Recent advances in brain imaging methods as well as increased sophistication in neuroscientific modeling of the brain’s reward systems have facilitated the study of neural mechanisms associated with addiction such as processes associated with motivation, decision-making, pleasure seeking, and inhibitory control. These scientific activities have increased optimism that the neurological underpinnings of addiction will be delineated, and that pharmaceuticals that target and change these mechanisms will by themselves facilitate early intervention and even full recovery. In this paper, we argue that (...) it is misguided to construe addiction as just or primarily a brain chemistry problem, which can be adequately treated by pharmaceutical interventions alone. (shrink)

Advances in applications of artificial intelligence and the use of data analytics technology in biomedicine are creating optimism, as many believe these technologies will fill the need-availability gap by increasing resources for mental health care. One resource considered especially promising is smartphone psychotherapy chatbots, i.e., artificially intelligent bots that offer cognitive behavior therapy to their users with the aim of helping them improve their mental health. While a number of studies have highlighted the positive outcomes of using smartphone psychotherapy chatbots (...) to handle various anxiety related problems no conclusive data illustrate their effectiveness or warrant their use in mental illness diagnosis and treatment settings. Yet smartphone psychotherapy is highly endorsed by experts in the field of mental health research. In this paper, I focus on the specific features of smartphone psychotherapy chatbots intended for the diagnosis and treatment of mental illness and criticize three popular promises; i.e., they enable early diagnosis and intervention through digital phenotyping; they defy the stigma of mental illness diagnosis and treatment; they offer increased access to mental health treatment globally. Going against the popular enthusiasm, I argue smartphone psychotherapy chatbots have epistemic and ethical limitations in the diagnosis and treatment of illnesses. In light of these, I encourage researchers, clinicians, policy makers, patients, and caregivers to pause before jumping on the artificial intelligence bandwagon to seek solutions for mental illness on the grounds of these three promises. (shrink)

This paper challenges the exclusion of patients from epistemic practices in psychiatry by examining the creation and revision processes of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a document produced by the American Psychiatric Association that identifies the properties of mental disorders and thereby guides research, diagnosis, treatment, and various administrative tasks. It argues there are epistemic—rather than exclusively social/political—reasons for including patients in the DSM revision process. Individuals with mental disorders are indispensable resources to enhance psychiatric epistemology, (...) especially in the context of the crisis, controversy, and uncertainty surrounding mental health research and treatment. (shrink)

Mental disorder is an urgent and growing public health problem.1 Scientific investigation of this problem has the pragmatic goals of identifying the causes of mental disorders and developing strategies to effectively treat them. Philosophers of psychiatry have participated in the inquiry into the empirical examination of mental disorders, predominantly by debating whether psychopathology is a legitimate target of scientific inquiry and, if so, how mental disorders should be explained, predicted, and intervened on. However, as I show in this paper, these (...) philosophical discussions have mostly neglected the actual state of inquiry in psychiatry and relevant disciplines, as well as the first-person experiences... (shrink)

Various traditions in mental health care, such as phenomenological, and existential and cognitive-behavioral psychotherapy, implicitly or explicitly acknowledge that a disruption of the self, or the person, or the agent is among the common denominators of different mental disorders. They often emphasize the importance of understanding patients as reasonsresponsive, in their full mental health relevant complexity, if their mental disorder is to be treated successfully. The centrality of the concept of the self is not mirrored in the mainstream scientific approaches (...) in psychiatry however; the self has rarely been considered as the object of scientific research, the empirical investigation of which might yield successful explanations of and interventions in mental disorders. Thus, even though self-related phenomena are clinically relevant in so far as they give important information about a mental disorder to the clinician and help the development of effective interventions, they are not considered among the scientifically relevant properties of mental disorders. Leaving the self-related phenomena out of the scientific research on mental disorders can be attributed to the presupposition that the self is not empirically tractable and its use will hinder psychiatry’s goal to be scientific. In this paper, taking issue with this, I argue the self is empirically tractable, and its use as a target of research will not hinder psychiatry’s scientific commitments. (shrink)

This paper explores the factors that contribute to the degree of a mood disorder patient’s self- insight, defined here as her understanding of the particular contingencies of her life that are responsive to her personal identity, interpersonal relationships, illness symptoms, and the relationship between these three necessary components of her lived experience. I consider three factors: (i) the Diagnostic Statistical Manual of Mental Disorders (DSM), (ii) the DSM culture, and (iii) the cognitive architecture of the self. I argue that the (...) symptom-based descriptions of mood disorders which eliminate the subjective features of the patient’s illness experience, in conjunction with the features of the DSM-culture and the cognitive biases that guide the patient, contribute to the impoverishment of her self-insight. The resulting impoverished self-insight would prevent her from developing resourceful responses to her interpersonal problems. In analyzing how these factors combine to influence the patient’s self-insight, I distinguish the therapeutic impact of receiving a psychiatric diagnosis, which facilitates patient’s clinical treatment, from its reflective impact, how the diagnosis informs the patient’s reflection on who she is, how her mental disorder is expressed, and how her interpersonal relationships proceed. I substantiate my argument by considering a patient’s memoir of psychopathology. (shrink)

The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what we call the “epistemological turn” in (...) recent work in the philosophy of medicine; the third part addresses new developments in medical research that raise interesting questions for philosophy of medicine; the fourth part is a discussion of philosophical issues within the practice of diagnosis; the fifth part focuses on the recent developments in psychiatric classification and scientific and ethical issues therein, and the final part focuses on the objectivity of medical research. (shrink)

his article develops a set of recommendations for the psychiatric and medical community in the treatment of mental disorders in response to the recently published fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, that is, DSM-5. We focus primarily on the limitations of the DSM-5 in its individuation of Complicated Grief, which can be diagnosed as Major Depression under its new criteria, and Post-Traumatic Stress Disorder (PTSD). We argue that the hyponarrativity of the descriptions of these disorders (...) in the DSM-5, defined as the abstraction of the illness categories from the particular life contingencies and personal identity of the patient (e.g., age, race, gender, socio-economic status), constrains the DSM-5's usefulness in the development of psychotherapeutic approaches in the treatment of mental disorders. While the DSM-5 is useful in some scientific and administrative contexts, the DSM's hyponarrativity is problematic, we argue, given that the DSMs are designed to be useful guides for not only scientific research, but also for the education of medical practitioners and for treatment development. our goal therefore is to offer suggestions for mental health practitioners in using the DSM-5, so that they can avoid or eliminate the problems that may stem from the limitations of hyponarrativity. When such problems are eliminated, we believe that effective psychotherapeutic strategies can be developed, which would be successful in repairing the very relationships that are strained in mental disorder: the patient's relationship to herself, her physical environment, and her social environment. (shrink)

Philosophers and psychologists have advanced a plethora of explanations of the self in relation to narratives, positing varying degrees of connection between them. For some, narratives created by a subject about herself shape her self-constitution (Flanagan 1991; Fivush 1994). For others, they help the subject to participate in social cognition (Hutto 2008). Some represent narratives as merely one basis of personal identity and consider them cognitive tools used by the subject to construct self-concepts (Neisser 1997; Tekin 2011); others render (...) narratives the basis for self-constitution (Dennett 1992; MacIntyre 1981; Schechtman 1996). Some require that the subject create her ‘whole life narrative’ unifying her .. (shrink)

The scientific investigation of mental disorders is an invigorating area of inquiry for philosophers of mind and science who are interested in exploring the nature of typical and atypical cognition as well as the overarching scientific project of ‘carving nature at its joints’. It is also important for philosophers of medicine and bioethicists who are concerned with concepts of disease and with the development of effective and ethical treatments of mental disorders and the just distribution of mental health services. Philosophical (...) worries surrounding mental health and its care have recently extended beyond the bounds of academia, becoming a vigorous topic of debate in a variety of public domains in the wake of the publication of the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , the psychiatric classification system used by mental health professionals in the USA, and increasingly, by those around the world.The DSM-5 lists mental disorders according to the observable symptoms presented by patients. It is designed for pragmatic use across a variety of settings to accomplish several tasks: to facilitate clinical treatment, to provide clear criteria of eligibility for various administrative and policy related purposes ), and primarily, to further scientific research into mental disorder aetiology. Although designed to meet the needs and interests of various stakeholders , the recently revised manual has not fully satisfied any of them. This failure challenges the assumption that a single manual …. (shrink)

, Looping Effects, the Self, Psychopathology.

Educators who start a philosophy of medicine or medical ethics class with a philosophical discussion on the definition of basic concepts in medicine, such as health and disease, might relate to this anecdotal account. Students initially find the topic engaging because of the ubiquity of the concept of disease regulating not only their direct encounter with health-related contexts, for example, when veterans returning to school receive accommodations after being diagnosed with Post Traumatic Stress Disorder, but also their social world, say, (...) when they get in an argument with their classmates about whether vaccines cause or prevent diseases, or when they join the campus gym to improve their health. Yet their enthusiasm wanes when they read the seminal naturalist and normative accounts of disease. This happens not because such conceptual work does not have any philosophical sophistication and value but because the discussion seldom makes direct contact with the common uses of the disease concept in the medical, social, moral and institutional contexts in which the students are heavily embedded. As the authors of ‘Rethinking ‘Disease’: A Fresh Diagnosis and a New Philosophical Treatment’ argue, the notion of disease central to the naturalist and normativist positions is conceptually insulated from its applications in various institutional settings in healthcare and also from its personal, social and economic contexts. This insularity largely stems from the fact that traditional conceptual analysis in philosophy assumes a lot more than it can show, including the assumption that concepts, such as disease, have necessary and sufficient conditions that exist independently of the world as we encounter it and are accessed through our intuitions. This is a problem, because the concept of disease plays a crucial role in medical epistemology, scientific research, and ethical and policy-related issues; a philosophical account of disease that does not directly engage …. (shrink)

In “Mad Narratives: Self-Constitutions Through the Diagnostic Looking Glass,” by using narrative approaches to the self, I explore how the diagnosis of mental disorder shapes personal identities and influences flourishing. My particular focus is the diagnosis grounded on the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM). I develop two connected accounts pertaining to the self and mental disorder. I use the memoirs and personal stories written by the subjects with a DSM diagnosis as illustrations to bolster (...) my claims. First, expanding on the narrative approaches to the self, I explain how narratives about a subject shape her self-constitution. I elucidate how this process is generated by drawing on research in developmental psychology, cognitive science, and social psychology. Next, using this account as a springboard, I argue that the DSM diagnosis of mental disorder serves as a source of narrative, entering into the patients’ autobiographical and social narratives. This plays an important role in the diagnosed subjects’ self-understanding, self-constitution and flourishing. In this vein, how mental disorders are classified is not only a theoretical question about accurately taxonomizing the various experiences related to mental distress but also an ethical question about which ways of talking about mental disorders will allow subjects to respond effectively to their psychological distress, to flourish and to live autonomous and fulfilling lives. Finally, I suggest that the DSM-based narratives wield a double-edged sword when it comes to the subject’s flourishing: On the one hand, there are problems with some DSM-based narratives that stem from the DSM diagnostic schema and the culture of DSM diagnoses. These problems render these DSM-based narratives unbeneficial for flourishing as they constrain the range of adoptive social, cognitive and emotional responses the subjects can give to their mental disorders. On the other hand, there are grounds to believe that some DSM-based narratives help subjects to flourish. For instance, they provide certainty to subjects' otherwise puzzling symptoms and help them reach out to others with similar experiences. Understanding how the DSM-based narratives can both benefit and harm will help us address problems with psychiatric diagnoses and the dissemination of knowledge about mental disorders in popular culture. The project aims to convince both philosophers and psychiatrists that no plausible theory of the self can be developed without attending to the topic of mental disorder and that no theory of mental disorder can be complete without devising the tools provided by the philosophical approaches to the self as well as developmental and social psychology. It also calls for methodological alterations in mental health ethics research, arguing that a careful scrutiny of mental disorder memoirs can advance the ethical underpinnings to the practice of psychiatry. (shrink)

In their article, “Patients’ beliefs about deep brain stimulation (DBS) for treatment resistant depression,” Lawrence, Kaufmann, DeSilva, and Appelbaum analyze the responses of 24 psychiatric inpat...

The special issue, “Psychiatry and Its Philosophy,” focuses on addressing the mindbrain dualism and connected problems in the clinical and scientific contexts of psychiatry. Authors in this special issue address the theoretical disagreements that are manifest in the clinical and scientific goals of psychiatry and explore the possibility of reconciling the claim that research on psychopathology needs to be scientific with the claim that it needs to address the needs of patients in the clinic. Our approach is forward looking and (...) concerned with drawing on ideas and methods from the philosophy of science and philosophy of mind to promote pluralism in psychiatry. (shrink)

Words we use to characterize mental states matter; they affect, for better or worse, the individual whose mental states are in question. For example, referring to a child whose behavior seems a bit...

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, and much more. The Oxford Handbook (...) of Psychotherapy Ethics covers the whole range of ethical issues in the heterogenous field of psychotherapy, closing a commonly perceived gap between ethical sensitivity, technical language, and knowledge among psychotherapists. The primary audience is psychotherapists in clinical practice. Furthermore, the Oxford Handbook of Psychotherapy Ethics addresses the whole range of professionals providing mental health services beyond psychology and medicine including counselors, social workers, nurses, or ministers. The Oxford Handbook of Psychotherapy Ethics is not only intended for a clinical audience but also for a philosophical/ethical audience. The goal of the is to explicitly link the two disciplines by fostering a productive dialogue between them, enriching both the psychotherapeutic encounter and the ethical analysis and sensitivity within and outside the clinic. (shrink)

1. Imagine the following hypothetical scenario: Sarah is often called an expert on depression: after all, she graduated from medical school and has a PhD in neuroscience. She knows all theories of...

In a compelling and provocative paper, ‘Solving the Self-Illness Ambiguity: The Case for Construction Over Discovery,’ Sofia M.I. Jeppsson distinguishes two ways of addressing the self-illness ambiguty problem. The first is the Realist Solution, which postulates a pre-existing border between the self and the illness and frames the goal of treatment in psychiatry as helping the patient ‘discover’ this boundary. Addressing the shortcomings of the Realist Solution, both in terms of its feasibility and possible outcomes, Jeppsson proposes and defends the (...) Constructivist Solution, according to which the patient, through self-reflection and deliberation with others, including the clinicians, decides, which parts of her experiences they identify with themselves and which parts they attribute to their illness. This paper critically evaluates Jeppson’s arguments and addresses some of the shortcomings of Jeppsson’s positive argument, i.e. the Constructivist Solution. (shrink)

The question “What is the relationship between the self and mental disorder?” is especially important for mental health professionals interested in understanding and treating patients, as most mental disorders are intimately tied to self‐related concerns, such as loss of self‐esteem and self‐control, or diminished agency and autonomy. Philosophy, along with the cognitive and behavioral sciences, offers a wealth of conceptual and empirical resources to answer this question, as the concepts of the self and psychopathology have occupied a central place in (...) these fields since their inception. Interestingly, and unfortunately, however, scientific psychiatry, in its approach to mental disorder as primarily a cluster of signs and symptoms has been slow in acknowledging the advances in conceptualizing and investigating mental disorders in relation to the self. The article addresses this problem and offers solutions for better cross‐fertilization between empirical and philosophical inquiry into the self and psychiatric research on mental disorders. The first part evaluates what empirically informed philosophical inquiry and philosophically informed empirical inquiry offer to the examination of the relationship between the self and mental disorders. The second part argues that scientific psychiatry has missed opportunities to find effective treatments for mental disorders because of its insularity from debates in naturalistic philosophy and cognitive and behavioral sciences. Psychiatry has much to gain from the conceptual, scientific, and clinical resourcefulness of philosophy's collaboration with the cognitive and behavioral sciences. (shrink)

In this short article I will review Galen Strawson’s most recent book, “Things That Bother Me: Death, Freedom, The Self, etc.“ As it is impossible to do justice to the full collection in a review,...

Bu makale Aristotelesçi bilim teorisinin ve filozofların ilmî eserlere belirli konularla giriş yapma geleneğinin İslamî ilimlerin tasavvur edilmesi ve sunulmasında etkili olduğunu fıkıh usulü el kitaplarından Muhtasarü’l-Müntehâ’nın girişi üzerine yapılan tartışmalara binaen göstermektedir. Aristotelesçi bilim teorisi her ilmin konu, ilke ve meselelerden oluştuğunu ileri sürmekte, felsefî mukaddime yazma geleneği ise bir eserin konusunu, amacını ve sair belli başlı meselelerini ele alarak giriş yapma tarzını sunmaktaydı. Makale felsefî bilim teorisiyle ilmî eserlere mukaddime yazma geleneğinin, İbnü’l-Hâcib’in (ö. 646/1249) Muhtasarü’l-Müntehâ’sının girişi üzerine yapılan (...) şerh ve haşiyelerde kesiştiklerini göstermektedir. Bu metne onlarca şerh ve haşiye yazılmıştır, fakat makalede bunlar içerisinden on üç ve on dördüncü yüzyıllarda Kâdî el-Beyzâvî (ö. 691/1291-92), Ziyâüddin et-Tûsî (ö. 706/1306-7), Kutbüddin eş-Şîrâzî (ö. 710/1311), Cemâleddin el-Hillî (ö. 726/1325), Bedreddin et-Tüsterî (ö. 732/1332), Adudüddin el-Îcî (ö. 756/1355), Sa‘deddin et-Teftâzânî (ö. 792/1390) ve Seyyid Şerif el-Cürcânî (ö. 816/1413) tarafından yazılanlar incelenmektedir. İbnü’l-Hâcib’in giriş mahiyetindeki iki cümlesi üzerine yapılan yorumlar mebâdî kelimesinin ilkeler ve başlangıçlar şeklindeki -ilki bilim teorisi ikincisi ise bilimlere giriş yazma geleneğiyle ilişkili olan- iki anlamı arasındaki gerilimi göstermektedir. Makale İbnü’l-Hâcib’in Muhtasar’ı üzerine yapılan şerh ve haşiyelerdeki tartışmalar üzerinden hem fıkıh usulünün tasavvur ve sunumunun felsefî bilim teorisi ve bilimlere giriş yazma geleneği doğrultusunda olduğunu hem de bu metnin mebâdî kavramının lügavî ve ıstılahî anlamlarını kapsayacak şekilde yeniden tasavvur edilmesini tetiklediğini ortaya koymaktadır. En nihayetinde, mebâdî üzerine yapılan tartışmaların bir bilimin birlik yönünü bilmeyi temellendiren etkili bir argümanı doğurduğu, ayrıca o dönemdeki yaygın bilim teorisine karşı ilimlerin esasında üç değil tek bir öğeden oluştuğu şeklinde bir eleştiriye yol açtığı gösterilmektedir. (shrink)

This book explores the central questions and themes lying at the heart of a vibrant area of philosophical inquiry. Aligning core issues in psychiatry with traditional philosophical areas, it presents a focused overview of the historical and contemporary problems dominating the philosophy of psychiatry. -/- Beginning with an introduction to research issues, it addresses what psychiatry is and distinguishes it from other areas of medical practice, other health care professions and psychology. With each section of the companion corresponding to a (...) philosophical subject, contributors systematically relate themes in philosophy of psychiatry to topics in philosophy of mind, phenomenology, philosophy of science, ethics, social and political philosophy, metaphysics, epistemology, and philosophy of medicine. Looking ahead to new research directions, chapters address recent issues including the metaphysics of mental disorders, gender and race in psychiatry and psychiatric ethics. -/- Featuring discussion questions, suggestions for further reading and an annotated bibliography, The Bloomsbury Companion to Philosophy of Psychiatry is an accessible survey of the debates and developments in the field suitable for undergraduates in philosophy and professional philosophers new to philosophy of psychiatry. (shrink)

The Prophet, whom Allah sent the whole universe and humanity as mercy, produced not only many judicial rules and practices regarding the relations of a person with Allah and other people in Islam but also uttered sentences about the explanation of holy book, Qur’an, and about how this book can be put into practice. The issue whether and how much these sentences of the prophet (hadith) and acts of the prophet (Sunnah) are binding have been discussed by both hadith methodologists (...) and fiqh methodologists; accordingly, a great many studies were produced. In hadith methodology, the discussions about Sunnah of the Prophet had their reflections in the studies of fiqh methodology; and especially Hanafi jurists propounded considerations about this issue. Hussein b. Ali al-Saymerî (d. 436/1045) one of these jurists, is the student of Muhammad b. Mûsa al-Khwârizmî (d. 403/1012), who is the student of Abû Bakr al-Jassâs (d. 370/980), who is an authority in Hanafi methodology. al-Saymerî, who adopted the method of al-Jassâs in fiqh methodology, systematically categorized several fundamental issues which were discussed and were related to fiqh methodology during his time; and he defended the views of Hanafi scholars about these issues primarily against Shâfiʿîs and several fiqh and kalam schools. While presenting the views and evidences of Hanafis, al-Saymerî initially applied for the views of founder imams of Hanafi sect such as Abû Hanîfa, Abû Yusuf and Muhammad al-Shaybânî; following these scholars, he greatly benefited from Hanafi scholars from Iraq region, such as Abu’l-Hasan al-Karkhî (d. 340/952) and his student, Abu Bakr al-Râzî al-Jassâs. When the relevant parts of his study is analysed, it is seen that the effect of al-Jassâs is especially noticeable. In this article, we will study the binding issue of the Sunnah of the Prophet within the context of al-Saymerî’s study, which has extant and is called Mesâilu’l-hilâf fi usûli’l-fiqh. We consider that the different attitude of al-Saymerî about the Sunnah of the Prophet from the other methodologists and hadith scholars and the underlying reasons of these differences are worth to be investigated and emphasized. (shrink)

All democratic constitutions feature "the people" as their author and ultimate source of legitimacy. They claim to embody the political form that citizens are in some sense supposed to have given themselves. But in what sense, exactly? When does a constitution really or genuinely speak for the people? Such questions are especially pertinent to our present condition, where the voice of "the people" turns out to be irrevocably fragmented, and people themselves want to speak and be heard in their own (...) voices. _Founding Acts_ explores the relationship between constitutional claims of popular sovereignty and the practice of constitution-making in our pluralistic age. Serdar Tekin argues that the process of making a constitution, or its pedigree, is as morally and politically significant as its content. Consequently, democratic constitution-making is not only about making a democratic constitution but also about making it, as much as possible, democratically. Tekin develops two overarching arguments in support of this claim. First, citizen participation in the process of constitution-making is essential to the democratic legitimacy of a new constitution. Second, collective action, that is, the political experience of constructing public life together, is what binds diverse people into a democratic peoplehood. Bringing into dialogue a wide range of canonical and contemporary thinkers, Tekin examines historical realities extending from revolutionary America and France to contemporary South Africa and Germany. (shrink)

In the history of Islam, many scholars who have contributed to Islamic sciences both with their works and their thoughts have been attributed to teşeyyuʻ (being inclined to Shi'ism). Dārakutnī (d. 385/995) is one of the scholars who were subjected to this accusation. Dārakutnī, who was considered one of the leading ḥadīth reciters of his period with his strong memory and deep understanding, wrote many works showing his competence in the science of ḥadīth He was also given the title of (...) “Amīr al-mu’minīn fi’l-hadīs”, a title bestowed upon very few people. The background behind Dārakutnī’s accusation of teşeyyuʻ is that he memorized the poems of Sayyid al-Himyerî (d. 173/789), a Shiite poet. In this article, the allegation of teşeyyu' attributed to Dārakutnī has been examined and the information that constitutes the source of the said accusation against him has been examined and whether this accusation has been handled on a solid basis has been examined. As a result of the research conducted on both Dārakutnī’s own words and works and the Ahl al-Sunnah and Shia rijāl literature, it was concluded that the accusation of teşeyyu' directed against Dārakutnī was merely an allegation and was not based on a scientific basis. In the research, the information in the relevant sources was examined and an attempt was made to present the information obtained in an objective manner. (shrink)

Background:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by (...) nurses nor a study conducted on the issue.Aim/objective:The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level.Method:The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised.Ethical considerations:The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality.Results:In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively.Conclusion:Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care. (shrink)

Background:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by (...) nurses nor a study conducted on the issue.Aim/objective:The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level.Method:The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised.Ethical considerations:The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality.Results:In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively.Conclusion:Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care. (shrink)

In this paper, the scientific realism/anti-realism debate, which is one of the most popular topics in the metaphysics of science, will be examined in supporting the realistic wing. In this respect, the discussion will be conducted by keeping the subjects of ‘existence of an external mind-independent world’ and ‘unobservable entities’ at the center of this paper. In the context of understanding the world, ‘Science’ activity is not the sum of the research carried out only by considering empirical data; on the (...) contrary, it will be claimed that it is an endeavor that pursues unknown but interesting things (such as protons, photons, or viruses) and tries to give meaning to the world. Thus, against the empirical rigid attitude of anti-realism –bearing in mind the views of logical positivists; it will be illustrated that scientific realism is an understanding based on metaphysics and has a philosophical basis. (shrink)

Kantçı strateji skolastik dönem boyunca etkisinden çıkılamayan teolojik ahlak perspektifinin yıkılmasına yol açarken, aklın otonomisi argümanıyla hesaplaşmayan bir ahlakın düşünülemez olmasını sağlamıştır. Ahlak yasasını düşünebilme ve bu yasa doğrultusunda seçimlerde bulunma ve eyleme özgürlüğünü savunan bu argüman, insanın doğası gereği, kendi yasalarını belirleyen bir varlık olduğu kabulüne dayanmaktadır. Ancak bu kabul, insan ve yaşam dünyasına ilişkin yeni birçok sorunu beraberinde getirmiştir. Bu sorunlar karşısında gelişen varoluşçu itirazın en radikal temsilcilerinden Heidegger, Kant tarafından benimsenen kavram ve kategorilerin neredeyse tamamını reddetmiş ve (...) işi etik veya ahlakın hiçbir hükmü olmayacağı bir düşünce sistemi inşa etmeye vardırmıştır. Heideggerci düşüncede ahlakın olanağı sorununun ele alınacağı bu çalışmada, geleneksel batı felsefesinin kalıplarından kurtulabilmek için ahlak kavramının terkedilmesi dışında bir seçenek bulunamayacağı iddiasının tartışmaya açılması hedeflenmektedir. (shrink)

In this paper, I aim to explore Lewis’s best system analysis and how it can accommodate laws with exceptions. The Best System Account has been introduced to provide an alternative view for both minimalist and counterfactual theories of regularities. Simple regularity theory faces problems in which there is some generalization that seems to be a law or some regularities that are established accidentally. It tries to exclude the accidental generalization from the account. However, the best system analysis can solve the (...) problem of how to distinguish between laws and accidents. (shrink)

ABSTRACT This article discusses the Celtic myths, figures, and central themes of Tomm Moore’s animated movie Song of the Sea, from a transmodern feminist perspective. While the movie offers a vivid portrayal of the dichotomy between the tranquil Irish countryside and the turbulent city of Dublin, its main theme revolves around a rural family’s lament for the loss of the mother who is a modern-day personification of the Celtic selkie. This curious female figure embodies contradictory characteristics: she is semi-human and (...) at the same time a mother and a wife who, in struggling with her in-between state, leaves her family and returns to her mythical roots. By focusing on several of the Celtic mythical figures and central themes of maternal loss, motherhood, gender relations, and family reconciliation, I attempt to show that the movie’s transmodern echoes and concerns suggest that alternative family formations and changed gender roles are possible in Irish society and in the world more generally. (shrink)