The environment can elicit biological responses such as oxidative stress (OS) and inflammation as a consequence of chemical, physical, or psychological changes. As population studies are essential for establishing these environment-organism interactions, biomarkers of OS or inflammation are critical in formulating mechanistic hypotheses. By using examples of stress induced by various mechanisms, we focus on the biomarkers that have been used to assess OS and inflammation in these conditions. We discuss the difference between biomarkers that are the result of a (...) chemical reaction (such as lipid peroxides or oxidized proteins that are a result of the reaction of molecules with reactive oxygen species) and those that represent the biological response to stress, such as the transcription factor NRF2 or inflammation and inflammatory cytokines. The high-throughput and holistic approaches to biomarker discovery used extensively in large-scale molecular epidemiological exposome are also discussed in the context of human exposure to environmental stressors. We propose to consider the role of biomarkers as signs and to distinguish between signs that are just indicators of biological processes and proxies that one can interact with and modify the disease process. (shrink)

Contentless experience involves an absence of mental content such as thought, perception, and mental imagery. In academic work it has been classically treated as including states like those aimed for in Shamatha, Transcendental, and Stillness Meditation. We have used evidence synthesis to select and review 135 expert texts from within the three traditions. In this paper we identify the features of contentless experience referred to in the expert texts and determine whether the experiences are the same or different across the (...) practices with respect to each feature. We identify 65 features reported or implied in one or more practices, with most being reported or implied in all three. While there are broad similarities in the experiences across the traditions, we find that there are differences with respect to four features and possibly many others. The main difference identified is that Shamatha involves substantially greater attentional stability and vividness. Another key finding is that numerous forms of content are present in the experiences, including wakefulness, naturalness, calm, bliss/joy, and freedom. The findings indicate that meditation experiences described as contentless in the academic literature can in fact involve considerable variation, and that in many and perhaps most cases these experiences are not truly contentless. This challenges classical understandings in academic research that in these so-called contentless experiences all content is absent, and that the experiences are therefore an identical state of _pure consciousness_ or consciousness itself. Our assessment is that it remains an open question whether the experiences aimed for in the three practices should be classed as pure consciousness. Implications of our analysis for neuroscientific and clinical studies and for basic understandings of the practices are discussed. (shrink)

Shamatha, Transcendental, and Stillness Meditation are said to aim for “contentless” experiences, where mental content such as thoughts, perceptions, and mental images is absent. Silence is understood to be a central feature of those experiences. The main source of information about the experiences is texts by experts from within the three traditions. Previous research has tended not to use an explicit scientific method for selecting and reviewing expert texts on meditation. We have identified evidence synthesis as a robust and transparent (...) method that is suitable for this purpose. In this paper we use evidence synthesis based on expert texts to examine silence/quietness as a feature of the contentless experiences in the three practices. Objective criteria were used to select a sample of 135 expert texts. A database containing the expert descriptions of the meditation techniques and experiences was produced by extracting the relevant material from the publications and coding that material to differentiate individual features. The database, which forms part of the supplementary material for this paper, identifies each feature of the contentless experiences referred to in the expert texts, including silence/quietness. Our key finding is that the experts indicate silence/quietness has a particular connection with stillness, and the absence of concepts, mental activity/noise, thoughts, and disturbance. Further analysis leads to the following insights. The silence/quietness reflects the absence of thoughts and sounds, and this fits neatly with a conception of silence/quietness as the absence of internal and external noise. In some cases the terms silence and quietness may also reflect the absence of other disturbances such as non-auditory perceptions, mental images, and negative feelings. That would fit with a conception of silence/quietness as complete calm or absence of disturbance. It is not clear from the expert texts how silence/quietness is distinct from other features such as stillness that also reflect the absence of disturbances. As a separate matter, silence/quietness has connections with all the other features of the contentless experiences, but the closeness of the connections varies. Our work uncovers fine distinctions and ambiguities which lead to new research questions that can be explored in future studies. (shrink)

The fairy tale The Three Princes of Serendip can be taken to be allegorical of not only chance discovery (serendipity) but of other aspects of scientific discovery as well. Just as Horace Walpole coined serendipity, so can the term bahramdipity be derived from the tale and defined as the cruel suppression of a serendipitous discovery. Suppressed, unpublished discoveries are designated nulltiples. Several examples are presented to make the case that bahramdipity is an existent aspect of scientific discovery. Other examples of (...) non-ideal scientific research and discovery are provided in order to contrast and clarify the meaning and use of bahramdipity. Additional allegories of scientific discovery are taken from the tale and a hope for the strengthening of scientific integrity is expressed. (shrink)

In contentless experience there is an absence of mental content such as thought, perception, and mental imagery. The path to contentless experience in meditation can be taken to comprise the meditation technique, and the experiences on the way to the contentless “goal-state/s”. Shamatha, Transcendental, and Stillness Meditation are each said to access contentless experience, but the path to that experience in each practice is not yet well understood from a scientific perspective. We have employed evidence synthesis to select and review (...) 135 expert texts from those traditions. In this paper we describe the techniques and interim-states based on the expert texts and compare them across the practices on key dimensions. Superficially, Shamatha and Transcendental Meditation appear very different to Stillness Meditation in that they require bringing awareness to a meditation object. The more detailed and systematic approach taken in this paper indicates that posturally Shamatha is closer to Stillness Meditation, and that on several other dimensions Shamatha is quite different to both other practices. In particular, Shamatha involves greater measures to cultivate attentional stability and vividness with respect to an object, greater focusing, less tolerance of mind-wandering, more monitoring, and more deliberate doing/control. Achieving contentless experience in Shamatha is much slower, more difficult, and less frequent. The findings have important implications for taxonomies of meditation and for consciousness, neuroscientific, and clinical research/practice, and will provide new and useful insights for meditation practitioners. (shrink)

In Glauben und Wissen, Hegel criticizes Kant for drawing a deep division between sensibility and understanding. Hegel suggests that Kant’s faculty of productive imagination is a step toward uniting intuition and concept in an original unity out of which the two arise, but this requires him to treat the productive imagination in ways Kant would not approve. I argue that Kant’s doctrine of the schematism offers an advance on the productive imagination when it comes to solving the intuition/concept dualism Hegel (...) critiques, although there remain serious problems with which Hegel would take issue. Although the schematism might answer some of the criticisms Hegel aims at the intuition/concept dualism, it does not solve the related problem Hegel finds in Kant, namely the dualism of cognition and thing-in-itself. (shrink)

Drawing on theoretical arguments from the psychology discipline, we investigate the implications of employee entitlement in organizational settings. Specifically, we utilize workplace engagement theory to suggest that due to their skewed sense of deservingness, employees high in entitlement are less likely to experience workplace engagement. Furthermore, the negative relationship between employee entitlement and workplace engagement is strengthened when ethical leadership is low, yet mitigated when ethical leadership is high. Finally, we predict that under conditions of low ethical leadership, reductions in (...) engagement explain why employee entitlement results in hindered job performance. This mediated effect does not hold when ethical leadership is high. We tested our theoretical model utilizing field data from employees and their direct supervisors in the financial services industry. Our results support our theoretical model. Theoretical and practical implications are discussed. (shrink)

Michael Walzer is one of the world's most important political thinkers. In this book, Toby J. Reiner provides the most wide-ranging and up-to-date introduction to his work available. Examining Walzer's multivarious writings and work, Reiner develops an illuminating new interpretation of his thought that no political theorist can afford to miss.

Climate engineering with stratospheric sulfate aerosol injections (SSAI) has the potential to reduce risks of injustice related to anthropogenic emissions of greenhouse gases. Relying on evidence from modeling studies, this paper makes the case that SSAI could have the potential to reduce many of the key physical risks of climate change identified by the Intergovernmental Panel on Climate Change. Such risks carry potential injustice because they are often imposed on low-emitters who do not benefit from climate change. Because SSAI has (...) the potential to reduce those risks, it thereby has the potential to reduce the injustice associated with anthropogenic emissions. While acknowledging important caveats, including uncertainty in modeling studies and the potential for SSAI to carry its own risks of injustice, the paper argues that there is a strong case for continued research into SSAI, especially if attention is paid to how it might be used to reduce emissions-driven injustice. (shrink)

Just-war theory has a long and distinguished history that stretches back to the Christian theologians of medieval Europe. Yet principles of just war must develop alongside social norms, standards of military practice and technology, and civilian-military relationships. Since World War II, and especially since American involvement in Vietnam, military ethics has developed into an academic cottage industry. As commonly taught to undergraduates and military practitioners, contemporary just-war theory seeks to ensure the political sovereignty and territorial integrity of nation-states. The theory (...) insists that the only just wars are defensive ones and forbids wars of national aggrandizement. On this view, because of the right to collective self-determination, wars must not seek to remake the world order, as that would undermine state sovereignty.In recent decades, however, cosmopolitan philosophers have challenged various aspects of the traditional edifice in an attempt to use just-war theory to enhance the protection of human rights around the world. Scholars have argued for greater scope for humanitarian intervention to protect individuals against their own government, for principles of justice after war to ensure that all states are legitimate, and most radically, for the responsibility of ordinary combatants to assess for themselves the justice of their military's cause. On this last argument, because combatants whose cause is just have done nothing to lose their immunity from harm, attacking them is unjust, and combatants whose cause is unjust cannot fight with discrimination.This publication surveys these recent developments, and it finds that they provide a radical challenge to both the theory and the practice of contemporary warfare. Of particular importance is its insistence on the need to strengthen international institutions, so as to provide combatants with an impartial perspective on their side's cause, and to strengthen military ethics education; and its suggestion that policies on dishonorable discharge be rethought. However, this monograph also challenges certain aspects of the new approach, suggesting important connections between military ethics and democratic theory and practice. (shrink)

In some important papers, and especially in his 'The Problem of the Essential Indexical', John Perry has argued that we should draw a clear distinction between two aspects of belief: its causal role in action, on the one hand, and its semantic content (the proposition that is believed), on the other. According to Perry, beliefs with the same semantic content (with the same truth conditions) may have a very different causal influence on the subject¿s action. In this paper, we show (...) that Perry's arguments in favor of this thesis are not sound and defend, against him, the common sense intuition according to which what leads us to act as we do is what we believe (the semantic content of our belief), or, in other words, that there is no schism between the semantic content and the causal role of our beliefs. (shrink)

Anil Gupta’s book Empiricism and Experience (2006) is a rich and complex piece of work, whose main aim is to elucidate the rational contribution of experience to knowledge. A minimally complete acc...

Following the widespread occurrence of birth defects from the use of thalidomide to treat nausea during pregnancy in the 1960s and 1970s, the Food and Drug Administration became particularly vigilant about the use of therapeutic agents during pregnancy and in women of childbearing potential. The FDA developed a list that categorizes an agent according to the known risks to a fetus. The drug thalidomide falls into Category X: agents that have demonstrated clear risk of fetal abnormalities and whose risks outweigh (...) the benefits of use during pregnancy.Another Category X drug is isotretinoin, commonly known by its trade name Accutane. Isotretinoin is an oral medication prescribed for severe recalcitrant, nodular acne in patients who are unresponsive to conventional therapy. Isotretinoin has been available since 1982, and it remains the only effective treatment for this condition. (shrink)

The United States Food and Drug Administration , in collaboration with pharmaceutical manufacturers, have recently implemented a heavily revised risk-management program for patients on isotretinoin , a drug with known and pronounced teratogenic effects. This revised risk management plan places significant burdens on both providers and patients in the hopes of achieving its goal of reducing fetal exposure to isotretinoin. The main focus of this paper is to discuss the burdens of various aspects of the program in relationship to potential (...) corresponding benefits. In particular, we evaluate the pregnancy rates of women on isotretinoin therapy compared with that of the general population and the rate changes based on the risk management programs. Additionally, we investigate whether the benefits of the program for women have increased as the benefits have risen. We devote special attention to the ethical implications of the intent of the program and to an analysis of the ethical justification of the restrictions placed on women of childbearing potential as it compares to the risk-benefit relationship of using isotretinoin. (shrink)

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

Mass vaccination has been a successful public health strategy for many contagious diseases. The immunity of the vaccinated also protects others who cannot be safely or effectively vaccinated—including infants and the immunosuppressed. When vaccination rates fall, diseases like measles can rapidly resurge in a population. Those who cannot be vaccinated for medical reasons are at the highest risk of severe disease and death. They thus may bear the burden of others' freedom to opt out of vaccination. It is often asked (...) whether it is legitimate for states to adopt and enforce mandatory universal vaccination. Yet this neglects a related question: are those who opt out, where it is permitted, morally responsible when others are harmed or die as a result of their decision? In this article, we argue that individuals who opt out of vaccination are morally responsible for resultant harms to others. Using measles as our main example, we demonstrate the ways in which opting out of vaccination can result in a significant risk of harm and death to others, especially infants and the immunosuppressed. We argue that imposing these risks without good justification is blameworthy and examine ways of reaching a coherent understanding of individual moral responsibility for harms in the context of the collective action required for disease transmission. Finally, we consider several objections to this view, provide counterarguments and suggest morally permissible alternatives to mandatory universal vaccination including controlled infection, self-imposed social isolation and financial penalties for refusal to vaccinate. (shrink)

In his 2000 paper, Hookway intends to argue that Fumerton’s Principle of Inferential Justification does not have the sceptical consequences that Fumerton sees into it. We think Hookway is right in holding this. However, after commenting on his main considerations for this thesis, we shall develop an independent line of argument which reinforces the same conclusion.

This paper examines and contrasts two closely related evolutionary explanations in human behaviour: signalling theory, and the theory of Credibility Enhancing Displays. Both have been proposed to explain costly, dangerous, or otherwise ‘extravagant’ social behaviours, especially in the context of religious belief and practice, and each have spawned significant lines of empirical research. However, the relationship between these two theoretical frameworks is unclear, and research which engages both of them is largely absent. In this paper we seek to address this (...) gap at the theoretical level, examining the core differences between the two approaches and prospects and conditions for future empirical testing. We clarify the dynamical and mechanistic bases of signalling and CREDs as explanatory models and contrast the previous uses to which they have been put in the human sciences. Because of idiosyncrasies regarding those uses, several commonly supposed differences and comparative advantages are actually misleading and not in fact generalisable. We also show that signalling and CREDs theories as explanatory models are not interchangeable, because of deep structural differences. As we illustrate, the proposed causal networks of each theory are distinct, with important differences in the endogeneity of various phenomena within each model and their explanatory targets. As a result, they can be seen as complementary rather than in competition. We conclude by surveying the current state of the literature and identifying the differential predictions which could underpin more comprehensive empirical comparison in future research. (shrink)

In this paper, we distinguish two ways in which someone can be said to believe a proposition. In the light of this distinction, we question the widely held equivalence between considering a proposition true and believing that proposition. In some cases, someone can consider a proposition true and not properly believe it. This leads to a distinction between the conventional meaning of the sentence by which a subject expresses a belief and the content of this belief. We also question some (...) principles of belief ascription, suggest a solution to a famous puzzle about belief and defend the unity of the semantic and causalaspects of beliefs. (shrink)

In this paper we don’t intend to show, against the sceptic, that most of our everyday beliefs about the external world are cases of knowledge. What we do try to show is that it is more rational to hold that most of such beliefs are actually cases of knowledge than to deny them this status, as the external world sceptic does. In some sense, our point of view is the opposite of Hume’s, who held that reason clearly favours scepticism about (...) the independent existence of an external world rather than common sense belief in such an independent existence. In arguing for the superior rationality of this common sense, Moorean view, we also take a fallibilist conception of knowledge to be rationally preferable to an infallibilist view of it. (shrink)

A hub and spoke model offers an effective and efficient approach to providing informed guidance to those who need it. The National Center for Ethics in Health Care (NCEHC) at the Veterans Health Administration, Department of Veterans Affairs, is the largest known hub and spoke healthcare ethics delivery model. In this article, we describe ways NCEHC’s hub and spoke configuration succeeded during the COVID- 19 pandemic, as well as limitations of the model and possible improvements to inform adoption at other (...) healthcare systems. (shrink)

Concerns about the risks of unmitigated greenhouse gas emissions are growing. At the same time, confidence that international policy agreements will succeed in considerably lowering anthropogenic greenhouse gas emissions is declining. Perhaps as a result, various geoengineering solutions are gaining attention and credibility as a way to manage climate change. Serious consideration is currently being given to proposals to cool the planet through solar-radiation management. Here we analyze how the unique and nontrivial risks of geoengineering strategies pose fundamental questions at (...) the interface between science and ethics. To illustrate the importance of integrated ethical and scientific analysis, we define key open questions and outline a coupled scientific-ethical research agenda to analyze solar-radiation management geoengineering proposals. We identify nine key fields of coupled research including whether solar-radiation management can be tested, how quickly learning could occur, normative decisions embedded in how different climate trajectories are valued, and justice issues regarding distribution of the harms and benefits of geoengineering. To ensure that ethical analyses are coupled with scientific analyses of this form of geoengineering, we advocate that funding agencies recognize the essential nature of this coupled research by establishing an Ethical, Legal, and Social Implications program for solar-radiation management. (shrink)

In J Philos Logic 34:155–192, 2005, Leitgeb provides a theory of truth which is based on a theory of semantic dependence. We argue here that the conceptual thrust of this approach provides us with the best way of dealing with semantic paradoxes in a manner that is acceptable to a classical logician. However, in investigating a problem that was raised at the end of J Philos Logic 34:155–192, 2005, we discover that something is missing from Leitgeb’s original definition. Moreover, we (...) show that once the appropriate repairs have been made, the resultant definition is equivalent to a version of the supervaluation definition suggested in J Philos 72:690–716, 1975 and discussed in detail in J Symb Log 51(3):663–681, 1986. The upshot of this is a philosophical justification for the simple supervaluation approach and fresh insight into its workings. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

Depuis 1996, plusieurs équipes sont au travail pour achever la traduction liturgique de l’Ancien Testament. Au moment où le chantier est en voie d’achèvement, un ouvrier de la première heure présente ici l’entreprise à travers le cas particulier du livre de Tobie, qui a été traduit sur frais nouveaux pour l’usage liturgique. La traduction liturgique ne prétend pas surclasser les traductions existantes, mais occupe un créneau qui lui est propre: celui de la proclamation publique.

We explain two ways of revising a tense logic like kripke's (1963) modal logic by adding predicate modifiers. first we show that modifiers allow us to render valid some mixing formulas--conditionals reversing the order of a quantifier and an operator--within a complete bivalent system. then we show how modifiers enable a tense logic to give analyses close to the surface form for sentences with temporal qualifications of singular terms, e.g., 'toby was fatter then than william is today'.

This is a review of Toby Handfield's book, "A Philosophical Guide to Chance", that discusses Handfield's Debunking Argument against realist accounts of chance.

A review of A Philosophical Guide to Chance by Toby Handfield. Cambridge CUP 2012.

Humanity stands at a precipice. -/- Our species could survive for millions of generations — enough time to end disease, poverty, and injustice; to reach new heights of flourishing. But this vast future is at risk. With the advent of nuclear weapons, humanity entered a new age, gaining the power to destroy ourselves, without the wisdom to ensure we won’t. Since then, these dangers have only multiplied, from climate change to engineered pandemics and unaligned artificial intelligence. If we do not (...) act fast to reach a place of safety, it may soon be too late. -/- The Precipice explores the science behind the risks we face. It puts them in the context of the greater story of humanity: showing how ending these risks is among the most pressing moral issues of our time. And it points the way forward, to the actions and strategies we can take today to safeguard humanity’s future. (shrink)

Supervaluationism is often described as the most popular semantic treatment of indeterminacy. There’s little consensus, however, about how to fill out the bare-bones idea to include a characterization of logical consequence. The paper explores one methodology for choosing between the logics: pick a logic thatnorms beliefas classical consequence is standardly thought to do. The main focus of the paper considers a variant of standard supervaluational, on which we can characterizedegrees of determinacy. It applies the methodology above to focus ondegree logic. (...) This is developed first in a basic, single-premise case; and then extended to the multipremise case, and to allowdegreesof consequence. The metatheoretic properties of degree logic are set out. On the positive side, the logic is supraclassical—all classical valid sequents are degree logic valid. Strikingly, metarules such as cut and conjunction introduction fail. (shrink)

It has often been noted that there is some tension between engaging in decision-making and believing that one’s choices might be predetermined. The possibility that our choices are predetermined forces us to consider, in our decisions, act-state pairs which are inconsistent, and hence to which we cannot assign sensible utilities. But the reasoning which justifies two-boxing in Newcomb’s problem also justifies associating a non-zero causal probability with these inconsistent act-state pairs. Put together these undefined utilities and non-zero probabilities entail that (...) expected utilities are undefined whenever it is a possibility that our choices are predetermined. There are three ways to solve the problem, but all of them suffer serious costs: always assume that, contrary to our evidence, the outcome of our present decision-making is not predetermined; give up the reasoning that justifies unconditional two-boxing in Newcomb’s problem; or allow epistemically impossible outcomes to contribute to expected utility, leading to the wrong results in a series of cases introduced by Ahmed :665–685, 2014a, Evidence, decision and causality, Cambridge University Press, Cambridge, 2014b). However they choose to respond, causal decision theorists cannot remain silent: the intuitive tension between decision-making and the possibility of predetermination can be made precise, and resolving it will require giving up something. Causal decision theorists have a predetermination problem. (shrink)

Settler colonialism is structured in part according to the principle of civilizational progress yet the roots of this doctrine are not well understood. Disparate ideas of progress and practices related to colonial dispossession and domination can be traced back to the Enlightenment, and as far back as ancient Greece, but there remain unexplored logics and continuities. I argue that civilizational progress and settler colonialism are structured according to the opposition between politics governed by reason or faith and the figure of (...) the child as sinful or bestial. Thus, it is not contingent, but rather necessary that justificatory frameworks of European empire and colonialism depict Indigenous peoples as children. To illustrate how the theoretical link between Indigenous peoples and children emerges not as a simple analogy, but rather, as the source of the premodern/modern and savage/civilized binaries, I trace the various historical iterations of the political/childhood opposition through the classical, medieval, enlightenment, and modern eras. I show how the model of civilizational progress from a premodern and savage state of childhood continues to serve as the model for settler colonial exclusion and domination of Indigenous peoples. (shrink)

The deliberative systems approach is a recent innovation within the tradition of deliberative democratic theory. It signals an important shift in focus from the political legitimacy produced within isolated and formal sites of deliberation (e.g., Parliament or deliberative mini-publics), to the legitimacy produced by a number of diverse interconnected sites. In this respect, the deliberative systems (DS) approach is better equipped to identify and address defects arising from the systemic influences of power and coercion. In this article, I examine one (...) of the least explored and least understood defects: the exclusion of non-speaking political actors generated by the uniform privileging of speech in all sites within a system. Using the examples of prefigurative protest, Indigenous refusal to deliberate, and the non-deliberative agency of disabled citizens, I argue that the DS approach allows theorists to better understand forms of domination related to the imposition of speech on those who are either unwilling or unable to speak. (shrink)

We think we know what healers do: they build on patients' irrational beliefs and treat them in a 'symbolic' way. If they get results, it's thanks to their capacity to listen, rather than any influence on a clinical level. At the same time, we also think we know what modern medicine is: a highly technical and rational process, but one that scarcely listens to patients at all. In this book, ethnopsychiatrist Tobie Nathan and philosopher Isabelle Stengers argue that this commonly (...) posed opposition between traditional and modern medicine is misleading. They show instead that healers are interesting precisely because they don't listen to patients, using techniques of 'divination' rather than 'diagnosis'. Healers construct genuine therapeutic strategies by identifying the origins of symptoms in external forces, outside of the mind of the sufferer, and in this regard African healers are virtuosos. Though it may claim otherwise, modern medicine, for its part, is characterised by empiricism rather than rationality. What appears to be the pursuit of rationality is ultimately only a means to dismiss and exclude other forms of treatment. Blurring the distinctions between traditional and modern practices and drawing on perspectives from across the globe, this ethnopsychiatric manifesto encourages us to think in radically new ways about illness, challenging accepted notions on the relationship between sufferer and symptom. It will be of great interest to those working in medicine and healthcare, as well as anthropologists, social scientists and those in the humanities more broadly. (shrink)