Sedlakova and Trachsel (hereafter referred to as “the authors”) argue that conversational artificial intelligence (CAI) in psychotherapy presents an ethical challenge as a tool with aspects of agen...

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

The white coat ceremony is a common practice at many American and European medical schools. Current justification for the ceremony is mainly based on the good will felt by participants and an assumed connection between the ceremony and encouraging humanistic values in medicine. Recent critiques of the ceremony faults its use of oaths, premature alignment of students and faculty, and the selective appropriation of meaning to the white coat itself. This paper responds to recent critiques by addressing their misconceptions and (...) arguing that the white coat ceremony is a contemporary medical ritual with a key role for students and faculty in developing a professional identity.Since its inception in 1993, the white coat ceremony has become a national and international phenomenon. It is now practised at the beginning of the year at more than 100 American medical schools and is supported by foundation grants dedicated to endorsing and encouraging professional development and humanism in medicine.1 While some literature addresses the symbolism and history of the white coat itself, few sources consider the meaning of the ceremony.2–4 A common appeal is to the emotion and good will felt at the event.1,5 Although feelings are important, a deeper justification is called for.Criticism of the WCC is more explicit, charging that the ceremony: uses the Hippocratic Oath inappropriately or, at best, prematurely; fosters improper student faculty relationships, and; interprets the meaning of the white coat selectively.6,7 Critics suggest either that students not be asked to swear an oath together because it might conflict with personally held beliefs, or that students not be allowed to take the oath until they have demonstrated competence as physicians.6 Some also say that the WCC aligns students with faculty and against patients.6 The third …. (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

Constitutivist accounts in metaethics explain the normative standards in a domain by appealing to the constitutive features of its members. The success of these accounts turns on whether they can explain the connection between normative standards and the nature of individuals they authoritatively govern. Many such explanations presuppose that any member of a norm-governed kind must minimally satisfy the norms governing its kind. I call this the Threshold Commitment, and argue that constitutivists should reject it. First, it requires constitutivists to (...) restrict the scope of their explanatory ambitions, because it is not plausibly true of social kinds. Second, despite the frequent reliance on physical artifacts in constitutivists’ illustrations of the Threshold Commitment, it counter-intuitively entails that physical artifacts can cease to exist without being physically destroyed. Third, it misconstrues the normative force of authoritative norms on very defective kind-members because it locates this force not in the norm, but in the threat of non-existence. Fortunately, constitutivism can be decoupled from the Threshold Commitment, and I close by sketching a promising alternative account. (shrink)

Sometimes form-meaning mappings in language are not arbitrary, but iconic: they depict what they represent. Incorporating iconic elements of language into a compositional semantics faces a number of challenges in formal frameworks as evidenced by the lengthy literature in linguistics and philosophy on quotation/direct speech, which iconically portrays the words of another in the form that they were used. This paper compares the well-studied type of iconicity found with verbs of quotation with another form of iconicity common in sign languages: (...) classifier predicates. I argue that these two types of verbal iconicity can, and should, incorporate their iconic elements in the same way using event modification via the notion of a context dependent demonstration. This unified formal account of quotation and classifier predicates predicts that a language might use the same strategy for conveying both, and I argue that this is the case with role shift in American Sign Language. Role shift is used to report others’ language and thoughts as well as their actions, and recently has been argued to provide evidence in favor of Kaplanian “monstrous” indexical expressions. By reimagining role shift as involving either quotation for language demonstrations or “body classifier” predicates for action demonstrations, the proposed account eliminates one major argument for these monsters coming from sign languages. Throughout this paper, sign languages provide a fruitful perspective for studying quotation and other forms of iconicity in natural language due to their lack of a commonly used writing system which is otherwise often mistaken as primary data instead of speech, the rich existing literature on iconicity within sign language linguistics, and the ability of role shift to overtly mark the scope of a language report. In this view, written language is merely a special case of a more general phenomenon of sign and speech demonstration, which accounts more accurately for natural language data by permitting more strict or loose verbatim interpretations of demonstrations through the context dependent pragmatics. (shrink)

Marx, like many of his contemporaries, uncritically assumed that humanity develops from primitive beginnings to ever more perfect stages. In his theory of human development he measured progress by two main standards: the decrease of all forms of dependence, and the increase of universality in man's relations to nature and to his fellow man. In our century, not only have new structures of power and dependence emerged, but successive movements have also been generated to restore the more ordered and limited (...) relationships of the past. If belief in progress is nowadays no longer self-evident, such a state of affairs can help us reflect on the conditions necessary to realize the values which determined Marx's categorical imperative, or his insistence that we overthrow all relations by which man is made a debased and enslaved being. One of these conditions is the voluntary limitation of our needs: the need to use material goods without regard for others, the need to build up or maintain security even at the cost of violence, and the need to restrict the circle of those with whom we identify to our own particular culture, race, class or ways of thinking and acting. (shrink)

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared (...) to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. (shrink)

Philosophers of science are increasingly interested in engaging with scientific communities, policy makers, and members of the public; however, the nature of this engagement has not been systematically examined. Instead of delineating a specific kind of engaged philosophy of science, as previous accounts have done, this article draws on literature from outside the discipline to develop a framework for analyzing different forms of broadly engaged philosophy of science according to two key dimensions: social interaction and epistemic integration. Clarifying the many (...) forms of engagement available to philosophers of science can advance future scholarship on engagement and promote more strategic engagement efforts. (shrink)

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

While acknowledging Hannah Arendt's keen philosophical and political insights, Kathryn T. Gines claims that there are some problematic assertions and oversights regarding Arendt’s treatment of the "Negro question." Gines focuses on Arendt's reaction to the desegregation of Little Rock schools, to laws making mixed marriages illegal, and to the growing civil rights movement in the south. Reading them alongside Arendt's writings on revolution, the human condition, violence, and responses to the Eichmann war crimes trial, Gines provides a systematic analysis (...) of anti-black racism in Arendt’s work. (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

The failure of psychiatry to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the structure and content of the Diagnostic and Statistical Manual of Mental Disorders. Here I argue that in fact what has retarded biomedical approaches to psychopathology is unwarranted optimism about diagnostic discrimination: the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I consider the Research Domain Criteria framework (...) as a new paradigm for classifying objects of psychiatric research that solves some of the challenges brought on by this assumption. (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)

We argue that a semantics for counterfactual conditionals in terms of comparative overall similarity faces a formal limitation due to Arrow’s impossibility theorem from social choice theory. According to Lewis’s account, the truth-conditions for counterfactual conditionals are given in terms of the comparative overall similarity between possible worlds, which is in turn determined by various aspects of similarity between possible worlds. We argue that a function from aspects of similarity to overall similarity should satisfy certain plausible constraints while Arrow’s impossibility (...) theorem rules out that such a function satisfies all the constraints simultaneously. We argue that a way out of this impasse is to represent aspectual similarity in terms of ranking functions instead of representing it in a purely ordinal fashion. Further, we argue against the claim that the determination of overall similarity by aspects of similarity faces a difficulty in addition to the Arrovian limitation, namely the incommensurability of different aspects of similarity. The phenomena that have been cited as evidence for such incommensurability are best explained by ordinary vagueness. (shrink)

This book explores the dynamic relationship between myth and philosophy in the Presocratics, the Sophists, and in Plato - a relationship which is found to be more extensive and programmatic than has been recognized. The story of philosophy's relationship with myth is that of its relationship with literary and social convention. The intellectuals studied here wanted to reformulate popular ideas about cultural authority and they achieved this goal by manipulating myth. Their self-conscious use of myth creates a self-reflective philosophic sensibility (...) and draws attention to problems inherent in different modes of linguistic representation. Much of the reception of Greek philosophy stigmatizes myth as 'irrational'. Such an approach ignores the important role played by myth in Greek philosophy, not just as a foil but as a mode of philosophical thought. The case studies in this book reveal myth deployed as a result of methodological reflection, and as a manifestation of philosophical concerns. (shrink)

The sixteen essays in Gender Struggles address a wide range of issues in gender struggles, from the more familiar ones that, for the last thirty years, have been the mainstay of feminist scholarship, such as motherhood, beauty, and sexual violence, to new topics inspired by post-industrialization and multiculturalism, such as the welfare state, cyberspace, hate speech, and queer politics, and finally to topics that traditionally have not been seen as appropriate subjects for philosophizing, such as adoption, care work, and the (...) home. (shrink)

Recent advances in virtual technologies have allowed the investigation of simulated moral actions in aversive moral dilemmas. Previous studies have employed diverse populations in order to explore these actions, with little research considering the significance of occupation on moral decision-making. For the first time, in this study we have investigated simulated moral actions in Virtual Reality made by professionally trained paramedics and fire service incident commanders who are frequently faced with and must respond to moral dilemmas. We found that specially (...) trained individuals showed distinct empathic and related personality trait scores and that these declined with years of experience working in the profession. Supporting the theory that these professionals develop resilience in moral conflict, reduced emotional arousal was observed during virtual simulations of a distressing dilemma. Furthermore, trained professionals demonstrated less regret following the execution of a moral action in virtual reality when compared to untrained control populations. We showed that, contrary to previous research, trained individuals made the same moral judgments and moral actions as untrained individuals, though showing less arousal and regret. In the face of increasing concerns regarding empathy decline in healthcare professionals, we suggest that the nature of this decline is complex and likely reflects the development of a necessary emotional resilience to distressing events. (shrink)

This book argues that formation lies at the heart of Dietrich Bonhoeffer's ethical project. Ryan Huber examines Bonhoeffer's life story and his most influential ethical writings, from his encounter with Jesus Christ in the early 1930s until his arrest in 1943, to illustrate the centrality of Christological formation in both.

Innovative, data-driven methods provide more rigorous and systematic evidence for the description and explanation of diachronic semantic processes. The volume systematises, reviews, and promotes a range of empirical research techniques and theoretical perspectives that currently inform work across the discipline of historical semantics. In addition to emphasising the use of new technology, the potential of current theoretical models (e.g. within variationist, sociolinguistic or cognitive frameworks) is explored along the way.

A series of writings describes Hellenistic philosophy as spiritual guidance. Starting from a selection of Heraclitean fragments, this essay considers whether it is possible to read pre-Socratic philosophy as spiritual guidance. Its conclusion is that one cannot talk about spiritual guidance in the case of Heraclitus since he does not accompany the scholar in his search for understanding and because his teachings are not meant to be followed strictly and diligently. Finally, Heraclitus sets the impersonal Logos as a teacher; he (...) himself does not accept any human teachings. The only accepted learning comes through one's own experience; no-one can pass his wisdom on to anyone else. Moreover, the teachings of Heraclitus do not soothe man's grief or offer any eschatol-ogy; on the contrary, they are meant to deprive his listeners of all security. His teaching goes no further than to encourage the scholar in his own search for understanding. Only insofar as Heraclitus' teachings lead to psychic autonomy can we call them therapeutic. (shrink)

This manuscript reviews recent evidence supporting the utility of telomeres and mitochondrial DNA copy number (mtDNAcn) in detecting the biological impacts of adverse childhood experiences (ACEs) and outlines mechanisms that may mediate the connection between early stress and poor physical and mental health. Critical to interrupting the health sequelae of ACEs such as abuse, neglect, and neighborhood disorder, is the discovery of biomarkers of risk and resilience. The molecular markers of chronic stress exposure, telomere length and mtDNAcn, represent critical biological (...) links between ACEs and poor health outcomes. We examine how telomeres and mtDNAcn may exacerbate health disparities and contribute to the intergenerational transmission of trauma. Finally, we explore how these molecular markers of early stress exposure may help define the role of resilience and develop effective interventions to moderate ACE health risk impact. (shrink)

Challenges current claims that humans ought to be vegetarians because animals have moral standing.

The vegan ideal is entailed by arguments for ethical veganism based on traditional moral theory (rights and/or utilitarianism) extended to animals. The most ideal lifestyle would abjure the use of animals or their products for food since animals suffer and have rights not to be killed. The ideal is discriminatory because the arguments presuppose a male physiological norm that gives a privileged position to adult, middle-class males living in industrialized countries. Women, children, the aged, and others have substantially different nutritional (...) requirements and would bear a greater burden on vegetarian and vegan diets with respect to health and economic risks, than do these males. The poor and many persons in Third World nations live in circumstances that make the obligatory adoption of such diets, where they are not already a matter of sheer necessity, even more risky.Traditional moral theorists (such as Evelyn Pluhar and Gary Varner whose essays appear in this issue) argue that those who are at risk would beexcused from a duty to attain the virtue associated with ethical vegan lifestyles. The routine excuse of nearly everyone in the world besides adult, middle-class males in industrialized countries suggests bias in the perspective from which traditional arguments for animal rights and (utilitarian) animal welfare are formulated. (shrink)

Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced the so-called precision medicine paradigm, a model for medical research that uses innovative techniques for data collection and analysis to reevaluate traditional theories of disease. The goal of precision medicine is to improve diagnostics by restratifying the patient population on the basis of a deeper understanding of disease processes. This paper argues that precision is ill-fitting for psychiatry for two reasons. First, in psychiatry, unlike in fields (...) like oncology, precision medicine has been understood as an attempt to improve medicine by casting out, rather than merely revising, traditional taxonomic tools. Second, in psychiatry the term “biomarker” is often used in reference to signs or symptoms that allow patients to be classified and then matched with treatments; however, in oncology “biomarker” usually refers to a disease mechanism that is useful not only for diagnostics, but also for discovering causal pathways that drug therapies can target. Given these differences between how the precision medicine paradigm operates in psychiatry and in other medical fields like oncology, while precision psychiatry may offer successful rhetoric, it is not a promising paradigm. (shrink)

The COVID-19 pandemic continues to pose significant health, economic, and social challenges. Given that many of these challenges have moral relevance, the present studies investigate whether the COVID-19 pandemic is influencing moral decision-making and whether moralisation of behaviours specific to the crisis predict adherence to government-recommended behaviours. Whilst we find no evidence that utilitarian endorsements have changed during the pandemic at two separate timepoints, individuals have moralised non-compliant behaviours associated with the pandemic such as failing to physically distance themselves from (...) others. Importantly, our findings show that this moralisation predicts sustained individual compliance with government-recommended behaviours. (shrink)

Zusammenfassung Case studies in the history of science and technology have shown that scientific norms, so called standards, contribute significantly to the evolution of scientific practices. They arise predominantly, but not exclusively, on the basis of interactions with instruments of measurement and other technical devices. As regards experimental practices standards are mandatory preparatory procedures in a variety of designs, including the inbreeding and genetic engineering of experimental organisms (e.g. transgenic mice). I claim that scientific norms not only regulate mere technical (...) preconditions of research but also guide experimental practices, for example with regard to the stabilisation and validation of phenomena. Against this background, the paper introduces different kinds of scientific norms and elaborates on the question if they are means to epistemic ends (e.g. stability). (shrink)