_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

This essay places psychiatrist and philosopher Frantz Fanon’s anti-colonial, anti-racist message from Peau Noire, Masques Blancs/Black Skin, White Masks in conversation with the new diagnoses of “Gender Dysphoria” and “Transvestic Disorder” in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Specifically, the essay discusses sexologist Ray Blanchard’s controversial theory of autogynephilia alongside Fanon’s ambivalent rendering of transgender desire and interracial trans phenomenology in a crucial but frequently overlooked passage in Black Skin. Fanon’s anti-colonial critique of psychiatry (...) allows us to reconsider how Blanchard’s theories on paraphilia engage with the foundational psychoanalytic concepts of identification and desire, as identified by the Freudian and Lacanian models and explored in the writings of Judith Butler, Catherine Millot, Charles Shepherdson, and others. By offering a fresh interpretation of the French text, this essay argues that a “trans of color critique” can benefit from Black Skin’s unexpected insight into trans desire: Fanon’s “man of color,” who simultaneously undergoes a gender transition and a racial transformation, represents the literal embodiment of his critique of colonial racism. Given the role of the new paraphilias in the DSM-V, this essay concludes that a trans of color critique is well positioned to reinforce the anti-colonial message Fanon addressed to the psychiatric and psychoanalytical fields, which have tended to diagnose psychic injury while ignoring its causation, and which continue to neglect the fact that medical access is just as important as material support and security for minority subjects, in particular. (shrink)

This paper presents a new model for how the voting worked at the Athenian dramatic competitions, and demonstrates its viability mathematically. Previous proposals have either failed to take full account of the ancient sources or have not considered all the possible permutations of judging results. As is generally recognized, ten votes were cast, but in most circumstances not all were counted. Sections I-IV consider the tragic competition at the Dionysia, in which three competitors vied for the prize. For the questions (...) we consider, two likely cases are examined (when the votes are divided 4-3-3 and 5-3-2), then a random distribution covering all possible cases, and finally the situation when two competitors are favoured against a third (when the votes are divided 5-5-0, 5-4-1 and 4-4-2). Section I presents the proposal and situates it within the Athenian cultural context. Section II asks how many lots are typically drawn before a victory is obtained. Section III considers how other places are determined. Section IV introduces the question of 'fairness': does the person who receives the most votes actually win? Section V considers adjudication for comedies and at the Lenaia. Section VI considers dithyrambic competitions. (shrink)

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

ABSTRACT In this wide-ranging interview Professor Douglas V. Porpora discusses a number of issues. First, how he became a Critical Realist through his early work on the concept of structure. Second, drawing on his Reconstructing Sociology, his take on the current state of American sociology. This leads to discussion of the broader range of his work as part of Margaret Archer’s various Centre for Social Ontology projects, and on moral-macro reasoning and the concept of truth in political discourse.

There is currently little empirical information about attitudes towards cognitive enhancement - the use of pharmaceutical drugs to enhance normal brain functioning. It is claimed this behaviour most commonly occurs in students to aid studying. We undertook a qualitative assessment of attitudes towards cognitive enhancement by conducting 19 semi-structured interviews with Australian university students. Most students considered cognitive enhancement to be unacceptable, in part because they believed it to be unethical but there was a lack of consensus on whether it (...) was similar or different to steroid use in sport. There was support for awareness campaigns and monitoring of cognitive enhancement use of pharmaceutical drugs. An understanding of student attitudes towards cognitive enhancement is important in formulating future policy. (shrink)

Researchers investigating gender and anger have consistently found that White women, but not White men, are evaluated unfavorably when experiencing anger in the workplace. Our project originally aimed to extend findings on White women’s, Black women’s, and White men’s workplace anger by examining whether evaluations are exacerbated or buffered by invalidating or affirming comments from others. In stark contrast to previous research on gender stereotyping and anger evaluations, however, results across four studies (N= 1,095) showed that both Black and White (...) women portrayed as experiencing anger in the workplace were evaluatedmore favorablythan White men doing so. After Study 1’s initial failure to conceptually replicate, we investigated whether perceivers’ evaluations of women’s workplace anger could have been affected by the contemporaneous cultural event of #MeToo. Supporting this possibility, we found evaluations were moderated by news engagement and beliefs that workplace opportunities are gendered. Additionally, we found invalidating comments rarely affected evaluations of a protagonist yet affirming comments tended to favorably affect evaluations. Overall, findings suggest the need for psychologists to consider the temporary, or perhaps lasting, effects of cultural events on research outcomes. (shrink)

Addiction is increasingly described as a “chronic and relapsing brain disease”. The potential impact of the brain disease model on the treatment of addiction or addicted individuals’ treatment behaviour remains uncertain. We conducted a qualitative study to examine: (i) the extent to which leading Australian addiction neuroscientists and clinicians accept the brain disease view of addiction; and (ii) their views on the likely impacts of this view on addicted individuals’ beliefs and behaviour. Thirty-one Australian addiction neuroscientists and clinicians (10 females (...) and 21 males; 16 with clinical experience and 15 with no clinical experience) took part in 1 h semi-structured interviews. Most addiction neuroscientists and clinicians did not uncritically support the use of brain disease model of addiction. Most were cautious about the potential for adverse impacts on individuals’ recovery and motivation to enter treatment. While some recognised the possibility that the brain disease model of addiction may provide a rationale for addicted persons to seek treatment and motivate behaviour change, Australian addiction neuroscientist and clinicians do not assume that messages about “diseased brains” will always lead to increased treatment-seeking and reduced drug use. Research is needed on how neuroscience research could be used in ways that optimise positive outcomes for addicted persons. (shrink)

Developments in neuroscience have raised the possibility that pharmaceuticals may be used to enhance memory, mood, and attention in people who do not have an illness or disorder, a practice known as “cognitive enhancement.” We describe historical experiences with two medicinal drugs for which similar enhancement claims were made, cocaine in the late 19th and early 20th centuries, and amphetamines in the mid 20th century. These drugs were initially introduced as medicinal agents in Europe and North America before becoming more (...) widely used for a variety of purposes, including what would nowadays be considered cognitive enhancement. Their trajectory of use conformed to the typical use cycle of psychotropic drugs. There was an initial steep rise in prescribing for medical use, followed by expanded nonmedical use that was fueled by enthusiasm for the drugs’ effects. As the number of regular users increased, problems related to use (such as addiction) became apparent, societal concern increased, and laws were passed banning nonmedical use and eventually, medical use. This historical experience draws attention to the adverse side effects of enhancement use that only become apparent with regular, wide-scale use of a drug. We highlight the similarities between the enthusiasms for cocaine and amphetamines and the current enthusiasms for using prescription stimulants for cognitive enhancement. We argue bioethicists should not encourage the cognitive enhancement use of drugs such as methylphenidate in the absence of evidence on the efficacy and safety of their use for cognitive enhancement purposes. (shrink)

The rationality of means-end reasoning is the bedrock of the Humean account of practical reasons. But the normativity of such reasoning can not be taken for granted. I consider and reject the idea that the normativity of instrumental reasoning can be explained – either in terms of its being constitutive of the very notion of having an end, or solely in terms of instrumental considerations. I argue that the instrumental principle is itself a brute norm, and that this is consistent (...) with a Humean account of practical reasons. (shrink)

Continuing the posthumous editions of the manuscripts of Maurice Merleau-Ponty started in 1964, we publish the preparation notes for the courses of the College of France of 1959 and 1961. Each of these courses questions in a different way the philosophical exercise. How is philosophy possible today after the phenomenological enterprise? In the course of 1959, Merleau-Ponty presented a study by Husserl and Heidegger. It shows the contributions but also the limits. In addition, he has recourse to the interpretation of (...) the philosophy developed by Hegel and Marx, and his gesture is also given as a work of self-interpretation. The reading he suggests of Descartes makes the different levels of his approach sensitive. It seemed interesting to us to associate with his course notes the first writing of the chapter “Interrogation and intuition” of the Visible and the invisible which is in great affinity with the problems approached in these courses. This draft of the Visible and the Invisible, abandoned by Merleau-Ponty, makes it possible to mark the difference in style from the preparation notes which, as Claude Lefort writes, “do not exactly constitute a writing”. Rather, they offer food for thought to continue to question the philosopher's thinking. (shrink)

Издание предназначено для студентов, магистрантов, аспирантов филологических факультетов вузов и широкого круга читателей.

Daniel Kahneman and his colleagues have made an interesting discovery about people's preferences. In several experiments, subjects underwent two separate ordeals of pain, identical except that one ended with an added amount of diminishing pain. When asked to evaluate these episodes after experiencing both, subjects generally preferred the longer episode--even though it had a greater objective quantity of pain. These data raise an ethical question about whether to respect such preferences when acting on another's behalf. John Broome thinks that it (...) is wrong to add extra pain in order to satisfy a person's preference for a better ending. His explanation for this intuition is that pain is intrinsically bad. I argue against this explanation, and raise several doubts about the moral intuition Broome endorses. In doing so, I offer alternate interpretations of Kahneman's data, and show that these each yield different values which are relevant to the ethical question. (shrink)