In this article, I examine the relation between Bateson and Guattari’s ecological thoughts: two thinkers whose ecological ideas at first sight have a lot in common. In order to show the difference between the thoughts of both thinkers, I will take my clue from Guattari’s remark that he parts ways with Bateson on the role of context. Explaining the role of context in both authors will allow me to show how Guattari’s thought implies both an endorsement and a critique of (...) cybernetics, and, specifically, promoting a machinic rather than cybernetic ecology. I will conclude by indicating what is at stake in this distinction. (shrink)

It is currently common to conceive of the classic methodological individualism–holism debate in level terms. Accordingly, the dispute is taken to concern the proper level of explanations in the social sciences. In this paper, I argue that the debate is not apt to be characterized in level terms. The reason is that widely adopted notions of individualist explanations do not qualify as individual-level explanations because they span multiple levels. I defend this claim relative to supervenience, emergence, and other accounts of (...) the social world as levelled. Moreover, I discuss the consequences of this finding for the ongoing methodological individualism–holism debate. (shrink)

The field of mental health continues to struggle with the question of how best to structure its diagnostic systems. This issue is of considerable ethical importance, but the implications for public health approaches to mental health have yet to be explored in any detail. In this article I offer a preliminary treatment, drawing out several core issues while sounding a note of caution. A central strand of the debates over diagnosis has been the contrast between categorical and dimensional models, with (...) renewed attention due to recent publication of the DSM-5, launch of the RDoC, and ongoing work on the ICD-11. This dispute involves an interesting assortment of ethical and empirical considerations, many with direct relevance for public health. It has been proposed, for example, that dimensional diagnosis may be morally preferable because it can help reduce the stigma associated with mental disorder. This is a pressing concern, as preventive strategies are expanded in mental health, often operating under dimensional assumptions that target various risk factors. But this type of proposal relies upon an empirical claim and the scientific status of dimensionality remains unresolved, including its relation to stigma. I suggest, then, that the current state of the evidence does not yet warrant clear adjudication between competing frameworks, and thus any implications for public mental health remain highly provisional. More research is needed to help resolve these issues, including ethical analysis. (shrink)

An important volume connecting classical studies with feminism, Feminism and Ancient Philosophy provides an even-handed assessment of the ancient philosophers' discussions of women and explains which ancient views can be fruitful for feminist theorizing today. The papers in this anthology range from classical Greek philosophy through the Hellenistic period, with the predominance of essays focusing on topics such as the relation of reason and the emotions, the nature of emotions and desire, and related issues in moral psychology. The volume contains (...) some new, ground-breaking essays on Plato, Aristotle, and the Stoics, as well as previously published pieces by established scholars like Martha Nussbaum and Julia Annas. It promises to be of interest to an interdisciplinary audience including those working in classics, ancient philosophy, and feminist theory. (shrink)

In this paper, I examine a heretofore ignored critic of Descartes on the heterogeneity problem: Anton Wilhelm Amo. Looking at Amo’s critique of Descartes reveals a very clear case of a thinker who attempts to offer a causal system that is not a solution to the mind-body problem, but rather that transcends it. The focus of my discussion is Amo’s 1734 dissertation: The Apathy [ἀπάθεια] of the Human Mind or The Absence of Sensation and the Faculty of Sense in the (...) Human Mind and their Presence in our Organic and Living Body. Amo’s discussion of the interaction, or lack thereof, of the mind and body hinges on the essential feature he identifies for the human mind—apathy, that is, impassivity. In this work, Amo engages explicitly with Descartes’s writing, which allows us to more precisely see the nature of his agreement and disagreement with the Cartesian metaphysics of mind. I proceed by treating Amo’s five stated criteria for spirit-hood which, in turn, reveal the kinds of causal connections that are possible for embodied spirits on his view. My aim is threefold: To lay out what I take to be Amo’s view of and arguments for the five criteria he takes to be required for a substance to be spirit. To locate Amo’s agreement and disagreement with Descartes. To suggest that Amo’s view on mind-body interaction involves a kind of occasional causation. (shrink)

The common assumption is that if a group comprising moral agents can act intentionally, as a group, then the group itself can also be properly regarded as a moral agent with respect to that action. I argue, however, that this common assumption is the result of a problematic line of reasoning I refer to as “the collective fallacy.” Recognizing the collective fallacy as a fallacy allows us to see that if there are, in fact, irreducibly joint actors, then some of (...) them will lack the full-fledged moral agency of their members. The descriptivist question of whether a group can perform irreducibly joint intentional action need not rise and fall with the normative question of whether a group can be a moral agent. (shrink)

This is an overview of Davidson's theory of anomalous monism. Objections and replies are also detailed.

Given that the concept of coercion remains a central concern for bioethics, Quigley's (Monash Bioethics Rev 32:141–158, 2014) recent article provides a helpful analysis of its frequent misapplication in debates over the use of ‘nudges’. In this commentary I present a generally sympathetic response to Quigley’s argument while also raising several issues that are important for the larger debates about nudges and coercion. I focus on several closely related topics, including the definition of coercion, the role of empirical research, and (...) the normative concerns at the core of these disputes. I suggest that while a degree of precision is certainly required when deploying the relevant concepts, perhaps informed by empirical data, we need to continue to push these debates towards more pressing normative considerations. (shrink)

This chapter examines the core explanatory strategies of cognitive science and their application to the study of psychopathology. In addition to providing a taxonomy of different strategies, we illustrate their application, with special attention to Autism Spectrum Disorder and Major Depressive Disorder. We conclude by considering two challenges to the prospects of a developed cognitive science of psychopathology.

This article discusses what is involved in having full moral status, as opposed to a lesser degree of moral status and surveys different views of the grounds of moral status as well as the arguments for attributing a particular degree of moral status on the basis of those grounds.

In recent years there has been increased recognition of the global burden of mental disorders, which in turn has led to the expansion of preventive initiatives at the community and population levels. The application of such public health approaches to mental health raises a number of important ethical questions. The aim of this collection is to address these newly emerging issues, with special attention to the principle of prevention and the distinctive ethical challenges in mental health. The collection brings together (...) an interdisciplinary group of experts in bioethics, mental health, public health, and global health. (shrink)

Across the health sector there is increased recognition of the ethical significance of interventions that constrain or coerce. Much of the recent interest stems from debates in public health over the use of quarantines and active monitoring in response to epidemics, as well as the manipulation of information in the service of health promotion (or ‘nudges’). But perhaps the area in which these issues remain most pressing is mental health, where the spectre of involuntary treatment has always loomed large. Indeed, (...) there are good reasons to think of psychiatry as ethically exceptional given its broader role as social and legal arbiter. This is compounded by the fact that mental health treatment has other special features that can serve as potential entry points for more subtle forms of pressure and influence. These include the relative cognitive and emotional vulnerability of patients, the highly confidential information involved, and the importance of the therapeutic relationship. Thus the field of mental health needs to grapple with a range of closely related issues concerning the ethics of influence. In this chapter I explore several, with a primary focus on clinical concerns, although implications for research ethics are also touched on. Discussion of treatment pressure has traditionally focused on ‘coercion,’ or, very roughly, the use of threats or force to get someone to do something they otherwise would not. Here I follow suit, beginning with discussion of its conceptual standing alongside other categories of influence, including manipulation and persuasion. As it stands, there is nothing close to a consensus on these matters. But a relatively broad understanding of coercion is available and can be useful for ethical deliberation. Or so I suggest here. Interestingly enough, there is also a growing body of empirical literature on coercion in psychiatry, including research on the use of coercive measures such as hospitalization, physical restraint, and forced medication, as well as the construct of ‘perceived coercion,’ which tracks patients’ experiences of treatment pressure. I briefly describe several key findings and their relation to recent recommendations to reduce coercion. Building on all of this, I then take up the normative questions directly, by way of evaluating a recently proposed framework for the ethical analysis of influence. (shrink)

We propose the Selfish Goal model, which holds that a person's behavior is driven by psychological processes called goals that guide his or her behavior, at times in contradictory directions. Goals can operate both consciously and unconsciously, and when activated they can trigger downstream effects on a person's information processing and behavioral possibilities that promote only the attainment of goal end-states (and not necessarily the overall interests of the individual). Hence, goals influence a person as if the goals themselves were (...) selfish and interested only in their own completion. We argue that there is an evolutionary basis to believe that conscious goals evolved from unconscious and selfish forms of pursuit. This theoretical framework predicts the existence of unconscious goal processes capable of guiding behavior in the absence of conscious awareness and control (theautomaticity principle), the ability of the most motivating or active goal to constrain a person's information processing and behavior toward successful completion of that goal (thereconfiguration principle), structural similarities between conscious and unconscious goal pursuit (thesimilarity principle), and goal influences that produce apparent inconsistencies or counterintuitive behaviors in a person's behavior extended over time (theinconsistency principle). Thus, we argue that a person's behaviors are indirectly selected at the goal level but expressed (and comprehended) at the individual level. (shrink)

Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013–2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs) of the UN’s 2030 Agenda for Sustainable Development (...) (United Nations, 2015). The WHO’s Action Plan calls for several specific objectives and targets, with a focus on improving global mental health governance and service coverage. In contrast, the UN’s SDGs include only one goal specific to mental health, with a single indicator tracking suicide mortality rates. The discrepancy between the WHO and UN frameworks suggests a need for increased policy coherence. Improved global health governance can provide the basis for ensuring and accelerating progress in global mental health. (shrink)

In a recent article in this journal, Brian Alters argued that, given the many ways in which the nature of science is described and poor student responses to NOS instruments such as Nature of Scientific Knowledge Scale, Nature of Science Scale, Test on Understanding Science, and others, it is time for science educators to reconsider the standard lists of tenets for the NOS. Alters suggested that philosophers of science are authorities on the NOS and that consequently, it would be wise (...) to investigate their views of current NOS tenets. To that end, he conducted a survey of members of the Philosophy of Science Association, and, via various statistical techniques, made claims about the nature and extent of variation among philosophers of science regarding basic beliefs about the NOS. As three philosophers of science, we laud Alters’ attempt to understand philosophers of science’ view on the NOS. We believe, however, that his techniques for investigating this question are inappropriate and that consequently, several of his conclusions are unwarranted. In this comment, we will substantiate these criticisms. In addition, we will address some of the important questions that motivate Alters’ research and attempt to unravel the “byzantine complexity” of philosophical views about the NOS. We begin with our concerns regarding Alters’ research. We then provide a taxonomy of philosophic issues; and finally, we suggest some roles for philosophy of science in science teaching and the education of science teachers. (shrink)

When we consider early modern philosophers who engage with sceptical arguments, Nicolas Malebranche is not usually among the first names to come to mind. But, while Malebranche does not spend much time with this topic, the way in which he responds to it when he does is nevertheless valuable. This is because his response underlines the central role of a particular principle in his system: the utter dependence of all created things on God. In this paper, I argue that the (...) end of Malebranche’s engagement with scepticism in general is to show that it is a position, like atheism, that is only possible if one has a disordered imagination. And, importantly, one feature of a disordered imagination is the questioning or denial of what Malebranche takes to be a foundational principle of human knowledge: that we, and all other finite things, utterly depend on God for everything. (shrink)

The National Institutes of Health and other federal health agencies are considering establishing a national biobank to study the roles of genes and environment in human health. A preliminary public engagement study was conducted to assess public attitudes and concerns about the proposed biobank, including the expectations for return of individual research results. A total of 141 adults of different ages, incomes, genders, ethnicities, and races participated in 16 focus groups in six locations across the country. Focus group participants voiced (...) a strong desire to be able to access individual research results. Recognizing the wide range of possible research results from a large cohort study, they repeatedly and spontaneously suggested that cohort study participants be given ongoing choices as to which results they received. (shrink)

Despite widespread recognition that psychiatry would be better served by a classificatory system based on etiology rather than mere description, it goes without saying that much of the necessary work is yet to be done. In this chapter I take up the increasingly important question of how mechanistic explanation fits into the larger effort to build a scientifically sound etiological and nosological framework. I sketch a rough picture of what mechanistic explanation should look like in the context of psychiatric research, (...) with a focus on several potential challenges posed by the special features of many psychiatric conditions. These include the role of social and environmental factors, the relatively transient nature of symptoms, the presumably complex organization of underlying systems, and the likelihood that many disorders are the product of nonstandard development. I suggest that these explanatory challenges can be met with a sufficiently broad notion of mechanism, one that allows for something less than the flawless execution of internal operations, appeals to the influence of contextual factors, and attends to organizational relations both within the mechanism itself and across the wider cognitive system. (shrink)

Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift toward nonideal theory means for ethical curricula (...) within healthcare education. In particular, we contend that more attention to the particularities of historical and social context needs to be incorporated into bioethics training. To make this argument, we focus on two examples: teaching units on race and medicine and those that focus on stigma and coercion in mental health. For both, we show how a pedagogical approach in which educators focus on social injustice could influence how practitioners engage in ethics in the clinic. This chapter, then, demonstrates what a commitment to nonideal theory can mean practically when it comes to bioethics education. (shrink)

We believe that the task goal in voluntary movements provides meaning to existing information sources in the environment and determines, in a dynamic way, the use and relative importance of these different sources. This task-centered meaning bridges the apparent controversy between what information is available in principle (i.e., specification), and what information is perceived.

Nunez's description of the brain as a medium capable of wave propagation has provided some fundamental insights into its dynamics. This approach soon reaches the descriptive limits of the brain as a physical system, however. We point out some biological constraints which differentiate the brain from physical systems and we elaborate on its consequences for future research.

The most recent global refugee figures are staggering, with over 82.4 million people forcibly displaced and 26.4 million registered refugees. The ongoing conflict in Syria is a major contributor. After a decade of violence and destabilization, over 13.4million Syrians have been displaced, including 6.7 million internally displaced persons and 6.7 million refugees registered in other countries. Beyond the immediate political and economic challenges, an essential component of any response to this humanitarian crisis must be health-related, including policies and interventions specific (...) to mental health. This policy and practice review addresses refugee mental health in the context of the Syrian crisis, providing an update and overview of the current situation while exploring new initiatives in mental health research and global health policy that can help strengthen and expand services. Relevant global health policy frameworks are first briefly introduced, followed by a short summary of recent research on refugee mental health. We then provide an update on the current status of research, service provision, and health policy in the leading destinations for Syrians who have been forcibly displaced. This starts within Syria and then turns to Turkey, Lebanon, Jordan, and Germany. Finally, several general recommendations are discussed, including the pressing need for more data at each phase of migration, the expansion of integrated mental health services, and the explicit inclusion and prioritization of refugee mental health in national and global health policy. (shrink)

In this chapter we outline ethical issues raised by the application of public health approaches to the field of mental health. We first set out some of the basics of public health ethics that are particularly relevant to mental health, with special attention to the ongoing debate over the traditional presumption of non-infringement, increased recognition of the social determinants of health, and the concept of prevention. Then we turn to the moral particularities of mental health, focusing on questions concerning coercion (...) and treatment pressure, personal identity and sociocultural factors (including stigma), and unresolved conceptual and methodological issues in psychiatry that complicate its extension into the domain of public health. (shrink)

The application of human right frameworks is an increasingly important part of efforts to accelerate progress in global mental health. Much of this has been driven by several influential legal and policy instruments, most notably the United Nations’ Convention on the Rights of Persons with Disabilities, as well as the World Health Organization’s QualityRights Tool Kit and Mental Health Action Plan. Despite these significant developments, however, much more needs to be done to prevent human rights violations. This chapter focuses on (...) a critical component of this broader challenge, which is the question of how best to regulate and reduce the use of coercive measures. The recent literature on coercion in psychiatry – which addresses involuntary commitment, seclusion, restraint, and forced medication – represents a useful resource that can help guide tractable solutions in global mental health. These issues are evaluated from the perspective of global health governance, and several general recommendations are made in order to improve monitoring and enforcement, provide guidance for domestic legislative reform, and strengthen health systems. (shrink)

The topic of coercion has a long and contentious history in both political philosophy and medical ethics. This substantial literature centers on two fundamental questions: What is coercion? And when is it justified? In the context of psychiatry there has been a recent upsurge of interest in coercion, with particular focus on the latter question. For example, a number of research groups have been investigating the relationship between coercion and clinical outcomes. But of course such research relies heavily on assumptions (...) about the former question, that of the concept of coercion. Coercion is often tracked in these studies by various measures of “perceived coercion,” in response to the recognition that involuntary legal status is a poor gauge of the presence of coercion. A result of this approach is that empirical research has started to provide an interesting picture of a variety of coercive pressures and experiences. And these newly emerging findings, in turn, underscore the need for further conceptual analysis. The aim of this paper, then, is to draw out provisional implications for philosophical debates about coercion from recent research in psychiatry. (shrink)

Background: The aim of this study was to investigate associations between demographic and clinical variables and duration of untreated psychosis (DUP) in a sample of cases of psychosis across an adult early intervention in psychosis service and a child and adolescent community team. Method: Cross-sectional baseline data for cases of psychosis across the two teams on the caseload at a given time point were collected, including age of onset, gender, ethnicity, referral route, and DUP. Results: The median DUP across the (...) entire sample was 91 days, while those patients with initial treatment for psychosis from the child and adolescent team had a median DUP of 69 days. Using multiple linear regression, there were two variables that showed a significant association with DUP: referral route (p < .001), and age of onset, with earlier age of onset associated with shorter DUP (p = .015). Conclusion: These findings are discussed in relation to possible explanatory factors, with particular focus on service-level variables and pathways to care. It is suggested that the involvement of child and adolescent teams is vital to the work of early intervention in psychosis services. (shrink)

Recent cognitive models of delusions have attempted to explain why delusions are commonly circumscribed, in that they tend to center on isolated beliefs, and incorrigible, as they often persist in the face of countervailing evidence. In this effort, the suggestion has been made that ‘modularity’ – a concept originating in seminal accounts of the architecture of perceptual and cognitive processes – may help explain delusions. The aim of this paper is to take up this suggestion, critically evaluating the applicability of (...) modularity and its attendant features to the explanation of delusions. The conclusion presented here is that although a modular explanation of delusions may be relatively consistent with models that implicate dysfunctional cognitive components such as motor control and ‘theory of mind’ (ToM) systems, ultimately the application of modularity to delusions conflicts with traditional understandings of cognitive architecture and does not help provide satisfactory or sufficient explanations of delusional symptomatology. (shrink)

Narcissism continues to be an important topic of research, with a great deal of ongoing empirical work in social and personality psychology. But there are theoretical issues that have received less attention recently, including those that relate to the foundational theories of the psychoanalytic tradition. As the first step in a larger project of reevaluation, this article offers a critical review of Freud and Heinz Kohut’s theories of narcissism. Centered on a theoretical reconstruction, it clarifies several significant – and often (...) underspecified – features of each account. I also explore the continuities and discontinuities between these two closely related systems. Most notably, both Freud and Kohut lacked fully developed accounts of primary narcissism and the relevant instinctual drives. At the same time, Kohut’s theory expanded upon Freud’s in innovative ways, particularly with its emphasis on a secondary line of narcissistic development that has positive, transformative features. In the final section, however, I introduce a speculative reading that describes theoretical prefigurations of these features in elements of Freud’s structural theory. (shrink)

Acknowledgments THROUGHOUT this book I cite the many people who have provided information on individual programs and activities. ...

Recent debates about inequality have focused almost exclusively on the distribution of wealth and disparities in income, but little notice has been paid to the distribution of free time. Free time is commonly assumed to be a matter of personal preference, a good that one chooses to have more or less of. Even if there is unequal access to free time, the cause and solution are presumed to lie with the resources of income and wealth. In Free Time, Julie (...) Rose argues that these views are fundamentally mistaken. First, Rose contends that free time is a resource, like money, that one needs in order to pursue chosen ends. Further, realizing a just distribution of income and wealth is not sufficient to ensure a fair distribution of free time. Because of this, anyone concerned with distributive justice must attend to the distribution of free time. On the basis of widely held liberal principles, Rose explains why citizens are entitled to free time—time not committed to meeting life's necessities and instead available for chosen pursuits. The novel argument that the just society must guarantee all citizens their fair share of free time provides principled grounds to address critical policy choices, including work hours regulations, Sunday closing laws, public support for caregiving, and the pursuit of economic growth. Delving into an original topic that touches everyone, Free Time demonstrates why all citizens have, in the words of early labor reformers, a right to "hours for what we will.". (shrink)

Some interesting exceptions notwithstanding, the traditional logic of economic efficiency has long favored hierarchical forms of organization and disfavored democracy in business. What does the balance of arguments look like, however, when values besides efficient revenue production are brought into the picture? The question is not hypothetical: In recent years, an ever increasing number of corporations have developed and adopted socially responsible behaviors, thereby hybridizing aspects of corporate businesses and social organizations. We argue that the joint pursuit of financial and (...) social objectives warrants significant rethinking of organizational democracy’s merits compared both to hierarchy and to non-democratic alternatives to hierarchy. In making this argument, we draw on an extensive literature review to document the relative lack of substantive discussion of organizational democracy since 1960. And we draw lessons from political theory, suggesting that the success of political democracy in integrating diverse values offers some grounds for asserting parallel virtues in the business case. (shrink)

Julie K. Ward examines Aristotle's thought regarding how language informs our views of what is real. First she places Aristotle's theory in its historical and philosophical contexts in relation to Plato and Speusippus. Ward then explores Aristotle's theory of language as it is deployed in several works, including Ethics, Topics, Physics, and Metaphysics, so as to consider its relation to dialectical practice and scientific explanation as Aristotle conceived it.