Understanding cognitive effort expended during assessments is essential to improving efficiency, accuracy, and accessibility within these assessments. Pupil dilation is commonly used as a psychophysiological measure of cognitive effort, yet research on its relationship with effort expended specifically during language processing is limited. The present study adds to and expands on this literature by investigating the relationships among pupil dilation, trial difficulty, and accuracy during a vocabulary test. Participants (n = 63, Mage = 19.25) completed a subset of trials from (...) the Peabody Picture Vocabulary Test while seated at an eye‐tracker monitor. During each trial, four colored images were presented on the monitor while a word was presented via audio recording. Participants verbally indicated which image they thought represented the target word. Words were categorized into Easy, Medium, and Hard difficulty. Pupil dilation during the Medium and Hard trials was significantly greater than during the Easy trials, though the Medium and Hard trials did not significantly differ from each other. Pupil dilation in comparison to trial accuracy presented a more complex pattern, with comparisons between accurate and inaccurate trials differing depending on the timing of the stimulus presentation. These results present further evidence that pupil dilation increases with cognitive effort associated with vocabulary tests, providing insights that could help refine vocabulary assessments and other related tests of language processing. (shrink)

This article considers conversations in and about education. To focus the discussion, it uses the scenario of a conversation between a trainee teacher and her mentor reflecting together on a lesson that the trainee has just taught. I begin by outlining the notion of reflective practice as popularised by Donald Schön, and show how, in the scenario, the reflective practice conversation leads to talk characterised by recourse to particular dominant discourses within education, and how this in turn can lead to (...) a certain voicelessness. I then consider what the possibilities for the reflective practice conversation might be, looking first at the Greek notion of parrhēsia and how this has been discussed in the work of Michel Foucault in contrast to other forms of talk such as rhetoric or chattering. I argue that, whilst the parrhēsiastic conversation may allow for the exploration of the relationships (between the mentor and the trainee, each participant and their words and a relationship of care for the self), such possibilities are fraught with difficulty. I then move to consider how such relationships might be developed through recognising the expressive aspects of language emphasised in Stanley Cavell's notion of passionate utterance. I first trace the development of Cavell's thought through John Austin's contrast in language between the constative and the performative. I then illustrate the idea of passionate utterance from the films Cavell describes as the ‘Hollywood comedies of remarriage’, and argue that the passionate utterance opens up opportunities for the kind of conversation in education that is itself educative. (shrink)

Amanda Fulford, Áine Mahon; The University as Sanctuary: Home and Unhomeliness, Journal of Philosophy of Education,, qhae037, https://doi.org/10.1093/jope.

In lieu of an abstract, here is a brief excerpt of the content:Spiritual Experience and PsychopathologyMike Jackson and K. W. M. Fulford (bio)AbstractA recent study of the relationship between spiritual experience and psychopathology (reported in detail elsewhere) suggested that psychotic phenomena could occur in the context of spiritual experiences rather than mental illness. In the present paper, this finding is illustrated with three detailed case histories. Its implications are then explored for psychopathology, for psychiatric classification, and for our understanding (...) of the concept of mental illness. It is argued that pathological and spiritual psychotic phenomena cannot be distinguished by 1) form and content alone (as in traditional psychopathology), 2) by their relationship either with other symptoms or with pathological causes (as in psychiatric classification), or 3) by reference to the descriptive criteria of mental illness implied by the “medical” model. The distinction is shown to depend, rather, on the way in which psychotic phenomena themselves are embedded in the values and beliefs of the person concerned. This in turn is shown to have implications for diagnosis (it shows the need for clinicians to attend to the values and beliefs of individual patients), for treatment (it points to a cognitive problem-solving model), and for research in psychopathology (especially as related to the emerging sciences of dynamic brain imaging and cognitive neuroscience).Keywordsfirst rank symptoms, schizophrenia, delusion, hallucination, thought disorder, religious experience, mystical experienceIntroductionThis paper explores some of the conceptual and practical implications of the finding that phenomena which in a medical context would probably be diagnosed as psychotic symptoms, may occur in the context of non-pathological, and indeed essentially benign, spiritual experiences.The existence of non-pathological psychotic experiences of this kind (we will call them “psychotic phenomena” as distinct from “psychotic symptoms”—see also Endnote 1, terminology) was a key finding in a study carried out by one of us (MJ) at the Alister Hardy Research Centre (AHRC) in Oxford. Details are given elsewhere both of the overall empirical findings of the study, including the relationship between spiritual experience and personality variables, and of a hypothetical cognitive problem-solving model of these phenomena (Jackson 1991, and forthcoming a and b). In the present paper, 1) the background to the study is described briefly in relation to earlier work on the possible links between spiritual experience and psychopathology; 2) some of the psychotic phenomena identified are illustrated with three detailed case histories; 3) the significance of these phenomena is reviewed for our understanding respectively of psychopathology, of diagnostic syndromes, and of the concept of mental illness; and 4) some of the practical implications of the study for clinical work and research in psychiatry are indicated.BackgroundIt has long been recognized that there are similarities between spiritual and psychotic experiences. [End Page 41] William James (1902), for example, argued that “in delusional insanity, paranoia as they sometimes call it, we may have a kind of diabolical mysticism, a sort of religious mysticism turned upside down” (426). Other commentators have noted a wide variety of phenomena, such as time distortion, synesthesias, loss of self-object boundaries and the transition from a state of conflict and anxiety to one of sudden “understanding,” all of which are reported in both spiritual and psychotic experiences (Buckley 1981; Watson 1982; Wapnick 1969; and Wootton and Allen 1983).Yet the similarities notwithstanding, the distinction between these two kinds of experience can be crucially important. Spiritual experiences, whether welcome or unwelcome, and whether or not they are psychotic in form, have nothing (directly) to do with medicine (Fulford 1996a). It would be quite wrong, then, to “treat” spiritual psychotic experiences with neuroleptic drugs, just as it is quite wrong to “treat” political dissidents as though they were ill (Fulford, Smirnoff and Snow, 1993). Pathological psychotic experiences, on the other hand, or psychotic symptoms, are by definition a proper object of medical treatment, sometimes even against the wishes of the person concerned. Hence it would be both negligent and, as Wing (1978) put it, morally “repellent,” to leave untreated someone who is genuinely ill (244).Given how much turns on the distinction between spiritual experience and psychopathology, it is perhaps not surprising that scholarly discussion of the relationship between them has at times... (shrink)

It is common to hear talk of the aim of belief and to find philosophers appealing to that aim for numerous explanatory purposes. What belief 's aim explains depends, of course, on what that aim is. Many hold that it is somehow related to truth, but there are various ways in which one might specify belief 's aim using the notion of truth. In this article, by considering whether they can account for belief 's standard of correctness and the epistemic (...) norms governing belief, I argue against certain prominent specifications of belief 's aim given in terms of truth, and advance a neglected alternative. (shrink)

The _Physics_ is a foundational work of western philosophy, and the crucial one for understanding Aristotle's views on matter, form, essence, causation, movement, space, and time. This richly annotated, scrupulously accurate, and consistent translation makes it available to a contemporary English reader as no other does—in part because it fits together seamlessly with other closely associated works in the New Hackett Aristotle series, such as the _Metaphysics_, _De Anima_, and forthcoming _De Caelo_ and _On Coming to Be and Passing Away_. (...) Eventually the series will include all of Aristotle's works. Sequentially numbered endnotes provide the information most needed at each juncture, while a detailed Index of Terms indicates places where focused discussion of key notions occurs. An illuminating general Introduction describes the book that lies ahead, explaining what sort of work it is and what sorts of evidence it relies on. (shrink)

The law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of what a reasonable body of medical opinion agree ought to be disclosed in the circumstances. The UK Supreme Court concluded that the information that is material to a patient’s decision should instead be judged (...) by reference to a new two-limbed test founded on the notions of the ‘reasonable person’ and the ‘particular patient’. The rationale outlined in Montgomery for this new test of materiality, and academic comment on the ruling’s significance, has focused on the central ethical importance that the law now accords to respect for patient autonomy in the process of obtaining consent from patients. In this paper, we dispute the claim that the new test of materiality articulated in Montgomery equates with respect for autonomy being given primacy in re-shaping the development of the law in this area. We also defend this position, arguing that our revised interpretation of Montgomery’s significance does not equate with a failure by the courts to give due legal consideration to what is owed to patients as autonomous decision-makers in the consent process. Instead, Montgomery correctly implies that doctors are ethically obliged to attend to a number of relevant ethical considerations in framing decisions about consent to treatment, which include subtle interpretations of the values of autonomy and well-being. Doctors should give appropriate consideration to how these values are fleshed out and balanced in context in order to specify precisely what information ought to be disclosed to a patient as a requirement of obtaining consent, and as a core component of shared decision-making within medical encounters more generally. (shrink)

This “open letter” to Christopher Boorse is a response to his influential naturalist analysis of disease from the perspective of linguistic-analytic value theory. The key linguistic-analytic point against Boorse is that, although defining disease value free, he continue to use the term with clear evaluative connotations. A descriptivist analysis of disease would allow value-free definition consistently with value-laden use: but descriptivism fails when applied to mental disorder because it depends on shared values whereas the values relevant to mental disorders are (...) highly diverse. A part-function analysis, similarly, although initially persuasive for physical disorders, fails with the psychotic mental disorders because these, characteristically, involve disturbances of the rationality of the person as a whole. The difficulties encountered in applying naturalism to mental disorders point, linguistic-analytically, to the possibility that there is, after all, an evaluative element of meaning, deeply hidden but still logically operative, in the concept of disease. (shrink)

This paper employs the methodological framework of linguistic analytic philosophy to explore the conceptual issues arising from a study of the different models of disorder implicit in five groups of stakeholders concerned in the community care of people with a diagnosis of long-term schizophrenia. Linguistic analysis, gives a precise fix on the nature of the practical difficulties presented by such models, suggests a powerful heuristic for displaying and comparing models, is the basis of a methodology which is neutral as between (...) users and providers of services, provides an intuitively powerful way of understanding the results of work of this kind, and facilitates the translation of research into practice. (shrink)

We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.

Examines the lived experience of social encounters drawing on phenomenological insights.

Sometimes, learning about the origins of a belief can make it irrational to continue to hold that belief—a phenomenon we call ‘genealogical defeat’. According to explanationist accounts, genealogical defeat occurs when one learns that there is no appropriate explanatory connection between one’s belief and the truth. Flatfooted versions of explanationism have been widely and rightly rejected on the grounds that they would disallow beliefs about the future and other inductively-formed beliefs. After motivating the need for some explanationist account, we raise (...) some problems for recent versions of explanationism. Learning from their failures, we then produce and defend a more resilient explanationism. (shrink)

Infallibilism is the view that a belief cannot be at once warranted and false. In this essay we assess three nonpartisan arguments for infallibilism, arguments that do not depend on a prior commitment to some substantive theory of warrant. Three premises, one from each argument, are most significant: if a belief can be at once warranted and false, then the Gettier Problem cannot be solved; if a belief can be at once warranted and false, then its warrant can be transferred (...) to an accidentally true belief; if a belief can be at once warranted and false, then it can be warranted and accidentally true. We argue that each of these is either false or no more plausible than its denial. Along the way, we offer a solution to the Gettier Problem that is compatible with fallibilism. (shrink)

Values-Based Medicine (VBM) is the theory and practice of clinical decision-making for situations in which legitimately different values are in play. VBM is thus to values what Evidence-Based Medicine (EBM) is to facts. The theoretical basis of VBM is a branch of analytic philosophy called philosophical value theory. As a set of practical tools, VBM has been developed to meet the challenges of value diversity as they arise particularly in psychiatry. These challenges are illustrated in this paper by a case (...) study of the differential diagnosis between delusion and religious experience. In a traditional model of scientific medicine, such challenges would be expected to become less pressing with advances in medical science. Philosophical value theory suggests, to the contrary, that scientific progress, through opening up an ever-wider range of choices, will increasingly bring the full range and diversity of human values into play not just in psychiatry but in all areas of medicine. The future, then, for medicine, is an integrated model in which VBM and EBM are equal partners in a genuinelyhuman discipline. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ IntroductionK. W. M. Fulford and John Z. SadlerThe editors are delighted to present the debut of a new feature in Philosophy, Psychiatry, & Psychology, “Clinical Anecdotes.” Clinical Anecdotes are short narrative essays that present, in concise fashion, several philosophical/conceptual issues concerning the experience of psychiatric practice in a realistic, nitty-gritty story format. A Clinical Anecdote essay serves as a stimulus to selected commentators from diverse fields, who (...) will prepare short responses that address any feature of the anecdote that captures their interest and imagination. Clinical Anecdote authors may then conclude the section with their own brief response, if desired.We encourage anyone (clinicians, patients, philosophers, others) interested in the conceptual aspects of psychiatric practice to submit their own Clinical Anecdotes for publication. Submissions should be formatted as a PPP Main Paper, with no requirement for references or an abstract. Clinical Anecdotes should not exceed a 1,500-word limit, and should have an original title relevant to the narrative content of the piece.How will Clinical Anecdotes submissions be evaluated? They will be sent out for peer review as with any other PPP main article, however, what reviewers will be looking for is:• a vivid, engaging, and compelling writing style,• a story that generates multiple areas of conceptual, philosophical, or ethical interest,• relevance to the editorial focus of PPP, and• novelty of theme (the submission addresses issues that have not previously been considered as a Clinical Anecdote).We hope you will find this inaugural essay from Dr. Christopher Bailey thought provoking. [End Page 221]Copyright © 2009 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 165-173 [Access article in PDF] Professional Judgment, Critical Realism, Real People, and, Yes, Two Wrongs Can Make a Right! K.W.M. Fulford Anthony Colombo Keywords values, values-based practice, models of disorder, concept of mental illness, user-centred practice, patient-centred practice, multidisciplinary teamwork We are grateful to our four commentators for putting much-needed conceptual air and space around the models project. Published originally as an (...) empirical study of the different implicit models of disorder, held by users of services, carers, nurses, psychiatrists, and social workers (Colombo et al. 2003), our paper outlined the philosophical roots of the models project in linguistic analytic philosophy of the "Oxford school" (Fulford and Colombo 2004). Our four commentators provide extra dimensions of understanding, respectively from professional education (Williams 2004), sociology (Bendelow 2004), Heideggerian phenomenology (Heginbotham 2004), and mental health policy and practice (Williamson 2004).Since the original study, the models project has been taken forward as a key contribution to a range of philosophy-into-practice initiatives called, collectively, Values-Based Practice. In this brief response, we outline the key features of Values-Based Practice and indicate how these connect with some of the many thoughtful points about models made by our commentators. Values-Based Practice Values-Based Practice, then, is the theory and skills-base for effective health care decision making where different, and hence potentially conflicting, values are in play (Fulford 2004). Premised on the democratic meta-value of equal respect for all voices, Values-Based Practice relies, much as a political democracy relies, on good process rather than preset outcomes for its practical effectiveness. The ten pointers to good process in Values-Based Practice are summarized in Figure 1. We return to the implications of these for the work on models below.Relying on good process may be thought to be a recipe more for relativism and indecision in clinical decision making than for practical effectiveness. To the contrary, however, the 'values democracy' of Values-Based Practice, again like a political democracy, carries a number of clear and coherent implications for policy and practice in health care. [End Page 165] Click for larger viewFigure 1 10 Pointers to Good Process in VBP [End Page 166]Examples of the implications of Values-Based Practice for policy and practice are given in the Values Framework shown in Figure 2. This is a policy framework for the development of Values-Based Practice in mental health produced by a project group in the National Institute for Mental Health in England (NIMHE), the section of the UK's National Health Service (NHS) responsible for implementing government policy on mental health as embodied in the National Service Framework for Mental Health (Department of Health 1999) and subsequent policies. The framework gives three key principles of Values-Based Practice (the three Rs of recognition, raising awareness, and respect) and then summarizes some of the specific implications of the approach. Racism, for example, is incompatible with Values-Based Practice because racism is by definition intolerant of diversity. Again, we indicate some of the policy implications of Values-Based Practice for the points about models made by our commentators below.Training for mental health practitioners in Values-Based Practice will be rolled out from April 2005, through both voluntary and statutory bodies, in each of the eight regions of the National Health Service of England and Wales. This roll out will be supported by training methods developed and piloted in a unique joint venture between Warwick University's Department of Philosophy and Medical School, and an in-service training provider, the Sainsbury Centre for Mental Health (Fulford, Williamson, and Woodbridge 2002; Woodbridge and Fulford 2003). These training methods are the basis of a detailed workbook for Values-Based Practice (Woodbridge and Fulford 2004). The workbook will be launched in July 2004 at a conference in London by the Minister of State with responsibility for mental health, Rosie Winterton. Professional Training and Professional Judgment The models project has been central to the development of... (shrink)

In Two Minds is a practical casebook of problem solving in psychiatric ethics. Written in a lively and accessible style, it builds on a series of detailed case histories to illustrate the central place of ethical reasoning as a key competency for clinical work and research in psychiatry. Topics include risk, dangerousness and confidentiality; judgements of responsibility; involuntary treatment and mental health legislation; consent to genetic screening; dual role issues in child and adolescent psychiatry; needs assessment; cross-cultural and gender issues; (...) rational and irrational suicide; shared decision making in multi-agency teams, and the growing role of the user's voice in psychiatry. Key ethical concepts are carefully introduced and explained. The text is richly supported by detailed guides for further reading. There are separate chapters on teaching psychiatric ethics, including a sample seminar, and on writing a research ethics application. Each case history and discussion is followed by a critical commentary from a practitioner with relevant experience. Jim Birley adds a comparative international perspective on psychiatric ethics. Cartoons by Johnny Cowee provide punchy counterpoint! In Two Minds is the sister volume to the third edition of Sidney, Paul Chodoff and Steven Green's highly successful Psychiatric Ethics. In providing a bridge between theory and practice, it will be essential reading for everyone concerned with improving standards in mental health care. (shrink)

" Qualia " is an unfamiliar term for something that could not be more familiar to each of us: the ways things seem to us. As is so often the case with philosophical jargon, it is easier to give examples than to give a definition of the term. Look at a glass of milk at sunset; the way it looks to you--the particular, personal, subjective visual quality of the glass of milk is the quale of your visual experience at the (...) moment. The way the milk tastes to you then is another, gustatory quale, and how it sounds to you as you swallow is an auditory quale; These various "properties of conscious experience" are prime examples of qualia. Nothing, it seems, could you know more intimately than your own qualia ; let the entire universe be some vast illusion, some mere figment of Descartes' evil demon, and yet what the figment is made of will be the qualia of your hallucinatory experiences. Descartes claimed to doubt everything that could be doubted, but he never doubted that his conscious experiences had qualia, the properties by which he knew or apprehended them. (shrink)

In Lukács: Praxis and the Absolute, Daniel Andrés López reassembles Lukács’s philosophy of praxis on a Hegelian basis, as a conceptual-historical totality, both defending him and proposing an unprecedented, immanent critique that raises problems for Marxian philosophy as a whole.

The social sciences playa variety of multifaceted roles in the policymaking process. So varied are these roles, indeed, that it is futile to talk in the singular about the use of social science in policymaking, as if there were one constant relationship between two fixed and stable entities. Instead, to address this issue sensibly one must talk in the plural about uses of dif ferent modes of social scientific inquiry for different kinds of policies under various circumstances. In some cases, (...) the influence of social scientific research is direct and tangible, and the connection between the find ings and the policy is easy to see. In other cases, perhaps most, its influence is indirect-one small piece in a larger mosaic of politics, bargaining, and compromise. Occasionally the findings of social scientific studies are explicitly drawn upon by policymakers in the formation, implementation, or evaluation of particular policies. More often, the categories and theoretical models of social science provide a general background orientation within which policymakers concep tualize problems and frame policy options. At times, the in fluence of social scientific work is cognitive and informational in nature; in other instances, policymakers use social science primarily for symbolic and political purposes in order to le gitimate preestablished goals and strategies. Nonetheless, amid this diversity and variety, troubling general questions persistently arise. (shrink)

In recent years, there has been an increased emphasis on learning outside the classroom (LOtC) in places such as in museums and art galleries, in forests, and by natural water courses; this has bec...

1. Happiness, then and now -- Happiness, eudaimonia, and practical reasoning -- Happiness as eudaimonia -- Happiness and virtuous activity -- New directions from old debates -- 2. Happiness then: the sufficiency debate -- Aristotle's case against the sufficiency thesis -- 3. Happiness now: rethinking the self -- Socrates' case for the sufficiency thesis -- Epictetus and the stoic self -- The Stoics' case for the sufficiency thesis -- The embodied conception of the self -- The embodied conception and psychological (...) well-being -- The Stoics' case against the embodied conception. (shrink)

Supererogatory acts are those that lie “beyond the call of duty.” There are two standard ways to define this idea more precisely. Although the definitions are often seen as equivalent, I argue that they can diverge when options are infinite, or when there are cycles of better options; moreover, each definition is acceptable in only one case. I consider two ways out of this dilemma.

Sometimes it takes years of debate for philosophers to discover what it is they really disagree about. Sometimes they talk past each other in long series of books and articles, never guessing at the root disagreement that divides them. But occasionally a day comes when something happens to coax the cat out of the bag. "Aha!" one philosopher exclaims to another, "so that's why you've been disagreeing with me, misunderstanding me, resisting my conclusions, puzzling me all these years!".

A remarkable number of Nietzsche's substantive moral psychological views have been borne out by evidence from the empirical sciences. Moral judgments are products of affects on Nietzsche's view, but the latter are in turn causally dependent upon more fundamental features of the individual. Nietzsche accepts a doctrine of types. The path is short from the acceptance of the Doctrine of Types to the acceptance of epiphenomenalism, as Leiter, and more recently, Riccardi argue. This chapter explains Nietzsche's phenomenological account of willing, (...) which serves as independent motivation for the view that Nietzsche denies the causal efficacy of conscious acts of willing. It also explores that in spite of an absence of volitional freedom, self‐control can be usefully understood on a strength‐model of motivational resources. The chapter concludes with a brief discussion of how Nietzsche, without employing the contemporary methods of empirical psychology, could nonetheless be such a prescient moral psychologist. (shrink)

It has become customary to conceptualize the living cell as an intricate piece of machinery, different to a man-made machine only in terms of its superior complexity. This familiar understanding grounds the conviction that a cell's organization can be explained reductionistically, as well as the idea that its molecular pathways can be construed as deterministic circuits. The machine conception of the cell owes a great deal of its success to the methods traditionally used in molecular biology. However, the recent introduction (...) of novel experimental techniques capable of tracking individual molecules within cells in real time is leading to the rapid accumulation of data that are inconsistent with an engineering view of the cell. This paper examines four major domains of current research in which the challenges to the machine conception of the cell are particularly pronounced: cellular architecture, protein complexes, intracellular transport, and cellular behaviour. It argues that a new theoretical understanding of the cell is emerging from the study of these phenomena which emphasizes the dynamic, self-organizing nature of its constitution, the fluidity and plasticity of its components, and the stochasticity and non-linearity of its underlying processes. (shrink)

Realists about possible worlds typically identify possible worlds with abstract objects, such as propositions or properties. However, they face a significant objection due to Lewis (1986), to the effect that there is no way to explain how possible worlds-as-abstract objects represent possibilities. In this paper, I describe a response to this objection on behalf of realists. The response is to identify possible worlds with propositions, but to deny that propositions are abstract objects, or indeed objects at all. Instead, I argue (...) that realists should follow Prior (1971) and others in treating higher-order quantification (e.g. quantification into predicate or sentence position) as a genuine form of quantification in its own right, and so in particular, not to be analysed in terms of first-order quantification over abstract objects. I argue that from this ‘higher-orderist’ perspective, there is a relatively straightforward answer to the question of how possible worlds-as-propositions succeed in representing possibilities. (shrink)

This paper explores the relationship between mania, or pathologically elevated mood, and philosophical theories of well-being. A patient, Mr. M., is described who oscillated between periods when he refused medication and periods when he was willing to accept it, and whose desires and life objectives were radically different in his medicated and unmedicated states. The practical dilemmas this raised are explored in terms of the three principal philosophical theories of well-being: hedonism, the desire fulfillment theory, and objectivism. None of these (...) adequately accounted for Mr. M.'s case: hedonism, because pleasure is increased in mildly manic states; desire fulfillment theories, because these suggest that an unending cycle of treatment and nontreatment would be in Mr. M.'s best interests; and objectivism, because, in a form that would be applicable to Mr. M., that theory brings with it substantial risks of paternalism. Four further philosophical approaches are explored briefly—approaches focusing on autonomy, rationality, personal identity, and illness, respectively—but these also provide no straightforward resolution of the clinical dilemmas. It is concluded that philosophical analysis, even if it does not resolve cases like Mr. M.'s, can deepen our understanding of the issues involved in clinical decision making in psychiatry, especially the importance of sensitivity to the patient's wishes and values; and conversely, that mild mania is an important "real life" case against which philosophical theories of well-being can be tested. (shrink)

Schizophrenia has been investigated predominately from psychological, psychiatric and neurobiological perspectives. This book is unique in examining it from a philosophical point of view. It should appeal to every reader who wants to better understand this major mental illness, providing unique insights into the 'experience' of schizophrenia.

This chapter introduces values-based practice as a resource for working with individually diverse values in health and social care, and describes its origins in an on-going development through the resources of philosophy. The chapter is in two main sections. Section I, Values-Based Practice, builds on two brief interactive exercises to introduce and explain the key features of values-based practice. As a relatively recent addition to the range of resources for working with values in health and social care, values-based practice is (...) distinctive in focussing on the diversity of values comprising individual lived experience. Like evidence-based practice, values-based practice is a process-driven rather than an outcome-driven methodology. That is to say, rather than offering prescribed answers, both approaches offer processes that support decision-makers in coming to answers for themselves based on the particular circumstances presented by the situation in question. Although entirely complementary, the processes involved are of course different. Where evidence-based practice relies on meta-analyses of the results of high-quality clinical trials to inform a consensual model of decision-making, values-based practice builds on learnable clinical skills and other process elements to inform a dissensual model of decision-making rather than seeking to overcome value-conflicts in reaching consensus. Working within a premise of mutual respect for differences of values, and guided by three key principles linking values and evidence, values-based practice, as described in the chapter, supports dissensual decision-making, balanced according to the circumstances presented by the decision in question, within frameworks of locally-set frameworks of shared values. Section II, The Theory-Practice Dynamic, then outlines the theory-practice dynamic on which values-based practice is based. The origins of values-based practice in mid-twentieth century ordinary language philosophy of the Oxford School are outlined. As the chapter illustrates, although a limited area of analytic philosophy, many aspects of values-based practice are informed by ordinary language philosophy, ranging from its premise, through the training exercises and other process elements described in Section I, to its role in hybrid empirical studies supporting its model of service delivery. The development of values-based practice, furthermore, as section II goes on to describe, is ongoing, with key initiatives drawing not only on both analytic and Continental traditions of European philosophy, but also on non-European philosophies such as those of Africa and the Caribbean. (shrink)

Realists about possible worlds typically identify possible worlds with abstract objects, such as propositions or properties. However, they face a significant objection due to Lewis (1986), to the effect that there is no way to explain how possible worlds-as-abstract objects represent possibilities. In this paper, I describe a response to this objection on behalf of realists. The response is to identify possible worlds with propositions, but to deny that propositions are abstract objects, or indeed objects at all. Instead, I argue (...) that realists should follow Prior (1971) and others in treating higher-order quantification (e.g. quantification into predicate or sentence position) as a genuine form of quantification in its own right, and so in particular, not to be analysed in terms of first-order quantification over abstract objects. I argue that from this ‘higher-orderist’ perspective, there is a relatively straightforward answer to the question of how possible worlds-as-propositions succeed in representing possibilities. (shrink)

In this groundbreaking book, Daniel D. Novotny explores one of the most controversial topics of Suarez's philosophy: "beings of reason." Beings of reason are impossible intentional objects, such as blindness and square-circle.

This paper will attempt to assess the primary differences between what I take to be the two primary philosophical "traditions" in contemporary French philosophy, using Derrida (transcendence) and Deleuze (immanence) as exemplary representatives. The body of the paper will examine the use of these terms in three different areas of philosophy on which Derrida and Deleuze have both written: subjectivity, ontology, and epistemology. (1) In the field of subjectivity, the notion of the subject has been critiqued in two manners, either (...) by appealing either to the transcendence of the other (Levinas, Derrida) or to the immanent jlux of experience itself, in relation to which the Ego itself is trancendent (Deleuze, Foucault, Sartre, James). (2) In the field of ontology, a purely "immanent" ontology would be an ontology in which there is neither a "beyond" or an "otherwise" Being, nor "interruptions" in Being, both of which would require an appeal to a formal element of transcendence (Deleuze). Such a "transcendent" and aporetic structure, which can never appear or be present as such within Being, is what lies at the basis of the project of deconstruction, with its attendant aporias (Derrida). (3) This distinction, finally, finds parallels in Kant's epistemology, for whom the possible experience is conditioned by purely immanent criteria (Deleuze), whereas what goes beyond the limits of possible experience is transcendent (Derrida). Drawing on these three thread of analysis, the paper concludes with an assessment of what is at stake in the ethical differences between the two traditions. The question of "transcendence" is "What mast I do?", which is the question of morality (a duty or obligation that is beyond being, an "ought" beyond the "is"). The question of "immanence" is "What can I do?" (my power or capacity as an existing individual within being). For Levinas and Derrida, ethics precedes ontology because it is derived from an element of transcendence (the Other); for Deleuze, ethics is ontology because it is derived from the immanent relation of beings to Being at the level of their existence (Spinoza). (shrink)