a tradition of separating depressions into subtypes; however, this subtyping has not yet led to clear-cut delineations of syndromes in populations. (Kaelber 1995, 4) The evidence is still insufficient to establish the biological or psychological origins of depression. Although many theories exist that explain why people become depressed, scientifically we are not yet in a position to determine which is the right theory. From a pragmatic perspective, however, whether or not we know what causes depression, we can nonetheless attempt to alleviate suffering from depression. And it is with this goal in mind that the DSM-IV and ICD-10 classify mental disorders.Now, given that our current methodology for psychiatric nosology does not establish causes, it is also insufficient for determining what... (shrink)

Les auteurs du présent ouvrage nous proposent une manière originale de se réapproprier l'histoire de la philosophie. Par le dialogue, les philosophes de la tradition semblent revivre pour faire le point sur leur cheminement. Socrate, Kant, Marx, Arendt et bien d'autres répondent aux questions de Laure Becdelièvre, Laurence Hansen-Löve et Fabien Lamouche. Au fil de ces conversations imaginaires, nous découvrons comment l'esprit de résistance a pu s'incarner à travers les figures de penseurs aussi profonds que subtils et aussi novateurs (...) qu'insoumis."--Résumé de l'éditeur. (shrink)

In this article we refine the design of context shifting experiments, which play a central role in contextualist debates, and we subject a large number of scenarios involving different types of expressions of interest to contextualists, including ‘know’ and color adjectives like ‘green’, to experimental investigation. Our experiment (i) reveals an effect of changing contexts on the evaluation of uses of the sentences that we examine, thereby overturning the absence of results reported in previous experimental studies (so‐called null results), (ii) (...) uncovers evidence for a ‘truth bias' in favor of positive over negative sentences, and (iii) reveals previously unnoticed distinctions between the strength of the contextual effects displayed by scenarios involving knowledge ascriptions and scenarios concerning color and other miscellaneous scenarios. (shrink)

Existing research on the formation of employee ethical climate perceptions focuses mainly on organization characteristics as antecedents, and although other constructs have been considered, these constructs have typically been studied in isolation. Thus, our understanding of the context in which ethical climate perceptions develop is incomplete. To address this limitation, we build upon the work of Rupp to develop and test a multi-experience model of ethical climate which links aspects of the corporate social responsibility, ethics, justice, and trust literatures and (...) helps to explain how employees’ ethical climate perceptions form. We argue that in forming ethical climate perceptions, employees consider the actions or characteristics of a complex web of actors. Specifically, we propose that employees look outward at how communities are impacted by their organization’s actions, upward to make inferences about the ethicality of leaders in their organizations, and inward at their own propensity to trust others as they form their perceptions. Using a multiple-wave field study conducted at a privately held US corporation, we find substantial evidence in support of our model. (shrink)

This important book examines how the growing field of cybernetic psychology - the study of the creative complexity of the mind - can be applied to a range of different realms, tapping into the unconscious potential within us all. Cybernetic psychology integrates theories from various schools of thought, bringing them together in one unified theory. First developed and described by Danish author and psychotherapist Ole Vedfelt. It can be used in therapeutic practice, in relation to learning and pedagogics, and as (...) a tool for better leadership. The 15 chapters within this volume apply the theory to these as well as other areas, including ecology, creativity, mindfulness and scientific enquiry itself. Insightful and wide-ranging, the book will appeal to psychotherapists and those working within mental health, as well as students and researchers across Education, Psychology and beyond. (shrink)