A child’s death is a profound loss for mothers and affects hundreds of thousands of women. Mothers report inconsolable and progressive grief that is distinct from depression and impacts daily emotions and functions. The brain mechanisms responsible for this relatively common and profound mental health problem are unclear, hampering its clinical recognition and care. In an initial exploration of this condition, we used resting state functional MRI (fMRI) scans to examine functional connectivity in key circuits, and task-based fMRI to examine (...) brain network activity in grieving mothers in response to pictures of their deceased child and as well as recognizable deceased celebrities and unfamiliar individuals. We compared nine mothers who had lost an adult child and aged-matched control mothers with a living child of a similar age. Additionally, we collected diffusion imaging scans to probe structural connectivity and complemented the imaging studies with neuropsychological assessments. Increased functional activation in Ventral Attention/Salience Networks accompanied by a reduced activation in the medial prefrontal cortex in response to the deceased child’s picture robustly distinguished the grieving mothers from controls. Heightened resting-state functional connectivity between the paraventricular thalamic nucleus (PVT) and the amygdala distinguished the grieving mothers from the controls and correlated with subjective grief severity. Structurally, maternal grief and its severity were associated with alterations in corticolimbic white matter tracts. Finally, grieving mothers performed worse than controls on neuropsychological tests of learning, memory, and executive function, linked with grief severity. Reduced activation in cortical regions inhibiting emotions and changes in the PVT circuitry—a region involved in long-term emotional memories and decision making under conflict—distinguish grieving mothers from controls. Notably, the magnitude of neurobiological changes correlates with the subjective severity of grief. Together, these new discoveries delineate a prevalent and under-recognized mental health syndrome and chart a path for its appreciation and care. (shrink)

Kerstein and Bognar (2010) and Persad, Wertheimer, and Emanuel (2009) defend specific principles for the allocation of health care resources, but their choice of principles is influenced by the exa...

Susser and Cabrera (2024) assess the role of bespoke neuro-privacy regulations including the creation of a novel right to mental privacy. They argue that focusing on what distinguishes mental priva...

"Psychiatry and Philosophy of Science" explores conceptual issues in psychiatry from the perspective of analytic philosophy of science. Through an examination of those features of psychiatry that distinguish it from other sciences - for example, its contested subject matter, its particular modes of explanation, its multiple different theoretical frameworks, and its research links with big business - Rachel Cooper explores some of the many conceptual, metaphysical and epistemological issues that arise in psychiatry. She shows how these pose interesting challenges for (...) the philosopher of science while also showing how ideas from the philosophy of science can help to solve conceptual problems within psychiatry. Cooper's discussion ranges over such topics as the nature of mental illnesses, the treatment decisions and diagnostic categories of psychiatry, the case-history as a form of explanation, how psychiatry might be value-laden, the claim that psychiatry is a multi-paradigm science, the distortion of psychiatric research by pharmaceutical industries, as well as engaging with the fundamental question whether the mind is reducible to something at the physical level. "Psychiatry and Philosophy of Science" demonstrates that cross-disciplinary contact between philosophy of science and psychiatry can be immensely productive for both subjects and it will be required reading for mental health professionals and philosophers alike. (shrink)

Psychedelic-assisted Psychotherapy combines the use of psychedelic compounds, such as psilocybin, with psychotherapy. PAP has shown some promise as a novel treatment for Major Depressive Disorder, and empirical research suggests that its efficacy turns on the altered states induced by psychedelic compounds. In this paper we draw on the literature of phenomenology to explain the therapeutic potential of psychedelic experiences. Svenaeus characterises mental illness as a form of suffering that entails three distinct but related experiences of alienation or “unhomelike being-in-the-world”: (...) illness suffering, which relates to embodiment; existential suffering, which relates to self-narratives, and political suffering, which relates to social relationships. Ratcliffe further characterises the experience of MDD in phenomenological terms as a loss of pre-intentional possibility that manifests as excessive noematic feeling in the experience of embodiment, restrictive narratives in the construction of self, and disconnectedness in experience of the social world. We contend that PAP ameliorates the suffering associated with MDD by inducing and consolidating a state of broadened pre-intentional possibility—one that entails sudden, profound and enduring changes in embodiment, self-narratives, and social experience. We argue further that this phenomenological account is consistent with a bio-psycho-social model of mental health and illness, and we frame it as an argument supporting the plausibility of recent claims about treatment success. This helps to justify ongoing future empirical research in this setting. (shrink)

Artificial intelligence (AI) and its introduction into clinical pathways presents an array of ethical issues that are being discussed in the JME. 1–7 The development of AI technologies that can produce text that will pass plagiarism detectors 8 and are capable of appearing to be written by a human author 9 present new issues for medical ethics. One set of worries concerns authorship and whether it will now be possible to know that an author or student in fact produced submitted (...) work. That seems likely to be a general worry for secondary and higher education, as well as for all academic journals. Thus far generative AI chatbots do not seem to be able to produce a fully referenced and well-argued ethics article, but they probably could generate a blog or student essay that would... (shrink)

Historically, the care of hospitalized children has evolved from being performed in isolation from parents to a situation where the parents and the child are regarded as a unit, and parents and nurses as equal partners in the child’s care. Parents are totally dependent on professionals’ knowledge and expertise, while nurses are dependent on the children’s emotional connection with their parents in order to provide optimal care. Even when interdependency exists, nurses as professionals hold the power to decide whether and (...) to what extent parents should be involved in their child’s care. This article focuses on nurses’ responsibility to act ethically and reflectively in a collaborative partnership with parents. To illuminate the issue of nurses as moral practitioners, we present an observation of contemporary child care, and discuss it from the perspective of the Danish moral philosopher KE Løgstrup and his book The ethical demand. (shrink)

Notions of research quality are contextual in many respects: they vary between fields of research, between review contexts and between policy contexts. Yet, the role of these co-existing notions in research, and in research policy, is poorly understood. In this paper we offer a novel framework to study and understand research quality across three key dimensions. First, we distinguish between quality notions that originate in research fields and in research policy spaces. Second, drawing on existing studies, we identify three attributes (...) considered important for ‘good research’: its originality/novelty, plausibility/reliability, and value or usefulness. Third, we identify five different sites where notions of research quality emerge, are contested and institutionalised: researchers themselves, knowledge communities, research organisations, funding agencies and national policy arenas. We argue that the framework helps us understand processes and mechanisms through which ‘good research’ is recognised as well as tensions arising from the co-existence of conflicting quality notions. (shrink)

This book explores the theories of transhumanism and posthumanism, two philosophies that deal with radically changing bodies, minds, and even the nature of humanity itself.

Psychopaths have emotional and rational impairments that can be expressed in persistent criminal behaviour. UK and US law has not traditionally excused disordered individuals for their crimes citing these impairments as a cause for their criminal behaviour. Until now, the discussion of whether psychopaths are morally responsible for their behaviour has usually taken place in the realm of philosophy. However, in recent years, this debate has been informed by scientific and psychiatric advancements, fundamentally so with the development of Robert Hare's (...) diagnostic tool, the Psychopathy Checklist. Responsibility and Psychopathy explores the moral responsibility of psychopaths. It engages with problems at the interface between law, psychiatry, and philosophy, and is divided into three parts offering relevant interdisciplinary background information to address this main problem. The first part discusses the public policy and legal responses to psychopathy. It offers an introduction to the central practical issue of how public policy should respond to psychopathy, providing insights for those arguing about the responsibility of psychopaths. The second part introduces recent scientific advancements in the classification, description, explanation, and treatment of psychopathy. The third part of the volume includes chapters covering the most significant dimensions of philosophical debate on the moral and criminal responsibility of psychopaths. (shrink)

Fake news is a scourge within modern society, brought about by foreign powers amplifying messages throughout the recently constructed echo chambers of social media and exacerbated by the lack of co...

The recent renaissance in research on psychedelic-assisted psychotherapy is showing great promise for the treatment of many psychiatric conditions. Interestingly, therapeutic outcomes for patients undergoing these treatments are predicted by the occurrence of a mystical experience—an experience characterised in part by a sense of profound meaning. This has led to hypotheses that psychedelic-assisted psychotherapy is therapeutic because it enhances perception of meaning, and consequently leads to a meaning response. The putative mechanism of action of psychedelics as meaning enhancers raises normative (...) ethical questions as to whether it can be justified to pharmacologically increase the perception of meaning in order to heal patients. Using the perspectives of hedonistic moral theories, this paper argues that if psychedelics operate as meaning enhancers, psychedelic-assisted psychotherapy can be ethically justified. An anti-hedonistic objection is presented by applying Robert Nozick’s Experience Machine thought experiment to the case of psychedelic-assisted psychotherapy. However, it is argued that this objection falls short for two reasons. First, even if pleasure and pain are not the only consequences which have moral value they are not morally irrelevant, therefore, therapeutic meaning enhancement can still be justified in cases of extreme suffering. Second, it is possible that psychedelic states of consciousness do not represent a false reality, hence their therapeutic meaning enhancement is not problematic according to Nozick’s standards. (shrink)

A report by the Nuffield Council on Bioethics, contrary to the Declaration of Helsinki, permits most important research initiatives in developing countries.The Ethics of Research Related to Health Care in Developing Countries by the Nuffield Council on Bioethics makes a number of innovative recommendations that depart from codes such as the Declaration of Helsinki. It recommends that standards of care might be relativised to the standard of that nation. It recommends that very good reasons need to be given for not (...) giving post-trial access to medications but recognises that there may be justifiable instances of this. It is the view of the authors that these and other recommendations of the report are sensible pieces of advice given the complexities of the developing world. (shrink)

Ritual circumcision of infant boys is controversial in Norway, as in many other countries. The procedure became a part of Norwegian public health services in 2015. A new law opened for conscientious objection to the procedure. We have studied physicians’ refusals to perform ritual circumcision as an issue of professional ethics. Qualitative interview study with 10 urologists who refused to perform ritual circumcision from six Norwegian public hospitals. Interviews were recorded and transcribed, then analysed with systematic text condensation, a qualitative (...) analysis framework. The physicians are unanimous in grounding their opposition to the procedure in professional standards and norms, based on fundamental tenets of professional ethics. While there is homogeneity in the group when it comes to this reasoning, there are significant variations as to how deeply the matter touches the urologists on a personal level. About half of them connect their stance to their personal integrity, and state that performing the procedure would go against their conscience and lead to pangs of conscience. It is argued that professional moral norms sometimes might become more or less ‘integrated’ in the professional’s core moral values and moral identity. If this is the case, then the distinction between conscience-based and professional refusals to certain healthcare services cannot be drawn as sharply as it has been. (shrink)

Research using explicit measures has linked decreased positive future thinking, but not increased negative future thinking, with clinical depression. However, individuals may be unable or unwilling to express thoughts about the future, and can be unaware of implicit beliefs that can influence their behavior. Implicit measures of cognition may shed light on the role of future thinking in depression. To our knowledge, the current study presents the first implicit measure of positive and negative future thinking. A sample of 71 volunteers (...) completed both implicit and explicit measures of positive and negative future thinking. The findings indicate differences in the evaluation of both positive and negative future events between the two groups. However, group differences were more pronounced on the implicit measure. These findings point to the potential utility of an implicit measure of future thinking in mental health research and clinical practice. (shrink)

Most studies on the reception of Darwinism in France focus on the scientific community. This essay investigates the popular press. Widely discussed in French newspapers in 1878, Darwinism was connected with a sensational murder case in which two well-educated young men, Aimé Barré and Paul Lebiez, killed an elderly woman. Before his arrest, Lebiez had given a public lecture on the Darwinian “struggle for life.” Competing factions of the press explicitly linked the case with Darwinism to advance either conservative or (...) republican political agendas, which brought Darwinism into the public eye. This essay argues that Charles Darwin’s instrumentalization was decisive in spreading his theory in French society. That same year, the Academy of Sciences elected Darwin to membership after six failed attempts. (shrink)

We are living in a world which is severely crisis-ridden and faces some major challenges. The fact that we are currently facing a genuine global pandemic brings about even more uncertainty. The social and political institutions, which emerged and consolidated during the 20th century, and which created stability, have become fragile. The young generation born in the 1990s and onwards have experienced 9/11 and the ‘war against terrorism’, the financial crisis of 2008, changes to climate, environmental degradation, and most recently (...) the COVID-19 pandemic. The generation born between 1960 and 1990 have had the same experiences along with severe economic crises in the 1970s and 1980s and the Cold War. Some of these challenges are in different ways intertwined with capitalism and its crises, while others are linked to the rapid development of new technologies, in particular innovations within communication and information technologies. This introduction lists the most important grand challenges facing the world as they have emerged more recently. The five articles following this introduction address some of these challenges, with particular attention to the problems of capitalism and democracy and the relation between these two areas. Most authors agree that climate change and the destruction of the environment are the biggest and most pertinent problems to address, but it is their stance that we can only meet these challenges if democracy is functioning well. (shrink)

This article deals with science content “in the making” and in particular the role of the body in producing scientific phenomena. While accounts of scientists’ work have repeatedly demonstrated, how producing phenomena requires immense amounts of time and effort, involving tinkering and manual labor, this is a little empirically studied content in science education. Seeking to shed light on how the body is involved with materiality to produce physics phenomena, and in what terms this is learning physics content, the article (...) first examines how bodily tinkering is a necessary part of knowing physics through reviewing major accounts of science studies and research in science education. Secondly, drawing on phenomenology and pragmatist ideas, the article examines how students’ bodies need to be educated in the transactional process with material and artifacts to produce phenomena in the context of science learning in lower secondary physics education. Demonstrating that embodied phenomena production is an inescapable part of learning scientific inquiry, and that bodies are just as much a part of the subject physics as conceptual knowledge, we suggest that the education of students’ bodies needs to be made an explicit content. This is important not only for making tacit content accessible to all, but also for addressing epistemological understandings of what science and technology is about. (shrink)

Empirical research in bioethics has developed rapidly over the past decade, but has largely eschewed the use of technology-driven methodologies. We propose “design bioethics” as an area of conjoined theoretical and methodological innovation in the field, working across bioethics, health sciences and human-centred technological design. We demonstrate the potential of digital tools, particularly purpose-built digital games, to align with theoretical frameworks in bioethics for empirical research, integrating context, narrative and embodiment in moral decision-making. Purpose-built digital tools can engender situated engagement (...) with bioethical questions; can achieve such engagement at scale; and can access groups traditionally under-represented in bioethics research and theory. If developed and used with appropriate rigor, tools motivated by “design bioethics” could offer unique insights into new and familiar normative and empirical issues in the field. (shrink)

While the UK Home Office’s proposals to preventively detain people with what it has called dangerous severe personality disorder have been subjected to debate and criticism the deeply troubling jurisprudential issues in these proposals have not yet entered into public debate in a way that their seriousness deserves.1 It is good that a commentator as well known as Professor Szasz is speaking out on this issue.Professor Szasz focuses upon a crucial question by calling into question the medicalisation of terms like (...) dangerousness and mental illness.2 There is a great temptation for legislators and the public to treat these terms as if they are purely scientific terms and to think of risk assessment as a precise science. I don’t share Professor’s Szasz’s worry about how psychiatry is using these terms but I think there are some important questions about how these concepts function in the public sphere.This issue is important enough to justify the use of some rhetorical claims because such claims can serve to bring out what are neglected and important issues. In raising the following objections I am not attempting to refute the message that is in Szasz’s article or to say that he is not making an important point but rather to attempt to sharpen the issues and to suggest ways that we can respond to Professor Szasz’s challenge.Psychiatry has progressed in a number of ways since Professor Szasz wrote The Myth of Mental Illness.3 The science is much better, we have much better medications, and psychiatrists are acutely aware of the tension between treating their patient and their obligations to the public interest.So when Professor Szasz says: “Psychiatrists offer to relieve the disturbed person of the burden of coping …. (shrink)

International Studies in the Philosophy of Science, Volume 25, Issue 1, Page 92-95, March 2011.

NICE, the draft fertility guideline and dodging the big question: should fertility treatment be provided by the NHS?In August of this year the National Institute for Clinical Excellence made its draft guideline on fertility treatment available for consultation.1 As has been widely reported in the media the draft guideline recommends that the National Health Service should provide publicly funded fertility treatment in a consistent way across England and Wales. The guideline recommends that three cycles of IVF should be available when (...) “The woman is within the optimal range for in vitro fertilisation and there is an appropriately diagnosed cause of infertility of any duration, or unexplained infertility of at least three years’ duration .Those who need fertility treatment will celebrate the guideline, as will many fertility clinics. The guideline does not, however, address key questions that will be obvious to many. Is fertility treatment the kind of thing that ought to be available on the NHS? Will the inevitable increase in demand mean that resources are directed away from other services? Is fertility treatment really the same kind of intervention as heart or hip replacement surgery?My view is that there are good reasons for doing what we can to help people access fertility services. Most of us will start a family and for those of us who do it is probably the most important of all of our life projects. Given that social status and wealth can be significant obstacles to many of the things that people would like to do with their lives, the fact that most of us are able to pursue this important life project is good from an egalitarian …. (shrink)

O trabalho analisa o marketing da candidatura Rio 2016, Live your passion e os discursos em torno da reforma urbana entendida como “legado” para o Rio de Janeiro dos Jogos Olímpicos de 2016. Argumenta que o discurso legitimador das remoções nas favelas começa a ser construído na candidatura com o discurso do legado e, adiante, com o do bom governo da cidade integrada via políticas públicas. Lançando mão da noção foucaultiana de biopoder, conclui que as atuais intervenções urbanísticas legitimam ações (...) de segregação social na cidade. (shrink)

Eugenicists in the 1930s and 1940s emphasised our moral responsibilities to future generations and the importance of positively selecting traits that would benefit humanity. In 1935 Herbert Brewer recommended ‘Eutelegenesis’ so that that future generations are not only protected from hereditary disease but also become more intelligent and fraternal than us. The development of these techniques for human use and animal husbandry was the catalyst for the cross fertilization of moral ideas and the development of a critical procreative morality. While (...) eugenicists argued for a new critical morality, religious critics argued against artificial insemination because of its potential to damage important moral institutions. The tension between critical and conservative procreative morality is a feature of the contemporary debates about reproductive technologies. This and some of the other aspects of the early and contemporary debates about artificial insemination and reproductive technologies are discussed in this article. (shrink)

The Social Value Judgments consultation document reveals NICE’s failure to understand its role in healthcare prioritisationThe National Institute for Health and Clinical Excellence has published a draft guideline, Social Value Judgments: Guidelines for the Institute and its Advisory Bodies , which outlines the ethical framework that will guide its decision making in the future.1 NICE guidance has a profound effect upon the delivery of health care within the National Health Service so it is crucial that an overarching guideline such as (...) this is suited to the task that it needs to perform. In this paper we argue that NICE has misunderstood the way in which its advice fits into prioritisation decisions. This misunderstanding is amplified by its views about the ethical principles that should apply to prioritisation and, in particular, its failure to appreciate the role of fair processes in prioritisation.The national and international standing of NICE means that the definitive version of Social Value Judgments: Guidelines for the Institute and its Advisory Bodies is likely to have influence beyond the institute itself. There is much to welcome about the document, not least the acknowledgement that there are important ethical dimensions to NICE’s decision making. Indeed, the significance of the document lies in the fact that NICE is attempting to create an explicit ethical framework for funding decisions.There is, however, much that is of concern. Although John Harris has made some important points about the NICE position on age and sex,2 there are other important problems that need to be discussed. First, there appears to be confusion over the nature of the funding decisions taken by NICE and, as a result, the role of its guideline. It is of vital importance that professionals and public alike understand the precise nature of …. (shrink)

Adjustments of everyday life in order to prevent disease or treat illness afflict partly unconscious preferences and cultural expectations that are often difficult to change. How should one, in medical contexts, talk with patients about everyday life in ways that might penetrate this blurred complexity, and help people find goals and make decisions that are both compatible with a good life and possible to accomplish? In this article we pursue the question by discussing how Habermas’ theory of communicative action can (...) be implemented in decision-making processes in general practice. The theory of deliberative decision-making offers practical guidelines for what to talk about and how to do it. For a decision to be rooted in patients’ everyday life it has to take into consideration the patient’s practical circumstances, emotions and preferences, and what he or she perceives as ethically right behaviour towards other people. The aim is a balanced conversation, demonstrating respect, consistency and sincerity, as well as offering information and clarifying reasons. Verbalising reasons for one’s preferences may increase awareness of values and norms, which can then be reflected upon, producing decisions rooted in what the patient perceives as good and right behaviour. The asymmetry of medical encounters is both a resource and a challenge, demanding patient-centred medical leadership, characterised by empathy and ability to take the patient’s perspective. The implementation and adjustments of Habermas’ theory in general practice is illustrated by a case story. Finally, applications of the theory are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 91-92 [Access article in PDF] Jaspers and Defining Phenomenology John McMillan IT IS POSSIBLE TO DISTINGUISH a number of positions that you might take on the importance of phenomenology for the study of the mind. The strongest position is to think that phenomenology is sufficient for understanding the mind. This is a position that would be very hard to defend and it (...) is unlikely that Gupta and Kay want to endorse such a view. It is clear that Jaspers did not believe this; although he thought that first-person experience was undervalued, his project was an attempt to make sense of different kinds of explanation, all of which contribute to our understanding of the mind.A second position is to deny that phenomenology gives us anything that is of use in understanding the mind and psychopathology. Philosophers have developed a number of such positions, from the eliminativism of Churchland (1981) to the heterophenomenology of Daniel Dennett (1989, 1991).A third position is to hold that phenomenology is one of the methods that are useful for understanding the mind and psychopathology. Along with neuroscience and other more behavioral approaches to behavior, phenomenology is an important component of an adequate understanding of the mind. This position appears to be that endorsed by Jaspers, Gupta, Kay, and the authors they discuss. It is also the position that Grant Gillett and I defend in Consciousness and Intentionality (2001). Gupta and Kay's paper presents an argument about where the boundaries between phenomenology and other approaches to the mind and psychopathology ought to be drawn. Gupta and Kay, following Jaspers, think that the boundaries of the phenomenological ought to be drawn around those approaches that employ empathy and the presuppositionless stance and do not include objective phenomena.Given that the paper is primarily about what phenomenology means and that it endorses the way that Jaspers used the term, it is fairly important that we have a definition from Jaspers. Gupta and Kay give a description of some of Jaspers's methods for getting at subjective phenomena, but do not give an account of what Jaspers thinks the aim of phenomenology is. In other words, one way to classify something as phenomenological is its methods and another is by what the point of the exercise is. In General Psychopathology, Jaspers (1997) says that phenomenology is an empirical method for investigating "individual psychic experience" (p. 55). We can think of this as a claim about the objective of phenomenology and then consider the merits of different phenomenological methodologies in terms of their success in achieving this objective. This opens up the possibility that a theory may be genuinely phenomenological because it has a plausible method for getting at psychic lived experience but does not use all of the methods advocated by Jaspers.Gupta and Kay are correct that Jaspers does stress the importance of the presuppositionless [End Page 91] stance, the importance of empathy and the importance of not simply relying on objective phenomena. However, it is not obvious why an approach to understanding the mind or psycho- pathology must satisfy these conditions to be phenomenological. Imagine the following kind of situation: when I am observed to hit my big toe against a brick and give a yelp, it is possible to infer something about my psychic lived experience. There is not much is room for doubt about my first-person experience and, although you might ask me questions about my pain, they are unlikely to add much to what you can simply read from my behavior. This example may appear a little crude because the first-person experience in this case is not especially complex and is not that interesting as a entrance to the inner workings of an individual's mental life. It is not hard to come up with other examples where we can read the first-person experience from behavior in a fairly accurate and informative way. A father gazing at his young child while she is sleeping in his arms may be having a number of thoughts that we would not know about... (shrink)

Some bioethicists are concerned about other bioethicists being paid by corporations. These concerns make sense if you have a particular view about what the most important role of a bioethicist should be. If you believe that a bioethicist should be a moral critic, attempting to expose wrongdoing, then being paid by corporations might compromise this role. It’s plausible to suppose that this can be a role for bioethicists but it’s unreasonable to insist that all bioethicists should be moral critics.