In this article, I side with those who argue that the debate about the definition of “disease” should be reoriented from the question “what is disease” to the question of what it should be. However, I ground my argument on the rejection of the naturalist approach to define disease and the adoption of a normativist approach, according to which the concept of disease is normative and value-laden. Based on this normativist approach, I defend two main theses: (1) that conceptual analysis (...) is not the right method to define disease and that conceptual engineering should be the preferred method and (2) that the method of conceptual engineering should be implemented following the principles of Alexandrova’s account of social objectivity in the context of the definition of disease. (shrink)

In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I (...) will argue that Kaczmarek’s proposal lacks guidance concerning the procedures through which we are to answer the four questions, and I will import the conceptual resources of epistemic injustice to guide our thinking on these issues. This will lead me to defend more inclusive decision-making procedures regarding medicalization in the DSM. Kaczmarek’s account complemented with an epistemic injustice framework can help us achieve better forms of medicalization. I will then use a contested case of medicalization, the creation of Premenstrual Dysphoric Disorder in the DSM-5 to illustrate how the epistemic injustice framework can help to shed light on these issues and to show its relevance to distinguish good and bad forms of medicalization. (shrink)

Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the lens of (...) French philosopher Gilles Deleuze's concept of ‘societies of control’. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of ‘societies of control’ is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities. (shrink)

This paper builds on previous work that investigated anticancer drugs as ‘informed materials’, i.e., substances that undergo an informational enrichment that situates them in a dense relational web of qualifications and measurements generated by clinical experiments and clinical trials. The paper analyzes the recent transformation of anticancer drugs from ‘informed’ to ‘informing material’. Briefly put: in the post-genomic era, anti-cancer drugs have become instruments for the production of new biological, pathological, and therapeutic insights into the underlying etiology and evolution of (...) cancer. Genomic platforms characterize individual patients’ tumors based on their mutational landscapes. As part of this new approach, drugs targeting specific mutations transcend informational enrichment to become tools for informing their targets, while also problematizing the very notion of a ‘target’. In other words, they have become tools for the exploration of cancer pathways and mechanisms. While several studies in the philosophy and history of biomedicine have called attention to the heuristic relevance and experimental use of drugs, few have investigated concrete instances of this role of drugs in clinical research. (shrink)

As the use of artificial intelligence (AI) technologies, particularly generative AI (Gen AI), becomes increasingly prevalent in nursing education, it is paramount to address the ethical implications of their implementation. This article explores the realm of cyberethics (a field of applied ethics that focuses on the ethical, legal, and social implications of cybertechnology), highlighting the ethical principles of autonomy, nonmaleficence, beneficence, justice, and explicability as a roadmap for facilitating AI integration into nursing education. Research findings suggest that ethical dilemmas that (...) challenge these five principles can emerge within the context of nursing education; however, adherence to these very principles, which is essential to improving patient care, can offer solutions to these dilemmas. To ensure the ethical and responsible use of Gen AI in nursing education, these principles must be woven into the fabric of curricula, and appropriate guidelines must be developed. Nurse educators have a pivotal role in strategizing comprehensive approaches for ethical AI integration, establishing clear guidelines, and instilling critical thinking among students. Fostering lifelong learning and adaptability is key to ensuring that future nurses can successfully navigate the constantly evolving landscape of health care technology. Future research should investigate the long-term impacts of AI utilization on learning outcomes and ethical decision-making. (shrink)

According to the literature, the family is now considered to be the most important resource for the care and support of a sick family member. Families are being increasingly invited and trained to play a utilitarian role, not just as family caregivers, but as healthcare agents. Healthcare institutions, based on neoliberal health policies, are encouraging them to perform increasingly complex and professionalized tasks. The burden associated with this expanded healthcare function, however, is significant (fatigue, emotional distress and exhaustion). The aim (...) of this article was to present French sociologist Jacques Donzelot's theoretical perspective on governing through the family. According to Donzelot, such a government is exercised through various power techniques, including the instrumentalization of the family role and the transfer to families of the responsibility for health care. This author describes how healthcare institutions call on the family to perform hospital and biomedical practices within the home. A spin‐off of neoliberalism, the practices of governing through families specifically target women, who are considered to be the pillar of the family. Donzelot's perspective is very relevant to nursing, but is still rarely mobilized in the discipline. His critical perspective allows for a re‐reading of relations of power and mechanisms of surveillance and control of families, issues that are often overlooked in nursing research. (shrink)

Robert Castel is an eminent figure in the social sciences because of his innovative contributions to various social and health fields. The seminal work of this poststructuralist author and social activist has influenced several research disciplines, but has not yet had a significant impact on nursing. In this article, we will present the thinking of this man, who considered himself a sociologist, philosopher and “historian of the present.” We will examine the most important issues he explored during his career, including (...) the psychiatric apparatus, the management of risk and the social vulnerability. We believe that this thinker's perspective on diverse social issues is very relevant to nursing practice and research and to the health sciences in general. The concepts he developed and utilized with finesse provide us with a critical reading of many contemporary health issues, particularly in mental health and psychiatric nursing. Castel's critical and engaged approach incites mobilization for social justice and greater protections for marginalized and vulnerable persons. These principles of advocacy and social justice are also at the heart of the nursing profession. (shrink)

The original version of this article unfortunately contained a mistake. Three entries are incorrect in the reference list. The corrected references are given below.

Les mots nous manquent pour dire le plus banal des paysages. Vite à court de phrases, nous sommes incapables de faire le portrait d'une orée. Un pré, déjà, nous met à la peine, que grêlent l'aigremoine, le cirse et l'ancolie. Il n'en a pourtant pas toujours été ainsi. Au temps de Goethe et de Humboldt, le rêve d'une " histoire naturelle " attentive à tous les êtres, sans restriction ni distinction aucune, s'autorisait des forces combinées de la science et de (...) la littérature pour élever la " peinture de paysage " au rang d'un savoir crucial. La galaxie et le lichen, l'enfant et le papillon voisinaient alors en paix dans un même récit. Ce n'est pas que l'homme comptait peu : c'est que tout comptait infiniment. Des croquis d'Alfred Wallace aux " proêmes " de Francis Ponge, des bestiaires de William Swainson aux sonnets de Rainer Maria Rilke, ce livre donne à entendre le chant, aussi tenace que ténu, d'un très ancien savoir sur le monde - un savoir qui répertorie les êtres par concordances de teintes et de textures, compose avec leurs lueurs des dictionnaires éphémères, s'abîme et s'apaise dans le spectacle de leurs métamorphoses. (shrink)

"Saturne, c'est ici l'Absolu de Hegel, un Absolu pensé si seul qu'il ne vit que de la perpétuelle dévoration de ses propres enfants, craignant d'être détrôné de son absoluité s'il n'absorbe pas, à mesure qu'il la produit, sa propre altérité. C'est cette solitude de Dieu qui est ici interrogée, en suivant au sein de l'oeuvre hégélien l'évolution, puis le plein déploiement conceptuel de la notion de Singularité, qui n'est autre que le nom divin par excellence. Si Dieu, l'Absolu, est pour (...) Hegel la Singularité même, ce n'est que parce qu'il est le mouvement de réflexion réciproque de l'Universel et du Particulier : l'Esprit est la réflexion du Logique dans la Nature, et de la Nature dans le Logique. Hegel ou Le Festin de Saturne se présente alors comme une enquête destinée à dévoiler le meurtre rituel dont la Singularité est le nom dans le Système hégélien. Or, cette Singularité, que nous sommes habitués à entendre individuelle, s'y révèle être boulimique ou, justement, saturnienne. S'ouvrant sur la faillite spéculative des singuliers sensibles au début de la Phénoménologie de l'Esprit, le présent ouvrage ne pourra se conclure qu'avec le triomphe de la Singularité dialectique ne laissant rien - pas même ou surtout pas son Autre - hors d'elle-même, lorsque ce triomphe sera mesuré à l'aune de la conceptualité chrétienne dont se revendique le protestant Hegel, mais qu'il trahit sur un point capital en voulant l'accomplir. Mais Saturne, c'est aussi le "soleil noir" des alchimistes, que l'on a pu associer au soleil obombré au moment de la mort du Christ : quoi de plus naturel, dès lors, que d'en faire l'astre tutélaire d'un système qui se construit tout entier autour d'un "Vendredi saint spéculatif"? Car, comme Dante dut traverser les neuf cercles de l'Enfer avant d'espérer pouvoir s'élever au Purgatoire, puis au Paradis, l'homme pensant doit traverser le Système de la Science, en subir peut-être les glaçantes tentations, en méditer en tous cas la fascinante rigueur conceptuelle, pour pouvoir ensuite espérer voir scintiller devant lui les lueurs matinales d'un inattendu "dimanche de Pâques spéculatif"."--Page 4 of cover. (shrink)

--I. The life of Ramakrishna. -- II. The life of Vivekananda and the universal gospel.

The Zhuangzi is one of China's greatest literary and philosophical masterpieces, yet its complexities make it a challenging read. This English translation leads you confidently through the comic scenes and virtuoso writing style, introducing all the little stories Zhuangzi invented and unpicking its philosophy through close commentaries and helpful asides. In Graziani's translation, the co-founder of Daoism emerges as a remarkable thinker. It is a must-read for anyone coming to Chinese philosophy or the Zhuangzi for the first time, and one (...) that reminds us of the importance of thinking beyond our limited, everyday perspectives. (shrink)

By the author of Life of Ramakrishna, who won the Nobel Prize in Literature.

In these three Indian biographies dating from the 1920s, Romain Rolland introduces the French reader to Gandhi's political struggle and to the spiritual careers of Ramakrishna and his disciple Vivekananda, while revealing the deep meaning of his attraction to Hindu India at this time of his life.

The conflict between Jupiter and Juno in the Aeneid is commonly read as a battle between the forces of order and chaos. The present article argues that this schematization, though morally and aesthetically satisfying, fails to account for most of the data. Virgil's Jupiter is in fact concerned solely with power and adulation, despite persistent attempts by readers——and characters in the poem——to see him as benign. By systematically discussing every appearance of Jupiter in the poem, the article seeks to correct (...) the distorted or incomplete views of the god that arise from selective examination. The first section looks at Jupiter's own speeches to illustrate his motivations. The second section demonstrates how these motivations, though frequently misconstrued by the human characters, are confirmed by the glimpses of Jupiter focalized through the omniscient narrator. The third discusses the implications of this portrait of Jupiter for Virgil's vision of Rome and of human happiness. (shrink)

Christopher Boorse’s Biostatistical Theory of Health has been the main contender among naturalistic accounts of health for the last 40 years. Yet, a recent criticism of this theory, presented by Elselijn Kingma, identifies a dilemma resulting from the BST’s conceptual linking of health and statistical typicality. Kingma argues that the BST either cannot accommodate the situation- specificity of many normal functions or cannot account for many situation-specific diseases. In this article, we expand upon with Daniel Hausman’s response to Kingma’s dilemma. (...) We propose that recalling Boorse’s specification that health is an intrinsic property of its bearers and explicating this intrinsic property in relation to the concept of homeostasis can illuminate how proponents of naturalistic accounts of health should deal with the situation- specificity of normal functions. We argue that beyond what Boorse and Hausman have delineated, the situation- specificity of normal function cannot be fully captured in a simple dichotomy between normal and abnormal environment or between relevant and irrelevant situations. By bringing homeostasis to the fore of the analysis of health, we set out a richer picture of what the various situations that affect living organisms’ functional performance can be. Accordingly, we provide a broader classification of these various situations which, we contend, better accounts for the main intuitions that philosophers of medicine have sought to accommodate than previous naturalistic theories of health. (shrink)

“Neural coding” is a popular metaphor in neuroscience, where objective properties of the world are communicated to the brain in the form of spikes. Here I argue that this metaphor is often inappropriate and misleading. First, when neurons are said to encode experimental parameters, the neural code depends on experimental details that are not carried by the coding variable. Thus, the representational power of neural codes is much more limited than generally implied. Second, neural codes carry information only by reference (...) to things with known meaning. In contrast, perceptual systems must build information from relations between sensory signals and actions, forming an internal model. Neural codes are inadequate for this purpose because they are unstructured and therefore unable to represent relations. Third, coding variables are observables tied to the temporality of experiments, whereas spikes are timed actions that mediate coupling in a distributed dynamical system. The coding metaphor tries to fit the dynamic, circular, and distributed causal structure of the brain into a linear chain of transformations between observables, but the two causal structures are incongruent. I conclude that the neural coding metaphor cannot provide a valid basis for theories of brain function, because it is incompatible with both the causal structure of the brain and the representational requirements of cognition. (shrink)

Drawing on data from interviews with 65 masculine-to-feminine transgenderists, the authors examine the coming-out experiences of transgendered individuals. Drawing on the literature that shows gender to be an inherent component of the social infrastructure that at an individual level is accomplished in interaction with others, they demonstrate that interactional challenges to gender are insufficient to challenge the system of gender. Whereas many transgenderists believe that their actions and identities are radical challenges to the binary system of gender, in fact, the (...) majority of such individuals reinforce and reify the system they hope to change. (shrink)

This article draws on Foucault's concept of the exercise of power and Gramsci's concept of hegemony to examine how women used cosmetic surgery to exercise power over their bodies and lives. The analysis is rooted in two feminist perspectives on cosmetic surgery. The first argues that women who elect to have their bodies surgically altered are victims of false consciousness whose bodies are disciplined by the hegemonic male gaze. The second asserts that women who undergo elective cosmetic surgery exercise free (...) choice in controlling their bodies and lives. By examining sites wherein power is exercised by and over women, the authors argue for a synthesis of these two perspectives. They find that the women achieved greater power and control over their bodies and lives when they embodied hegemonic ideals of feminine beauty. Cosmetic surgery can be empowering for individual women while reinforcing the hegemonic ideals that oppress women as a group. (shrink)

Inner speech has been shown to vary in form along several dimensions. Along condensation, condensed inner speech forms have been described, that are supposed to be deprived of acoustic, phonological and even syntactic qualities. Expanded forms, on the other extreme, display articulatory and auditory properties. Along dialogality, inner speech can be monologal, when we engage in internal soliloquy, or dialogal, when we recall past conversations or imagine future dialogues involving our own voice as well as that of others addressing us. (...) Along intentionality, it can be intentional (when we deliberately rehearse material in short-term memory) or it can arise unintentionally (during mind wandering). We introduce the ConDialInt model, a neurocognitive predictive control model of inner speech that accounts for its varieties along these three dimensions. ConDialInt spells out the condensation dimension by including inhibitory control at the conceptualization, formulation or articulatory planning stage. It accounts for dialogality, by assuming internal model adaptations and by speculating on neural processes underlying perspective switching. It explains the differences between intentional and spontaneous varieties in terms of monitoring. We present an fMRI study in which we probed varieties of inner speech along dialogality and intentionality, to examine the validity of the neuroanatomical correlates posited in ConDialInt. Condensation was also informally tackled. Our data support the hypothesis that expanded inner speech recruits speech production processes down to articulatory planning, resulting in a predicted signal, the inner voice, with auditory qualities. Along dialogality, covertly using an avatar’s voice resulted in the activation of right hemisphere homologues of the regions involved in internal own-voice soliloquy and in cerebellar deactivation, consistent with internal model adaptation. Switching from first-person to third-person perspective resulted in activations in precuneus and parietal lobules. Along intentionality, compared with intentional inner speech, mind wandering with inner speech episodes was associated with greater bilateral inferior frontal activation and decreased activation in left temporal regions. This is consistent with the reported subjective evanescence and presumably reflects condensation processes. Our results provide neuroanatomical evidence compatible with predictive control and in favor of the assumptions made in the ConDialInt model. (shrink)

The neural coding metaphor is so ubiquitous that we tend to forget its metaphorical nature. What do we mean when we assert that neurons encode and decode? What kind of causal and representational model of the brain does the metaphor entail? What lies beneath the neural coding metaphor, I argue, is a bureaucratic model of the brain.

Countless conceptual metaphors related to human experience have been identified and discussed in the literature. In most conceptual metaphors, a concrete, experiential sou...

The anti-psychiatry movement of the 20th century has notably denounced the role of values and social norms in the shaping of psychiatric categories. Recent activist movements also recognize that psychiatry is value-laden, however, they do not fight for a value-free psychiatry. On the contrary, some activist movements of the 21st century advocate for self-advocacy in sciences of mental health in order to reach a more accurate understanding of psychiatric categories/mental distress. By aiming at such epistemic gain, they depart from the (...) anti-psychiatry movement. Through the analysis of the epistemic and political influence of two of these movements – Neurodiversity and the Mad Studies, we show how this new activism has taken a scientific turn compatible with current philosophical scientific frameworks, while still developing a critical approach on psychiatry. (shrink)

In this paper, I argue for a new way to understand the integration of facts and values in the concept of mental disorder that has the potential to avoid the flaws of previous hybrid approaches. I import conceptual tools from the account of procedural objectivity defended by Helen Longino to resolve the controversy over the definition of mental disorder. My argument is threefold: I first sketch the history of the debate opposing objectivists and constructivists and focus on the criticisms that (...) led to the emergence of the debate. Second, I offer a reconstruction of the “Natural Function Approach” argument to make explicit an unsound assumption underlying this approach. The reconstruction will allow me to show that the NFO’s argument depends on the ideal of value-free science that I will criticize. Then I propose an alternative ideal for psychiatry: social objectivity. I argue that the concept of mental health should be seen as “socially objective” rather than value-free, moving the debate towards the social procedures by which the definition is produced rather than the normative and factual content of its definition. (shrink)

Little is known about how bow mechanical characteristics objectively and quantitatively influence violinists' preferences and performance. Hypothesizing that the bow shape and mass distribution modifications would alter both violinists' appreciations of a bow and objective assessments of their performance, we recruited 10 professional violinists to play their own violin using 18 versions of a single bow, modified by combining three cambers and six mass distributions, in random order. A musical phrase, composed for this study, was played legato and spiccato at (...) three octaves and two tempi. Each violinist scored all 18 bows. Then, experts assessed the recorded performances according to criteria inspired by basic musical analysis. Finally, 12 audio-descriptors were calculated on the same note from each trial, to objectivise potential acoustic differences. Statistical analysis reveals that bow camber impacted the violinists' appreciations, and that heavier bow tips gave lower scores for spiccato playing. The expert evaluations reveal that playing with a lighter bow, or with a bow whose camber's maximum curvature is close to the frog, had a positive impact on some violinists' performance. The “camber-participant” interaction had significant effects on the violinists' appreciations, on the expert's evaluation and on almost all the audio-descriptors. While trends were identified, multiple camber-participant interactions suggest that bow makers should provide a variety of cambers to satisfy different violinists. (shrink)