For more than 20 years, both here and abroad, significant efforts have been undertaken to provide equal access to nutritional food for all citizens. Yet, the numbers of under-nourished continue to rise, as do those afflicted with non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and heart disease. Clearly, current efforts are not working. Relying on the psychological phenomena of learned helplessness and fundamental attribution error, it is argued that certain individuals may not be willing, or able, to take actions (...) that are currently prescribed regarding access to nutritious food. The water is muddied regarding potential solutions as the various actors involved (e.g., corporations, governments, individuals) cannot agree on a starting point and continue to point fingers regarding responsibility. It is posited that emphasis needs to shift from the current “one-size-fits-all” approach to one that is more tailored to the various actors, specifically the individuals. Within the group of individuals (consumers), based on Wenar’s Least Cost Theory, even further distinction must be made between those who see themselves as capable actors and those who do not. In this conceptual piece intended to refocus the discussion surrounding food access, we propose that future research should approach these issues from a unit of analysis perspective in an attempt to identify the solutions most likely to succeed at various participating levels. (shrink)

Despite worldwide attention given to food access, very little progress has been made under the current model. Recognizing that individual engagement is likely based on individual experiences and perceptions, this research study investigated whether or not a correlation exists between one’s socioeconomic status (SES) and perceived personal responsibility for food access. Discussion of results and implications provide fresh insight into the ongoing global debate surrounding food access. Outcomes also provide insight into willing and able participants and point to least-cost solutions (...) which may be better suited to implement and initiate change. Results indicate that the issue of food access is more complex than simply lobbying for better decision-making among individuals and populations, highlighting the importance of unit of analysis considerations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Spiritual Experience and Psychopathology”Francis G. Lu (bio), David Lukoff (bio), and Robert P. Turner (bio)Jackson and Fulford have written an impor-tant paper which addresses an area of increasing interest in the United States—the relationship between religious/spiritual experiences and psychopathology. Using primarily the Present State Examination as the diagnostic framework, the authors describe in rich clinical detail three patients where certain phenomena lead to a possible (...) diagnosis of schizophrenia. However, the patients’ outcomes were uniformly positive—how can this be? The authors argue persuasively for the importance of a contextual assessment “in which psychotic phenomena themselves are embedded in the values and beliefs of the person concerned.” In this commentary, we will first present innovations in the DSM-IV relevant to cultural and religious/spiritual issues, which complement the authors’ conclusions, and then comment upon the paper from this perspective.In the DSM-IV Introduction (1994), a section entitled “Ethnic and Cultural Considerations” provides a rationale for innovations in DSM-IV that better enables its use with culturally diverse individuals: “A clinician who is unfamiliar with the nuances of an individual’s cultural frame of references may incorrectly judge as psychopathology those normal variations in behavior, belief, or experience that are particular to the individual’s culture. For example, certain religious practices or beliefs (e.g., hearing or seeing a deceased relative during bereavement) may be misdiagnosed as manifestations of a Psychotic Disorder” (xxiv). In the introduction, three types of information are cited: 1) sections entitled “Age, Gender and Cultural Considerations” in the text of ninety diagnostic categories discuss clinical variations due to these factors; 2) an Outline for Cultural Formulation designed to assist the clinician in systematically evaluating and reporting the impact of the individual’s cultural context; and 3) a Glossary of Culture-Bound Syndromes. These innovations, based on recommendations of the NIMH Workgroup on Culture, Diagnosis and Care to the Task Force on DSM-IV, are described in extensive detail in an important recent book (Mezzich, Kleinman, Fabrega, and Parron 1996).As an example of the importance of the Age, Gender, and Cultural Consideration section relevant to religious and spiritual experiences, consider the section in the text describing schizophrenia, where the following appears: “Clinicians assessing the symptoms of Schizophrenia in socioeconomic or cultural situations that are different from their own must take cultural differences into account. Ideas that may appear to be delusional in one culture (e.g., sorcery and witchcraft) may be commonly held in another. In some cultures, visual or auditory hallucinations with a [End Page 75] religious content may be a normal part of religious experience (e.g., seeing the Virgin Mary or hearing God’s voice)” (281). Secondly, in the analogous section of the text describing Brief Psychotic Disorder, the following appears: “It is important to distinguish symptoms of Brief Psychotic Disorder from culturally sanctioned response patterns. For example, in some religious ceremonies, an individual may report hearing voices, but these do not generally persist and are not perceived as abnormal by most members of the person’s community” (303).The Outline for Cultural Formulation provides the clinician a concise tool to specify the following information concerning the cultural context that is relevant to clinical care: cultural identity of the individual, cultural explanations of the individual’s illness, cultural factors related to psychosocial environment and levels of functioning, cultural elements of the relationship between the individual and the clinician, and overall cultural assessment for diagnosis and care. Religion is explicitly mentioned in the third section so as to encourage the assessment of “the role of religion... in providing emotional, instrumental, and information support” (1994, 844). This outline for cultural formulation is more fully explicated in a recent chapter by Lu, Lim, and Mezzich (1995).A major innovation in DSM-IV relevant to this topic is the new diagnostic category entitled Religious or Spiritual Problem defined as follows: “This category can be used when the focus of clinical attention is a religious or spiritual problem. Examples include distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of spiritual values that may not necessarily be related to an organized... (shrink)

Decision-making depends on bringing evidence together with values: decision theory for example employs probabilities and utilities; health economic decisions employ measures such as quality of life. The hypothesis guiding this chapter is that bringing evidence together with values in clinical decision-making requires an exercise of phronesis. Our aim however is not to justify our guiding hypothesis. It is rather to outline an account of phronesis that is in principle fit for the purposes of clinical decision-making if our guiding hypothesis is (...) correct. The chapter has three sections. Section 1 describes the growing gap between evidence and values in clinical decision-making: the missing link, we suggest, required to bridge this gap, is an appropriate account of phronesis. Section 2 provides an initial characterisation of the required account of phronesis via Michael Polanyi’s twin stipulation on the nature of tacit knowledge. Section 3 then fills out the required account using John McDowell’s characterisation of phronesis as a situation specific but at the same time conceptually structured form of practical discernment. A McDowellian account of phronesis, we argue, in satisfying Polanyi’s twin stipulation, provides an in-principle bridge between evidence and values. We conclude with a note on some of the further requirements if the gap is to be bridged not only in principle but in practice too. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Spiritual Experience and PsychopathologyMike Jackson and K. W. M. Fulford (bio)AbstractA recent study of the relationship between spiritual experience and psychopathology (reported in detail elsewhere) suggested that psychotic phenomena could occur in the context of spiritual experiences rather than mental illness. In the present paper, this finding is illustrated with three detailed case histories. Its implications are then explored for psychopathology, for psychiatric classification, and for our understanding (...) of the concept of mental illness. It is argued that pathological and spiritual psychotic phenomena cannot be distinguished by 1) form and content alone (as in traditional psychopathology), 2) by their relationship either with other symptoms or with pathological causes (as in psychiatric classification), or 3) by reference to the descriptive criteria of mental illness implied by the “medical” model. The distinction is shown to depend, rather, on the way in which psychotic phenomena themselves are embedded in the values and beliefs of the person concerned. This in turn is shown to have implications for diagnosis (it shows the need for clinicians to attend to the values and beliefs of individual patients), for treatment (it points to a cognitive problem-solving model), and for research in psychopathology (especially as related to the emerging sciences of dynamic brain imaging and cognitive neuroscience).Keywordsfirst rank symptoms, schizophrenia, delusion, hallucination, thought disorder, religious experience, mystical experienceIntroductionThis paper explores some of the conceptual and practical implications of the finding that phenomena which in a medical context would probably be diagnosed as psychotic symptoms, may occur in the context of non-pathological, and indeed essentially benign, spiritual experiences.The existence of non-pathological psychotic experiences of this kind (we will call them “psychotic phenomena” as distinct from “psychotic symptoms”—see also Endnote 1, terminology) was a key finding in a study carried out by one of us (MJ) at the Alister Hardy Research Centre (AHRC) in Oxford. Details are given elsewhere both of the overall empirical findings of the study, including the relationship between spiritual experience and personality variables, and of a hypothetical cognitive problem-solving model of these phenomena (Jackson 1991, and forthcoming a and b). In the present paper, 1) the background to the study is described briefly in relation to earlier work on the possible links between spiritual experience and psychopathology; 2) some of the psychotic phenomena identified are illustrated with three detailed case histories; 3) the significance of these phenomena is reviewed for our understanding respectively of psychopathology, of diagnostic syndromes, and of the concept of mental illness; and 4) some of the practical implications of the study for clinical work and research in psychiatry are indicated.BackgroundIt has long been recognized that there are similarities between spiritual and psychotic experiences. [End Page 41] William James (1902), for example, argued that “in delusional insanity, paranoia as they sometimes call it, we may have a kind of diabolical mysticism, a sort of religious mysticism turned upside down” (426). Other commentators have noted a wide variety of phenomena, such as time distortion, synesthesias, loss of self-object boundaries and the transition from a state of conflict and anxiety to one of sudden “understanding,” all of which are reported in both spiritual and psychotic experiences (Buckley 1981; Watson 1982; Wapnick 1969; and Wootton and Allen 1983).Yet the similarities notwithstanding, the distinction between these two kinds of experience can be crucially important. Spiritual experiences, whether welcome or unwelcome, and whether or not they are psychotic in form, have nothing (directly) to do with medicine (Fulford 1996a). It would be quite wrong, then, to “treat” spiritual psychotic experiences with neuroleptic drugs, just as it is quite wrong to “treat” political dissidents as though they were ill (Fulford, Smirnoff and Snow, 1993). Pathological psychotic experiences, on the other hand, or psychotic symptoms, are by definition a proper object of medical treatment, sometimes even against the wishes of the person concerned. Hence it would be both negligent and, as Wing (1978) put it, morally “repellent,” to leave untreated someone who is genuinely ill (244).Given how much turns on the distinction between spiritual experience and psychopathology, it is perhaps not surprising that scholarly discussion of the relationship between them has at times... (shrink)

The law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of what a reasonable body of medical opinion agree ought to be disclosed in the circumstances. The UK Supreme Court concluded that the information that is material to a patient’s decision should instead be judged (...) by reference to a new two-limbed test founded on the notions of the ‘reasonable person’ and the ‘particular patient’. The rationale outlined in Montgomery for this new test of materiality, and academic comment on the ruling’s significance, has focused on the central ethical importance that the law now accords to respect for patient autonomy in the process of obtaining consent from patients. In this paper, we dispute the claim that the new test of materiality articulated in Montgomery equates with respect for autonomy being given primacy in re-shaping the development of the law in this area. We also defend this position, arguing that our revised interpretation of Montgomery’s significance does not equate with a failure by the courts to give due legal consideration to what is owed to patients as autonomous decision-makers in the consent process. Instead, Montgomery correctly implies that doctors are ethically obliged to attend to a number of relevant ethical considerations in framing decisions about consent to treatment, which include subtle interpretations of the values of autonomy and well-being. Doctors should give appropriate consideration to how these values are fleshed out and balanced in context in order to specify precisely what information ought to be disclosed to a patient as a requirement of obtaining consent, and as a core component of shared decision-making within medical encounters more generally. (shrink)

This “open letter” to Christopher Boorse is a response to his influential naturalist analysis of disease from the perspective of linguistic-analytic value theory. The key linguistic-analytic point against Boorse is that, although defining disease value free, he continue to use the term with clear evaluative connotations. A descriptivist analysis of disease would allow value-free definition consistently with value-laden use: but descriptivism fails when applied to mental disorder because it depends on shared values whereas the values relevant to mental disorders are (...) highly diverse. A part-function analysis, similarly, although initially persuasive for physical disorders, fails with the psychotic mental disorders because these, characteristically, involve disturbances of the rationality of the person as a whole. The difficulties encountered in applying naturalism to mental disorders point, linguistic-analytically, to the possibility that there is, after all, an evaluative element of meaning, deeply hidden but still logically operative, in the concept of disease. (shrink)

The abstract structure of inquiry - the process of acquiring and changing beliefs about the world - is the focus of this book which takes the position that the "pragmatic" rather than the "linguistic" approach better solves the philosophical problems about the nature of mental representation, and better accounts for the phenomena of thought and speech. It discusses propositions and propositional attitudes (the cluster of activities that constitute inquiry) in general and takes up the way beliefs change in response to (...) potential new information, suggesting that conditional propositions should be understood as projections of epistemic policies onto the world.Robert C. Stalnaker is a professor in the Sage School of Philosophy at Cornell University. A Bradford Book. (shrink)

This paper employs the methodological framework of linguistic analytic philosophy to explore the conceptual issues arising from a study of the different models of disorder implicit in five groups of stakeholders concerned in the community care of people with a diagnosis of long-term schizophrenia. Linguistic analysis, gives a precise fix on the nature of the practical difficulties presented by such models, suggests a powerful heuristic for displaying and comparing models, is the basis of a methodology which is neutral as between (...) users and providers of services, provides an intuitively powerful way of understanding the results of work of this kind, and facilitates the translation of research into practice. (shrink)

Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

Robert B. Brandom is one of the most original philosophers of our day, whose book Making It Explicit covered and extended a vast range of topics in metaphysics, epistemology, and philosophy of language--the very core of analytic philosophy. This new work provides an approachable introduction to the complex system that Making It Explicit mapped out. A tour of the earlier book's large ideas and relevant details, Articulating Reasons offers an easy entry into two of the main themes of Brandom's (...) work: the idea that the semantic content of a sentence is determined by the norms governing inferences to and from it, and the idea that the distinctive function of logical vocabulary is to let us make our tacit inferential commitments explicit. Brandom's work, making the move from representationalism to inferentialism, constitutes a near-Copernican shift in the philosophy of language--and the most important single development in the field in recent decades. Articulating Reasons puts this accomplishment within reach of nonphilosophers who want to understand the state of the foundations of semantics. Table of Contents: Introduction 1. Semantic Inferentialism and Logical Expressivism 2. Action, Norms, and Practical Reasoning 3. Insights and Blindspots of Reliabilism 4. What Are Singular Terms, and Why Are There Any? 5. A Social Route from Reasoning to Representing 6. Objectivity and the Normative Fine Structure of Rationality Notes Index Displaying a sovereign command of the intricate discussion in the analytic philosophy of language, Brandom manages successfully to carry out a program within the philosophy of language that has already been sketched by others, without losing sight of the vision inspiring the enterprise in the important details of his investigation ' Using the tools of a complex theory of language, Brandom succeeds in describing convincingly the practices in which the reason and autonomy of subjects capable of speech and action are expressed. --J'rgen Habermas. (shrink)

We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.

Amanda Fulford, Áine Mahon; The University as Sanctuary: Home and Unhomeliness, Journal of Philosophy of Education,, qhae037, https://doi.org/10.1093/jope.

In a new retelling of the romantic rationalist adventure of ideas that is Hegel's classic The Phenomenology of Spirit, Robert Brandom argues that when our self-conscious recognitive attitudes take Hegel's radical form of magnanimity and trust, we can overcome a troubled modernity and enter a new age of spirit.

Winner of the Los Angeles Times Book Prize With a new preface by the author In his most powerful and important book, renowned psychiatrist Robert Jay Lifton presents a brilliant analysis of the crucial role that German doctors played in the Nazi genocide. Now updated with a new preface, The Nazi Doctors remains the definitive work on the Nazi medical atrocities, a chilling exposé of the banality of evil at its epitome, and a sobering reminder of the darkest side (...) of human nature. (shrink)

Values-Based Medicine (VBM) is the theory and practice of clinical decision-making for situations in which legitimately different values are in play. VBM is thus to values what Evidence-Based Medicine (EBM) is to facts. The theoretical basis of VBM is a branch of analytic philosophy called philosophical value theory. As a set of practical tools, VBM has been developed to meet the challenges of value diversity as they arise particularly in psychiatry. These challenges are illustrated in this paper by a case (...) study of the differential diagnosis between delusion and religious experience. In a traditional model of scientific medicine, such challenges would be expected to become less pressing with advances in medical science. Philosophical value theory suggests, to the contrary, that scientific progress, through opening up an ever-wider range of choices, will increasingly bring the full range and diversity of human values into play not just in psychiatry but in all areas of medicine. The future, then, for medicine, is an integrated model in which VBM and EBM are equal partners in a genuinelyhuman discipline. (shrink)

This paper revisits some foundational questions concerning the abstract representation of a discourse context. The context of a conversation is represented by a body of information that is presumed to be shared by the participants in the conversation – the information that the speaker presupposes a point at which a speech act is interpreted. This notion is designed to represent both the information on which context-dependent speech acts depend, and the situation that speech acts are designed to affect, and so (...) to be a representation of context that is appropriate for explaining the interaction of context and the contents expressed in them. After reviewing the motivating ideas and the outlines of the apparatus, the paper responds to a criticism of the framework, and considers the way it can help to clarify some phenomena concerning pronouns with indefinite antecedents. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ IntroductionK. W. M. Fulford and John Z. SadlerThe editors are delighted to present the debut of a new feature in Philosophy, Psychiatry, & Psychology, “Clinical Anecdotes.” Clinical Anecdotes are short narrative essays that present, in concise fashion, several philosophical/conceptual issues concerning the experience of psychiatric practice in a realistic, nitty-gritty story format. A Clinical Anecdote essay serves as a stimulus to selected commentators from diverse fields, who (...) will prepare short responses that address any feature of the anecdote that captures their interest and imagination. Clinical Anecdote authors may then conclude the section with their own brief response, if desired.We encourage anyone (clinicians, patients, philosophers, others) interested in the conceptual aspects of psychiatric practice to submit their own Clinical Anecdotes for publication. Submissions should be formatted as a PPP Main Paper, with no requirement for references or an abstract. Clinical Anecdotes should not exceed a 1,500-word limit, and should have an original title relevant to the narrative content of the piece.How will Clinical Anecdotes submissions be evaluated? They will be sent out for peer review as with any other PPP main article, however, what reviewers will be looking for is:• a vivid, engaging, and compelling writing style,• a story that generates multiple areas of conceptual, philosophical, or ethical interest,• relevance to the editorial focus of PPP, and• novelty of theme (the submission addresses issues that have not previously been considered as a Clinical Anecdote).We hope you will find this inaugural essay from Dr. Christopher Bailey thought provoking. [End Page 221]Copyright © 2009 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 165-173 [Access article in PDF] Professional Judgment, Critical Realism, Real People, and, Yes, Two Wrongs Can Make a Right! K.W.M. Fulford Anthony Colombo Keywords values, values-based practice, models of disorder, concept of mental illness, user-centred practice, patient-centred practice, multidisciplinary teamwork We are grateful to our four commentators for putting much-needed conceptual air and space around the models project. Published originally as an (...) empirical study of the different implicit models of disorder, held by users of services, carers, nurses, psychiatrists, and social workers (Colombo et al. 2003), our paper outlined the philosophical roots of the models project in linguistic analytic philosophy of the "Oxford school" (Fulford and Colombo 2004). Our four commentators provide extra dimensions of understanding, respectively from professional education (Williams 2004), sociology (Bendelow 2004), Heideggerian phenomenology (Heginbotham 2004), and mental health policy and practice (Williamson 2004).Since the original study, the models project has been taken forward as a key contribution to a range of philosophy-into-practice initiatives called, collectively, Values-Based Practice. In this brief response, we outline the key features of Values-Based Practice and indicate how these connect with some of the many thoughtful points about models made by our commentators. Values-Based Practice Values-Based Practice, then, is the theory and skills-base for effective health care decision making where different, and hence potentially conflicting, values are in play (Fulford 2004). Premised on the democratic meta-value of equal respect for all voices, Values-Based Practice relies, much as a political democracy relies, on good process rather than preset outcomes for its practical effectiveness. The ten pointers to good process in Values-Based Practice are summarized in Figure 1. We return to the implications of these for the work on models below.Relying on good process may be thought to be a recipe more for relativism and indecision in clinical decision making than for practical effectiveness. To the contrary, however, the 'values democracy' of Values-Based Practice, again like a political democracy, carries a number of clear and coherent implications for policy and practice in health care. [End Page 165] Click for larger viewFigure 1 10 Pointers to Good Process in VBP [End Page 166]Examples of the implications of Values-Based Practice for policy and practice are given in the Values Framework shown in Figure 2. This is a policy framework for the development of Values-Based Practice in mental health produced by a project group in the National Institute for Mental Health in England (NIMHE), the section of the UK's National Health Service (NHS) responsible for implementing government policy on mental health as embodied in the National Service Framework for Mental Health (Department of Health 1999) and subsequent policies. The framework gives three key principles of Values-Based Practice (the three Rs of recognition, raising awareness, and respect) and then summarizes some of the specific implications of the approach. Racism, for example, is incompatible with Values-Based Practice because racism is by definition intolerant of diversity. Again, we indicate some of the policy implications of Values-Based Practice for the points about models made by our commentators below.Training for mental health practitioners in Values-Based Practice will be rolled out from April 2005, through both voluntary and statutory bodies, in each of the eight regions of the National Health Service of England and Wales. This roll out will be supported by training methods developed and piloted in a unique joint venture between Warwick University's Department of Philosophy and Medical School, and an in-service training provider, the Sainsbury Centre for Mental Health (Fulford, Williamson, and Woodbridge 2002; Woodbridge and Fulford 2003). These training methods are the basis of a detailed workbook for Values-Based Practice (Woodbridge and Fulford 2004). The workbook will be launched in July 2004 at a conference in London by the Minister of State with responsibility for mental health, Rosie Winterton. Professional Training and Professional Judgment The models project has been central to the development of... (shrink)

In Two Minds is a practical casebook of problem solving in psychiatric ethics. Written in a lively and accessible style, it builds on a series of detailed case histories to illustrate the central place of ethical reasoning as a key competency for clinical work and research in psychiatry. Topics include risk, dangerousness and confidentiality; judgements of responsibility; involuntary treatment and mental health legislation; consent to genetic screening; dual role issues in child and adolescent psychiatry; needs assessment; cross-cultural and gender issues; (...) rational and irrational suicide; shared decision making in multi-agency teams, and the growing role of the user's voice in psychiatry. Key ethical concepts are carefully introduced and explained. The text is richly supported by detailed guides for further reading. There are separate chapters on teaching psychiatric ethics, including a sample seminar, and on writing a research ethics application. Each case history and discussion is followed by a critical commentary from a practitioner with relevant experience. Jim Birley adds a comparative international perspective on psychiatric ethics. Cartoons by Johnny Cowee provide punchy counterpoint! In Two Minds is the sister volume to the third edition of Sidney, Paul Chodoff and Steven Green's highly successful Psychiatric Ethics. In providing a bridge between theory and practice, it will be essential reading for everyone concerned with improving standards in mental health care. (shrink)

This collection of papers (including three completely new ones) by one of the foremost philosophers in epistemology transcends two of the most widely misunderstood positions in philosophy--foundationalism and coherentism. Audi proposes a distinctively moderate, internalist foundationalism that incorporates some of the virtues of both coherentism and reliabilism. He develops important distinctions between positive and negative epistemic dependence, substantively and conceptually naturalistic theories, dispositional beliefs and dispositions to believe, episodically and structurally inferential beliefs, first and second order internalism, and rebutting as (...) opposed to refuting skepticism. These contrasts are applied not only to rational belief, but to rational action and the rationality of desires and intentions. The overall position is a pluralist, moderately rationalistic, internalist theory of justification and a partly externalist conception of knowledge. However, by virtue of offering a theory of rationality as well as an account of knowledge and justified belief, it will interest philosophers of ethics, science, and the social sciences and teachers and students of epistemology. (shrink)

In recent years, there has been an increased emphasis on learning outside the classroom (LOtC) in places such as in museums and art galleries, in forests, and by natural water courses; this has bec...

Classical American pragmatism: the pragmatist -- Enlightenment-and its problematic semantics -- Analyzing pragmatism: pragmatics and pragmatisms -- A Kantian rationalist pragmatism: pragmatism -- Inferentialism, and modality in Sellars's arguments against -- Empiricism -- Linguistic pragmatism and pragmatism about norms: an arc of -- Thought from Rorty's eliminative materialism to his pragmatism -- Vocabularies of pragmatism: synthesizing naturalism and -- Historicism -- Towards an analytic pragmatism: meaning-use analysis -- Pragmatism, expressivism, and anti-representationalism: -- Local and global possibilities.

This chapter introduces values-based practice as a resource for working with individually diverse values in health and social care, and describes its origins in an on-going development through the resources of philosophy. The chapter is in two main sections. Section I, Values-Based Practice, builds on two brief interactive exercises to introduce and explain the key features of values-based practice. As a relatively recent addition to the range of resources for working with values in health and social care, values-based practice is (...) distinctive in focussing on the diversity of values comprising individual lived experience. Like evidence-based practice, values-based practice is a process-driven rather than an outcome-driven methodology. That is to say, rather than offering prescribed answers, both approaches offer processes that support decision-makers in coming to answers for themselves based on the particular circumstances presented by the situation in question. Although entirely complementary, the processes involved are of course different. Where evidence-based practice relies on meta-analyses of the results of high-quality clinical trials to inform a consensual model of decision-making, values-based practice builds on learnable clinical skills and other process elements to inform a dissensual model of decision-making rather than seeking to overcome value-conflicts in reaching consensus. Working within a premise of mutual respect for differences of values, and guided by three key principles linking values and evidence, values-based practice, as described in the chapter, supports dissensual decision-making, balanced according to the circumstances presented by the decision in question, within frameworks of locally-set frameworks of shared values. Section II, The Theory-Practice Dynamic, then outlines the theory-practice dynamic on which values-based practice is based. The origins of values-based practice in mid-twentieth century ordinary language philosophy of the Oxford School are outlined. As the chapter illustrates, although a limited area of analytic philosophy, many aspects of values-based practice are informed by ordinary language philosophy, ranging from its premise, through the training exercises and other process elements described in Section I, to its role in hybrid empirical studies supporting its model of service delivery. The development of values-based practice, furthermore, as section II goes on to describe, is ongoing, with key initiatives drawing not only on both analytic and Continental traditions of European philosophy, but also on non-European philosophies such as those of Africa and the Caribbean. (shrink)

Robert John Ackermann deals decisively with the problem of relativism that has plagued post-empiricist philosophy of science. Recognizing that theory and data are mediated by data domains (bordered data sets produced by scientific instruments), he argues that the use of instruments breaks the dependency of observation on theory and thus creates a reasoned basis for scientific objectivity. Originally published in 1985. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished (...) backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

_A moving meditation on recent geopolitical crises, viewed through the lens of ancient and modern tragedy__ “Spare, elegant and poignant.... If there is a single contemporary book that should be pressed into the hands of those who decide issues of war and peace, this is it.”—John Gray, _New Statesman_ “It is tragic that Robert D. Kaplan’s luminous _The Tragic Mind_ is so urgently needed.”—George F. Will_ Some books emerge from a lifetime of hard-won knowledge. Robert D. Kaplan has (...) learned, from a career spent reporting on wars, revolutions, and international politics in Europe, the Middle East, and East Asia, that the essence of geopolitics is tragedy. In _The Tragic Mind_, he employs the works of ancient Greek dramatists, Shakespeare, German philosophers, and the modern classics to explore the central subjects of international politics: order, disorder, rebellion, ambition, loyalty to family and state, violence, and the mistakes of power. The great dilemmas of international politics, he argues, are not posed by good versus evil—a clear and easy choice—but by contests of good versus good, where the choices are often searing, incompatible, and fraught with consequences. A deeply learned and deeply felt meditation on the importance of lived experience in conducting international relations, this is a book for everyone who wants a profound understanding of the tragic politics of our time. (shrink)

What kind of mental state is episodic memory? I defend the claim that it is, in key part, imagining the past, where the imagining in question is experiential imagining. To remember a past episode is to experientially imagine how things were, in a way controlled by one’s past experience of that episode. Call this the Inclusion View. I motive this view by appeal both to patterns of compatibilities and incompatibilities between various states, and to phenomenology. The bulk of the paper (...) defends the account against four objections. Imagining and remembering seem to differ in whether they are active or passive, in the forms of singular content they involve, in their relations to observation and in their relations to belief. I argue that these differences can be accommodated, and some even explained, once we flesh out what else is involved in episodic memory, in addition to imagining the past. (shrink)

It is almost unanimously accepted that Kant denies resultant moral luck—that is, he denies that the lucky consequence of a person’s action can affect how much praise or blame she deserves. Philosophers often point to the famous good will passage at the beginning of the Groundwork to justify this claim. I argue, however, that this passage does not support Kant’s denial of resultant moral luck. Subsequently, I argue that Kant allows agents to be morally responsible for certain kinds of lucky (...) consequences. Even so, I argue that it is unclear whether Kant ultimately endorses resultant moral luck. The reason is that Kant does not write enough on moral responsibility for consequences to determine definitively whether he thinks that the lucky consequence for which an agent is morally responsible can add to her degree of praiseworthiness or blameworthiness. The clear upshot, however, is that Kant does not deny resultant moral luck. (shrink)

Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the (...) circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals? perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research. (shrink)

In the Western world it is usually taken as given that we all want happiness, and our educational arrangements tacitly acknowledge this. Happiness, Hope, and Despair argues, however, that education has an important role to play in deepening our understanding of suffering and despair as well as happiness and joy. Education can be uncomfortable, unpredictable, and unsettling; it can lead to greater uncertainty and unhappiness. Drawing on the work of Søren Kierkegaard, Miguel de Unamuno, Fyodor Dostoevsky, Simone Weil, Paulo Freire, (...) and others, Peter Roberts shows why these features of educational life need not be feared; to the contrary, they can be seen as a source of hope and human fulfilment. After years of negotiating an education system dominated by the language of competition, performance, and economic advancement, students and teachers often long for something different; they seek not just measurable success but also opportunities to ask searching questions of themselves and the world they encounter. Happiness, Hope, and Despair makes an important contribution toward meeting this need. It fosters a rethinking of the nature, purpose, and value of education, and opens up possibilities for further scholarly and professional inquiry. (shrink)

This paper provides an overview of the history of the notion of essence in 20th century analytic philosophy, focusing on views held by influential analytic philosophers who discussed, or relied on essence or cognate notions in their works. It in particular covers Russell and Moore’s different approaches to essence before and after breaking with British idealism, the (pre- and post-)logical positivists’ critique of metaphysics and rejection of essence (Wittgenstein, Carnap, Schlick, Stebbing), the tendency to loosen the notion of logical necessity (...) to accommodate certain metaphysical truths in Wittgenstein and others, Quine’s logical rehabilitation of metaphysics and criticism of de re modality, the modal view of essence promoted by the development of quantified modal logic (C. I. Lewis, Barcan Marcus, Kripke) and direct reference theory (Barcan Marcus, Kripke, Putnam), and the emergence of the notion of metaphysical necessity (Kneale, Kripke), and finally Fine’s re-establishment of a Neo-Aristotelian, hyperintensional notion of essence in contemporary metaphysics. (shrink)

Philosophers often consider problems of free will and moral luck in isolation from one another, but both are about control and moral responsibility. One problem of free will concerns the difficult task of specifying the kind of control over our actions that is necessary and sufficient to act freely. One problem of moral luck refers to the puzzling task of explaining whether and how people can be morally responsible for actions permeated by factors beyond their control. This chapter explicates and (...) assesses skeptical, compatibilist, and libertarian approaches to moral luck. First, I argue that what makes the above problems of free will and moral luck distinct is largely their emphasis on different kinds of luck. Second, I describe and evaluate skeptical arguments from constitutive and circumstantial luck that it is impossible to act freely. Third, I explicate and assess various support and implication relationships between various kinds of compatibilism and libertarianism, on the one hand, and causal, constitutive, circumstantial, and resultant moral luck, on the other. (shrink)

In this essay I sketch some vices of virtue ethics, draw on inference about the philosophical source of the vices, and conclude with a recommendation concerning future efforts in moral theory construction. The source of the vices, I argue, lies in a mononomic or single-principle strategy within normative theory construction, a reductionist conceptual scheme which distorts certain integral aspects of our moral experience. My recommendation is that this strategy be abandoned, for the moral field is not unitary -- mononomic methods (...) are not the best tools for moral theorists. (shrink)

Robert C. Stalnaker presents a set of essays on the structure of inquiry. First he focuses on the concepts of knowledge, belief, and partial belief, and on the rules and procedures we ought to use to determine what to believe. Then he explores the relations between conditionals and causal and explanatory concepts.

We describe the teaching programme in ethics, law and communication skills for clinical medical students which is being developed as part of the Oxford Practice Skills Project. These three elements of practice are approached in an integrated teaching programme which aims to address everyday clinical practice. The role of a central value of patient-centred health care in guiding the teaching is described. Although the final aim of the teaching is to improve actual practice, we have found three 'sub-aims' helpful in (...) the development of the programme. These sub-aims are: increasing students' awareness of ethical issues; enhancing their analytical thinking skills, and teaching specific knowledge. (shrink)

In Pascal Boyer’s book Religion Explained inference systems are made to do a lot of work in his attempts to explain cognition in religion. These inference systems are systems in the brain that produces inferences when they are activated by things we perceive in our environment. According to Boyer they perceive things, produce explanations, and perform calculations. However, if Wittgenstein’s observation, that “only of a living human being and what resembles (behaves like) a living human being can one say: it (...) has sensations; it sees; is blind; hears; is deaf; is conscious or unconscious” is correct then it seems that Boyer’s talk of inference systems perceiving and inferring is confused. (shrink)

Mental health research and care in the twenty first century faces a series of conceptual and ethical challenges arising from unprecedented advances in the neurosciences, combined with radical cultural and organisational change. The Oxford Textbook of Philosophy of Psychiatry is aimed at all those responding to these challenges, from professionals in health and social care, managers, lawyers and policy makers; service users, informal carers and others in the voluntary sector; through to philosophers, neuroscientists and clinical researchers. Organised around a series (...) of case studies in five key topic areas - concepts of disorder, the philosophical history of psychopathology, philosophy of science, ethics and philosophical value theory, and philosophy of mind - the book provides a detailed introduction to the field and a framework for study and skill development. Each case study is supported by selected readings from both philosophy and mental health, thinking skills exercises, self-test questions, key learning points and detailed guides to further reading. There is an introduction for philosophers to classification and descriptive psychopathology, and for practitioners to philosophical methods (including logic). The philosophical topics covered include philosophical methods (analytic and Continental); phenomenology, hermeneutics and existentialism, logical empiricism and its successors; idealism and realism; reasons and causes; and modern theories of mind and brain, free will and personal identity. Topics from mental health include psychiatry and 'anti-psychiatry'; Jaspers' psychopathology and the new neurosciences; the future of psychiatric classifications; strengths-based approaches, recovery practice, social inclusion and diversity; and key topics in psychopathology, such as delusion, autism, disorders of volition, thought insertion and other experiences in schizophrenia. The Oxford Textbook of Philosophy of Psychiatry aims to secure the skills-base of the discipline by bringing philosophers closer to the realities of practice in mental health, and mental health practitioners closer to the resources of philosophy as a partner to the sciences in responding to the challenges of twenty-first century mental health and social care. (shrink)

Human beings have the ability to ‘augment’ reality by superimposing mental imagery on the visually perceived scene. For example, when deciding how to arrange furniture in a new home, one might project the image of an armchair into an empty corner or the image of a painting onto a wall. The experience of noticing a constellation in the sky at night is also perceptual-imaginative amalgam: it involves both seeing the stars in the constellation and imagining the lines that connect them (...) at the same time. I here refer to such hybrid experiences – involving both a bottom-up, externally generated component and a top-down, internally generated component – as make-perceive (Briscoe 2008, 2011). My discussion in this paper has two parts. In the first part, I show that make-perceive enables human beings to solve certain problems and pursue certain projects more effectively than bottom-up perceiving or top-down visualization alone. To this end, the skillful use of projected mental imagery is surveyed in a variety of contexts, including action planning, the interpretation of static mechanical diagrams, and non-instrumental navigation. In the second part, I address the question of whether make-perceive may help to account for the “phenomenal presence” of occluded or otherwise hidden features of perceived objects. I argue that phenomenal presence is not well explained by the hypothesis that hidden features are represented using projected mental images. In defending this position, I point to important phenomenological and functional differences between the way hidden object features are represented respectively in mental imagery and amodal completion. (shrink)