Psychiatry uncomfortably spans biological and psychosocial perspectives on mental illness, an idea central to Engel's biopsychosocial paradigm. This paradigm was extremely ambitious, proposing new foundations for clinical practice as well as a non-reductive metaphysics for mental illness. Perhaps given this scope, the approach has failed to engender a clearly identifiable research programme. And yet the view remains influential. We reassess the relevance of the biopsychosocial paradigm for psychiatry, distinguishing a number of ways in which it could be (re)conceived.

The orthodox monadic determination thesis holds that we represent colour relations by virtue of representing colours. Against this orthodoxy, I argue that it is possible to represent colour relations without representing any colours. I present a model of iconic perceptual content that allows for such primitive relational colour representation, and provide four empirical arguments in its support. I close by surveying alternative views of the relationship between monadic and relational colour representation.

This paper resolves a paradox concerning colour constancy. On the one hand, our intuitive, pre-theoretical concept holds that colour constancy involves invariance in the perceived colours of surfaces under changes in illumination. On the other, there is a robust scientific consensus that colour constancy can persist in cerebral achromatopsia, a profound impairment in the ability to perceive colours. The first stage of the solution advocates pluralism about our colour constancy capacities. The second details the close relationship between colour constancy and (...) contrast. The third argues that achromatopsics retain a basic type of colour constancy associated with invariants in contrast processing. The fourth suggests that one person-level, conscious upshot of such processing is the visual awareness of chromatic contrasts ‘at’ the edges of surfaces, implicating the ‘colour for form’ perceptual function. This primitive type of constancy sheds new light on our most basic perceptual capacities, which mark the lower borders of representational mind. (shrink)

Psychiatry widely assumes an internalist biomedical model of mental illness. I argue that many of psychiatry’s diagnostic categories involve an implicit commitment to constitutive externalism about mental illness. Some of these categories are socially externalist in nature.

Colour constancy is a foundational and yet puzzling phenomenon. Standard appearance invariantism is threatened by the psychophysical matching argument, which is taken to favour variantism. This argument, however, is inconclusive. The data at best support a pluralist view: colour constancy is sometimes variantist, sometimes invariantist. I add another potential explanation of these data, complex invariantism, which adopts an atypical six-dimensional model of colour appearance. Finally I prospect for a unifying conception of constancy among two neglected notions: discriminatory colour constancy and (...) relational colour constancy. The former arguably marks a common core capacity that is present across widely differing viewing contexts. (shrink)

This paper presents a new response to the colour similarity argument, an argument that many people take to pose the greatest threat to colour physicalism. The colour similarity argument assumes that if colour physicalism is true, then colour similarities should be scrutable under standard physical descriptions of surface reflectance properties such as their spectral reflectance curves. Given this assumption, our evident failure to find such similarities at the reducing level seemingly proves fatal to colour physicalism. I argue that we should (...) dispense with this assumption, and thus endorse the inscrutability of colour similarity. This strategy is inspired by parallels between the colour similarity argument and the explanatory gap between mind and body made vivid by Jackson’s (1986) knowledge argument, and in particular by type-B physicalist responses to that argument. This inscrutability response is further motivated by cases in chemistry and biochemistry in which analogous scrutability theses fail to hold. Along the way, I present a challenge to standard formulations of the colour similarity argument based on the extreme context sensitivity of the similarity relation. Most presentations of the argument fail to control for such contextual variation, which raises the distinct possibility that the argument equivocates on the similarity relation across its premises. Although ultimately inconclusive, this context challenge forces a significant reformulation of the colour similarity argument, and highlights the need for much greater care in handling claims about colour similarity. (shrink)

Colour vision plays a foundational explanatory role in the philosophy of colour, and serves as perennial quarry in the wider philosophy of perception. I present two contributions to our understanding of this notion. The first is to develop a constitutive approach to characterizing colour vision. This approach seeks to comprehend the nature of colour vision qua psychological kind, as contrasted with traditional experiential approaches, which prioritize descriptions of our ordinary visual experience of colour. The second contribution is to argue that (...) colour vision does not constitutively involve the ability to see colours, in a natural and categorically committed sense. I argue that two subjects exactly alike in respect of their constitutive colour vision abilities could differ in respect of whether or not they have categorical perception of colour. The argument is supported by thought experiment and dissociations observed in cognitive neuropsychology. The argument also bears connections to recent neo-Whorfian accounts of colour categorization. _1._ Introduction _2._ Colour Vision, Experience, and Natures _3._ The Central Argument _3.1._ Colour constancy and discrimination _3.2._ Dissociating colour vision and categorical perception for colour _4._ Whorf and the View from Cognitive Neuropsychology _5._ Conclusion. (shrink)

With contributions from psychiatry, psychology, neuroscience, and philosophy, this book provides the most comprehensive account to date of the interplay between biological, psychological, and social factors in mental health and their ethical dimensions.

I argue that it is possible to perceptually represent colour relations between two objects, without perceptually representing their colours. Such primitive relational colour representation goes against the orthodox view that we represent colour relations by virtue of representing colours. I first argue that under certain assumptions, PRCR is conceptually and even nomically possible. I then compare two possible models of PRCR: the linguaform model and chromatic edge model, the latter involving iconic rather than discursive representation. I argue that the chromatic (...) edge model gives a better account of putative cases of PRCR in cerebral achromatopsia, a rare disorder of colour consciousness. (shrink)

A growing body of literature critical of ethics review boards has drawn attention to the processes used to determine the ethical merit of research. Citing criticism on the bureaucratic nature of ethics review processes, this literature provides a useful provocation for (re)considering how the ethics review might be enacted. Much of this criticism focuses on how ethics review boards _deliberate,_ with particular attention given to the lack of transparency and opportunities for researcher recourse that characterise ethics review processes. Centered specifically (...) on the conduct of ethics review boards convened within university settings, this paper draws on these inherent criticisms to consider the ways that ethics review boards might enact more communicative and deliberative practices. Outlining a set of principles against which ethics review boards might establish strategies for engaging with researchers and research communities, this paper draws attention to how _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ for the ethics review might be enacted in the day-to-day practice of the university human ethics review board. This paper develops these themes via a conceptual lens derived from Habermas’ (The theory of communicative action. Volume 1: Reason and the rationalization of society, 1984 ) articulation of ‘communicative action’ and Fraser’s (Social Text, 25(26), 56–80, 1990 ) consideration of ‘strong publics’ to cast consideration of the role that human ethics review boards might play in supporting university research cultures. _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ provide useful conceptual prompts for considering how ethics review boards might undertake their work. (shrink)

The aim of the present study was to provide support for the validation of the Teammate Burnout Questionnaire. Athletes from a variety of team sports completed the TBQ and the Athlete Burnout Questionnaire. Confirmatory factor analysis revealed acceptable fit indexes for the three-dimensional models of the TBQ and the ABQ. Multi-trait multi-method analysis revealed that the TBQ and ABQ showed acceptable convergent and discriminant validity. The preliminary validation of the TBQ indicates the utility of the scale to reflect athletes’ perceptions (...) of their teammates’ burnout and offers researchers the opportunity to quantitatively assess an important aspect of the social environment in the development of athlete burnout. (shrink)

Benedict Spinoza is feted as the philosopher par excellence of the popular democratic multitude by Antonio Negri and others. But Spinoza himself expresses a marked ambivalence about the multitude in brief asides, and as for his thoughts on what he calls “the rule of multitude,” that is, democracy, these exist only as meager fragments in his unfinished Tractatus Politicus or Political Treatise. This essay addresses the problem of Spinoza’s multitude. First, I reconstruct a vision of power that is found in (...) the Ethics but that tends to be overlooked in the scholarly literature: power is not just sheer efficacy or imposition of will, but rather involves a capacity for being-affected; I call this the conception of power as sensitivity. The second part of my argument shows how, given Spinoza’s emphatic political naturalism, the conception of power as sensitivity can be extended to his political philosophy to shed light on what Spinoza calls potentia multitudinis, or “the power of the multitude”—a term found solely in the Political Treatise and nowhere else in his oeuvre. This juxtaposition reveals significant qualifications to the liberatory potential of the multitude currently claimed in the scholarly literature. (shrink)

H. P. Grice virtually discovered the phenomenon of implicature (to denote the implications of an utterance that are not strictly implied by its content). Gricean theory claims that conversational implicatures can be explained and predicted using general psycho-social principles. This theory has established itself as one of the orthodoxes in the philosophy of language. Wayne Davis argues controversially that Gricean theory does not work. He shows that any principle-based theory understates both the intentionality of what a speaker implicates and (...) the conventionality of what a sentence implicates. In developing his argument the author explains that the psycho-social principles actually define the social function of implicature conventions, which contribute to the satisfaction of those principles. This challenging book will be of importance to philosophers of language and linguists, especially those working in pragmatics and sociolinguistics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:328 HUME, MIRACLES AND LOTTERIES This paper addresses recent criticisms of Hume's skepticism with regard to miracles, by 1 2 Sorensen and Hambourger who argue that there are counterexamples, illustrated by lotteries, to Hume's account of how the truth of reports of improbable events (either first or second hand) must be evaluated. They believe these counterexamples are sufficient to prove that Hume's argument against the believability of miracles, defined (...) as violations of laws of nature caused by God, is unsound. Their arguments merit consideration not only in their own right but also on the basis of historical precedent, since they have in common an assumption that is found in Butler's criticism of Hume's predecessors in this debate. The bulk of my paper deals with Hambourger, who presents the most detailed version of the 'Butler' criticism. Sorensen's version can be answered in light of the evaluation of Hambourger 's argument. Hume's Argument Hume's argument is not against the possibility of miracles but against the possibility that it could ever be reasonable to believe a miracle 4 had occurred. His argument can be summed up as follows: in judging the credibility of a report of an improbable event, the probability of the event must be weighed against the probability that the report could be mistaken. The probability of an event is determined by the degree to which it conforms to known laws of nature. Laws of nature are formulated on the basis of uniform experience. Assuming that a miracle is a violation of laws of nature, any judgment that an event is miraculous presupposes a 329 judgment that there exists a uniform pattern of causation to which it is opposed, which pattern would constitute empirical proof against the miracle's occurrence. Testimony, on the other hand, is shown by experience not to be uniformly reliable. Consequently, no report of a miracle will have credibility since there will always be a uniform experience that is full proof against it, which therefore outweighs whatever merits testimony may have. In Hume's words, [N]o testimony is sufficient to establish a miracle, unless the testimony be of such a kind, that its falsehood would be more miraculous, than the fact, which it endeavors to establish.... When anyone tells me, that he saw a dead man restored to life, I immediately consider with myself, whether it be more probable, that this person should either deceive or be deceived, or that the fact, which he relates, should really have happened.... If the falsehood of his testimony would be more miraculous, than the event which he relates; then, and not till- then, can he pretend to command my belief or opinion (E 115-116). Hambourger 's Criticism Hambourger maintains that Hume's argument depends on a principle which he calls the "principle of relative likelihood." He restates this principle as follows: Suppose that someone or, perhaps, a group of people testify to the truth of a proposition P that, considered by itself, is improbable. Then to evaluate the testimony, one must weight (sic) the probability that P is true against the probability that the informants are lying or mistaken. If it is more likely that P is true than that the informants are lying or mistaken, then, on balance, the 330 testimony renders P more likely than not, and it may be reasonable for one to believe that P. However, if it is as likely, or even more likely, that the informants are lying or mistaken than it is that P is true, then, on balance, the testimony does not render P more likely true than false, and it would not be,reasonable for one to believe that P. As a counterexample to this principle, Hambourger asks us to suppose that a lottery is held in which there are one million entrants, each of whom has a one in a million chance of winning, and that a reliable newspaper, the New York Times, reports that the winner of the lottery is Smith. He further asks us to suppose that the Times errs only once out of every 10,000 times. Thus, the probability that the Times ' report is wrong is... (shrink)

This classic, with a new introduction by Madeleine L'Engle, is by turns an entrancing mediation on language a piercing commentary on the nature of art and why so much of what we read, hear, and see falls short and a brilliant examination of the fundamental tenets of Christianity. The Mind of the Maker will be relished by those already in love with Dorothy L. Sayers and those who have not yet met her. A mystery writer, a witty and perceptive (...) theologian, culture critic, and playwright, Dorothy Sayers sheds new,unexpected light on a specific set of statements made in the Christian creeds. She examines anew such ideas as the image of God, the Trinity, free will, and evil, and in these pages a wholly revitalized understanding of them emerges. The author finds the key in the parallels between the creation of God and the human creative process. She continually refers to each in a way that illuminates both. (shrink)

The host actin nucleation machinery is subverted by many bacterial pathogens to facilitate their entry, motility, replication, and survival. The majority of research conducted in the past primarily focused on exploitation of a host actin nucleator, the Arp2/3 complex, by bacterial pathogens. Recently, new studies have begun to explore the role of formins, another family of host actin nucleators, in bacterial pathogenesis. This review provides an overview of recent advances in the study of the exploitation of the Arp2/3 complex and (...) formins by bacterial pathogens. Secreted bacterial effector proteins seem to manipulate the regulation of these actin nucleators or functionally mimic them to drive bacterial entry, motility and survival within host cells. An enhanced understanding of how formins are exploited will provide us with greater insight into how a fundamental eurkaryotic cellular process is utilized by bacteria and will also advance our knowledge of host‐pathogen interactions. (shrink)

Public discourse on race-specific medicine typically erects a wall between the scientific use of race as a biological category and the ideological battle over race as a social identity. Scientists often address the potential for these therapeutics to reinforce a damaging understanding of “race” with precautions for using them rather than questioning their very development. For example, Esteban Gonzalez Burchard, an associate professor of medicine and biopharmaceutical sciences at the University of California, San Francisco, states, “We do see racial differences (...) between populations and shouldn’t just close our eyes. Unfortunately, race is a politically charged topic, and there will be evildoers. But the fear should not outweigh the benefit of looking.” Although it is recognized that ideology influences thesocialmeaning of race, it is usually assumed that there is a separate, prior scientific understanding of race that is not contaminated by politics. (shrink)

Public discourse on race-specific medicine typically erects a wall between the scientific use of race as a biological category and the ideological battle over race as a social identity. Scientists often address the potential for these therapeutics to reinforce a damaging understanding of “race” with precautions for using them rather than questioning their very development. For example, Esteban Gonzalez Burchard, an associate professor of medicine and biopharmaceutical sciences at the University of California, San Francisco, states, “We do see racial differences (...) between populations and shouldn’t just close our eyes. Unfortunately, race is a politically charged topic, and there will be evildoers. But the fear should not outweigh the benefit of looking.” Although it is recognized that ideology influences thesocialmeaning of race, it is usually assumed that there is a separate, prior scientific understanding of race that is not contaminated by politics. (shrink)

The social impacts of computer technology are often glorified in public discourse, but there is growing concern about its actual effects on society. In this article, we ask: how does “consent” as an analytical framework make visible the social dynamics and power relations in the capture, extraction, and labor of data science knowledge production? We hypothesize that a form of boundary violation in data science workplaces—gender harassment—may correlate with the ways humans’ lived experiences are extracted to produce Big Data. The (...) concept of consent offers a useful way to draw comparisons between gender relations in data science and the means by which machines are trained to learn and reason. Inspired by how Big Tech leaders describe unsupervised machine learning, and the co-optation of “revolutionary” rhetoric they use to do so, we introduce a concept we call “techniques of invisibility.” Techniques of invisibility are the ways in which an extreme imbalance between exposure and opacity, demarcated along fault lines of power, are fabricated and maintained, closing down the possibility for bidirectional transparency in the production and applications of algorithms. Further, techniques of invisibility, which we group into two categories—epistemic injustice and the Brotherhood—include acts of subjection by powerful actors in data science designed to quell resistance to exploitative relations. These techniques may be useful in making further connections between epistemic violence, sexism, and surveillance, sussing out persistent boundary violations in data science to render the social in data science visible, and open to scrutiny and debate. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:139 HUME'S "DIALECTIC" Hume's treatment of contradiction in his discussion of external existence has generally been understood to resemble the Pyrrhonian model of dialectic; consequently, Hume has been viewed as a sceptic and an irrationalist. According to that model of dialectic, the sceptic, by showing that equally strong arguments can be constructed both for and against a proposition, raises doubts about the ability of reason to determine the truth (...) or falsity of 2 beliefs. However, I will argue that Hume's treatment of contradiction differs significantly from Pyrrhonian dialectic. I will further argue that his treatment of contradiction is strongly analogous to the Kantian model of dialectic. According to Kant, dialectic is a method which not only shows that reason generates contradictions but which also provides a critique of 3 the logic generating those contradictions. The goal of Kant's dialectic is thus distinctly different from the goal of Pyrrhonian dialectic. For Kant, dialectic is a method for resolving scepticism. The parallels between Hume's treatment of contradiction and Kant's dialectic will suffice to show that Hume's "dialectic" is also a method for resolving, rather than generating, scepticism. Two features of Pyrrhonian dialectic have been deemed relevant for Hume's treatment of contradiction in his discussion of external existence. The Pyrrhonist argues that (1) if equally strong arguments can be given for and against a proposition, it is impossible to assess the truth or falsity of the proposition on the basis of any argument; and (2) if it 140 is impossible to assess rationally the truth or falsity of propositions, we must content ourselves in practical life with following custom and convention in all matters of opinion. Hume describes the contradiction in our belief in external existence as an opposition between two equally natural and unavoidable modes of inference. Both modes of inference are operations of the imagination. Hume does not give a special name to the first of these modes of inference, but he describes it as an "irregular" inference based upon the resemblance A of two distinct mental operations (T 203-204). The second is reflective, or causal, inference based on observation of the constant conjunction of like objects. Causal reasoning is reflective insofar as it is regulated by rules and is, consequently, a check or monitor for judgments resulting from the irregular or unchecked operation of the imagination. These two principles of inference lead to two different judgments about the nature of our perceptions: The imagination tells us, that our resembling perceptions have a continu'd and uninterrupted existence, and are not annihilated by their absence. Reflection tells us, that even our resembling perceptions are interrupted in their existence, and different from each other. (T 215) Just as the Pyrrhonian sceptic maintains that the constructibility of equally strong arguments establishing contradictory propositions makes it impossible to decide which proposition is true, Hume similarly maintains that two opposing modes of inference have an equal influence on the mind and therefore are "unable mutually to destroy each other" (T 215). However, Hume's account of this contradiction would be Pyrrhonian only if he argued that these principles, in addition to being equal in psychological 141 force, also have the same epistemic status. Only their having the same epistemic status makes it impossible to decide rationally whether one of the two principles is a reliable guide for making sound empirical inferences. Popkin, a defender of the Pyrrhonian reading of Hume, maintains that this is just what Hume does argue. Reflection for Hume, he maintains, is no more -a rational principle than is unchecked imagination: There is no rational basis for believing that those objects that have constantly been conjoined in the past, will be so conjoined in the future. It is only custom, or "a certain instinct of our nature," that makes us believe that they will be so conjoined, and this instinct which may be hard to resist psychologically, may well be fallacious and deceitful. The basis for all factual and probable reasoning is thus irrational. 5 If reflection is as irrational a principle as unchecked imagination, then the opposition between reflection and unchecked imagination would be an opposition between equally irrational principles. Consequently, a... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:139 HUME'S "DIALECTIC" Hume's treatment of contradiction in his discussion of external existence has generally been understood to resemble the Pyrrhonian model of dialectic; consequently, Hume has been viewed as a sceptic and an irrationalist. According to that model of dialectic, the sceptic, by showing that equally strong arguments can be constructed both for and against a proposition, raises doubts about the ability of reason to determine the truth (...) or falsity of 2 beliefs. However, I will argue that Hume's treatment of contradiction differs significantly from Pyrrhonian dialectic. I will further argue that his treatment of contradiction is strongly analogous to the Kantian model of dialectic. According to Kant, dialectic is a method which not only shows that reason generates contradictions but which also provides a critique of 3 the logic generating those contradictions. The goal of Kant's dialectic is thus distinctly different from the goal of Pyrrhonian dialectic. For Kant, dialectic is a method for resolving scepticism. The parallels between Hume's treatment of contradiction and Kant's dialectic will suffice to show that Hume's "dialectic" is also a method for resolving, rather than generating, scepticism. Two features of Pyrrhonian dialectic have been deemed relevant for Hume's treatment of contradiction in his discussion of external existence. The Pyrrhonist argues that (1) if equally strong arguments can be given for and against a proposition, it is impossible to assess the truth or falsity of the proposition on the basis of any argument; and (2) if it 140 is impossible to assess rationally the truth or falsity of propositions, we must content ourselves in practical life with following custom and convention in all matters of opinion. Hume describes the contradiction in our belief in external existence as an opposition between two equally natural and unavoidable modes of inference. Both modes of inference are operations of the imagination. Hume does not give a special name to the first of these modes of inference, but he describes it as an "irregular" inference based upon the resemblance A of two distinct mental operations (T 203-204). The second is reflective, or causal, inference based on observation of the constant conjunction of like objects. Causal reasoning is reflective insofar as it is regulated by rules and is, consequently, a check or monitor for judgments resulting from the irregular or unchecked operation of the imagination. These two principles of inference lead to two different judgments about the nature of our perceptions: The imagination tells us, that our resembling perceptions have a continu'd and uninterrupted existence, and are not annihilated by their absence. Reflection tells us, that even our resembling perceptions are interrupted in their existence, and different from each other. (T 215) Just as the Pyrrhonian sceptic maintains that the constructibility of equally strong arguments establishing contradictory propositions makes it impossible to decide which proposition is true, Hume similarly maintains that two opposing modes of inference have an equal influence on the mind and therefore are "unable mutually to destroy each other" (T 215). However, Hume's account of this contradiction would be Pyrrhonian only if he argued that these principles, in addition to being equal in psychological 141 force, also have the same epistemic status. Only their having the same epistemic status makes it impossible to decide rationally whether one of the two principles is a reliable guide for making sound empirical inferences. Popkin, a defender of the Pyrrhonian reading of Hume, maintains that this is just what Hume does argue. Reflection for Hume, he maintains, is no more -a rational principle than is unchecked imagination: There is no rational basis for believing that those objects that have constantly been conjoined in the past, will be so conjoined in the future. It is only custom, or "a certain instinct of our nature," that makes us believe that they will be so conjoined, and this instinct which may be hard to resist psychologically, may well be fallacious and deceitful. The basis for all factual and probable reasoning is thus irrational. 5 If reflection is as irrational a principle as unchecked imagination, then the opposition between reflection and unchecked imagination would be an opposition between equally irrational principles. Consequently, a... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume's Internalism1 Dorothy Coleman Hume is typically taken to be an internalist, that is, one who maintains that motivation is built into the acceptance or affirmation of a moral judgement.2However, Hume didnot provide any systematic defence of the internalist view, and consequently his views about moral motivation are problematic. Recently, for example, it has been argued that Hume is an externalist, one who maintains that the acceptance of (...) a mora] judgement does not itself motivate but requires independent desires to do so.3 This suggests thatclarification is needed to determine more precisely Hume's position on the issue ofmoral motivation. Since the distinction between internalism and externalism is a twentieth-century one,4 something should first be said about the wisdom of describing Hume in these terms. The contemporary debate between externalism and internalism concerns both the nature of moral motivation, whether moral judgements are themselves motivating, and the reason for this concern: internalists hold that motivation must be built into moraljudgements because it is "essential for an action's being or being shown to be obligatory."5 As Nagel puts it in ThePossibility ofAltruism, the problem with externalist accounts of motivation is that they cannot justify the requirement to perform one's obligations, "for they permit that someone who has acknowledged that he should do something and has seen why it is the case that he should do it, to ask ifhe has any reason for doing it."6 Seen in this way, the debate is about how to justify morality, how to account for our obligation to be moral at all, and how to answer the question, "Why ought I be moral?" Hume, on the other hand, was a thoroughgoing naturalist. He intended not tojustify morality but rather to provide its "natural history," a narration of the origin of moral concepts out of a set ofsocial and environmental conditions together with passions that constitute human nature. For example, concerning what he called the artificial virtues, such asjustice or the regardfor the public good, Hume argued that while the original motive to be just is self-interest, once individuals are educated and socialized into a community regulated by rules ofjustice, they come to "internalize" or moralize these norms so that their motive for being just is no longer self-interest but simply a regard for the public good, the sense ofjustice itself. Hume's concern with internalism, then, seems far removed from the problem of justifying morality that propels the current debate. Volume XVIII Number 2 331 DOROTHY COLEMAN Even though the internalist-externalist distinction applies only anachronistically to Hume, as long as those engaged in the contemporary debate insist on identifying historical figures as exemplars of one or the other of these viewpoints, and even disagree about who does and why,7 clarification of the extent to which this distinction can apply to Hume would be of assistance. Since the justification of morality is not a problem Hume addressed, for the purpose ofthis paper I will use the terms internalism and externalism to refer only to theories about moral motivation. To defend this interpretation ofHume, it will help first to clarify his terminology: whathe meantby moraljudgement, moral sense, and action from a sense ofduty. Hume claimed that moral judgements are based on feelings of pleasure or displeasure arising from impartial or disinterested reflection on the general influence ofmotives or traits of character. Those motives or passions that produce impartial feelings of approval are judged to be virtues; those that produce impartial feelings ofdisapproval arejudged to be vices.8 By moral sense or moral passions Hume meant feelings of approval and disapproval by which passions are judged to be virtuous or vicious.9 In defining duty or obligation, Hume stated that these are actions or qualities of mind whose neglect or non-performance causes disinterested displeasure or disapproval (T 517). To act from ásense ofduty or virtue would then be to be motivated by the sense whichjudges what our duties are, namely, bymoral passions, the feelings ofdisinterested approval ordisapproval ofmotives and the actions ofwhich they are signs. Thè Evidence for Hume's Internalism Hume's commitment to an internalist theory of ethical motivation is nowhere made explicit... (shrink)

According to Peter Galison , science has a highly fractionated structure with multiple sub-sub-disciplines, each with its own agenda. Cooperative trading between groups is necessary for most scientific work to move forward, and it is this trading that preserves the stability of science. We argue that it is not trading per se, but trading in a gift economy that guarantees stability. We support our claims with an examination of contemporary work on magnetic resonance imaging instrumentation. Specifically, we consider: How a (...) feature improvement, intended to reduce scan time, led to substantial medical mis-diagnosis; How a technical error, when corrected, created a consumer crisis in which radiologists preferred technically flawed instruments; How new magnetic resonance theory radically altered the physical interpretation of MRI images; How the MRI instrument at first was financially supported by, and--ironically--ultimately invalidated, the accepted understanding of the nature, source and management of chronic back pain. Ultimately there are three reasons stability requires gifting. First, without a general sense of shared purpose traders will not be committed to mutual engagement; profit does not provide an adequate shared purpose for the MRI community. Second, stability requires trust, and profits are not an adequate foundation for trust. Finally, knowledge is a gift that will not keep on giving if treated simply as a source of profit. (shrink)

I present five theses to characterize and argue for "Instrumental Realism," a realism wedded to what we do with instruments, and not what our theories say: The Independence Thesis: Questions about realism are independent of questions about meaning. The Intervening Thesis: Our ability to produce consistent effects with our instruments provides one guarantee that we are engaged with the real world. The Historical Thesis: If the descriptions of what we know and do are of something real, then it will be (...) possible to trace a history from earlier antiquated names and actions to current usages. The Instruments-Do-Not-Always-Work-Right Thesis: Since instruments do not always work right, a successful instrumental intervention cannot be a social construct. The Tinkering Thesis: Since instruments are created by tinkering, we should not take any claim that generalizes away from our instrumental practice realistically. (shrink)

This volume offers a rich and accessible introduction to contemporary research on Buddhist ethical thought. It includes contributions of many of the leading scholars in this field, on topics including the nature of Buddhist ethics, karma and rebirth, mindfulness, narrative, intention, free will, politics, anger, and equanimity.

Withholding or withdrawing life-saving ventilators can become necessary when resources are insufficient. In the USA, such rationing has unique social justice dimensions. Structural elements of dominant allocation frameworks simultaneously advantage white communities, and disadvantage Black communities—who already experience a disproportionate burden of COVID-19-related job losses, hospitalisations and mortality. Using the example of New Jersey’s Crisis Standard of Care policy, we describe how dominant rationing guidance compounds for many Black patients prior unfair structural disadvantage, chiefly due to the way creatinine and (...) life expectancy are typically considered.We outline six possible policy options towards a more just approach: improving diversity in decision processes, adjusting creatinine scores, replacing creatinine, dropping creatinine, finding alternative measures, adding equity weights and rejecting the dominant model altogether. We also contrast these options with making no changes, which is not a neutral default, but in separate need of justification, despite a prominent claim that it is simply based on ‘objective medical knowledge’. In the regrettable absence of fair federal guidance, hospital and state-level policymakers should reflect on which of these, or further options, seem feasible and justifiable.Irrespective of which approach is taken, all guidance should be supplemented with a monitoring and reporting requirement on possible disparate impacts. The hope that we will be able to continue to avoid rationing ventilators must not stand in the way of revising guidance in a way that better promotes health equity and racial justice, both to be prepared, and given the significant expressive value of ventilator guidance. (shrink)

When people go shopping for gametes, their first and most important criterion is the donor's race. In so choosing, they are making wrong and invidious assumptions about what race is. They are also assuming that their child will develop her sense of self within those parameters. The effect is harmful both for children and for society at large. People should be able to recognize racial categories as they construct their own identities, but those categories should not limit their self‐identification from (...) the very outset. (shrink)

A good deal of moral criticism employed in everyday life associates, in a variety of ways and in varying degrees of complexity, selfish behaviour and attitudes with a deficiency in what Dr Leavis calls ‘ethical sensibility’. A primitive ethical sensibility is a species of ignorance; it is to be unperceptive, muddled, superficial, undiscriminating and slipshod in one's understanding and appreciation of the nature and quality of one's own and other people's experience. It might involve, for example, being afflicted with sentimentalism; (...) perceiving people through a distorting medium of stereotypes or impressionistically; being dominated by wishful thinking in the Freudian sense; holding beliefs on the basis of hearsay, authority, or because it suits one to hold them; being immersed in situations and relationships whose continued existence requires self-deception; having the sense of one's own worth be wholly dependent upon the opinions of others. A developed ethical sensibility, on the other hand, includes what Professor Peters and others believe to be among the defining characteristics of rationality—impartiality; a caring for clarity, evidence, relevance, consistency and sincerity; a willingness to question authorities, tradition and one's own motives; refusing to be tempted by the cosiness of easy certainties and the stock response. The content of such a sensibility will, of course, depend upon the context in which reason is employed, and attempts to describe the content must take the form of a detailed discussion of particular cases. (shrink)

Because we are frightened of being humiliated, being treated like an object, being rejected, losing control of things, and, most of all, we are frightened of uncertainty. Often we get our lies in before any of these things can happen. We lie to maintain our vanity. We lie when we call our fantasies the truth. Lying is much easier than searching for the truth and accepting it, no matter how inconvenient it is. We lie to others, and, even worse, we (...) lie to ourselves.In both private and public life, we damage ourselves with our lies, and we damage other people. Lies destroy mutual trust, and fragment our sense of who we are.Lies have played a major part in climate change and the global economic crisis. Fearing to change how they live, many people prefer to continue lying rather than acknowledge that we are facing a very uncertain but undoubtedly unpleasant future unless we learn how to prefer the truths of the real world in which we live rather than the comforting lies that ultimately betray us. We are capable of changing, but will we choose to do this? (shrink)

Among industrialized nations the United States is relatively unique in relying on a mix of public and private financing and delivery of healthcare: federal and federal-state programs, such as Medicare and Medicaid; employment-based health insurance ; and state-subsidized insurance pools for high-risk individuals. In recent years, however, there have been efforts to apply the principles of private employment-based health insurance to the other forms of healthcare, and there is speculation that rising healthcare costs can only be addressed by further extending (...) capitated payment plans. This suggests that U.S. healthcare may increasingly be organized according to market principles. For some, this represents a historic departure from an emphasis on public responsibility for healthcare and a sacrifice of the value principles embodied in health relationships between patient and provider. But defenders of HMOs and a larger role for markets argue that managed care allows for a more rational allocation of scarce healthcare resources by minimizing inefficient low-benefit–high-cost care. More individuals receive essential care if inessential care is eliminated. HMOs are also said to encourage non-HMOs to provide lower priced healthcare. (shrink)

Discussion on the Platonic Socrates in relation to the historic Socrates has to some extent subsided in recent years. The older tradition looks like maintaining itself. But the question remains a provocative one, and further light on it would be welcome. It is some years, indeed, since Professor Field showed reason to doubt whether any further light will now be found, and advised reliance on the main line of tradition, through Aristotle, in the belief that we cannot in any case (...) reach behind it. (shrink)

At the beginning of Sein und Zeit, Martin Heidegger raises the question “What is the meaning of Being?”. In a celebrated review of Heidegger, Gilbert Ryle observes that, though some would quarrel with the assumption “that there is a problem about the Meaning of Being,” he, for the moment, will not. Why not? Because, says Ryle, the “question of the relation between Being qua timeless ‘substance’ and existing qua existing in the world of time and space seems to me a (...) real one.”. (shrink)

But what is thus presented is something additional to a study in the history of ideas. The author courageously undertakes not simply to recount but to interpret the story and, indeed, to point out the lesson to be learned from it. This lesson is not that we have gone astray and that our business is to discover where we took the wrong turning and who is chiefly responsible for this misdirection. On the contrary, the slow and difficult development of a (...) value-free mode of scientific thought is accounted a positive gain. But though this is so, we have no grounds for complacency. Indeed our present situation is described as one of crisis and predicament. This is because scientific success in the independent treatment of fact has not been matched by a comparable success in the independent treatment of value. The latter is our most pressing intellectual task and we are warned that it will be exceedingly difficult, requiring, indeed, the development of nothing less than a whole new logic and methodology. (shrink)

Most discussions of medical futility try to answer the Futility Question: when is a medical procedure futile? No answer enjoys universal support. Some futility policies say that the health care provider will answer this question when the provider and patient cannot agree. This raises the Decision Question: who has the moral authority to decide what to do in cases where futility is disputed? I look for a procedural answer to this question, an answer that does not turn on whether a (...) given party happens to answer the Futility Question correctly. I argue that these policies get it right; the provider should decide because providers have a right of conscientious refusal that extends to refusing procedures on grounds of futility. This is a procedural answer because providers have this right even if they are sincerely mistaken about whether a procedure is futile. (shrink)

The United States Food and Drug Administration's recent approval of the commercial use of Deep Brain Stimulation (DBS) as a treatment for Obsessive Compulsive Disorder (OCD) will be discussed within the context of the existing USA regulatory framework. The purpose will be to illustrate the current lack of regulation and oversight of the DBS market, which has resulted in the violation of basic ethical norms. The discussion will focus on: 1) the lack of available evidence on procedural safety and efficacy, (...) 2) the numerous conflicts of interest held by research investigators, and 3) the ambiguity of both aforementioned categories due to an inherent lack of transparency in the research. It is argued that in order to address these issues, ethical analyses of DBS for psychiatric disorders must include the role of the industry forces that have become the primary impetus for this research. As such, DBS for OCD serves as an important case example in studies of neurotechnology and innovative surgery. (shrink)

There are certain ideals that can never be realised yet play an important role in our thinking, our morality, and our politics: they include the final comprehensive Truth, the General Will, the absolute Good, and certain religious ideals. Our attempts to get closer to them profoundly influence what we do, and our concern for them informs our criticism of what we reject. In politics, in particular, too many idealists are under the illusion that these ideals can be realised and if (...) disillusioned about this they too easily turn to cynicism - which is equally mistaken. This book looks at the role of such ideals in our intellectual and moral lives and in our politics by taking Kant's concept of the Regulative Ideal, and in so doing develops the concept itself further. Other thinkers whose ideas are considered in relation to this range from Plato to Iris Murdoch. (shrink)

Recent contributions to the literature on the topic of futility have focused primarily on two areas: 1) definitions of the term and 2) the suggestion that cardiopulmonary resuscitation may be futile in certain patients. This suggestion is based on “scientific” measures and analyses of outcomes, describing the low probability of success of CPR in patients over age 70, those with cancer, those with multiorgan failure, etc. The research reported suggests that with such patients the physician need not get the patient's (...) consent to withhold resuscitation; the physician need only inform either the patient or the surrogate that CPR will not be Instituted in the event of an arrest. (shrink)

I Take it that my part in this series is not to set forward some particular world outlook, or even to describe different kinds of world outlook. That will have been done already much more adequately by the lecturers who precede me. My part is to discuss what in general is meant by world outlooks, why it is so difficult to arrive at agreement on them, and what kind of considerations should be taken into account in deciding for one rather (...) than another. (shrink)

Most of us, were we faced with a life threatening situation, would try to avoid it; we do not want to die. Yet Lucretius has argued that death can be ‘nothing to us,’ for when death has occurred we don't exist: we can't suffer something if we don't exist.If death can be a misfortune, what is the misfortune suffered, and who suffers it? The misfortune must be suffered by the person who dies, before death has occurred, otherwise – as Lucretius (...) points out – there is no subject to suffer the misfortune. But what kind of misfortune can the misfortune of death be, that a person can suffer it before he or she dies? This question provides the focus of the paper.Our attitudes towards death and life are determined in part by beliefs we have about a variety of things, for example, whether or not there is a life after death. As I shall assume that life ceases at death the attitudes towards death for which I seek explanations will not be universally endorsed; nor are the attitudes towards life, in terms of which the explanations will be given, universally endorsed. My project is not to defend a set of attitudes but to show that the set of attitudes towards life that I consider provide an explanation of a set of attitudes that some people have towards death. (shrink)

It is, I think, one of the outstanding characteristics of our age that during a short spell of thirty or forty years fundamental advances have been made in a large number of different sciences. These developments have altered almost every aspect of material life—they have certainly had great influence upon modern education, and upon modern ideas of politics, as well as upon a host of less important things. But chief of all we notice the effect of this Golden Age of (...) Science in the birth of new ideas. The revolution in ideas has only just started. Where it will end no one can see. (shrink)

The patient was a woman in her 30s who, until the rapid progression of an ultimately fatal neurologic disease, had been a very successful professional, enjoying athletics and an active social life. In the 6 months of swift deterioration, she had gone from being extremely vibrant and energetic to being totally unable to care for her personal needs. There had been no loss of intellectual capacity. Her sister later recounted to Dr. J., the emergency department physician, that she had found (...) the patient unconscious and unresponsive at home and had immediately called the patient's neurologist in a neighboring city. He directed her to call the paramedics. (shrink)