Without taking a position on the overall justification of anti-doping regulations, I analyse the possible justification of Therapeutic Use Exemptions from such rules. TUEs are a creative way to prevent the unfair exclusion of athletes with a chronic condition, and they have the potential to be the least bad option. But they cannot be competitively neutral. Their justification must rest, instead, on the relevance of intentions to permissibility. I illustrate this by means of a set of thought experiments in (...) which only an athlete’s intentions vary. I argue that the Doctrine of Double Effect sheds some light on TUEs and illustrate this by applying different readings of the DDE to the thought experiment. This underpins a justification of anti-doping exemptions very different from the approach adopted by the World Anti-Doping Agency. I argue for three changes to bring TUEs in line with this understanding: rewriting of the regulations, transparency, and a greater role for athletes in determining what exemptions are allowed, and when. (shrink)

The use of genetic technologies within the equine industries has become increasingly common since the horse genome was published in 2009 (Wade et al. 2009). Testing for genes coding for disease in...

Heart and Soul is a collection of essays which examine those concepts and questions which are at the heart of both psychotherapy and philosophy. Topics discussed include the nature of the self, motivation and subjectivity, the limits of certainty and subjectivity in interpersonal situations, and the scope of narrative, dialogue and therapy itself. Looking at the work of key figures such as Wittgenstein, Socrates, Kierkegaard, Foucault, Lacan and Klein, contributors draw on a wide range of philosophical approaches and examine (...) how they can deepen our understanding of the processes involved in different types of psychotherapy in a wide range of clinical settings. Each chapter includes a summary of the implications to clinical practice of the ideas discussed. Contributors: Joady Brennan, John M. Heaton, Jeremy Holmes, Joan Hurd, Paul Sepping, Geraldine Shipton, Paul Sturdee, Digby Tantam, Myra Thomas, Emmy van Deurzen, Werdie van Staaden, John Wheway, and Catherine Wieder. (shrink)

[Excerpted From Editor's Introduction] Matthew Crippen takes this up in a Marcusian critique of Wittgenstein that attends, among other things, to the place of silence in that discourse. Referring to Horkheimer’s citation of the Latin aphorism that silence is consent, Crippen is critical of Wittgenstein’s admonition that we must pass over in silence those matters of which we cannot speak. This raises fascinating questions for critical theory that Crippen explores particularly with reference to Marcuse’s concept of one-dimensionality. To the extent (...) that Wittgenstein’s philosophy is “therapeutic,” it may effectively contain dissent by “helping” dissenters become “well-adjusted.” Marcuse, of course, was particularly concerned with the power of Total States— and particularly those engendered by advanced industrial capitalism—to contain dissent precisely by using therapeutic techniques to maintain adjustment. Bringing Marcuse and Wittgenstein together here has particularly explosive possibilities. In the context of a Total State, transformation depends on the possibility of calling the State into question from the inside (since “total” States systematically eliminate “outsides”). This is the point at which Wittgenstein’s silence becomes most intriguing. What is it, we must ask, that we cannot say? Silence may be (as Martin Luther King, Jr. said) more than consent: there comes a time when silence is betrayal. But this is one of many places where it pays to look at what is done as much as what is said. What game, we might ask, is Wittgenstein playing? And, more to the point, what is the field of play that joins Wittgenstein and Marcuse? John Cage famously said “I have nothing to say and I am saying it and that is poetry as I need it...” Crippen begins a process (via Wittgenstein) of putting poetry into play that has important implications for the public work of philosophers. (shrink)

Therapeutic touch, a healing technique based upon the laying‐on of hands, has found wide acceptance in the nursing profession despite its lack of scientific plausibility. Its acceptance is indicative of a broad antiscientific trend in nursing. Adherents of this movement use the jargon of postmodern philosophy to justify their enthusiasm for a variety of mystically based techniques, citing such postmodern critics of science as Derrida and Michel Foucault as well as philosophical forerunners Heidegger and Husserl. Between 1997 and (...) 1999, 94 articles in nursing journals referred to postmodernism, according to a database search. This paper criticizes the postmodern movement for abandoning the biological underpinnings of nursing and for misreading philosophy in the service of an antiscientific world‐view. It is also suggested that nursing can retain its tradition of ‘caring’ without abandoning the scientific method. (shrink)

This article utilizes recent Western approaches to the ethical inquiry into human activities of forgetting, especially the approach represented by Ricoeur’s work on memory and forgetting and their ethical functioning. The three areas of Ricoeur’s investigation includes the therapeutic/pathological area; pragmatic area, which deals with the issue of individual and group’s self-identity in relation to time and otherness; and the more explicitly ethical area. These three divisions are useful to start with, but Ricoeur’s work shows some narrowness in neglect (...) of positive, productive and healthy forgetting, which has been deemed significant by the Zhuangzi. This paper is the first of the author’s serial writings to apply Ricoeur’s three areas of forgetting to investigate the forgetfulness of the Zhuangzi, and examines therapeutic forgetting and its ethical dimension only. (shrink)

Religious therapeutics is the term I use to designate relations between health and spirituality, and medicine and religion. Dimensions of religious therapeutics include religious meanings that inform medical theory, religious means of healing, health as part of religious life, and religion as a remedy for human suffering. Classical Yoga is analyzed to establish an initial matrix of religious therapeutics with 5 branches: philosophical foundations, soteriology, value theory, physical practice, and cultivation of consciousness. Through comparative criticism of classical Yoga, the study (...) presents a heuristic of religious therapeutics: a model for interpreting relations among healing and liberative functions in world religions. ;Body and health are of instrumental but not ultimate value in classical Yoga: the body is used to transcend itself for attainment of Yoga's soteriological goal, realization of self as pure consciousness. Yoga's Samkhya-based metaphysics contains an unreconciled dualism, and while practice of Yoga is paradigmatic of mind/body holism, Yoga prescribes realization of a spiritual self, independent of material and psychological nature. The study rehabilitates the body in respect of the compatibility of embodiedness with religiousness. ;Other Indian and world traditions suggest dimensions of religious therapeutics both resonant with classical Yoga and lacking from it. India's Ayurvedic medicine represents the sixth branch of religious therapeutics: medical therapeutics. I distill from Ayurvedic and Western sources a set of determinants of health: biological, medical/psychological, cultural, and metaphysical. Significant determinants of health are wholeness, self-identity, and freedom; these are incorporated in discussion of the complementary functions of medicine and religion, grounding the claim that in classical Yoga, liberation is healing in an ultimate sense. ;Tantric yogas utilize material nature for human spiritual progress, and unlike classical Yoga, esteem nature, body/mind, the feminine, and relationality. Tantra provides another branch of religious therapeutics: aesthetic therapeutics. The study anticipates elements of health/medicine in western religions, Buddhism, and Lakota religious philosophy. Sacred speech and song are explored to demonstrate comparative inquiry into religious therapeutics; some Native American Indian and Hindu applications of sacred language are considered. Finally, the model of religious therapeutics is supplemented with community, embracing ecological, social, and religious relationality and communication. (shrink)

Concern for “reproductive liberty” suggests that decisions about embryos should normally be made by the persons who would be the genetic parents of the child that would be brought into existence if the embryo were brought to term. Therapeutic cloning would involve creating and destroying an embryo, which, if brought to term, would be the offspring of the genetic parents of the person undergoing therapy. I argue that central arguments in debates about parenthood and genetics therefore suggest that (...) class='Hi'>therapeutic cloning would be prima facie unethical unless it occurred with the consent of the parents of the person being cloned. Alternatively, if therapeutic cloning is thought to be legitimate, this undermines the case for some uses of reproductive cloning by implying that the genetic relation it establishes between clones and DNA donors does not carry the same moral weight as it does in cases of normal reproduction. (shrink)

Concern for “reproductive liberty” suggests that decisions about embryos should normally be made by the persons who would be the genetic parents of the child that would be brought into existence if the embryo were brought to term. Therapeutic cloning would involve creating and destroying an embryo, which, if brought to term, would be the offspring of the genetic parents of the person undergoing therapy. I argue that central arguments in debates about parenthood and genetics therefore suggest that (...) class='Hi'>therapeutic cloning would be prima facie unethical unless it occurred with the consent of the parents of the person being cloned. Alternatively, if therapeutic cloning is thought to be legitimate, this undermines the case for some uses of reproductive cloning by implying that the genetic relation it establishes between clones and DNA donors does not carry the same moral weight as it does in cases of normal reproduction. (shrink)

Angeregt durch Pierre Hadots bahnbrechendes Buch Philosophie als Lebensform ist in den letzten Jahren das griechische und romische Denken als eine Art philosophische Praxis in den Blick gekommen. Philosophie sei nicht nur eine Schule des Denkens, sondern auch eine Schule des Lebens. Philosophie eroffne die Moglichkeit einer Bekehrung des Menschen, die das ganze Leben verandert und das Wesen desjenigen verwandelt, der sie vollzieht. Im Zusammenspiel von vita contemplativa und vita activa vermag ein Mensch eine Lebenseinstellung zu kultivieren, die auch dann (...) tragt, wenn Schicksalsschlage oder Erfahrungen von Leid und Enttauschung ihn die Fluchtigkeit bzw. Abgrundigkeit seiner Existenz erkennen lassen. Dazu bedarf es allerdings einer meditativ-reflexiven Transformation durch geistige Ubungen, wie sie die Schulen der Epikureer, Stoiker und Skeptiker im Sinne einer Therapeia entwickelt haben. Verwandte Ideen und Ansatze finden sich spater bei Philosophen wie David Hume, William James, Friedrich Nietzsche, Ludwig Wittgenstein oder Karl Jaspers, aber auch in der chinesischen und in der indischen Tradition lassen sich bei Buddha, im Lotos-Sutra, bei Nagarjuna, Sri Aurobindo oder Zhuangzi Grundgedanken einer therapeutischen Wirkung von Philosophie ausmachen. Ram Adhar Mall und Damian Peikert bringen diese Traditionslinien in einen Dialog, der nicht nur fur die interkulturelle Philosophie eine Bereicherung bedeutet. (shrink)

This paper aims at analysing the problem of remainder and regret in moral conflicts. Four different approaches are subject of investigation: a moral-theoretical strategy aimed at consistency; a narrative approach of moral coherence and open consensus; Plato's moral methodology of dialogue and aporetic resolution of moral conflicts and finally, an approach deduced from Greek tragedy of emotional resolution of moral conflicts. A central argument is that since there exists no theoretically convincing way of solving the problem of remainder and regret, (...) the attention should instead be directed towards finding alternative ways of coping with this problem. The three last approaches subject of investigation attempt - each in their own way - to do this. Teaching medical ethics to medical students and the burning issue of medical fallibility is used to demonstrate the relevance of these forms of resolution in a medical context. (shrink)

In the course of the long 18th century, medical theory and theories underwent profound changes. These in turn reflected discontinuities and often conflicting assumptions and premises, engendering divergent concepts of physiology and pathology. However, most theoretical considerations were only very inconsistently and partially reflected in therapeutic practice, which continued to be governed by experience with traditional and known medicinals and by patient expectations regarding provider practices. Additional factors in therapeutic decision making were economic considerations and preferences for particular (...) therapies in certain social and religious networks. The present volume deals with some aspects of this complex relationship between medical theory and therapeutic practice, using a transatlantic perspective. Individual essays reflect the current state of historical research in Germany, the US and Great Britain. (shrink)

In a well-known paper entitled, ‘Survival Lottery’, published in a philosophical journal, John Harris proposed for discussion an interesting idea for saving the lives of certain kinds of patients who are at the point of death. Let us assume that there are two such patients, one that could be saved by a heart transplant and the other by the transplantation of a pair of lungs. However, no suitable organs are available for this purpose. Might it perhaps not be immoral to (...) select, by national lottery, a healthy person, who would be sacrificed, his organs used as transplants, and thus two lives be saved through the sacrifice of only one? This proposal is subjected first to a critical philosophical and ethical analysis, and then to a critical analysis from the point of view of Jewish Ethics as embodied in Halakhah. CiteULike Connotea Del.icio.us What's this? (shrink)

This book discusses the philosophical questions asked by counselees and the philosophical dilemmas faced by counselors in philosophical counseling. It illustrates the role of tacit philosophical assumptions in the creation and resolution of problems, as well as the contribution of philosophical dialogue in overcoming presuppositions.

Twenty-five years after the term "therapeutic misconception’ (TM) first entered the literature, most commentators agree that it remains widespread. However, the majority of scholarly attention has focused on the reasons why a patient cum human subject might confuse the goals of research with the goals of therapy. Although this paper addresses the social and cultural factors that seem to animate the TM among subjects, it also fills a niche in the literature by examining why investigators too might operate under (...) a similar confusion. In framing these issues, the paper expressly adopts a Wittgensteinian approach to evaluating the TM, suggesting that interlocutors do not need any analytic definition of the TM to use the term meaningfully in thinking about the moral implications of the TM in practice. (shrink)

Abstract:In reference to Pierre Hadot's idea of spiritual exercises, this essay examines how Zhiyi suggests his unique vision of spiritual exercises for therapeutic transformation. Though the recent interest in Madhyamaka spiritual exercises has focused on the implication of non-duality for moral-psychological transformation and self-cultivation, more research is needed on the issue of contradiction in spiritual exercises, which can also relate to the recent concern for dialetheism and the pragmatics of contradiction in Tiantai studies. This essay traces how dialectic contradiction (...) and its pragmatic uses underlie Zhiyi's non-dualistic spiritual exercises, examining his unique philosophical vision of the middle and its effects on therapeutic transformation, which is to be cultivated through various meditative techniques. (shrink)

The article sets out to develop the concept of attention as a key aspect to building the possible therapeutics that Bernard Stiegler’s recent works have pointed to (The Automatic Society, 2016, The Neganthropocene, 2018 and Qu’appelle-t-on Panser, 2018). The therapeutic aspect of pharmacology takes place through processes that are neganthropic; therefore, which attempt to counteract the entropic nature of digital technologies where there is flattening out to the measurable and the calculable of Big Data. The most obvious examples of (...) this flattening out can be seen in relation to the use of natural language processing technologies for text interpretation and the use of text analytics alongside student analytics. However, the process of exosomatisation of knowledge takes place in forms of hypomnesic tertiary retentions or digital technologies. The loss of knowledge is inherent to these processes of exteriorisation, this loss of knowledge takes place through a process proletarianisation which Marx had pointed to in the Grundisse (1939). The therapeutic gesture is, therefore, an intrinsically educational one, where the loss of knowledge of the pharmacological nature of digital technologies is counteracted by other forms of knowledge construction that can be enabled by digital technologies. Hence, there is a profound educational gesture necessary to enable the re-harnessing of technology to enable the therapeutics. This paper will argue that the positive re-harnessing, the therapeutics, can take place through the development of new forms of neganthropic gestures which can be afforded by the development of specific forms of digital technologies. These also enable a contributive research process whereby the rationalisation of the production of knowledge within the university can be challenged by collaborative, interpretative processes of knowledge production. (shrink)

Conceptually, recognition claims a cardinal role in many prominent philosophical theories. Kant, in the Critique of Pure Reason, uses the German word Rekognition—a term that in many ways has no antecedent in prior tradition—to signify the identification, the grasping of, a unified meaning through thought. However, it is through Hegel that a substantial step in practical philosophy is taken, and recognition is put into dialogue with self-consciousness and freedom. Hegel uses the German word Anerkennung, in the period of Jena (...) Realphilosophie, to mean the "real" actualization of freedom through a struggle which leads to two different levels of recognition: legal and moral—their forms constituted by love... (shrink)

This article is about the therapeutic use of photography in mental health care. We will first describe the intelligent nature of perception as we understand on the basis of neurobiological research findings. We will link our interpretation of visual perception with the phenomenology of perception from the theory of Merleau‐Ponty.. Then we will discuss how patients in mental health care with mental health problems may profit by an experiential approach that is concomitant with the existential reality described by Merleau‐Ponty. (...) The experiential approach we go into more detail is Focusing. We will demonstrate the limitations and feasibility of Focusing in the procedures of working with photography as a therapeutic medium. (shrink)

The ethical treatment of cancer patientsparticipating in clinical trials requiresthat patients are well-informed about thepotential benefits and risks associated withparticipation. When patients enrolled in phaseI clinical trials report that their chance ofbenefit is very high, this is often taken as evidence of a failure of the informed consent process. We argue, however, that some simple themes from the philosophy of language may make such a conclusion less certain. First, the patient may receive conflicting statements from multiple speakers about the (...) expected outcome of the trial. Patients may be reporting the message they like best. Second, there is a potential problem of multivocality. Expressions of uncertainty of the frequency type can be confused with expressionsof uncertainty of the belief type. Patients may be informed using frequency-type statements and respond using belief-type statements. Third, each speech episode involving the investigator and the patient regarding outcomes may subservemultiple speech acts, some of which may beindirect. For example, a patient reporting ahigh expected benefit may be reporting a beliefabout the future, reassuring family members,and/or attempting to improve his or her outcome by apublic assertion of optimism. These sources oflinguistic confusion should be considered injudging whether the patient's reported expectation isgrounds for a bioethical concern that there hasbeen a failure in the informed consent process. (shrink)

Designing and manufacturing medical devices for specific patients is becoming increasingly feasible with developments in 3D printing and 3D imaging software. This raises the question of how patient-specific devices can be evaluated, since our ‘gold standard’ method for evaluation, the randomised controlled trial, requires that an intervention is standardised across a number of individuals in an experimental group. I distinguish several senses of patient-specific device, and focus the discussion on understanding the problem of variations between instances of an intervention for (...) RCT evaluation. I argue that, despite initial appearances, it is theoretically possible to use RCTs to evaluate some patient-specific medical devices. However, the argument reveals significant difficulties for ensuring the validity of such trials, with implications for how we should think about methods of evidence gathering and regulatory approaches for these technologies. (shrink)

Morality and mental health are now inseparably linked in our view of character. Alcoholics are sick, yet they are punished for drunk driving. Drug addicts are criminals, but their punishment can be court ordered therapy. The line between character flaws and personality disorders has become fuzzy, with even the seven deadly sins seen as mental disorders. In addition to pathologizing wrong-doing, we also psychologize virtue; self-respect becomes self-esteem, integrity becomes psychological integration, and responsibility becomes maturity. Moral advice is now sought (...) primarily from psychologists and therapists rather than philosophers or theologians. This book asks: are we replacing morality with therapy, in potentially confused and dangerous ways, or are we creatively integrating morality and mental health? According to the book, it's a little bit of both. It surveys the ways in which morality and mental health are related, touching on practical concerns like love and work, self-respect and self-fulfillment, guilt and depression, crime and violence, and addictions. Terming this integrative development “the therapeutic trend in ethics,” the book uses examples from popular culture, various moral controversies, and draws on line of thought that includes Plato, the Stoics, Freud, Nietzsche, and contemporary psychotherapeutic theories. The book develops some interesting conclusions, among them that sound morality is indeed healthy, and that moral values are inevitably embedded in our conceptions of mental health. In the end, the book shows how both morality and mental health are inextricably intertwined in our pursuit of a meaningful life. (shrink)

What is the relation between later Wittgenstein’s method of dissolving philosophical problems by reminding us of how we would actually use words, and his famous statement that “meaning is use ” in Investigations §43? The idea is widespread among readers of Wittgenstein that a close relation obtains between the two. This paper addresses a specific type of answer to this question: answers which have drawn on remarks of Wittgenstein’s where he explicitly establishes a connection between this method and certain misconceptions (...) about meaning – remarks such as Investigations §117. The paper will discuss answers which have advanced the following claim: Since it is places such as §43 which play a main role in debunking misconceptions of this kind, Wittgenstein’s statement that “meaning is use” must be taken as directly related to the method of asking for the use of words. Drawing on so-called “therapeutic” readings of Wittgenstein, what I intend to show is that this seemingly straightforward answer fails to fully accommodate the fact that §43 is itself a reminder of how we would actually use a word. The paper sets out to show how truly acknowledging this forces us to rethink the relation between “meaning is use” and this method of Wittgenstein’s. (shrink)

New class of therapies, including bipolar therapies (BPT) and paradoxical unipolar therapies (PUT) were firstly proposed in relation to a clinical insight and to some results of biological investigations, then they gave rise to mathematical modeling which brought a justification of these therapies, at least from a theoretical point of view. After recalling the mathematical model for the regulation of agonistic antagonistic couples, and reporting the fundamental types of control simulation by means of it, we point out the validity of (...) therapeutical applications inferred from this model. These therapy modalities, including BPT and PUT, now concern the following diseases: astrocytomas, epilepsia and trials on multiple sclerosis. Even if such attempts are in their early stage, noticeably for the last case where biological changes have mainly been studied, it seems that a large span of treatments is open to BPT and PUT. Improvement of these techniques in the future depends, in our opinion, on a parallel working on the dynamics of the mathematical model and the dynamics, perceived by clinical insight and confirmed by biological investigations, of the body reactions to such strategies. Justification of BPT and PUT was given, by resorting to the notion of pathological homeostasis which, too often, intervenes in order to nullify the effects of unilateral (not paradoxical) therapies. This research has elicited some therapies which use two agents with antagonistic effects or only an agent with effects similar to the agent already in excess in the body - in both cases at nearly physiological doses. (shrink)

Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical (...) implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and (...) risks of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

This paper offers a critical response to the claims of Sivin and Lloyd and Mattice to the effect that Greek and Roman philosophy was characterised by a predominance of combat metaphors. Drawing on Plato and Plutarch, as well as contemporary studies led by Nussbaum, I argue that a host of different metaphors was demonstrably used in the Greek tradition to describe philosophy and its subjects, led by the therapeutic or medicinal metaphor of philosophy as ‘therapy of (...) desire’ or of desiderative opinion. I propose that it was the sophists like Protagoras, at least as they are depicted by Plato, who sought to conceive of philosophising as a strategic, warlike activity. In conclusion, I reflect on the invisibility of the medicinal metaphor, outside of certain dedicated studies in the history of ideas, in contemporary thinking about Western philosophy and its past. (shrink)

In clinical lectures given between 1850 and 1852, William Pultney Alison, a senior Edinburgh physician, reflected on whether therapeutic bloodletting could be useful in some cases of pneumonia but harmful in others. If so, Alison reasoned, a change in the form of the disease—a change of type—could explain why therapeutic bloodletting had been nearly abandoned in treating a disease for which, only a few years earlier, it had been the standard therapy. In response, a young pathologist, John Hughes (...) Bennett, denied that anything like a change of type had occurred and insisted that bloodletting had never been an effective therapy. Over the next two decades, more than forty physicians debated the usefulness of bloodletting and the reasons for its decline. This debate, known as the Edinburgh Bloodletting Controversy, has attracted the attention of contemporary historians. Those who have discussed the debate side with Bennett and give Alison little serious attention. I argue that by examining the texts to determine what the issues really were, we can see that Alison may actually have been right. Moreover, this examination illuminates the practice of bloodletting and reveals one hitherto unrecognized factor that contributed to its decline. (shrink)

A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral (...) effects of three widely used drugs or drug types: propranolol, selective serotonin reuptake inhibitors, and drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis. (shrink)

The idea of philosophy as a kind of therapy, though by no means standard, has been present in metaphilosophical reflection since antiquity. Diverse versions of it were also discussed and applied by more recent authors such as Wittgenstein, Hadot and Foucault. In order to develop an explicit, general and systematic model of therapeutic philosophy a relatively broad and well-structured account provided by Martha Nussbaum is subjected to analysis. The results obtained, subsequently, form a basis for a new (...) model constructed around the set of notions intrinsically connected with any, philosophical, psychological, or medical, form of therapy. The conceptual framework of: disease and its symptoms, the health ideal, the process of treatment with its techniques, therapeutic theory, physician, patient, and the physician-patient relationship is constructed and investigated in the context of its possible metaphilosophical use. An illustrative application of this scheme to philosophical therapy developed by Stoicism is, then, discussed. Finally, the issue of the therapeutic metaphilosophy's scope as well as the problem of therapeutic philosophy's specificity and integrity are briefly indicated. (shrink)

Researchers, clinicians, and patients have good reasons for wanting answers to causal questions of disease and therapeutic intervention. This paper uses microbiologist Robert Koch’s pioneering work and famous postulates to extrapolate a logical sequence of evidence for confirming the causes of disease: association between individuals with and without a disease; isolation of causal agents; and the creation of a counterfactual. This paper formally introduces counter-counterfactuals, which appear to have been used, perhaps intuitively, since the time of Koch and possibly (...) earlier. An argument is presented that counter-counterfactuals are a useful tool for identifying necessary causes of disease, and sometimes must be used in place of isolation which is not always possible. In addition, a logical sequence of causal evidence for a therapeutic intervention is presented: creating a counterfactual, comparisons between subjects in receipt of treatment versus those who are not, and counter-counterfactuals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.3 (2005) 239-242 [Access article in PDF] The Uses of Borrowed Knowledge: Chaos Theory and Antidepressants Stephen H. Kellert Keywords chaos, metaphor, rhetoric, values Ever since the popularization of chaos the-ory in the 1980s, there has been an explo-sion of interest in work in nonlinear dynamics generally and the study of strange attractors in particular. From law to economics to theology, researchers in the (...) social sciences and the humanities have sought to make use of the concepts, methods, and results of chaos theory. Previous generations have seen similar attempts to explore the consequences of relativity theory or quantum mechanics for their own areas of inquiry. In examining the implications of chaos for the treatment of mental illness, Douglas Heinrichs provides an example of this phenomenon, which I call "borrowed knowledge." Lacking expertise in the areas of psychotherapy or psychopharmacology, I view his suggestions as a case study in the ways that knowledge gets used across disciplinary boundaries. In these remarks, I examine some of the different functions that borrowed knowledge can serve in order to argue that although cross-disciplinary borrowing can be a fruitful source of new insights, it is not without its dangers. I look at the persuasive function that borrowed knowledge can serve in making one's ideas plausible candidates for further exploration, as well as in motivating methodological change. I look at the conceptual work performed by metaphors, paying special attention to the question of how we can judge whether or not a nonliteral use of knowledge from the natural sciences is fruitful. And finally, I look at the ways in which borrowed knowledge can be used to address evaluative questions—in this case, questions about autonomy and appropriate therapeutic practice. I do not mean for these various functions to be thought of as exclusive categories. Instead, they overlap, interact, and combine in various ways. Rhetorical Functions, Disciplinary Prestige, and Methodologic Change In examining the persuasive uses of chaos theory, I should make it clear that by "persuasive" I do not mean illegitimate or deceptive. When Heinrichs points out that what he calls the traditional model of brain function is used to [End Page 239] present and explain the use of antidepressants (ADs) to clinicians and the general public, it becomes clear that he believes an alternative model can be useful for explicating and justifying the use of ADs for clinicians and patients. This descriptive function of the metaphorical appeal to a chaotic "attractor landscape" shows up where Heinrichs discusses the use of the chaotic model for patient education and the "rationale for pharmacotherapy," giving patients "appropriate expectations."But the rhetorical functions of chaos theory also come into play with audiences other than patients; they apply to the audience for the scholarly article itself, perhaps attracting attention because of the novelty or promise of a new field of research, but also harnessing the considerable disciplinary prestige that the natural sciences wield in our culture. All of these functions are useful in directing attention to the author's suggestions for further research, especially where he suggests that it would provide the clinician with guidance in working with an individual patient. Here I take it that Heinrichs has made fruitful use of the work of Thelen and others on the variability of individual developmental trajectories. This proposal for methodological change suggests that focusing on the dynamics of system and its evolution through time may be important in addition to focusing on equilibrium states. The disciplinary prestige of the natural sciences can provide a valuable and legitimate resource for the persuasive task of encouraging one's colleagues to explore a new methodological approach.A further rhetorical use is found in the appeal to the unpredictability of chaotic systems to account for the variability of results in the application of ADs. We see this where Heinrichs says, "a meaningful science of persons is possible even in the face of their ultimate unpredictability" (2005, 221). The disciplinary prestige of the natural sciences, which in studying chaotic systems are able to achieve genuinely "scientific" status without being able... (shrink)

Why does Bernard Stiegler speak of “this culture, which I have named, after Epictetus, my melete?” In the first part of this article, I elucidate Stiegler’s claims about both Stoic exercises of reading and writing and their significance for the interpretive questions he has adapted from Michel Foucault and Jacques Derrida. In particular, I address the relations among care for oneself and others, the use of material technologies, and resistance to subjection or “freedom.” In the second part, I consider the (...) merits and limitations of Stiegler’s comments about reading and writing in Stoicism, with particular attention to Epictetus. We will see that Stiegler’s interpretive frame-work casts considerable light on ancient texts and contexts, on the condition that it be combined with close reading of ancient texts and engagement with specialist scholarship. Finally, in the conclusion, I will suggest that the history of technology in Epictetus’s time contributes to a debate about Stiegler’s theories.Bernard Stiegler signale à plusieurs reprises l’importance des exercices stoïciens de lecture et d’écriture. Dans la première partie de cet article, j’essaye de clarifier ces assertions et d’expliquer leur lien aux oeuvres de Michel Foucault et de Jacques Derrida. Il s’agit en particulier des rapports entre le souci de soi et d’autrui, l’usage des techniques et des matériaux et la résistante à la soumission ou à la « liberté ». Dans la deuxième partie, je considère les mérites ainsi que les limites des remarques de Stiegler sur la lecture et l’écriture au sein du stoïcisme, en portant une attention particulière à Épictète. Le point du vue stieglerien donnera de nouvelles significations à quelques passages des oeuvres d’Épictète, à condition qu’il soit conjugué à une lecture attentive d’études spécialisées et de textes anciens. Je conclurai, dans la troisième partie, en proposant que l’histoire des techniques à l’époque d’Épictète pourrait alimenter un débat à l’égard des théories de Stiegler. (shrink)

In his article Banicki proposes a universal model for all forms of philosophical therapy. He is guided by works of Martha Nussbaum, who in turn makes recourse to Aristotle. As compared to Nussbaum’s approach, Banicki’s model is more medical and less based on ethical argument. He mentions Foucault’s vision to apply the same theoretical analysis for the ailments of the body and the soul and to use the same kind of approach in treating and curing them. In his interpretation of (...) philosophical therapy, there are, however, some controversial issues, to which we would like to call attention: -/- Is restoring health by a philosophical method of treatment – health understood as a person’s ability to reach his/her vital goals – a convincing explication of philosophical therapy in general? In order to answer this question, it may be useful to look at Plato. It is not only Platonism (and especially Neo-platonism since Plotinus) that questions the idea that therapy is necessarily connected with „vital goals“. Buddhist and Gnostic philosophies are questioning „the vital“ in general. The immense effort in the history of philosophy to liberate the mind from the body casts doubt on the project to explain philosophical therapy solely in analogy to medical therapy. -/- According to Banicki a therapeutic philosophy has to identify the diseases it attempts at curing. There are, however, reasons for associating the term therapy with suffering/risk rather than disease. If a therapy aims at reducing the fear of death, as for example many classical philosophical therapies do, then there is no disease to be cured. A model based on chances and risks also has the advantage that the Buddhist and Stoic reinterpretation of desires/emotions as “diseases” can be dropped in contemporary philosophical therapy. -/- Banicki mentions the comparison of therapies as one of the primary goals of modelling. Methods should be verified by a statistical correlation between method and therapeutic success and/or by a theory which justifies the method. Some forms of therapies, however, avoid theory-specific terms and concepts in favor of an unprejudiced interpretation of the patient’s statements. Others share the (Nietzschean) aspiration to explore and change measures of value. If the therapeutic process is seen as a unique phenomenon, then there can be no theory and no statistics with co-occurrences. -/- According to Banicki philosophical therapy has to describe techniques which qualify as genuinely philosophical. Techniques like maieutics and hermeneutics, however, are antique philosophical “inventions”, which were later adopted by psychotherapy. If meditation is accepted as a therapeutic tool – as it was in ancient times – then there is not only a methodical but also an emotional relation to religion. If finally, the Socratic search for a good life is seen as one of the characteristics of philosophical therapy, then delimitation even turns into a criterion for non-philosophical therapies. The search for a good life requires an interdisciplinary approach. -/- For the concretization of the formal structure, we suggest a typology of therapies, which is based on chances and risks. Such a typology has the advantage, that it can model conflicting (and even opposing) forms of therapies. The variety of therapeutic goals and methods is a consequence of the historical development towards conceptual freedom. (shrink)

An important strand of current experimental philosophy promotes a new kind of methodological naturalism. This chapter argues that this new ‘metaphilosophical naturalism’ is fundamentally consistent with key tenets of Wittgenstein’s metaphilosophy, and can provide empirical foundations for therapeutic conceptions of philosophy. Metaphilosophical naturalism invites us to contribute to the resolution of philosophical problems about X by turning to scientific findings about the way we think about X – in general or when doing philosophy. This new naturalism (...) encourages us to use resources from psychology that can empirically vindicate precisely some of the most controversial aspects of Wittgenstein’s conception of philosophy: They can establish the need, and provide key tools, for something worth calling ‘therapy’, in philosophy. As ‘pudding proof’ this chapter shows how methods and findings from psycholinguistics motivate and facilitate a therapeutic approach to a characteristically philosophical problem: ‘the problem of perception’. (shrink)

In Alan Bennett’s play The History Boys, Irwin, a sixth-form history tutor destined for a media career (based, it is rumored, on that specialist in historical controversy Niall Ferguson) sets out his views on how a difficult change in the law that will affect individual rights should be dealt with. The tactic Irwin advocates is for the Government to insist that the Bill, rather than reducing the liberty of the subject “amplifies it.” The use of paradox, notes Irwin, “works well (...) . . . the loss of liberty is the price we pay for freedom type thing” (Bennett 2004, 3). Thus, in a few sentences, Bennett encapsulates one of the greatest, or, at least, what we in the West have come to think of as one of the greatest, of .. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy's Role in Psychopathology Back to Jaspers and an Appeal to Grow PracticalThe author reports no conflicts of interest.In "Philosophy's role in theorizing psychopathology," Gibson presents a defense of the continued relevance of philosophy to psychopathology, and a non-exhaustive framework for the role of philosophy in this domain (Gibson, 2024). I find it hard to disagree that psychopathology is soaked in philosophy from its (...) origins, and that to try and dry it out would be both unwise and impossible.In this commentary, I go back to Karl Jaspers' account of the role of philosophy in his General Psychopathology. In doing so, I do not find that Gibson adds anything new, but instead gives us a well-illustrated reminder that philosophy "is operative within every living science" (Jaspers, 1997, p. 770).Situated Psychopathological TheorizingGibson addresses a broad 'we' who might be engaged with psychopathological theorizing. This seems to encompass three main settings, from which examples are drawn.1. Everyday and regulative social practices (ordinary and legal setting).2. Empirically driven disciplines which work with psychopathological constructs (academic setting).3. Psychiatry and psychotherapy (clinical setting).In my view, it is a mistake not to map the terrain where psychopathological theorizing is situated. In each setting psychopathological theorizing has its own set of aims and constraints. In the ordinary setting, the aim might be to know whether to blame a loved one for their action. In the legal setting it might be to decide whether treatment or punishment is appropriate. In the clinical setting, the aim is usually a therapeutic assessment, and moral stance taking is often best kept at bay. In the academic setting, we might want to ensure our concepts are reliable and valid, opening them up to investigation using objective scientific methods. [End Page 13]Beyond what can be said in the most general terms, the role of philosophy will look different in these different situations.Understanding Is Not (Just) a Philosophical ToolUnderstanding is a mode of knowing that is concerned with the particular, rather than the general, and accessed inter-relationally, relying on tacit knowledge and empathetic imagination. Gibson introduces the concept as an elementary form of social intuition, used in ordinary life to make sense of social relations and other people's behaviors and reactions. I agree with Gibson, drawing on Strawson, that Understanding is a mode of knowledge that involves the subject of enquiry as a participant (Strawson, 1982). There is a moral imperative to take this stance, which drives us to value the expansion of what we are able to understand of other people's mental states. This at least partly motivates the agenda when we theorize about psychopathology.At times throughout his argument, Gibson seems to be arguing for the role of Understanding in psychopathological theorizing, in place of his explicit aim of arguing for the role of philosophy. However it is not at all clear that this replacement can be made. Accepting the picture drawn, Understanding is not any more the expertise or domain of the philosopher than the author, police officer, or sociologist. We are surely not meant to take Understanding as a uniquely philosophical tool, but rather a mode of knowing available to all social agents, integral to social reasoning in ordinary life and in the human studies.What philosophy can distinctively do is point to and defend the existence of forms of intersubjective and tacit knowledge within human studies such as psychopathology. For Jaspers, Understanding can be a scientific tool, albeit one that reminds us that knowledge in psychopathology is not all of one kind. One role for philosophy therefore is to help us to "distinguish the different modes of knowing," so that we might "order knowledge into a comprehensive whole" (Jaspers, 1997, p. 769). This is akin to the 'synthetic' role that Gibson proposes.Philosophy and ScienceJaspers defines scientific knowledge broadly as knowledge with "general validity, convincing insights (which can be proved), clarity of method, and the possibility for a meaningful discussion" (Jaspers, 1997, p. 768).We do not get such a definition from Gibson, but in the sections of... (shrink)

The Western world is experiencing a resurgence of interest in the therapeutic potential of psychedelics, most of which are derived from plants or fungi with a history of Indigenous ceremonial use. Recent research has revealed that psychedelic compounds have the potential to address treatment‐resistant depression and anxiety, as well as post‐traumatic stress disorder and addictions. These findings have contributed to the decriminalization of psychedelics in some jurisdictions and their legalization in others. Despite psychedelics’ opaque legal status, numerous companies and (...) individuals are profiting from speculative investments with few, if any, benefits accruing to Indigenous Peoples. In this paper, we suggest that the aptly named “psychedelic renaissance,” like the European Renaissance, is made possible by colonial extractivism. We further suggest that Indigenous philosophical traditions offer alternative approaches to reorient the “psychedelic renaissance” towards a more equitable future for Indigenous Peoples, psychedelic medicines, and all our relations. (shrink)

The few people familiar with the pseudo-Platonic dialogue Axiochus generally have a low opinion of it. It's easy to see why: the dialogue is a mish-mash of Platonic, Epicurean and Cynic arguments against the fear of death, seemingly tossed together with no regard whatsoever for their consistency. As Furley notes, the Axiochus appears to be horribly confused. Whereas in the Apology Socrates argues that death is either annihilation or a relocation of the soul, and is a blessing either way, "the (...) Socrates of the Axiochus wants to have it both ways": death is both annihilation and a release of the soul from the body into a better realm. This may be used to construct a valid argument for the conclusion that death is not evil, but at the expense of having a contradiction as one of its premises. But D. S. Hutchinson has recently proposed that these inconsistencies shouldn't surprise us if we view the Axiochus as "an unconventional version of a very conventional genre--the consolation letter." In this paper I expand on Hutchinson's brief suggestion and argue that the Axiochus can be rehabilitated by paying attention to its genre. Although the Axiochus does display many similarities to the consolation letter, the shift from letter to dialogue does--pace Hutchinson--significantly affect what's going on. Within the dialogue, Socrates behaves toward Axiochus in a way similar to the way the author of a consolation letter behaves towards the letter's reader: he is willing to use inconsistent arguments, borrowed from any source, in order to soothe the patient. However, in depicting this type of consolatory relationship between Socrates and Axiochus, the dialogue itself is not aiming at consoling its readers. Instead, it should be seen as displaying for the reader's consideration a certain type of consolatory argumentative practice. -/- Socrates notes that Axiochus is "very much in need of consolation" (365a), and he uses any means necessary to accomplish this task. Socrates exhibits many ways in which he is willing to sacrifice argumentative hygiene for the sake of therapeutic effectiveness. These include: -/- * Use of arguments with inconsistent premises, presented in propria persona. * Appeals to emotion * Tailoring arguments to the audience. * Presenting invalid arguments so as to induce unjustified but comforting beliefs. * Evasion. In these respects, I think that Socrates' argumentative practice is best compared to PH III 280-1, where Sextus Empiricus says that the skeptic will deliberately use logically weak arguments as long as they work. Dorothy Tarrant claims that what links the Socrates of the Axiochus to Socrates as he appears elsewhere in the Platonic corpus is his evident care for the welfare of his interlocutor's psyche. But this concern takes a quite different form in the Axiochus than it usually does. As with Sextus, psychic therapy in the Axiochus involves relief from pain. The primary difference between them is that Socrates, unlike Sextus, is not aiming at producing epochê in his patient. (shrink)

While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment (...) effects. We use the pulmonary condition bronchiectasis as a source of examples of the importance of mechanistic reasoning to clinical practice. (shrink)

This book provides the first in-depth exploration of the importance of music for Ludwig Wittgenstein’s life and work. Wittgenstein’s remarks on music are essential for understanding his philosophy: they are on the nature of musical understanding, the relation of music to language, the concepts of representation and expression, on melody, irony and aspect-perception, and, on the great composers belonging to the Austrian-German tradition. Biography and philosophy, this work suggests that Wittgenstein was a composer of philosophy who used (...) the musical form as a blueprint for his own writing and thought. For Wittgenstein music is not alone, but connects and resonates with our cultural forms of life. His relation to composers, especially to Richard Wagner and Gustav Mahler, enables Wittgenstein to address the question of how to do philosophy and compose music in the breakdown of tradition. Unlike his conservative musical sensibility, Wittgenstein’s philosophy is open to musical experiments. Reflecting on his remarks on music makes it possible to compare the therapeutic aim of his philosophical activity with that of music, and thus notice affinities between Wittgenstein and John Cage. Béla Szabados has a Ph.D. in philosophy from the University of Calgary and is professor of philosophy at the University of Regina. His publications include Wittgenstein Reads Weininger (2004), Wittgenstein at the Movies (2011) and Wittgenstein on Race, Gender, and Cultural Identity: Philosophy as a Personal Endeavour (2010). (shrink)

Expressions belonging to the lexical fields of medicine and psychology recur repeatedly throughout Ludwig Wittgenstein’s writings since the 1930s. He uses therapeutic vocabulary mostly in the context of metaphilosophical reflections, i.e. reflections about the activity of philosophizing. But how are we to understand such expressions? Even though some interpreters admit their metaphorical nature, the methodological background of using figurative language has hitherto been neglected concerning this matter. Here, I argue that Wittgensteinian therapy is what G. Lakoff and M. Johnson (...) have termed a “structural metaphor”. Thus we do not only obtain a better understanding of Wittgenstein’s metaphilosophy, but also of the role metaphor use plays within his methodology. I shall try to show that he uses therapeutic metaphors (akin to pictorial elements) as argumentative and epistemological devices and thereby investigates the philosophically problematic expression ‘philosophy’ grammatically. (shrink)

In spite of Stein and Glasier's justifiable conclusion that initial optimism concerning the immediate clinical applicability of neural transplantation was premature, there exists much experimental evidence to support the potential for incorporating this procedure into a therapeutic arsenal in the future. To realize this potential will require continued evolution of our knowledge at multiple levels of the clinical and basic neurosciences.

Background: Psychedelics are known for their powerful mental effects due to the activation of 5HT-2A receptors in the brain. During the 1950s and 1960s, research was conducted on these molecules until their criminalization. However, their clinical investigation as therapeutic tools for psychiatric disorders has revived the deontological ethics surrounding this subject. Questions arise as research on their therapeutic outcome becomes a reality. We aim to explore deontological ethics to understand the implications of psychedelics for the clinician, patient, and (...) society. Results: A total of 42 articles were considered for this review. Methods: A methodological search of psychedelic studies from 2017 to 2022 was conducted in PubMed, Scopus, EBSCOhost, and ScienceDirect to address the deontological ethics of clinical psychedelic use. Conclusion: Psychedelics need to be culturally contextualized, epistemic harm minimized and represented to ensure informed consent. Open data and commissions are needed to ensure safe and equal distribution. (shrink)