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

Jealousy is an emotion that arises in diverse circumstances and is experienced in phenomenologically diverse ways. In part because of this diversity, evaluations of jealous subjects tend to be conflicting and ambiguous. Thus philosophers who are interested in the moral status of jealousy face a challenge: to explain how, despite the diversity of jealous subjects and experiences of jealousy, our moral evaluations of those subjects in light of those experiences might be unified. In this project, I confront and respond to (...) this challenge, which I call the challenge of heterogeneity. -/- In Part I, I refine and expand on existing descriptive accounts of jealousy, defending an account with three necessary but not sufficient conditions. On my view, if one is jealous: -/- A. One desires that oneself stand in some relation to a specific, non-replicable good. B. One has in mind a (possibly imagined) rival and regards the rival’s having the good as logically or causally inconsistent with the satisfaction of this desire C. One has in mind some (possibly imagined) set of circumstances in which this desire would be satisfied. -/- In discussing this view I emphasize the role that relationships play in giving rise to jealousy, since its connections to relationships make jealousy descriptively and normatively unique. -/- In Part II, I develop an account of jealousy’s moral significance. To do so, I divide cases of jealousy into three types: those involving jealous desires relating to (1) caring relationships, (2) non-caring relationships, and (3) material goods or personal qualities. I argue that in all three types of cases, jealousy undermines the actual or potential moral value of the jealous subjects’ relationships, and that this undermining provides the paradigmatic moral reason to criticize jealous subjects. Thus I respond to the challenge of heterogeneity without simply portraying jealous subjects as selfish or insecure. -/- After doing so, I consider multiple arguments for the claim that a person’s being jealous sometimes constitutes a moral reason to praise that person. I critique each of those arguments and conclude that we have good reasons to see jealous subjects as worthy of moral criticism but not moral praise. (shrink)

Through an examination of the actual research strategies and assumptions underlying the Human Genome Project (HGP), it is argued that the epistemic basis of the initial model organism programs is not best understood as reasoning via causal analog models (CAMs). In order to answer a series of questions about what is being modeled and what claims about the models are warranted, a descriptive epistemological method is employed that uses historical techniques to develop detailed accounts which, in turn, help to reveal (...) forms of reasoning that are explicit, or more often implicit, in the practice of a particular field of scientific study. It is suggested that a more valid characterization of the reasoning structure at work here is a form of case-based reasoning. This conceptualization of the role of model organisms can guide our understanding and assessment of these research programs, their knowledge claims and progress, and their limitations, as well as how we educate the public about this type of biomedical research. (shrink)

A major goal of this work is to specify some steps of the process by which participants maintain coherency in their conversations.The underlying element of the analysis is a construct called a “context space.” Roughly, a group of utterances that refers to a single issue or episode forms the basis for a context space. Superficially, a conversation is a sequence of utterances; at a deeper level it is a structured entity whose utterances can be parsed into hierarchically related context spaces.As (...) a conversation proceeds, each conversant builds a discourse model that includes the conversation's context space structure, a notion of the present discourse topic, and a list of items being focused upon. Conversational coherency depends upon a lack of conflict between the respective models of the participants. Conflicts are prevented by speakers following high level syntactic and semantic relational rules that enable listeners to identify their discourse models. These rules, given in the study, are highly integrated with the view of conversation presented here—a hierarchy of related context spaces. (shrink)

Through an examination of the actual research strategies and assumptions underlying the Human Genome Project, it is argued that the epistemic basis of the initial model organism programs is not best understood as reasoning via causal analog models. In order to answer a series of questions about what is being modeled and what claims about the models are warranted, a descriptive epistemological method is employed that uses historical techniques to develop detailed accounts which, in turn, help to reveal forms of (...) reasoning that are explicit, or more often implicit, in the practice of a particular field of scientific study. It is suggested that a more valid characterization of the reasoning structure at work here is a form of case-based reasoning. This conceptualization of the role of model organisms can guide our understanding and assessment of these research programs, their knowledge claims and progress, and their limitations, as well as how we educate the public about this type of biomedical research. (shrink)

Bioethics has entered a new era: as many commentators have noted, the familiar mantra of autonomy, beneficence, nonmaleficence, and justice has proven to be an overly simplistic framework for understanding problems that arise in modern medicine, particularly at the intersection of public policy and individual preferences. A tradition of liberal pluralism grounds respect for individual preferences and affirmation of competing conceptions of the good. But we struggle to maintain (or at times explicitly reject) this tradition in the face of individual (...) preferences that we find distasteful, suspect, or even repugnant, especially where the broader social good or respect for equality is at stake. Directed donation presents us with such a dilemma: can we uphold the right of self-determination through respect of individual preferences regarding disposition of transplantable organs while at the same time maintaining an allocation system that reflects values of equity and justice claimed to underlie the socially negotiated practice of transplantation? Or are some preferences simply to be deemed unethical and not respected, even if that leads to a reduction in the number of transplantable organs available and to an apparent disregard for the autonomous decisions of the recently deceased? (shrink)

Autonomy and the Situated Self offers a critique of contemporary mainstream bioethics and proposes an alternative framework for the exploration of bioethical issues. It also contrasts two conceptions of autonomy, one based on a liberal model but detached from its political foundation and one that is responsive to the concerns of virtue ethics and connected to the concept of human flourishing.

Extensive and diverse conceptual work towards developing a definition of ‘mental disorder’ was motivated by the declassification of homosexuality from the Diagnostic and Statistical Manual in 1973. This highly politicised event was understood as a call for psychiatry to provide assurances against further misclassification on the basis of discrimination or socio-political deviance. Today, if a definition of mental disorder fails to exclude homosexuality, then it fails to provide this safeguard against potential abuses and therefore fails to do an important part (...) of the work it was intended to do. We argue that fact-based definitions of mental disorder, relying on scientific theory, fail to offer a robust definition of mental disorder that excludes homosexuality. Definitions of mental disorder based on values do not fare better: these definitions are silent on questions about the diagnostic status of individuals in oppressive societies and over-inclusive of mental or behavioural states that happen to be negatively valued in the individual's social context. We consider the latest definition proposed for the Diagnostic and Statistical Manual-5 in light of these observations. We argue that definition fails to improve on these earlier deficiencies. Its inclusion in the manual may offer false reassurance against repetition of past misclassifications. We conclude with a provocation that if candidate definitions of mental disorder are unable to exclude homosexuality, it might perhaps be preferable not to attempt a definition at all. (shrink)

Autonomy and the Situated Self offers a critique of contemporary mainstream bioethics and proposes an alternative framework for the exploration of bioethical issues.

This paper surveys recent trends in the history of science, using quotations from works published in the last decade. It suggests that philosophers of science have not yet come to terms with those changes, indicates which might or might not lead to productive interchange, and concludes that history and philosophy of science are now further apart than at any time since the early 1960's.

Four experiments and 2 corpus-based studies demonstrate that negation is a determinant factor affecting novel nonliteral utterance-interpretation by default. For a nonliteral utterance-interpretation to be favored by default, utterances should be potentially ambiguous between literal and nonliteral interpretations. They should therefore be (a) unfamiliar, (b) free of semantic anomaly or any kind of internal incongruity, and (c) unbiased by contextual information. Experiments 1–3 demonstrate that negative utterances, meeting these 3 conditions, were interpreted metaphorically (This is not a safe) or sarcastically (...) (Ambitious she is not) when presented in isolation and were therefore processed faster in contexts strongly biasing them toward their nonliteral than toward their (equally biased) literal interpretation. Experiment 4 reduces the possibility that it is structural markedness on its own that induces nonliteralness. Two corpus-based studies provide corroborating evidence, supporting the view of negation as an operator generating nonliteral interpretations by default. (shrink)

This paper attributes to Nietzsche a theory of cultural development according to which pyramid societies—steeply hierarchical societies following a unified morality—systematically alternate with motley societies, which emerge when pyramid societies encounter other cultures or allow their strict mores to relax. Motley societies contain multiple value systems due to individual innovation or intercultural contact, and are less stringent in dictating individuals' roles. Consequently, many people are torn between incompatible values and lack direction, so they are drawn to a morality of mediocrity, (...) which offers the modest goals of comfort and conformity. However, the need to mediate between conflicting values also tends to yield exceptional individuals who create new values, and can reshape the society into a new pyramid society governed by those values. I argue that Nietzsche favors neither type of society at the expense of the other, but believes the alternation itself is valuable: a pyramid society develops a value system to its full potential; then, when it encounters alternative values, the extraordinary individuals in the resulting motley society synthesize the competing systems into a fuller vision of human flourishing. (shrink)

It is necessary to recognize the variety of levels at which values and norms may inappropriately affect the equity of the transplantation process, including candidate selection. Using a revised, richer concept of objectivity, adopted from Longino's work in the philosophy of science and empirical studies of candidate selection, this paper examines what sort of objectivity can be obtained in the transplant candidate selection process, and the closely related question of how selection can occur in an equitable manner. This concept of (...) objectivity requires that transformative criticism occur so that (1) the conceptual and normative commitments underlying selection may be articulated and perhaps challenged, and (2) the relationship between those commitments and criteria for candidate selection may be examined and justified, or revised. Through such transformative criticism, a greater degree of objectivity may be attained, which in turn will increase the likelihood of equity. (shrink)

This article describes a new prenatal genetic test that is painless, early, and increasingly available. State legislatures have reacted by prohibiting abortion for reason of fetal sex or of fetal diagnosis and managing genetic counseling. This article explores these legislative responses and considers how physicians and genetic counselors currently communicate post-testing options. The article then examines the challenges ahead for genetic counseling, particularly in light of the troubling grip of abortion politics on conversations about prenatal diagnosis.

Cultural forces such as film create and reinforce rigidly-defined images of a doctor's identity for both the public and for medical students. The authoritarian and hierarchical institution of medical school also encourages students to adopt rigidly-defined professional identities. This restrictive identity helps to perpetuate the power of the patriarchy, limits uniqueness, squelches inquisitiveness, and damages one's self-confidence. This paper explores the construction of a physician's identity using cultural theorists' psychoanalytic analyses of gender and race as a framework of analysis. Cultural (...) theorists' politically-motivated work provides an excellent point of departure for destabilizing parts of the authoritarian medical hierarchy that can damage a student's professional development. Drawing on such discourse, this paper examines the processes by which a doctor's identity becomes rigidly defined and fixed by daily training. It finally proposes a way for a medical student to extrapolate himself from the current definitions of this identity and create a broader, more malleable concept of professional identity by defining himself from outside of, rather than through, difference. (shrink)

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative (...) analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes and one overarching theme. The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine. (shrink)

A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain’s point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of (...) damaging them beyond repair? (shrink)

The complex regulatory framework governing the U.S. health care system can be an obstacle to programming that address health-related social needs. In particular, health care fraud and abuse law is a pernicious barrier as health care organizations may minimize or forego programming altogether out of real and perceived concern for compliance. And because health care organizations have varying resources to navigate and resolve compliance concerns, as well as different levels of risk tolerance, fears related to the legal landscape may further (...) entrench inequities in access to meaningful programs that improve health outcomes. This article uses food and nutrition programming as a case study to explore the complexities presented by this area of law and to highlight pathways forward. (shrink)

The stage is often a space where artists engage in experiments with identity politics. Plays like Welcome to Thebes appear to present global human engagement and a cultural exchange of ideas. However, using European narrative structures as a playground to explore Africana political issues highlights the limitations to cross-cultural exchange between aesthetic paradigms. This essay first articulates a conflict between European and Africana aesthetics and then offers an analysis of gender dynamics operating in the play Welcome to Thebes, arguing that (...) performative conditions not only constrain racialized realities, but also limit the possibility of cross-cultural performances of history. (shrink)

I set out to read the book of Joshua together with its most literal interpreters – those who enacted a version of the war for the Promised Land – and suggest that interpretations of the book are always bound up with current ideas about war and territorial rights. In particular, I analyze how David Ben-Gurion, the first Prime Minister of Israel, and his Bible study group parsed the book of Joshua and argue that their interpretations, like the book of Joshua (...) itself, represent projections of nationalist desire onto a varied, multifarious social setting. Joshua’s conquest and Israel’s founding narrative both involve military narratives generated in order to obscure the presence of non-nationals. In the next stage of the argument, I suggest that the story of the conquest itself attests to the very fluid social setting that it aims to overcome. Just as Ben-Gurion appealed to Joshua as precedent and the contemporary State of Israel looks to Ben-Gurion as a model, post-nationalists can locate a paradigm in the selfsame founding myths. (shrink)

Kant claims in the third Critique that one can make about wine the merely subjective judgment that it is agreeable but never the universally valid judgment that it is beautiful. This follows from his views that judgments of beauty can be made only about the formal (spatiotemporal) features of a representation and that aromas and flavors consist of formless sensory matter. However, I argue that Kant's theory permits judgments of beauty about wine because the experience displays a temporal structure: the (...) aromas and flavors evolve over the course of a tasting from the bouquet through the palate to the finish. An analogy with music, which Kant describes as 'a play of sensations in time', illuminates how wine qualifies as an object of pure judgments of taste: the 'structure' of a wine can be compared to harmonic structure, and its development throughout the taste can be compared to the unfolding of melody and harmonic progression. (shrink)

A medical student's ability to present a case history is a critical skill that is difficult to teach. Case histories presented without theatrical engagement may fail to catch the attention of their intended recipients. More engaging presentations incorporate ‘stage presence’, eye contact, vocal inflection, interesting detail and succinct, well organised performances. They convey stories effectively without wasting time. To address the didactic challenge for instructing future doctors in how to ‘act’, the Mayo Medical School and The Mayo Clinic Center for (...) Humanities in Medicine partnered with the Guthrie Theater to pilot the programme ‘Telling the Patient's Story’. Guthrie teaching artists taught storytelling skills to medical students through improvisation, writing, movement and acting exercises. Mayo Clinic doctors participated and provided students with feedback on presentations and stories from their own experiences in patient care. The course's primary objective was to build students' confidence and expertise in storytelling. These skills were then applied to presenting cases and communicating with patients in a fresher, more engaging way. This paper outlines the instructional activities as aligned with course objectives. Progress was tracked by comparing pre-course and post-course surveys from the seven participating students. All agreed that the theatrical techniques were effective teaching methods. Moreover, this project can serve as an innovative model for how arts and humanities professionals can be incorporated for teaching and professional development initiatives at all levels of medical education. (shrink)

Normative reasons for action are considerations that count in favor of actions. They are the considerations that determine what an agent should do in a given situation. If the agent acts on these considerations, they justify her action. This paper concerns accounts of normative reasons that separate the explanation of why a particular reason counts in favor of an agent’s performing some action from the content of that reason. Elements of this explanation of why the reason is a reason are (...) “background conditions” on that reason, rather than part of the reason itself. (shrink)

In 1755, Lisbon was destroyed by an earthquake whose aftershocks were felt across Europe. One of the less well-known responses to this abyssal event is that offered by Kant in his three essays on earthquakes and their causes. According to Irigaray, Kant's concern with an earth that moves is not incidental, but central to the emergence of his critical project. The goal of this paper is to trace a line from Kant's earthquake essays, through his later writings on the sublime, (...) to Irigaray's critique of the Kantian project and her positive re-appropriation of a matter that moves, a well as the sublime figure of the abyss. I will suggest that, in her work, the abyss is transformed from a rupturing cleft into a shelter for sexuate difference, and from a site of terror into a space for wonder. (shrink)

This chapter begins with the discussion of one of the earliest texts in the Western tradition to explore the relations between philosophy and pedagogy, Plato's Symposium. In this text, love (or more properly, eros) plays the mediating role, turning a love of wisdom into a pedagogical erotics that enables a journey of enlightenment. The author refers to the work of more recent thinkers, including Hannah Arendt, Jean‐François Lyotard and Luce Irigaray. The author's suggestion is that by approaching Symposium through their (...) work, this text can yield insights that are helpful for contemplating the educational process in a more contemporary context. In Symposium, the initial expulsion of the flute‐girl is undercut by Diotima's later inclusion as an apparently privileged female voice. ‘Diotima's speech’ is intriguing for many reasons, not least because it is the only place in Plato's known oeuvre where a woman takes on the part of the philosopher. (shrink)

The only Israelis this generation of Palestinians know are soldiers and settlers. For them, Israel is no more than a subsidiary of an army that knows no limits and settlements that know no borders.Recipient of the UNESCO Guillermo Camo World Press Freedom Prize in 2003, Amira Hass is the only Jewish Israeli correspondent on Palestinian affairs to live among the people about whom she reports. The child of Holocaust survivors, Hass prefers the title "expert in Israeli occupation," and, as such, (...) is relentless in her quest for both truth and justice. (shrink)

The purpose of the current research was to examine strategies of persuasion used by Arabic-speaking and Hebrew-speaking boys and girls to determine the relative contributions of culture and gender in determining communication styles. Children were asked to write a letter to a male or female peer asking for a gender-stereotyped or a gender-neutral gift. Four meta-categories were identified: formality, self-focus, other-focus, and gift-focus. For each meta-category except gift-focus, there were significant main effects and interactions. Language group was significant for formality (...) and other-focus but not for self-focus. Importantly, there were several interactions between participant gender, target gender, and gender-stereotypy of gift, but these did not interact with language group. The results were discussed in the context of children’s socialization to the ethos of musayara and dugri in Arabic-speaking and Hebrew-speaking culture. (shrink)

Policy and technological transformation have coalesced to usher in massive changes to educational systems over the past two decades. Teachers’ roles, subjectivities and professional identities have been subject to sweeping changes enabled by sophisticated forms of governance. Simultaneously, students have been recast as ‘learners’; like teachers, learners have become subject to new forms of governance, through technological surveillance and datafication. This paper focuses on the intersection of the metrics driven approach to education and the political as a way to re-think (...) the future of schooling in more explicitly philosophical terms. This exploration starts with a critical examination of constructions of teachers, learners and the digital data-driven educational culture in order to explicate the futures being generated. The trajectory of this future is explored through reference to the techno-educational models currently being developed in Silicon Valley. Drawing on Deleuze’s notion of control societies we contribute to the ongoing philosophical investigation of the datafication of education; a necessary discussion if we are to explore the future implications of schooling in a technologically saturated world. We present consideration of the past, present and future, as three ways of considering alternatives to a datafied education system. Alternative conceptualisations of the future of schooling are possible which offer ways of understanding and politicising what happens when we impose data-driven accountabilities into people’s lives. (shrink)