Reviews the book, The psychology of human possibility and constraint by J. Martin and J. Sugarman . This wide-ranging, compact, dense, yet very readable little book presents many of the key elements of a badly needed, more credible philosophy of social science for academic and professional psychologists. The book gives no specific examples of theories or research findings that might illustrate what is meant by a better kind of "knowledge" or "theory" in psychology, so the reader is left somewhat high (...) and dry concerning this question. Perhaps it is simply the case that these questions about what might be the best kind of social and psychological inquiry and what sense to make of the plethora of theories and findings to date, are difficult, murky, and on the frontier of a hermeneutic reenvisioning of psychology. 2012 APA, all rights reserved). (shrink)

In this article, we focus on a particular kind of emotional impact of the pandemic, namely the phenomenology of the experience of moral injury in healthcare professionals. Drawing on Weber's reflections in his lecture Politics as a Vocation and data from the Experiences of Social Distancing during the COVID-19 Pandemic Survey, we analyse responses from healthcare professionals which show the experiences of burnout, sense of frustration and impotence, and how these affect clinicians’ emotional state. We argue that this may relate (...) to the ethical conflicts they experience when they are forced to make clinical decisions where there are no optimal outcomes, and how in turn that impacts on their own emotional state. We then further examine the notion of ‘burnout’ and the phenomenology of ‘moral injury’. Our argument is that these experiences of moral injury across a range of clinicians during the pandemic may be more prevalent and long-standing in psychiatry and mental health than in other areas of healthcare, where ethically difficult decisions and resource constraints are common outside times of crisis. Hence, in these clinical arenas, moral injury and the phenomenology of emotional changes may be independent of the pandemic. The insights gained during the pandemic may provide wider insights into the challenges of developing services and training the workforce to provide appropriate mental health care. (shrink)

Previous findings indicate that negative arousal enhances bottom-up attention biases favouring perceptual salient stimuli over less salient stimuli. The current study tests whether those effects were driven by emotional arousal or by negative valence by comparing how well participants could identify visually presented letters after hearing either a negative arousing, positive arousing or neutral sound. On each trial, some letters were presented in a high contrast font and some in a low contrast font, creating a set of targets that differed (...) in perceptual salience. Sounds rated as more emotionally arousing led to more identification of highly salient letters but not of less salient letters, whereas sounds’ valence ratings did not impact salience biases. Thus, arousal, rather than valence, is a key factor enhancing visual processing of perceptually salient targets. (shrink)

The concept of modernity is fraught with contestation, a wedge that divides people, practices, institutions, and beliefs. This chasm is particularly pronounced for traditional institutions like the...

Emperor Julian's three-book treatiseContra Galilaeossurvives solely in those Christian sources that quoted it in order to respond to its forceful attack on Christianity. The bulk of these survivals comes from Cyril of Alexandria's twenty-bookContra Iulianum. The recent publication of the first modern critical edition of Cyril's work creates the occasion for a fresh study of the remnants of Julian's text that can be recovered from it. This is especially true for Books 11–20 of Cyril's treatise that are themselves lost and (...) survive only in quotations in later Greek and Syriac sources. The present article undertakes a reassessment of the Julianic material preserved via the Syriac transmission ofContra Iulianum, including several passages hitherto unknown or ignored in earlier studies of Julian's treatise. It provides the Syriac text and English translation of eight passages and contextualizes them in the wider argumentative aim ofContra Galilaeos. (shrink)

The contemporary methodological debate about justice has centered around a dispute about the value of so-called ideal theory. I argue that justice performs a social-guiding function, which explains how people should respond to their limited and fallible abilities to realize justice institutionally. My argument helps to re-orientate the contemporary methodological debate. The obvious disagreement between many prominent supporters and skeptics of ideal theory obscures the fact that they are united by a false assumption: the practical value of justice exclusively consists (...) of its institution-guiding function. To capture the overlooked social-guiding function, a richer normative theory of justice is required; I show how such a theory can be supplied by “ideal-transitional” principles. (shrink)

Although ethics consultation services often engage in some of the most complex and delicate clinical situations, little is known about the qual­ity of these services or their effect on patient care and patient and provider satisfaction. There is still significant work to be done in the areas of training, credentialing, and standardization. This article articulates the essential “build­ing blocks” of the Proactive Ethics Integration model developed at Ascension as well as the lessons we have learned along the way.

The issues and problems of mandatory vaccination policy and roll out in First Nations communities are unique and do not concern the safety and effectiveness of vaccines. These issues are also independent of more specific arguments of mandatory vaccination of healthcare workers as a condition of employment. As important as these issues are, they do not consider the complex politics of ongoing settler colonialism and First Nations community relations. In this paper, we also set aside the very real problems of (...) disinformation, hesitancy, scientific and health illiteracy, and other concerns that drive vaccine hesitancy and refusal. These affect all communities, including First Nations communities. We, instead describe the dominant arguments in favour of mandatory vaccination and critique them in terms of the disputed legitimacy of Settler-Colonial decision-making as it impacts First Nations communities. We contend cultural responsiveness and safety—not state compulsion—must remain the first principles of any engagement—including vaccination—with First Nations Peoples, families, and communities. (shrink)

In this paper I propose a novel defence of political cosmopolitanism grounded in a familiar principle: universal moral equality. Critics of cosmopolitanism generally agree to universal moral equality, but disagree about what moral equality means politically. According to my argument, if we accept that all people are morally equal, then we ought to accept their equal moral standing. We should therefore prefer socio-political arrangements that reflect the equal moral standing of all people over those that reflect differentiated moral standing. A (...) reasonable cosmopolitanism need not preclude partialist attachment to co-nationals, or undermine the significance of self-determination, so long as political arrangements do not produce differentiated moral standing. As the political application of an uncontroversial moral principle, I defend reasonable cosmopolitanism against nationalism and statism. Neither of these, I argue, are suitable foundations for global justice in migration because they each conceive of justice as a local concern for insiders. (shrink)

Looking at the breadth of Joan Didion's writing - from journalism, essays, fiction, memoir and screen plays - it may appear that there is no unifying thread, but in this original exploration of her work Matthew R. McLennan argues that 'the ethics of memory' - the question of which norms should guide public and private remembrance - offers a promising vision of what is most characteristic and salient in Didion's works. By framing her universe as indifferent and essentially precarious, (...) McLennan demonstrates how this outlook guides Didion's reflections on key themes linked to memory: namely witnessing and grieving, nostalgia, and the paradoxically amnesiac qualities of our increasingly archived public life that she explored in famous texts like Slouching Towards Bethlehem, The Year of Magical Thinking and Salvador. McLennan moves beyond the interpretive value of such an approach and frames Didion as a serious, iconoclastic philosopher of time and memory. Through her encounters with the past, the writer is shown to offer lessons for the future in an increasingly perilous and unsettled world. (shrink)

Conspiracy theories are typically thought to be examples of irrational beliefs, and thus unlikely to be warranted. However, recent work in Philosophy has challenged the claim that belief in conspiracy theories is irrational, showing that in a range of cases, belief in conspiracy theories is warranted. However, it is still often said that conspiracy theories are unlikely relative to non-conspiratorial explanations which account for the same phenomena. However, such arguments turn out to rest upon how we define what gets counted (...) both as a ‘conspiracy’ and a ‘conspiracy theory’, and such arguments rest upon shaky assumptions. It turns out that it is not clear that conspiracy theories are prima facie unlikely, and so the claim that such theories do not typically appear in our accounts of the best explanations for particular kinds of events needs to be reevaluated. (shrink)

Belief in conspiracy theories is typically considered irrational, and as a consequence of this, conspiracy theorists––those who dare believe some conspiracy theory––have been charged with a variety of epistemic or psychological failings. Yet recent philosophical work has challenged the view that belief in conspiracy theories should be considered as typically irrational. By performing an intra-group analysis of those people we call “conspiracy theorists”, we find that the problematic traits commonly ascribed to the general group of conspiracy theorists turn out to (...) be merely a set of stereotypical behaviours and thought patterns associated with a purported subset of that group. If we understand that the supposed prob- lem of belief in conspiracy theories is centred on the beliefs of this purported sub- set––the conspiracists––then we can reconcile the recent philosophical contribu- tions to the wider academic debate on the rationality of belief in conspiracy theories. (shrink)

Vatsyayana's Commentary on the Nyaya-sutra is one of classical India's most important philosophical works.

Originally published in 1954, this volume describes and analyses the course of short-period fluctuations in the British economy between 1833 and 1842. Through concentrating on a relatively short space of time, the text is able to provide a rigorous examination of the evidence and also avoids the over-simplification inherent in comparing the history of fluctuations in different periods. A variety of sources are put under scrutiny, both 'literary' and statistical, reflecting a relative lack of surviving economic material from the period. (...) This, in turn, reflects a generally broad approach which is described by the author as 'quantitative-historical'. Concise and highly informative, this book will remain of value to anyone with an interest in nineteenth century and economic history. (shrink)

Explores the often elided and interesting relationship between Badiou and Lyotard.

In this recently published book, Jefferson provides a lucid and detailed examination of, and answer to, its provocative title. In doing so, the focus of Jefferson’s analysis is largely on what a br...

In the literature on conspiracy theories, the least contentious part of the academic discourse would appear to be what we mean by a “conspiracy”: a secretive plot between two or more people toward some end. Yet what, exactly, is the connection between something being a conspiracy and it being secret? Is it possible to conspire without also engaging in secretive behavior? To dissect the role of secrecy in con- spiracies – and thus contribute to the larger debate on the epistemology (...) of conspir- acy theories – we dene the concepts of “conspiracy,” “conspirator,” and “secret,” and argue that while conspirators might typically be thought to commit to keeping secrets once their conspiracy is underway, the idea that conspiracies are necessarily secretive to start with is not as obvious as previously thought. (shrink)

Health professionals are involved in humanitarian assistance and development work in many regions of the world. They participate in primary health care, immunization campaigns, clinic- and hospital-based care, rehabilitation and feeding programs. In the course of this work, clinicians are frequently exposed to complex ethical issues. This paper examines how health workers experience ethics in the course of humanitarian assistance and development work. A qualitative study was conducted to consider this question. Five core themes emerged from the data, including: tension (...) between respecting local customs and imposing values; obstacles to providing adequate care; differing understandings of health and illness; questions of identity for health workers; and issues of trust and distrust. Recommendations are made for organizational strategies that could help aid agencies support and equip their staff as they respond to ethical issues. (shrink)

Most philosophical defences of the state’s right to exclude immigrants derive their strength from the normative importance of self-determination. If nation-states are taken to be the political institutions of a people, then the state’s right to exclude is the people’s right to exclude – and a denial of this right constitutes an abridgement of self-determination. In this paper, I argue that this view of self-determination does not cohere with a group-agency view of nation-states. On the group-agency view that I defend, (...) a nation-state is the kind of group-agent that does not supervene on the intentionality of member/citizens. If we think that a nation-state is an intentional group-agent in its own right, then we should think that self-determination resides with the institutions of the state rather than with the citizens. If nation-states do not supervene on the intentionality of citizens, then it is unclear why citizens might have the right to control membership in the state as a feature of self-determination. (shrink)

Brings together and interprets previously hard-to-find texts, new translations and passages detailing the interplay between philosophy and psychopathology.

The contributors to this volume argue that whilst there is a commonplace superstition conspiracy theories are examples of bad beliefs (and that the kind of people who believe conspiracy theories are typically irrational), many conspiracy theories are rational to believe: the members of the Dewey Commission were right to say that the Moscow Trials of the 1930s were a sham; Woodward and Bernstein were correct to think that Nixon was complicit in the conspiracy to deny any wrongdoing in the Watergate (...) Hotel break in; and if we either accept the terrorist events of 9/11 were committed by Al-Qaeda, or that the Bush Administration was responsible, then it seems we are endorsing some theory about a conspiracy to commit an act of terror on American soil. As such, there is no reason to reject conspiracy theories sui generis. This volume challenges the prima facie that conspiracy theories are irrational beliefs, arguing that we should treat conspiracy theories and the phenomena of conspiracy theories seriously. It presents fresh perspectives from the wider philosophical, sociological and psychological community on what is becoming an issue of increasing relevance in our time. (shrink)

Schuklenk and van de Vathorst's paper is a very welcome addition to the literature on the assisted dying debate and will be of great interest to clinicians working in the field of mental health.1 Many psychiatrists will have had patients who have asked them to allow them to die, to desist in their efforts to prevent their suicide, and one of us has had personal experience, outside of professional life, of being asked to aid in someone's attempt to end their (...) life in the context of an episode of mood disorder. The person with depression asking professionals, friends and family members to aid them in ending their life is a very real phenomenon. In their discussion, Schuklenk and van de Vathorst's paper uses two principles that we endorse and add weight to their argument: namely, the reality of suffering in depression and the parity of mental and physical illness. Indeed, the case Schuklenk and van de Vathorst make is a strong one and our commentary will focus on the premise of the argument around choosing death and some empirical clarification about competence in depression and the nature of treatment-resistant depression (TRD) and its prognosis. The conceptual concern we wish to discuss in relation to assisted dying, endorsed by the state and legislature, is not linked to any moral or religious concern, or even on grounds related to ‘slippery slope’ or ‘abuse’ arguments. Rather the worry is how one could operationalise decisions around assisted dying as based on competence and capacity and view such decisions as rational. I think this concern is not limited to depressive illness, but to all decisions regarding choosing non-existence. Schuklenk and van de Vathorst offer the following useful criteria to regulate assisted suicide:1. (shrink)

Since the nineteenth century, hominid palaeontology has offered critical information about prehistoric humans and evidence for human evolution. Human fossils discovered at a time when there was growing agreement that humans existed during the Ice Age became especially significant but also controversial. This paper argues that the techniques used to study human fossils from the 1850s to the 1870s and the way that these specimens were interpreted owed much to the anthropological examination of Stone, Bronze, and Iron Age skeletons retrieved (...) by archaeologists from prehistoric tombs throughout Europe. What emerged was the idea that a succession of distinct human races, which were identified using techniques such as craniometry, had occupied and migrated into Europe beginning in the Ice Age and continuing into the historic period. This marks a phase in the history of human palaeontology that gradually gave way to a science of palaeoanthropology that viewed hominid fossils more from the perspective of evolutionary theory and hominid phylogeny. (shrink)

Various authors have argued that progress in the neurocognitive and neuropsychiatric sciences might threaten the commonsense understanding of how the mind generates behavior, and, as a consequence, it might also threaten the commonsense ways of attributing moral responsibility, if not the very notion of moral responsibility. In the case of actions that result in undesirable outcomes, the commonsense conception—which is reflected in sophisticated ways in the legal conception—tells us that there are circumstances in which the agent is entirely and fully (...) responsible for the bad outcome and circumstances in which the agent is not at all responsible for the bad outcome. (shrink)

Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations (...) relating to participation and partnership arising in the action-research. (shrink)

From the early modern period, Western epistemologists have often been concerned with a rigorous notion of epistemic justification, epitomized in the work of Descartes: properly held beliefs require insulation from extreme skepticism. To the degree that veridical cognitive states may be indistinguishable from non-veridical states, apparently veridical states cannot enjoy high-grade positive epistemic status. Therefore, a good believer begins from what are taken to be neutral, subjective experiences and reasons outward—hopefully identifying the kinds of appearances that properly link up to (...) the world and those that do not. Good beliefs, beliefs that are justified (warranted, etc.), are those that a believer has .. (shrink)

This article poses a challenge to the assumption that all conceptions of the imago Dei are practical, meaning that they can coherently provide a guide for human action. The article identifies three criteria for practicality and applies them to two accounts of the imago, one in the thought of the twentieth-century theologian Helmut Thielicke, the other in the Roman Catholic tradition. It argues that Thielicke’s account of the imago, which forms the basis for what he calls ‘alien dignity’, fails to (...) meet the criteria of practicality, and thus cannot serve as an adequate guide for action. In contrast, the account of the imago and human dignity in the Roman Catholic tradition does meet the criteria. This comparison, the article concludes, ultimately helps provide a means of assessing diverse theological interpretations of the imago and their value for supporting a morally useful conception of human worth. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Seductiveness of Virtue: Abraham Joshua Heschel and John Paul II on Morality and Personal Fulfillment by John J. FitzgeraldMatthew R. PetrusekThe Seductiveness of Virtue: Abraham Joshua Heschel and John Paul II on Morality and Personal Fulfillment John J. Fitzgerald new york: bloomsbury t&t clark, 2017. 240 pp. $114The Seductiveness of Virtue offers a close study of the twentieth-century Polish-American rabbi Abraham Joshua Heschel, and the first Polish (...) pope, St. John Paul II, on the relationship between being good and being happy. Overall the book advances the conversation on the meaning and continued relevance of virtue in contemporary ethics, though its eagerness to build bridges across competing religious and philosophical traditions opens the argument to both methodological and substantive criticisms. [End Page 206]Fitzgerald divides the book into an introduction and four chapters. Chapter 1, "The Meaning of Our Question," establishes the definitions of concepts that Fitzgerald addresses throughout the rest his argument, including "happiness," "meaning," "freedom," "personal fulfillment," "good and evil," and "doing." Fitzgerald locates each term within the theologies of Heschel and John Paul II and provides his own definitions. Chapter 2, "Heschel and the 'Joys of Mitsvah,'" enters more deeply into Heschel's theology, arguing that, despite some ambiguity about whether morality will always lead to personal fulfillment, Heschel establishes a firm theological and practical connection between following the law (mitzvah) and being happy. Chapter 3, "John Paul II and the Good We Must Do to Have Eternal Life," engages in a similar analysis of John Paul's thought (including his writings before becoming pope) and, despite using different theological categories (chief among them "Christ"), arrives at a similar conclusion: there is a necessary connection between being good and being happy. Chapter 4, which also functions as a conclusion, places the comparison between Heschel and John Paul into a wider comparative context, examining how their respective conclusions on morality and the good relate to insights from other contemporary perspectives, including the Dalai Lama, Peter Singer, and present-day "positive psychology." Fitzgerald concludes by offering five reasons why it is important to continue, in his words, an "interworldview" and "interdisciplinary" dialogue on how virtue relates to happiness.The book is richly sourced—containing 199 footnotes, bibliography, and detailed index—and serves as a good addition to the libraries of those working on John Paul II, Abraham Heschel, virtue theory, or comparative ethics more broadly. Yet its breadth on the comparative front also highlights its vulnerabilities, particularly on the question of what defines the relationship between virtue and happiness from a normative perspective. While providing lucid descriptive accounts of different conceptions of God and the good, for example, Fitzgerald acknowledges near the book's conclusion, "whether one finds [any] author persuasive will depend in large part on one's prior conclusions about the existence and nature of God and the afterlife" (184) and notes that this topic "cannot be resolved or even explored here" (185). However, these "prior conclusions" themselves are ultimately most meaningful for answering the book's central question.This reticence to engage in meta-ethical questions also leads the text to a problematic epistemological and ethical equalizing of each perspective, one that allows Fitzgerald to claim, for example, "while there is much common ground between Heschel, John Paul II, and [Peter] Singer on the relationship between morality and fulfillment, there are also key differences" (174). Here Fitzgerald understates the contrast: one of the "key" differences between Singer's utilitarian materialism and John Paul II's gospel of life is that Singer's position could serve as a paradigmatic representation of the "culture of death" [End Page 207] that John Paul spent his papacy resisting. Thus, while providing an excellent analysis of each thinker individually, the book's argument would benefit from establishing a firmer and more transparent standard for evaluating ethical claims across traditions.Matthew R. PetrusekLoyola Marymount UniversityCopyright © 2018 Society of Christian Ethics... (shrink)

Humanitarian healthcare work presents a range of ethical challenges for expatriate healthcare professionals, including tragic choices requiring the selection of a least-worst option. In this paper we examine a particular set of tragic choices related to the prioritization of care and allocation of scarce resources between individuals in situations of widespread and urgent health needs. Drawing on qualitative interviews with clinicians, we examine the nature of these choices. We offer recommendations to clinical teams and aid organizations for preparing and supporting (...) frontline clinicians in their efforts to determine the least-worst option, and in their responsibility for making such choices. (shrink)

Despite the growing popularityof farmers' markets (FMs) across the UnitedStates, the experiences and perspectives offarmers who sell at markets have received verylittle research attention. This study describesthe views of 18 farmers from Upstate New Yorkon the importance of FMs as part of theirlifestyle and livelihood, the challenges theyface selling at markets, and their conceptionsof ideal FMs. Through in-depth, semi-structuredinterviews, farmers expressed economic andsocial motivations for selling at FMs; socialbenefits from interacting with customers; andthe challenges they faced as small-scalefarmers and sellers, (...) including extra-marketcompetition, uncooperative and problematicmarket vendors, rising farm input costs, andchanging consumer trends. Farmers alsodiscussed personal values associated withselling at FMs, such as pride in raising andmarketing one's own products, working togetherwith other farmer-vendors, and providingcustomers with honest information. Visions ofideal FMs were varied among farmers, but therewas general agreement that FMs should provide adiversity of products to attract customers andeducational opportunities for the public tolearn more about FMs and local produce. Theinterdependence of FM farmers was a majoremergent theme across interviews. Findingssuggested that market experiences of FMfarmers, including economic success, are notonly contingent on personal effort, but canalso be affected by the work of fellow vendors.Future research may look to further explore howFM farmers and other vendors interact ascooperative and competitive social and economicunits. At the community level, FM leadershipshould continue to focus on the experiences andperspectives of farmers and other marketvendors, in addition to identifying ways forenhancing cooperative FM enterprises. (shrink)

This philosophical dialogue explores some of the barriers to an adequate definition of general health, encompassing physical, social, and mental/emotional well-being. Many of the putative obstacles to such a definition—concerns about subjectivity, cultural difference, marginal cases, etc.—prove to be chimerical once the characters take seriously the Peircean insight that truth-claims methodologically grounded in people’s lives, experiences, and conversations need not be apodictic to be useful. Drawing on Canguilhem and others, the characters critically discuss a proposed definition of health: a dynamic (...) equilibrium by which a human being thrives in relation to its situation. Although they do not manage to resolve all of this definition’s difficulties, or all of their differences, their interaction in some ways models the ongoing task of inquiry. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 35-41 [Access article in PDF] The Rationality of Psychosis and Understanding the Deluded Matthew R. Broome Campbell's important and influential paper (Campbell 2001) has framed the debate that Bayne and Pacherie (2004) most explicitly, and Klee (2004) and Georgaca (2004) more implicitly, engage in. Campbell has offered two broad ways of thinking about explanations of delusions—the empirical and the rational. He offers (...) some criticism of the former and an endorsement of the latter. Campbell uses examples from clinical psychopathology to illustrate his argument and Bayne and Pacherie in turn employ these. Campbell discusses the eponymously named delusions of Capgras and Cotard—the former a subtype of delusional misidentification and the latter a delusion whose content is colored predominantly with nihilistic and possibly hypochondriacal themes. Campbell, Bayne and Pacherie, and Klee discuss the empirical data in relation to such delusions and as an aid to discussing the empirical model more generally. It does seem a little unfortunate that these delusions, which are less than typical, become the focus of Campbell's paper, and Bayne and Pacherie's criticism of his work. Delusions are remarkably heterogeneous; this indeed may be part of the reason why there is so much difficulty in reaching a definition as Klee discusses, and occur in a wide variety of mental and neurological illnesses. The most common delusions are those of persecution and reference (World Health Organization [WHO] 1973) and typically occur in schizophrenia. By contrast, delusional misidentification occurs most commonly in patients with dementia, delirium, and focal cognitive impairment, but can occur in other functional psychoses such as an affective or schizophrenic psychosis. The most common form of delusional misidentification is not that of either the exotic Capgras or Fregoli syndromes but delusional misidentification for place; thus, although Bayne and Pacherie's arguments against Campbell may still hold, delusional misidentification tends to occur in the context of a patient believing that they are at home or on holiday rather than in hospital and may not necessarily involve close family members or other intimate relationships. Similarly, Cotard's syndrome tends to occur in the context of a severe depressive illness with mood-congruent psychotic symptoms, typically in an elderly individual. It does not have to have the content that the deluded is dead, but can include beliefs, for example, that the world no longer exists or that their internal organs are not present. Thus, a patient with either Capgras' or Cotard's syndrome is likely to differ from patients with delusions of persecution. They would [End Page 35] have different diagnoses, probably be older, and have a greater likelihood of structural abnormalities of the brain on imaging and consequent neuropsychological dysfunction. That is not to say that patients with schizophrenia have normal cerebral anatomy and neuropsychology, but rather that the Capgras' and Cotard's patients are likely to have neurological quality to their presentation that is clinically relevant, rather than what commonly the case in schizophrenia and the other functional psychoses, where the neurological abnormalities are only currently important at the level of academic research. Empirical Models of Delusion Formation Different delusions may not have that much in common, nor may the patients who believe in them. This in turn relates to the empirical paradigm that both Campbell and Bayne and Pacherie discuss. It is true that current research, and indeed the clinical practice of cognitive behavioral therapy for psychosis, is indebted to the work of Maher and it is within his legacy which we work. This, however, is not to say that we think his initial formulation was correct. Maher's (1988, 1992) work focused attempts in explaining delusions—both to support and refute his thesis that delusions are the consequence of normal cognitive mechanisms seeking to explain an anomalous sensory experience. Such a view initially led to work demonstrating delusions in the absence of anomalous perceptions, the presence of reasoning biases in the deluded population, and the possibility that abnormal sensory experience may be consequent upon biased cognitive processes (Garety and Freeman 1999). More recent work has demonstrated the prevalence of... (shrink)

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure for examining the moral (...) dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)