In the 1950s, estimates of the incidence of depression were fifty people per million; today the estimate is 100,000 per million. What was once defined as “anxiety” and treated with tranquilizers in the wake of the crisis of benzodiazipine dependence and the development of selective serotonin reuptake inhibitors became “depression.” And as SSRIs have been shown to be effective for treating other nervous conditions, such as panic disorder, estimates of their frequency have increased markedly as well. Disease increasingly means whatever (...) we have a reimbursable treatment for. (shrink)

When the University of Toronto withdrew a contract it held with me in December 2000, it initiated a sequence of events that led to a public letter to the University from senior figures in the world psychopharmacology community protesting against the infringement of academic freedom involved and a first ever legal action, undertaked by this author, seeking redress for a violation of academic freedom. The issues of academic freedom surrounding this case have been intertwined with a debate about the possibility (...) that the selective serotonin reuptake inhibitor (SSRI) group of antidepressants have the potential to trigger suicidality in a subgroup of patients. Whether the SSRIs do trigger suicidality or not, exploration of this issue has given rise to a number of worrying sets of observations. First, in my view, there is evidence that pharmaceutical companies have miscoded raw data on suicidal acts and suicidal ideation. Second, this author also maintains that there is a growing body of examples of ghostwriting of articles in the therapeutics domain. Many of the tensions evident in this case, therefore, can be linked to company abilities to keep clinical trial data out of the public domain — this is the point at which the pharmaceutical python gets a grip on academia. (shrink)

Motorcycle helmet laws are perceived to infringe upon individual rights even though they reduce mortality and health care costs. We describe proposed helmet legislation that protects individual rights and provides incentives for helmet use through a differential motorcycle registration fee that requires higher fees for those who wish to ride without a helmet.

The systematic funding of University research has brought into relief a question of conflicting interests. The potential in funded research for conflict and the damaging effects that conflicting interests might have on civil society had been first noted by Eisenhower in the context of State-funded research. Since the 1980s, there has been greater concern with the corrosive effects of private or corporate funding on research. Initial efforts to manage the problems have focused on authorship declarations, but recent controversies with the (...) SSRIs suggest the only way to manage the problem is by placing all clinical trial data in the public domain. (shrink)

It's sold as happiness in a blister pack - a cure-all that has changed the way we think about wellbeing. As Prozac reaches its 20th birthday, Anna Moore presents 20 things you need to know about the most widely used antidepressant in the world.

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the earliest (...) of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

First ever English Translation of Philippe PInel's 2nd Medico-Philosophical Treatise on Mental Alienation. The founder of French psychiatry wrote Medico-Philosophical Treatise on Mental Alienation in 1800 and reworked it nine years later. This book is the "Entirely Reworked and Extensively Expanded" version from 1809. Today, it can give historians of medicine and psychiatrists an overview of mental illnesses as they were viewed in that era. The author, Philippe Pinel, became known as the doctor who worked to free the insane from (...) chains. (shrink)

No discussion of academic freedom, research integrity, and patient safety could begin with a more disquieting pair of case studies than those of Nancy Olivieri and David Healy. The cumulative impact of the Olivieri and Healy affairs has caused serious self examination within the biomedical research community. The first part of the essay analyses these recent academic scandals. The two case studies are then placed in their historical context—that context being the transformation of the norms of science (...) through increasingly close ties between research universities and the corporate world. After a literature survey of the ways in which corporate sponsorship has biased the results of clinical drug trials, two different strategies to mitigate this problem are identified and assessed: a regulatory approach, which focuses on managing risks associated with industry funding of university research, and a more radical approach, the sequestration thesis, which counsels the outright elimination of corporate sponsorship. The reformist approach is criticised and the radical approach defended. (shrink)

Bioethics journals have lagged behind medical and science journals in exploring the threat of conflict of interest (COI) to the integrity of publications. Some recent discussions of COI that have occurred in the bioethics literature are reviewed. Discussions of what has been termed the ?Healy affair? unintentionally demonstrate that the direct and indirect influence of undisclosed COI may come from those who call for protection from the undue influence of industry. Paradoxically, the nature and tone of current discussions may (...) serve to dull sensitivities to what is indeed a serious set of issues facing bioethics. Some proposals are presented to address COI and other challenges to the integrity of bioethics and its journals. COI is too important a topic to be left to ideologues, and there is no substitute for readers' caution and skepticism as tools in dealing with the full range of biases that exist in published papers. (shrink)

Given its contribution to enhancing the inclusiveness, responsiveness, transparency and accountability of socio-political decision-making, the deliberative model has achieved considerable prominence in recent times as a basis for revitalizing democracy. But notwithstanding its strengths, it has also become clear that the deliberative proposal exhibits certain weaknesses that stand in need of correction if it is to realize its potential for revitalizing democracy in our contemporary pluralistic and multicultural world. Not surprisingly, then, there have been calls for significant modifications to the (...) core proposal. Of particular interest for present purposes is Iris Marion Young’s call for a ‘communicative’ reappropriation of the standard model with a view to rendering it more inclusive of and responsive to difference. While Young’s call for reconfiguring the deliberative template in a manner conducive to treating difference as a resource rather than as a barrier to unity is judicious and timely, the present article contends that her communicative proposal does not go far enough to achieve the envisaged outcomes. Instead, to enhance inclusiveness and responsiveness to difference in a manner conducive to promoting mutual understanding and potentially transformative learning, a thoroughgoing dialogical reappropriation is called for, along the lines defended here. Only in this way can the deliberative proposal live up to its pluralistic as well as inclusive intent. Moreover, far from being an external imposition, a dialogical reconfiguration of the requisite sort is rather a means of liberating potentials inherent in the deliberative proposal from the outset but typically suppressed by an undue emphasis on homogeneity, uniformity and consensus. (shrink)

This chapter contains sections titled: Loyalty in the Civic Sphere What is Loyalty? Loyalty and Identity What Makes Us Loyal? Loyalty and Schools Which Type of Loyalty Should Schools Aim At? Notes References.

Contemporary social-scientific research seeks to identify specific causal mechanisms for outcomes of theoretical interest. Experiments that randomize populations to treatment and control conditions are the “gold standard” for causal inference. We identify, describe, and analyze the problem posed by transformative treatments. Such treatments radically change treated individuals in a way that creates a mismatch in populations, but this mismatch is not empirically detectable at the level of counterfactual dependence. In such cases, the identification of causal pathways is underdetermined in a (...) previously unrecognized way. Moreover, if the treatment is indeed transformative it breaks the inferential structure of the experimental design. Transformative treatments are not curiosities or “corner cases,” but are plausible mechanisms in a large class of events of theoretical interest, particularly ones where deliberate randomization is impractical and quasi-experimental designs are sought instead. They cast long-running debates about treatment and selection effects in a new light, and raise new methodological challenges. (shrink)

David Hume's Enquiry concerning Human Understanding is the definitive statement of the greatest philosopher in the English language. His arguments in support of reasoning from experience, and against the "sophistry and illusion"of religiously inspired philosophical fantasies, caused controversy in the eighteenth century and are strikingly relevant today, when faith and science continue to clash. The Enquiry considers the origin and processes of human thought, reaching the stark conclusion that we can have no ultimate understanding of the physical world, or (...) indeed our own minds. In either sphere we must depend on instinctive learning from experience, recognizing our animal nature and the limits of reason. Hume's calm and open-minded skepticism thus aims to provide a new basis for science, liberating us from the "superstition" of false metaphysics and religion. His Enquiry remains one of the best introductions to the study of philosophy, and his edition places it in its historical and philosophical context. (shrink)

Setting goals in the workplace can motivate improved performance but it might also compromise ethical behavior. In this paper, we propose that individual differences in the dispositional tendency to morally justify behavior moderate the effects of specific performance goals on unethical behavior. We conducted an experimental study in which working participants, who were randomly assigned to a specific goal condition or to a condition with a vague goal that lacked a specific target, completed two tasks in which they had the (...) opportunity to act unethically. In an ethical dilemma task, participants in the specific goal condition were more likely to advocate using unethical methods. However, in an anagram task, only those with high moral justification overstated their performance to a greater degree in the specific goal condition. As such, individuals may not be equally susceptible to the ‘dark side’ of goal-setting. (shrink)

A leading political theorist’s groundbreaking defense of ideal conceptions of justice in political philosophy Throughout the history of political philosophy and politics, there has been continual debate about the roles of idealism versus realism. For contemporary political philosophy, this debate manifests in notions of ideal theory versus nonideal theory. Nonideal thinkers shift their focus from theorizing about full social justice, asking instead which feasible institutional and political changes would make a society more just. Ideal thinkers, on the other hand, question (...) whether full justice is a standard that any society is likely ever to satisfy. And, if social justice is unrealistic, are attempts to understand it without value or importance, and merely utopian? Utopophobia argues against thinking that justice must be realistic, or that understanding justice is only valuable if it can be realized. David Estlund does not offer a particular theory of justice, nor does he assert that justice is indeed unrealizable—only that it could be, and this possibility upsets common ways of proceeding in political thought. Estlund engages critically with important strands in traditional and contemporary political philosophy that assume a sound theory of justice has the overriding, defining task of contributing practical guidance toward greater social justice. Along the way, he counters several tempting perspectives, including the view that inquiry in political philosophy could have significant value only as a guide to practical political action, and that understanding true justice would necessarily have practical value, at least as an ideal arrangement to be approximated. Demonstrating that unrealistic standards of justice can be both sound and valuable to understand, Utopophobia stands as a trenchant defense of ideal theory in political philosophy. (shrink)

The zetetic turn in epistemology raises three questions about epistemic and zetetic norms. First, there is the relationship question: what is the relationship between epistemic and zetetic norms? Are some epistemic norms zetetic norms, or are epistemic and zetetic norms distinct? Second, there is the tension question: are traditional epistemic norms in tension with plausible zetetic norms? Third, there is the reaction question: how should theorists react to a tension between epistemic and zetetic norms? Drawing on an analogy to practical (...) philosophy, I develop a focal point view to resolve these motivating questions. On the focal point view, traditional epistemic norms and zetetic norms answer different types of normative questions. There is nevertheless a familiar type of evaluative tension between traditional epistemic norms and zetetic norms, but this tension is an unavoidable feature of the normative landscape and not a sign that traditional epistemic norms need revision. But if traditional epistemic norms are not zetetic norms, then in what sense is zetetic epistemology a project for epistemologists? I conclude by articulating a sense in which some nontraditional epistemic norms are zetetic norms, and in which zetetic epistemology is an important part of the study of theoretical rationality. (shrink)

One of the enduring concerns of moral philosophy is deciding who or what is deserving of ethical consideration. Much recent attention has been devoted to the "animal question" -- consideration of the moral status of nonhuman animals. In this book, David Gunkel takes up the "machine question": whether and to what extent intelligent and autonomous machines of our own making can be considered to have legitimate moral responsibilities and any legitimate claim to moral consideration. The machine question poses a (...) fundamental challenge to moral thinking, questioning the traditional philosophical conceptualization of technology as a tool or instrument to be used by human agents. Gunkel begins by addressing the question of machine moral agency: whether a machine might be considered a legitimate moral agent that could be held responsible for decisions and actions. He then approaches the machine question from the other side, considering whether a machine might be a moral patient due legitimate moral consideration. Finally, Gunkel considers some recent innovations in moral philosophy and critical theory that complicate the machine question, deconstructing the binary agent--patient opposition itself. Technological advances may prompt us to wonder if the science fiction of computers and robots whose actions affect their human companions could become science fact. Gunkel's argument promises to influence future considerations of ethics, ourselves, and the other entities who inhabit this world. (shrink)

This book is an attempt to get to the bottom of an acute and perennial tension between our best scientific pictures of the fundamental physical structure of the world and our everyday empirical experience of it. The trouble is about the direction of time. The situation (very briefly) is that it is a consequence of almost every one of those fundamental scientific pictures--and that it is at the same time radically at odds with our common sense--that whatever can happen can (...) just as naturally happen backwards. Albert provides an unprecedentedly clear, lively, and systematic new account--in the context of a Newtonian-Mechanical picture of the world--of the ultimate origins of the statistical regularities we see around us, of the temporal irreversibility of the Second Law of Thermodynamics, of the asymmetries in our epistemic access to the past and the future, and of our conviction that by acting now we can affect the future but not the past. Then, in the final section of the book, he generalizes the Newtonian picture to the quantum-mechanical case and (most interestingly) suggests a very deep potential connection between the problem of the direction of time and the quantum-mechanical measurement problem. The book aims to be both an original contribution to the present scientific and philosophical understanding of these matters at the most advanced level, and something in the nature of an elementary textbook on the subject accessible to interested high-school students. Table of Contents: Preface 1. Time-Reversal Invariance 2. Thermodynamics 3. Statistical Mechanics 4. The Reversibility Objections and the Past-Hypothesis 5. The Scope of Thermodynamics 6. The Asymmetries of Knowledge and Intervention 7. Quantum Mechanics Appendix: Gedankenexperiments with Heat Engines Index Reviews of this book: The foundations of statistical mechanisms are often presented in physics textbooks in a rather obscure and confused way. By challenging common ways of thinking about this subject, Time and Chance can do quite a lot to improve this situation. --Jean Bricmont, Science Albert is perfecting a style of foundational analysis that is uniquely his own...It has a surgical precision...and it is ruthless with pretensions. The foundations of thermodynamics is a topic that has accumulated a good deal of dead wood; this is a fire that will burn and burn. --Simon W. Saunders, Oxford University As usual with Albert's work, the exposition is brisk and to the point, and exceptionally clear...The book will be an extremely valuable contribution to the literature on the subject of philosophical issues in thermodynamics and statistical mechanics, a literature which has been thin on the ground but is now growing as it deserves to. --Lawrence Sklar, University of Michigan. (shrink)

By means of an example, shows the possibility of beliefs that are separately rational whilst together inconsistent.

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

I attempt to get as clear as possible on the chain of reasoning by which irreversible macrodynamics is derivable from time-reversible microphysics, and in particular to clarify just what kinds of assumptions about the initial state of the universe, and about the nature of the microdynamics, are needed in these derivations. I conclude that while a “Past Hypothesis” about the early Universe does seem necessary to carry out such derivations, that Hypothesis is not correctly understood as a constraint on the (...) early Universe’s entropy. (shrink)

The Health (Regulation of Termination of Pregnancy) Act 2018 was commenced on 01/01/2019 in Ireland. The Act provides for legal termination of pregnancy under defined circumstances including for any reason at < 12 weeks gestation; and where two doctors agree there is ‘a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth’. As such, abortion for congenital anomaly (CA) can occur at a number of time points, (...) depending on the adjudged severity. Infants born with CAs frequently require significant medical intervention and account for a high proportion of admissions to paediatric intensive care units (PICUs). The purpose of this paper was to evaluate the number of infants with CAs admitted to an Irish PICU in the period before and after the implementation of the Act. All PICU admissions < 1 month of age to a single Irish paediatric hospital between 2012 and 2021 were analysed. CAs were recorded, and the periods before and after the commencement of the Act compared. We found a difference in admissions involving CAs, particularly those related to congenital heart disease involving single ventricle anatomy. It is plausible that this difference was as a result of improved access to abortion services following the implementation of the Act. This article explores the legal conditions related to the abortion of a foetus with a CA in Ireland, and the possible impact of the Independent Review of the Operation of the Health ( Regulation of Termination of Pregnancy) Act 2018. (shrink)