Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...) ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

This book is about experiential content: what it is; what kind of account can be given of it. I am concerned with identifying and attacking one main view - I call it the inferentialist proposal. This account is central to the philosophy of mind, epistemology and philosophy of science and perception. I claim, however, that it needs to be recast into something far more subtle and enriched, and I attempt to provide a better alternative in these pages. The inferentialist proposal (...) holds that experiential content is necessarily under¬pinned by sophisticated cognitive influences. My alternative, the continuum theory, holds that these influences are relevant to experience only at certain levels of organisation and that at other levels there are contents which such features do not capture at all. Central to my account is that there are degrees to which cognitive influences affect experiential content; indeed, for the most part, experience is an amalgam of both inferential and non-inferential features. I claim that the inferentialist proposal is fundamentally flawed and deserves replacement, and I argue that my alternative fills the hollow that remains. The book is divided into four sections. In Part I, Chapter 1, I introduce two traditionally rival views of experiential content. In Chapter 2, I develop my continuum alternative. Chapter 3 assesses the relationship between experience and language, while Chapter 4 explores the relationship between beliefs and experience. The overall argument is that it has been a mistake to understand experience simply in inferential or non-inferential terms. In Part II, I examine the structure of mental content. Chapter 5 is concerned with the kinds of experiences which escape the inferentialist analysis. Chapter 6 considers Kant’s metaphysic of experience counterpointed to Lorenz’s reading of his work in the light of evolutionary biology. Chapter 7 treats animal experience in relation to the continuum view I am developing, while Chapter 8 reviews Fodor’s contribution to perceptual psychology. It is argued that the view of experiential content being developed is both consistent with empirical data on informationally local perceptual sub-systems, but also accords well with evolutionary theory and a naturalist interpretation of Kant’s taxonomy. Part III deals with inferentialism in the philosophy of science. In Chapter 9, I assess the theory dependence of observation thesis as it is advanced by Paul Feyerabend. I bring out of his account a subtle confusion concerning the importance of inference in the context of scientific inquiry. Part IV deals with the issue of experience in the philosophy of mind. In Chapter 10, I look at Wilfred Sellars’s attack on sense data theories. Chapter 11 confronts Paul Churchland’s treatment of ‘folk psychology’ while Chapter 12 isolates the issue of experiential qualia and the position of property dualism. I offer a critical review of Thomas Nagel’s work in this chapter and claim that his position can be read in a way which is consistent with the continuum account I am developing. I conclude the book in the usual fashion with a summary of the central claims. (shrink)

From the perspective of values-based practice, there is much of interest in Lorenzo Gilardi and Giovanni Stanghellini's "I am a Schizophrenic." Their dialogue exhibits many of the key elements of VBP, it exemplifies the particular challenges presented by VBP in mental health, it illustrates the power of phenomenology in meeting these challenges, and it points by extension to an insight into contemporary psychiatry's professional identity as a medical profession.VBP is a resource for working with values—with what matters or is important (...) to those concerned—in healthcare. Avoiding preset answers, it offers instead a process that supports those concerned in a given situation... (shrink)

This Section examines several moral dilemmas and epistemological aporias in clinical practice and shows how clinicians can benefit from the introduction of philosophical methods and discourse. The authors develop these issues having in mind emblematic mental disorders and typical clinical situations. One important claim shared by the Authors is that a great effort has been made to ground psychiatry on evidence-based science, and to tie it to our growing understanding of the human brain. This is obviously an exceedingly important project, (...) but it would be a mistake to assume that the central questions of psychiatry can be completely resolved through scientific inquiry. Science offers guidance for clinical practice only in light of our concepts and normative judgments. (shrink)

In the editorial introduction the stage is set for the chapters in the section by a brief discussion of the relationship between the disciplines of philosophy and psychiatry. Then each chapter briefly is summarized or highlighted.

In this introduction to the Section II, the thrust of the component chapters is described. An important strand in the philosophy of psychiatry since its beginnings has been sociopolitical critiques: criticism which aims to improve and humanize psychiatric practice and mental health systems. From this standpoint, the introduction provides an overview of this tradition, including considerations of "postpsychiatry," value commitments in psychiatry, the recovery movement, racism and sexism in the field, and technology.

A cross-disciplinary discussion of the basis of interpersonal relating is of interest to philosophers and psychiatrists for several reasons. The development of successful clinical practice may depend, at least partly, on having an accurate understanding of the basic character of unimpaired interpersonal relating because such understanding can shed light on the nature and source of its disturbed forms. How we think about the basis of "mind-minding" competencies influences how we think about the prognosis and possible treatment of dysfunctional interpersonal relating. (...) Another reason is that philosophical frameworks influence the way we think about and evaluate possible psychiatric disorders and philosophical discussions may be of direct practical importance to psychiatry given that different theories suggest different potential ways of devising therapies. (shrink)

The editorial introduction sets the stage for the chapter by identifying the roles that concepts and categories play not just in the field of mental health medicine but in the human mind itself. Then, each chapter is summarized or highlighted.

Following on from Section IV on summoning concepts, this section of the Handbook presents theoretically informed descriptions of psychopathologies. The topics of the chapters range from anxiety, depression, and body image disorders, through emotion and affective disorders, to delusion, thought insertion, and the fragmentation of consciousness. These phenomena call, not only for assessment and diagnosis, but also for understanding on the part of both the engaged clinician and the philosophical commentator. They also provide case studies for general philosophical questions about (...) different levels of description and conceptualisation and the relationships between them, and about the contributions to psychological understanding that are made by phenomenology, clinical expert knowledge, and the sciences of the mind. (shrink)

In this introduction to Section VI, the thrust of the component chapters is described. The classification and diagnosis of mental disorders collects a number of philosophical challenges to the field that call for responses from a variety of philosophical resources: hermeneutics, phenomenology, philosophy of mind, narrative theory, philosophy of science, epistemology-to name a few. The authors in this section address the general challenges in the classification of psychopathology, as well as address particular kinds of mental disorders, including autism, dementia, mania, (...) psychotic disorders, and personality disorders. (shrink)

The Birkhoff-Maltsev problem asks for a characterization of those lattices each of which is isomorphic to the lattice L(K) of all subquasivarieties for some quasivariety K of algebraic systems. The current status of this problem, which is still open, is discussed. Various unsolved questions that are related to the Birkhoff-Maltsev problem are also considered, including ones that stem from the theory of propositional logics.

In this presentation I discuss the concept of “place” in the Japanese twentieth century philosopher and founder of the Kyoto School of philosophy, Nishida Kitarō, in light of the ancient Greek concept of chōra, and compare it with the German thinker Martin Heidegger’s notion of “region” that was also inspired by chōra. We can point to Plato’s concept of chōra in his Timaeus as an important source for both twentieth century philosophers of the East and the West. But we can (...) also draw connections to the pre-Platonic everyday understanding of chōra as well. I argue that chōra in general entails concretion-cum-indetermination, a space that implaces human existence into its environment and clears room for the presencing-absencing of beings. (shrink)

This chapter outlines the origins in ordinary language philosophy of a new skills-based approach to working with complex and conflicting values in medicine called values-based practice. Ordinary language philosophy focuses on our use of words as a useful first step in coming to a more complete understanding of their meanings. The theory of values-based practice was developed by applying ideas from ordinary language philosophy to the long-running debate about the "boundary problem" presented by the concept of mental disorder. Ordinary language (...) philosophy turns this debate topsy-turvy: it shows, that the concept of mental disorder instead of being the target problem is a resource for coming to a more complete understanding of the meanings of concepts of disorder as a whole including the concept of bodily disorder; and correspondingly, that the value-laden nature of mental disorder far from being part of the problem points to an evaluative element of meaning in concepts of disorder as a whole, again including concepts of bodily disorder. It is these topsy-turvy results that underpin the development of values-based practice. In a brief concluding section we indicate the potential for further development of values-based practice supported by ordinary language and other philosophies particularly through engagement with non-Western language groups representing diverse traditions of thought and practice in mental health. (shrink)

This chapter introduces the edited volume, The Oxford Handbook of Philosophy and Psychiatry. Published in 2013, the centenary of Karl Jaspers' General Psychopathology, the chapter draws lessons from the last hundred years for the coming century. No predictions are made. Instead, five 'conditions for flourishing' are set out: 1) Particular Problems - the importance of focussing on well-defined particular problems rather than general theory building, 2) Product- orientation - remaining always responsibly product oriented in the specific sense that both sides (...) put in the work necessary to 'go deep' with each other's fields, 3) Partnership - working in partnerships of one kind or another, 4) Process - constant reflection on process based on peer review but leaving scope for the occasional rogue voice to cut innovatively against the grain, and 5) Q - a condition of a different kind, Q is an empirically derived measure of the balance between in-group cohesion and out-group openness required to support creativity. Illustrations are given of how these five conditions for flourishing have underpinned the rapid expansion of philosophy and psychiatry in the closing decades of the twentieth century, and, correspondingly, are also reflected in the Handbook as a whole. Overviews and commentaries on individual contributions to the Handbook are given in extended editorial introductions to each of its eight sections. (shrink)

Organic chemists have been able to develop a robust, theoretical understanding of the phenomena they study; however, the primary theoretical devices employed in this field are not mathematical equations or laws, as is the case in most other physical sciences. Instead it is diagrams, and in particular structural formulas and potential energy diagrams, that carry the explanatory weight in the discipline. To understand how this is so, it is necessary to investigate both the nature of the diagrams employed in organic (...) chemistry and how these diagrams are used in the explanations of the discipline. I will begin this paper by characterizing some of the major ways that structural formulas used in organic chemistry. Next I will present a model of the explanations in organic chemistry and describe how both structural formulas and potential energy diagrams contribute to these explanations. This will be followed by several examples that support my abstract account of the role of diagrams in the explanations of organic chemistry. In particular, I will consider both the appeal to ‘hyperconjugation’ in the explanation of alkene stability and how the idea of ‘ring strain’ was developed to explain the relative stability of cyclic compounds. (shrink)

Ordinairement les manuels de biologie débutent par une exposition des caractéristiques qui distinguent la nature organique de la nature anorganique. En définissant et en limitant aussi exactement que possible son sujet, la biologie, le biologue ne fait pas autre chose que le mathématicien. La présente étude nous montre les obstacles presque insurmontables auxquels se heurtent le biologue et le mathématicien. A les bien considérer, les anciennes distinctions entre l'organisme d'une part et la matière non-organisée ou un système statique matériel, comme (...) la machine, d'autre part, se basant sur la nutrition, la respiration, les échanges vitaux et le mouvement ne tiennent plus debout. L'auteur allègue les expériences récentes de W. M. Stanley (Rockefeller Institute à Princeton) d'où il appert qu'il peut y avoir aussi génération dans les substances qui se secrètent sous la forme de cristaux (cristaux vivants), et s'en rapporte aux fameuses expériences de Driesch sur la régénération. Il y rattache les conceptions de Jordan (Utrecht) -- rapports entre les enchaînements des causes "d'après leur caractère amboceptor"; "le dessein des causes". Les vitalistes portent surtout leur attention sur "la totalité", les mécanistes sur "les parties". Le naturaliste qui se propose uniquement la recherche des causes physico-chimiques des phénomènes physico-chimiques serait parfaitement en droit de se contenter d'une conception mécaniste de la nature. Mais cette conception mécaniste ne suffirait pas à celui qui, comme l'auteur, aspire à comprendre l'organisme dans son ensemble. (shrink)

THE PROBLEM OF THE INTERPRETATION OF HAMANN Johann Georg Hamann is an intriguing but poorly known figure in the contemporary intellectual world. Yet this is the man whom Kierkegaard saluted as "Emperor!", whose writings were to have been arranged for publication by none other than Goethe himself, and whom Dilthey numbered among the primordial figures in the rise of modern historical consciousness. There are reasons for the persistence of this general ignorance. Hamann is deep. And, in addition, there is his (...) forbidding style. The readers of Kierkegaard and Dilthey, two other giants who them selves achieved late recognition, have not had to face this kind of imposing obstacle. Not only does Hamann expect his readers to handle themselves in deep water, but to intuit their way between his ideas which bob up like islands with no visible connection between them. Like Kierkegaard too, Hamann has had his troubles with the public. He himself referred to the hope that he would be understood by a "better posterity". In fact only the last few years have seen the printing of some of his more controversial writings, in particular his theories on the nature of human sexuality. (shrink)

In his pioneering work of moral phenomenology, K. E. Løgstrup offered a phenomenological articulation of a central moment of ethical life: the experience in which “one finds oneself with the life of another more-or-less in one’s hands”. In such circumstances we encounter what Løgstrup calls simply the ethical demand. Løgstrup’s preferred formulation of the content of that demand is taken from the Bible: Love thy neighbor. This neighborly love is expressed in the form of spontaneous, selfless care for the other. (...) We shall have occasion in what follows to return to the content that Løgstrup associates with the ethical demand, but my primary focus here is not its content but its distinctive modality. Løgstrup specifies that modality in a fourfold analysis: the ethical demand is radical, silent, one-sided, and unfulfillable. My concern in what follows will be with the fourth element in this analysis – or what I shall refer to simply as Løgstrup’s unfulfillability thesis. My discussion addresses three specific questions: Is it coherent to suppose that the ethical demand is unfulfillable? Why does Løgstrup hold that the ethical demand is unfulfillable? What kind of response is appropriate in the face of an unfulfillable ethical demand? (shrink)

The death of Jesse Gelsinger in 1999 during a gene therapy trial raised many questions about the ethical review of medical research. Here, the author argues that the principle of justice is interpreted too narrowly and receives insufficient emphasis and that what we permit in terms of bodily invasion affects the value we place on individuals. Medical research is a societally supported activity. As such, the author contends that justice requires that invasive medical research demonstrates sufficiently compelling societal benefit. Many (...) consider this societal benefit to be self evident. However, medical research is a complex activity; it yields new treatments but also creates financial rewards and affects health resource allocation. As research evolves into a multibillion pound, multinational enterprise, justice requires a much broader analysis of societal benefit. Without such evaluation we risk undermining the value of bodily integrity and of research participants. (shrink)