The enduring psychiatric myth is that particular personal, interpersonal and social problems in living are manifestations of ‘mental illness’ or ‘mental disease’, which can only be addressed by ‘treatment’ with psychiatric drugs. Psychiatric drugs are used only to control ‘patient’ behaviour and do not ‘treat’ any specific pathology in the sense understood by physical medicine. Evidence that people, diagnosed with ‘serious’ forms of ‘mental illness’ can ‘recover’, without psychiatric drugs, has been marginalized by drug-focused research, much of this funded by (...) the pharmaceutical industry. The pervasive myth of psychiatric drugs dominates much of contemporary ‘mental health’ policy and practice and raises discrete ethical issues for nurses who claim to be focused on promoting or enabling the ‘mental health’ of the people in their care. (shrink)

One specific instantiation of the storm-and-stress view of adolescence is the idea that “normal” adolescence involves high-risk substance use behaviors. However, although uptake of some substance use behaviors is more common during adolescence than other life stages, it is clear that not all adolescents engage in risky substance use—and among those who do, there is much variation in emotional, behavioral, and contextual precursors of this behavior. One such set of predictors forms the internalizing pathway to substance use disorder, whereby internalizing (...) symptoms in childhood such as negative affect and anxiety set off a chain of consequences culminating in high-risk substance use in late adolescence. However, findings linking internalizing symptoms to substance use are mixed, and it is clear that this link varies across adolescents and contexts. One heretofore unanswered question is whether and how geographic location, specifically whether the adolescent lives in an urban or rural location, moderates this link. The current report is a secondary analysis of data from the Longitudinal Study of Australian Children, in which we examined the link between internalizing symptoms in childhood and initiation of substance use through age 19. Using a multiple event process survival mixture model, we identified three trajectories of substance use initiation in adolescence: one characterized by near-complete abstinence until late adolescence, another by earlier initiation of alcohol, nicotine, and cannabis, and another by early initiation of these substances and later initiation of more hazardous drugs such as cocaine and methamphetamine. Although childhood externalizing symptoms increased the risk of being in the second or third class, internalizing symptoms decreased risk when rural and non-rural adolescents were considered together. Few effects of rurality were found, but the negative relationship between internalizing at age 10 and high-risk substance use was only observed among non-rural adolescents. This finding, which was inconsistent with our initial predictions that rurality might confer higher risk for substance use, instead suggests a potentially protective effect of internalizing symptoms for engagement in risky substance use which may differ based on an adolescent’s geographical context. (shrink)

Living things are often plastic during their early development and are moulded by the environment. Many human fetuses have to adapt to a limited supply of nutrients, and in doing so they permanently change their physiology and metabolism. These programmed changes may be the origins of a number of diseases in later life, including coronary heart disease, stroke, diabetes and hypertension.

Recent events at Enron, K-Mart, Adelphia, and Tyson would seem to suggest that managers are still experiencing ethical lapses. These lapses are somewhat surprising and disappointing given the heightened focus on ethical considerations within business contexts during the past decade. This study is designed, therefore, to increase our understanding of the forces that shape ethical perceptions by considering the effects of business school education as well as a number of other individual-level factors (such as intra-national culture, area of specialization within (...) business, and gender) that may exert an influence on ethical perceptions. We found significant effects for business education, self-reported intra-national culture, area of specialization within business, and gender for some and/or all areas of ethics examined (i.e., deceit, fraud, self-interest, influence dealing, and coercion). One of our most encouraging findings is that tolerance for unethical behavior appears to decrease with formal business education. Despite the prevalent stereotype that business students are only interested in the bottom line or that business schools transform idealistic freshman into self-serving business graduates, our results suggest otherwise. Given the heightened criticism of the ethicality of contemporary managerial behavior, it is heartening to note that, even as adults, individuals can be positively affected by integration of ethics training. (shrink)

Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements (...) usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (shrink)

The study reports on the results of an empirical investigation of the education and recruitment processes used in HIV vaccine trials conducted in South Africa. Interviews were conducted with 21 key informants involved in HIV vaccine research in South Africa and three focus groups of community advisory board members. Data analysis identified seven major themes on the relationship between education and recruitment: the process of recruitment, the combined dual role of educators and recruiters, conflicts perceived by field staff, pressure to (...) achieve recruitment targets, problems in achieving comprehension, accountability and education as capacity building. The results raise ethical concerns about the adequacy of current informed consent processes in these settings. The study findings bear directly on current debates about issues of exploitation and the scope of moral responsibilities of researchers and funding agencies to assure that HIV clinical prevention research is conducted ethically. (shrink)

Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

According to proponents of the face-value account, a beliefreport of the form ‘S believes that p’ is true just in case the agentbelieves a proposition referred to by the that-clause. As againstthis familiar view, I argue that there are cases of true beliefreports of the relevant form in which there is no proposition that thethat-clause, or the speaker using the that-clause, can plausibly betaken as referring to. Moreover, I argue that given the distinctiveway in which the face-value theory of belief-reports (...) fails, there ispressure to give up the metaphysical thesis that belief is apropositional attitude. I conclude by suggesting that we allownon-propositional entities to be amongst the relata of thebelief-relation, and make some speculative remarks concerning whatsuch entities might be like. (shrink)

Grice's (1957) analysis of non-natural meaning generated a huge industry, where new analyses were put forward to respond to successively more complex counterexamples. Davis (2003) offers a novel and refreshingly simple analysis of meaning in terms of the expression of belief, where (roughly) an agent expresses the belief that p just in case she performs a publicly observable action with the intention that it be an indication that she occurrently believes that p. I argue that Davis's analysis fails to capture (...) the essentially overt nature of our meaning-intentions, and with it, a plausible sufficient condition for meaning. (shrink)

In order to apply known general theorems about the effective properties of recursive structures in a particular recursive structure, it is necessary to verify that certain decidability conditions are satisfied. This requires the determination of when certain relations, called back and forth relations, hold between finite strings of elements from the structure. Here we determine this for recursive reduced abelian p-groups, thus enabling us to apply these theorems.

Why ever assert clarity? If It is clear that p is true, then saying so should be at best superfluous. Barker and Taranto (2003) and Taranto (2006) suggest that asserting clarity reveals information about the beliefs of the discourse participants, specifically, that they both believe that p . However, mutual belief is not sufficient to guarantee clarity ( It is clear that God exists ). I propose instead that It is clear that p means instead (roughly) 'the publicly available (...) evidence justifies concluding that p '. Then what asserting clarity reveals is information concerning the prevailing epistemic standard that determines whether a body of evidence is sufficient to justify a claim. If so, the semantics of clarity constitutes a grammatical window into the discourse dynamics of inference and skepticism. (shrink)

Frege’s distinction between force and sense is a central pillar of modern thinking about meaning. This is the idea that a self-standing utterance of a sentence S can be divided into two components. One is the proposition P that S’s linguistic meaning and context associates with it. The other is S’s illocutionary force. The force/sense distinction is associated with another thesis, the embedding principle, that implies that the only content that embeds in compound sentences is propositional content. We argue that (...) both the Force/Sense distinction and the principle of embedding are seriously challenged by figurative language, and irony in particular. We conclude that theorists need to go back to the drawing board about the nature of illocutionary acts. (shrink)

This paper falls into two parts. In the first part, I argue that consideration of general indicative conditionals, e.g., sentences like If a donkey brays it is beaten, provides a powerful argument that a pure material implication analysis of indicative if p, q is correct. In the second part I argue, opposing writers like Jackson, that a Gricean style theory of pragmatics can explain the manifest assertability conditions of if p, q in terms of its conventional content – assumed to (...) be merely (p⊃q) – and the conversational implicature contents which utterance of if p, q may gain in certain contexts. I also defend the pragmatic approach against a recent objection by Edgington that appeal to pragmatics cannot explain what we are inclined to say about the believability conditions, as opposed to the assertability conditions, of indicative if p, q. (shrink)

Closure is the epistemological thesis that if S knows that P and knows that P implies Q, then if S infers that Q, S knows that Q. Fred Dretske acknowledges that closure is plausible but contends that it should be rejected because it conflicts with the plausible thesis: Conclusive reasons (CR): S knows that P only if S believes P on the basis of conclusive reasons, i.e., reasons S wouldn‘t have if it weren‘t the case that P. Dretske develops an (...) analysis of knowing that centers on CR, and argues that the requirement undermines skepticism by implying the falsity of closure. We develop a Dretske-style analysis of knowing that incorporates CR, and we argue that this analysis not only accords with closure, but also implies it. In addition, we argue that the analysis accounts for the prima facie plausibility of closure-invoking skeptical arguments, and nonetheless implies that they are fallacious. If our arguments turn out to be sound, the acceptability of Dretske‘s analysis of knowing will be significantly enhanced by the fact that, despite implying closure, it undermines closure-based skepticism. (shrink)

In this article applied and theoretical epistemologies benefit each other in a study of the British legal case of R. vs. Clark. Clark's first infant died at 11 weeks of age, in December 1996. About a year later, Clark had a second child. After that child died at eight weeks of age, Clark was tried for murdering both infants. Statisticians and philosophers have disputed how to apply Bayesian analyses to this case, and thereby arrived at different judgments about it. By (...) dwelling on this applied case, I make theoretical gains: clarifying and defending pragmatic principles of inference that are important for estimating key probabilities in a range of cases. Then, partly by drawing on such principles, and uncovering overlooked data on post-partum psychosis, I make applied gains: improving the rationality of judgments about the Sally Clark case in particular, judgments important to future similar cases. (shrink)

The standard view about counterfactuals is that a counterfactual (A > C) is true if and only if the A-worlds most similar to the actual world @ are C-worlds. I argue that the worlds conception of counterfactuals is wrong. I assume that counterfactuals have non-trivial truth-values under physical determinism. I show that the possible-worlds approach cannot explain many embeddings of the form (P > (Q > R)), which intuitively are perfectly assertable, and which must be true if the contingent falsity (...) of (Q > R) is to be explained. If (P > (Q > R)) has a backtracking reading then the contingent facts that (Q > R) needs to be true in the closest P-worlds are absent. If (P > (Q > R)) has a forwardtracking reading, then the laws required by (Q > R) to be true in the closest P-worlds will be absent, because they are violated in those worlds. Solutions like lossy laws or denial of embedding won't work. The only approach to counterfactuals that explains the embedding is a pragmatic metalinguistic approach in which the whole idea that counterfactuals are about a modal reality, be it abstract or concrete, is given up. (shrink)

A comprehensive theory ofeven if needs to account for consequent ‘entailing’even ifs and in particular those of theif-focused variety. This is where the theory ofeven if ceases to be neutral between conditional theories. I have argued thatif-focusedeven ifs,especially if andonly if can only be accounted for through the suppositional theory ofif. Furthermore, a particular interpretation of this theory — the conditional assertion theory — is needed to account foronly if and a type of metalinguistic negation ofQ if P. We therefore (...) have evidence that the currently accepted approaches to conditionals are basically wrong about the semantic forms they attribute toif P, Q.11. (shrink)

The tattered remains of a few paragraphs of a work on harmonic theory were published in 1986 as P. Oxy. LIII.3706, with a careful commentary by M. W. Haslam. There are six fragments. Four of them are too small for any substantial sense to be recovered; and while fr. 2 and the second column of fr. 1 allow us to pick out significant words and phrases here and there, the remnants of these columns are very narrow, and the line of (...) reasoning seems inaccessible. Musicological analysis must focus on the first column of fr. 1. There is little enough even of that, and in attempting a relatively detailed interpretation I shall have to be rather less cautious than Haslam quite properly was. But I think that something can be made of it without stretching speculation too far, and if I am right the piece is of some genuine interest. Here are the two versions of the text that Haslam prints. The first records what is decipherable on the papyrus itself, while the second represents a partial reconstruction, restoring word-divisions and some of the missing letters. (shrink)

Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early-life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion-processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting-state functional connectivity (rsFC) between the amygdala (...) and other areas of the salience network. We analyzed data of young European adults from the general population (N = 774; mean age = 18.76 years) who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula (p <.025, FWE-corrected), which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology. (shrink)

Some bioethicists have argued in favor of a sliding scale notion of competence, paternalistically requiring greater competence in relation to more significant risk. I argue against a sliding scale notion, taking issue with the positions of Allen E. Buchanan and Dan W. Brock, Ian Wilkes, and Joel Feinberg. Rejecting arguments that a sliding scale is supported by legal cases, by ordinary usage, and by fallible judgments about competence, I argue in favor of greater evidence of competence when risk is (...) greater. Two clinical cases are examined, both involving amputation, to show that my fixed concept of competence, with a requirement of clearer evidence of competence when risk is high, better accounts for good moral decisions in bioethics. (shrink)