Online research in philosophy

There are obvious flaws in REM sleep suppression paradigms that do not allow any conclusion to be drawn either pro or contra the REM sleep-memory hypothesis. However, less intrusive investigations of REM sleep suggest that this sleep stage or its adjunct neuroendocrine characteristics exert a facilitating influence on certain aspects of ongoing memory formation during sleep. [Nielsen; Vertes & Eastman].

The phylogenetic data are inconsistent with the hypothesis that REM sleep duration is correlated with learning or learning ability. Humans do not have uniquely high amounts of REM sleep. The platypus, marsupials, and other mammals not generally thought to have extraordinary learning abilities have the largest amounts of REM sleep. The whales and dolphins (cetaceans) have the lowest amounts of REM sleep and may go without REM sleep for extended periods of time, despite their prodigious learning abilities. Vertes & Eastman].

Cellular mechanisms hypothesized to underlie sleep-dependent memory consolidation are expressed throughout the brain during sleep. Use of sleep deprivation to evaluate the functional importance of these mechanisms is confounded by degradation in waking performance resulting from impaired vigilance. There is a need for methods that will permit disruption of specific mechanisms during sleep only in the neuronal circuits most critically involved in learning. This should be accomplished without global sleep disruption and with preservation of the restorative aspects of sleep.

Philosophical and political discussions of health inequalities have largely focused on questions of justice. The general strategy employed by philosophers like Norman Daniels is to identify a certain state of affairs—in his case, equality of opportunity—and then argue that health disparities limiting an individual's or group's access to that condition are unjust, demanding intervention. Recent work in epidemiology, however, has highlighted the importance of socioeconomic status in creating health inequalities. I explore the ways in which theories of justice have been expanded in light of this data, suggesting that more work is required if such theories are to provide an adequate framework for addressing health disparities. I conclude by sketching an alternative possibility for thinking about health disparities outside of the context of justice.

It has been widely demonstrated that dreaming occurs throughout human sleep. However, we once again are facing new variants of the equation “REM sleep = Dreaming.” Nielsen proposes a model that assumes covert REM processes in NREM sleep. I argue against this possibility, because dream research has shown that REM sleep is not a necessary condition for dreaming to occur. [Nielson].

The Walker model raises a number of questions, particularly about the nature of the sleep states involved in consolidation enhancement. While REM sleep, Stage 2 sleep, and Stage 3/4 sleep have been implicated in procedural learning, we still do not understand which types of learning are involved with specific sleep states. Several possible ideas for future research are suggested.

The advent of functional imaging has reinforced the attempts to define dreaming as a sleep state-dependent phenomenon. PET scans revealed major differences between nonREM sleep and REM sleep. However, because dreaming occurs throughout sleep, the common features of the two sleep states, rather than the differences, could help define the prerequisite for the occurrence of dreams. [Hobson et al.; Nielsen; Solms; Revonsuo; Vertes & Eastman].

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of negative interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods.

Just health: meeting health needs fairly is an ambitious book, in which Norman Daniels attempts to bring together in a single framework all his work on health and justice from the past 25 years. One major aim is to reconcile his earlier work on the special moral importance of healthcare with his later work on the social determinants of health. In his earlier work, Daniels argued that healthcare is of special moral importance because it protects opportunity. In this later work, Daniels argues that the social determinants of health (which in fact tend to have a larger effect on health outcomes than healthcare does) should also be considered special. This paper argues that it is a mistake to base a theory of justice for health on the claim that health (or the social determinants of health) are "special", for three reasons. First, once we realise that health is to a large part socially determined by features such as distribution of income, which are also of independent importance for justice, we cannot talk about a theory of justice for health in isolation from an overall theory of justice. Second, when we are trying to work out the place of health in a general theory of justice, being told that health (or the social determinants of health) is special is unhelpful. The relevant starting point should rather be whether health matters in a fundamental way for justice, or whether it matters merely for the effects it has on those goods which are of fundamental importance for justice. Third, treating the social determinants of health as special would in fact be counterproductive in terms of the broad approach to justice Daniels favours.

In this paper we claim that individual subjects do not have so much control over sleep that it is aptly characterized as a personal choice; and that normative implications related to public health and sleep hygiene do not necessarily follow from current findings. It should be true of any empirical study that normative implications do not necessarily follow, but we think that many public health sleep recommendations falsely infer these implications from a flawed explanatory account of the decision to sleep: the consumer choice view. This view, which we criticize here, proposes that sleep duration and sleep quality be understood as one choice among many.