Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

Are psychotherapy clients who pay via health insurance more likely to receive Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) diagnoses than identical clients who pay out of pocket? Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004) indicates that when psychologists consider a mildly depressed or anxious client, payment method significantly influences diagnostic decisions. This study extends the scope of the previous study to include clients whose symptoms are even less severe. Independent practitioners (...) responded to vignettes of clients whose profiles deliberately included subclinical impairment and a high level of functioning. Half of the participants were told that the clients would pay via managed care; the other half were told that the clients would pay out of pocket. As in the earlier study, payment method had a highly significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to be assigned DSM-IV diagnoses. In addition, a noteworthy percentage of participants assigned diagnoses regardless of payment method. Ethical implications are discussed. (shrink)

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared (...) to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed. (shrink)

Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004; Pomerantz & Segrist, 2006) indicates that when psychologists consider a client with symptoms of depression or anxiety, payment method significantly influences diagnostic decisions. This study extends the scope of the previous research to consider clients with symptoms of social phobia and attention deficit hyperactivity disorder (ADHD). Psychologists in independent practice responded to vignettes of clients whose descriptions deliberately included subclinical impairment. Half of the participants were told that the clients would (...) pay via managed care; the other half were told that the clients would pay out-of-pocket. Confirming previous studies, payment method had a highly significant impact on diagnosis such that compared to out-of-pocket clients, managed care clients were much more likely to be assigned Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses. Ethical implications relate to informed consent, accuracy and truthfulness in diagnosis, and psychologists' integrity. (shrink)

The present study examined nonprofessionals' perceptions of culturally based and noncultural ethical violations. One hundred seventy-four undergraduates students read 12 vignettes depicting situations in which a clinician committed either a culturally based violation (e.g., sexist or ageist behavior) or a noncultural violation (e.g., breeching confidentiality or multiple relationship). Results indicated that participants were more likely to have unfavorable views of clinicians who had committed culturally based violations. In addition, results suggested that participants would be more likely to report a clinician (...) who had committed a culturally based violation to a supervisor or ethics board. (shrink)

Research on multiple relationships by practicing psychologists has typically presumed the presence of a professional relationship and focused on the ethicality of subsequent, nonprofessional relationships. Instead, this study focused on the question of what, exactly, constitutes the professional relationship in the first place. Practicing psychologists and undergraduates responded to vignettes portraying various early stages of interaction between a therapist and a prospective client. Participants' responses indicated that determinations of professional relationship establishment, and the ethicality of subsequent nonprofessional relationships, depended upon (...) the degree of engagement. Some differences emerged between perceptions by professionals and nonprofessionals. Ethical and professional implications are discussed. (shrink)

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay (...) via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues. (shrink)

Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

Our thinking is still the captive of the dichotomy “national/ international.” The reaction to nationalism takes the form of an abstract internationalism, and reaction to internationalism leads to the rebirth of nationalism. However, this dichotomy was only true (and that relatively) in 19th century Europe, or at the latest, at the beginning of the twentieth century, when subnational cultures seemed on the way to disappearing, and everything European was considered “universal” (two hypotheses that the facts prove to be untrue). As (...) H. Frey observes, “Today, the decline or decadence of the West is part of the contemporary view of the world, like the electron or the dinosaur.” The linear outline of progress, with Europe at the head, did not withstand the test of the First World War. The year 1918 marked the beginning of the end of Europeanism. Since then, we have begun to speak of “areas of civilization” (Splengler), “civilizations” (Toynbee), “cultural coalitions” (Lévi-Strauss). The existence of “areas of civilization” (regions) is commonly admitted today; it has entered journalistic language and even the structure of regional commissions and agencies of the United Nations (Europe, Near East, Southern Asia, South-east Asia, and the Far East). New communities have inserted themselves between nations and humanity. What do they represent? Are they something unique, or are they divided into a certain number of types in opposition to each other because of some characteristic? And in what way have they modified our view of universal history? (shrink)

This paper examines the idea of objective phenomenology, or a way of understanding the phenomenal character of conscious experiences that doesn’t require one to have had the kinds of experiences under consideration. My central thesis is that structural facts about experience—facts that characterize purely how conscious experiences are structured—are objective phenomenal facts. I begin by precisifying the idea of objective phenomenology and diagnosing what makes any given phenomenal fact subjective. Then I defend the view that structural facts about experience are (...) objective. I also argue that structural facts about experience, despite being objective, nevertheless still give rise to an explanatory gap. (shrink)

Some accounts of moral responsibility hold that an agent's responsibility is completely determined by some aspect of the agent's mental life at the time of action. For example, some hold that an agent is responsible if and only if there is an appropriate mesh among the agent's particular psychological elements. It is often objected that the particular features of the agent's mental life to which these theorists appeal (such as a particular structure or mesh) are not necessary for responsibility. This (...) is because there appear to be cases in which an agent acts at an earlier time which causes her to lack the appropriate psychological features at some later time and yet, intuitively, she is responsible at that later .. (shrink)

Perception is riddled with cases of reliable misperception. These are cases in which a perceptual state is tokened inaccurately any time it is tokened under normal conditions. On the face of it, this fact causes trouble for theories that provide an analysis of perceptual content in non-semantic, non-intentional, and non-phenomenal terms, such as those found in Millikan (1984), Fodor (1990), Neander (2017), and Schellenberg (2018). I show how such theories can be extended so that they cover such cases without giving (...) up their core commitments. (shrink)

We are all familiar with the phenomenon of a proposition seeming true. Many think that these seeming states can yield justified beliefs. Very few have seriously explored what these seeming states are. I argue that seeming states are not plausibly analyzed in terms of beliefs, partial beliefs, attractions to believe, or inclinations to believe. Given that the main candidates for analyzing seeming states are unsatisfactory, I argue for a brute view of seemings that treats seeming states as irreducible propositional attitudes.

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there exists a limited (...) focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)

This is a discussion of the state of discussion on pragmatic reasons for belief.

This book brings together an international group of scholars to discuss the ramifications of Heidegger's Black Notebooks for philosophy and the humanities. In contrast to both those who seek to exonerate Heidegger and those who simply condemn him, they urge careful reading and rereading of his work to turn Heideggerian thought against itself.

For Kant, knowledge involves certainty. If “certainty” requires that the grounds for a given propositional attitude guarantee its truth, then this is an infallibilist view of epistemic justification. Such a view says you can’t have epistemic justification for an attitude unless the attitude is also true. Here I want to defend an alternative fallibilist interpretation. Even if a subject has grounds that would be sufficient for knowledge if the proposition were true, the proposition might not be true. And so there (...) is sometimes still rational room for doubt. The goal of this paper is to present four different models of what “certainty” amounts to, for Kant, each of which is compatible with fallibilism. (shrink)

In his 1978 paper “Mathematical Explanation”, Mark Steiner attempts to modernize the Aristotelian idea that to explain a mathematical statement is to deduce it from the essence of entities figuring in the statement, by replacing talk of essences with talk of “characterizing properties”. The language Steiner uses is reminiscent of language used for proofs deemed “pure”, such as Selberg and Erdős’ elementary proofs of the prime number theorem avoiding the complex analysis of earlier proofs. Hilbert characterized pure proofs as those (...) that use only “means that are suggested by the content of the theorem”, a characterization we have elsewhere called “topical purity”. In this paper we will examine the connection between Steiner’s account of mathematical explanation and topical purity. Are Steiner-explanatory proofs necessarily topically pure? Are topically pure proofs necessarily Steiner-explanatory? Answers to these questions will shed light on the general question of the relation between purity and explanatory power. (shrink)

The aim of the Analytic of Concepts is to derive and deduce a set of pure concepts of the understanding, the categories, which play a central role in Kant’s explanation of the possibility of synthetic a priori cognition and judgment. This chapter is structured around two questions. First, what is a pure concept of the understanding? Second, what is involved in a deduction of a pure concept of the understanding? In answering the first, we focus on how the categories differ (...) from the pure forms of sensibility and examine whether they are known only to be the pure forms of human thinking or rather the forms of discursive cognition as such. In answering the second, we draw a distinction between the application and the exemplification of the categories and use it to identify different ways of understanding Kant’s project in the Transcendental Deduction of the Categories. These questions connect because the answer to the first determines how we should understand the kind of entitlement which is to be established in the Deduction. (shrink)

While many aspects of cognition have been shown to be shared between humans and non-human animals, there remains controversy regarding whether the capacity to mentally time travel is a uniquely human one. In this paper, we argue that there are four ways of representing when some event happened: four kinds of temporal representation. Distinguishing these four kinds of temporal representation has five benefits. First, it puts us in a position to determine the particular benefits these distinct temporal representations afford an (...) organism. Second, it provides the conceptual resources to foster a discussion about which of these representations is necessary for an organism to count as having the capacity to mentally time travel. Third, it enables us to distinguish stricter from more liberal views of mental time travel that differ regarding which kind(s) of temporal representation is taken to be necessary for mental time travel. Fourth, it allows us to determine the benefits of taking a stricter or more liberal view of mental time travel. Finally, it ensures that disagreement about whether some species can mentally time travel is not merely the product of unrecognised disagreement about which temporal representation is necessary for mental time travel. We argue for a more liberal view, on the grounds that it allows us to view mental time travel as an evolutionarily continuous phenomenon, and to recognise that differences in the ways that organisms mentally time travel might reflect different temporal representations, or combinations thereof, that they employ. Our ultimate aim, however, is to create the conceptual framework for further discussion regarding what sorts of temporal representations are required for mental time travel. (shrink)

Public reason in practice and theory -- False starts: unsuccessful justifications of public reason -- Respect for persons as a constraint on coercion -- Higher-order unanimity escape clause -- Civic friendship as a constraint on reasons for decision -- Public reason and (same-sex) marriage.

The fallacy fallacy is either the misdiagnosis of fallacy or the supposition that the conclusion of a fallacy must be a falsehood. This paper explores the relevance of these and related errors of reasoning for the appraisal of arguments, especially within virtue theories of argumentation. In particular, the fallacy fallacy exemplifies the Owl of Minerva problem, whereby tools devised to understand a norm make possible new ways of violating the norm. Fallacies are such tools and so are vices. Hence a (...) similar problem arises with argumentative vices. Fortunately, both instances of the problem have a common remedy. (shrink)

Some have it that wholes are, somehow, identical to their parts. This doctrine is as alluring as it is puzzling. But in this paper, I show that the doctrine is inconsistent with two widely accepted theses. Something has to go.

This chapter addresses an ambiguity in some of the literature on rational peer disagreement about the use of the term 'rational'. In the literature 'rational' is used to describe a variety of normative statuses related to reasons, justification, and reasoning. This chapter focuses most closely on the upshot of peer disagreement for what is rationally required of parties to a peer disagreement. This follows recent work in theoretical reason which treats rationality as a system of requirements among an agent's mental (...) states. It is argued that peer disagreement has either no, or a very limited, affect on what rationality requires of an agent in a given circumstance. This is in part because of difficulties generated by a novel example of evidence of evidence of p being evidence against p. This example calls into question the mechanisms whereby peer disagreement might affect what is rationally required of an agent. The chapter also reevaluates the importance of actual peer disagreement against the backdrop of prior expectations about whether disagreement is believed to be likely, arguing that peer disagreement is most likely to change what is rationally required of an agent when it is believed to be unlikely. (shrink)

Towards the unconditioned: Kant, Epicurus and Glückseligkeit -- Arendt and the time of the pardon -- Kant, evil, and the unconditioned -- Judgment after Derrida.

The norm of monogamy is pervasive, having remained widespread, in most Western cultures at least, in spite of increasing tolerance toward more diverse relationship types. It is also puzzling. People willingly, and often with gusto, adhere to it, yet it is also, prima facie at least, highly restrictive. Being in a monogamous relationship means agreeing to give up certain sorts of valuable interactions and relationships with other people and to severely restrict one’s opportunities for sex and love. It is this (...) restrictiveness which has led for calls among some philosophers for the justification of the norm, and some have argued that it cannot be justified. John McMurtry, for example, writing in 1972, compared monogamy to private property and argued that it serves the capitalist order (McMurtry 1972, 596–97). More recently, Harry Chalmers (2019) has argued that monogamy is morally impermissible. In this chapter we argue that rather than justify the norm, we ought to explain and understand its pervasiveness. Not everyone who follows the norm is doing so blindly, irrationally, or immorally. Indeed, many people are monogamous because being monogamous supports their needs and best enables them to flourish. We suggest that the human need for trust and attachment could underlie many people’s desires for monogamy and, therefore, explain monogamy’s pervasiveness. Focusing on the human need for trust and attachment security can also help us to understand why sexual infidelity can feel like such a betrayal. It can make sense to mutually agree to exclusivity in relationships, in spite of the apparent restrictions this brings. In a sense, not all restrictions are restrictive, because holding ourselves to limits on our behavior can in fact help us to invest in and experience the things we value most. (shrink)

Many say that ontological disputes are defective because they are unimportant or without substance. In this paper, we defend ontological disputes from the charge, with a special focus on disputes over the existence of composite objects. Disputes over the existence of composite objects, we argue, have a number of substantive implications across a variety of topics in metaphysics, science, philosophical theology, philosophy of mind, and ethics. Since the disputes over the existence of composite objects have these substantive implications, they are (...) themselves substantive. (shrink)

European Journal of Philosophy, EarlyView.

This is a critical, but sympathetic, examination of the manifesto for naturalized metaphysics that forms the first chapter of James Ladyman and Don Ross's 2006 book, Every Thing Must Go, but it has wider implications than this description suggests.

I argue that the following theses are both popular among evidentialists but also jointly inconsistent with evidentialism: 1) Time-Slice Mentalism: one’s justificational properties at t are grounded only by one’s mental properties at t; 2) Experience Ultimacy: all ultimate evidence is experiential; and 3) Sleep Justification: we have justified beliefs while we have dreamless, nonexperiential sleep. Although I intend for this paper to be a polemic against evidentialists, it can also be viewed as an opportunity for them to clarify their (...) views. Furthermore, the paper is not only relevant to evidentialists. For example, the arguments of this paper could give Time-Slice Mentalists a reason to deny evidentialism. (shrink)

To be conscious—according to a common metaphor—is for the “lights to be on inside.” Is this a good metaphor? I argue that the metaphor elicits useful intuitions while staying neutral on controversial philosophical questions. But I also argue that there are two ways of interpreting the metaphor. Is consciousness the inner light itself? Or is consciousness the illuminated room? Call the first sense subjectivity (where ‘consciousness’ =def what makes an entity feel some way at all), and the second sense phenomenal (...) character (where ‘consciousness’ =def what it feels like to be an entity). I use this distinction—as well as the metaphor of the inner light—to clarify some philosophical questions about whether consciousness comes in degrees, whether consciousness is multidimensional, and whether there are borderline cases of consciousness. (shrink)

Matteo Ricci (1552-1610) was an Italian Jesuit and one of the first Christian missionaries to China in the modern era. He was a genuine polymath—a translator, cartographer, mathematician, astronomer, and musician. Above all, Ricci was a missionary for the gospel. As we briefly examine his 1603 seminal work, The True Meaning of the Lord of Heaven, our hope is that we, as evangelical educators, will perceive some of the deeper principles necessary for our own missionary work among unreached people.

The Stoics are traditionally regarded as the founders of propositional logic. However, this is not entirely correct. They developed a theory of inference from signs (omens). And their theory became a continuation of the logical technique of Babylonian divination (in particular, of Babylonian medical forecasting). The Stoic theory was not so much propositional logic as it was a technique of propositional logic for databases consisting of IF-THEN expert rules. In the Babylonian divination, each event has a positive or negative value (...) and all events are connected to each other. The Stoics also developed this idea and proposed a special modal logic in which logical determinism is considered an axiom. The paper reconstructs the sign-inference of the Stoics, as well as their modal logic. In particular, two Stoic squares of oppositions are proposed (for signs and for modal operators), which differ markedly from Aristotle’s square. (shrink)

Here's an interesting question: what are we? David Barnett has claimed that reflection on consciousness suggests an answer: we are simple. Barnett argues that the mereological simplicity of conscious beings best explains the Datum: that no pair of persons can itself be conscious. In this paper, I offer two alternative explanations of the Datum. If either is correct, Barnett's argument fails. First, there aren't any such things as pairs of persons. Second, consciousness is maximal; no conscious thing is a proper (...) part of another conscious thing. I conclude by showing how both moves comport with materialist theories of what we are and then apply them to another anti-materialist argument. (shrink)

Let a smooth experience be an experience with perfectly gradual changes in phenomenal character. Consider, as examples, your visual experience of a blue sky or your auditory experience of a rising pitch. Do the phenomenal characters of smooth experiences have continuous or discrete structures? If we appeal merely to introspection, then it may seem that we should think that smooth experiences are continuous. This paper (1) uses formal tools to clarify what it means to say that an experience is continuous (...) or discrete, and (2) develops a discrete model of the phenomenal characters of smooth experiences. As a result, I'll argue that introspection leaves open whether smooth experiences are continuous or discrete. Yet I’ll also argue—perhaps surprisingly—that the discrete theory may better fit our introspective evidence. (shrink)

The official definitions that appear at the beginning of four of the five parts of the "Ethics" do not include an account of "existence." However Spinoza does provide a definition of “existence” in the scholium to proposition 45 of Part 2. This is an odd place for such an important doctrine, and all the more so given that the account there differs from anything resembling commonsense. In this paper I show that, for Spinoza, to exist is to be eternal. Existence (...) in the strict sense is eternal existence. (shrink)

Source [1] Andrew E. P. Mitchell, Federica Galli, Sondra Butterworth. (2023). Editorial: Equality, diversity and inclusive research for diverse rare disease communities. Front. Psychol., vol. 14. doi:10.3389/fpsyg.2023.1285774. "It is also important to recognize that certain mental health disorders are classified as rare conditions and have their own cultural concepts of distress, as defined in the DSM-5 (American Psychiatric Association, 2013)" and require “equal attention and support for individuals and their families, both physically and emotionally”. [1].

Heidegger's later thought is a thinking of things, so argues Andrew J. Mitchell in The Fourfold. Heidegger understands these things in terms of what he names "the fourfold"--a convergence of relationships bringing together the earth, the sky, divinities, and mortals--and Mitchell's book is the first detailed exegesis of this neglected aspect of Heidegger's later thought. As such it provides entré to the full landscape of Heidegger's postwar thinking, offering striking new interpretations of the atomic bomb, technology, plants, animals, weather, (...) time, language, the holy, mortality, dwelling, and more. What results is a conception of things as ecstatic, relational, singular, and, most provocatively, as intrinsically tied to their own technological commodification. A major new work that resonates beyond the confines of Heidegger scholarship, The Fourfold proposes nothing less than a new phenomenological thinking of relationality and mediation for understanding the things around us. (shrink)