The issue of how to incorporate the individual's first‐hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces and (...) suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in‐depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions. (shrink)

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and (...) ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns. (shrink)

A book chapter exploring the potential consquences and ethical ramifications of using coercive measures within community mental healthcare. We argue that, althogh the move towards 'care in the community' may have had liberalising motivations, the subsequent reduction in inpatient or other supported residential provision, means that there has been an increasing move towards coercive measures outside of formal inpatient detention. We consider measures such as Community Treatment Orders, inducements, and other forms of leverage, explaining the underlying concepts, aims, and exploring (...) adverse consequences and ethical difficulties. (shrink)

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts (...) to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. (shrink)

Despite extensive evidence for its effectiveness, ECT remains the subject of fierce opposition from those contesting its benefits and claiming extreme harms. Alongside some reflections on my experiences of this treatment, I examine the case against ECT, and find that it appears to rest primarily on unsubstantiated claims about major ethical violations, rather than clinical factors such as effectiveness and risk.

The Sophists, who rose to prominence in democratic Athens during the mid-fifth century b.c., understood the art of rhetoric and the importance of being able to transform effective reasoning into persuasive public speaking. Their inquiries-into the gods, the origins of religion, and whether virtue can be taught-influenced the next generation of classical philosophers and formed the foundations of the European prose style and formal oratory. In this new translation each chapter is organized around the work of one character, including Gorgias, (...) Prodicus, Protagoras, and Antiphon, among others. (shrink)

Educational policy and social sciences researchers have been studying dishonest behaviors among students for a long time. In this bibliometric study we examine the extant literature on academic dishonesty until 2017. We also analyze the specific case of the literature on plagiarism since it is arguably one of the most common academic dishonest behavior. We aim at identifying the intellectual structure of the field of academic dishonesty and plagiarism. Results show that Donald L. McCabe and Richard L. Marsh appear as (...) the most productive authors. Furthermore, Whitley, 235–274, 1998) “Factors associated with cheating among college students: A review”, and Pennycook, 201–230, 1996), entitled “Borrowing others’ words: Text, ownership, memory, and plagiarism” are the most cited publications on academic dishonesty and on plagiarism, respectively. Additionally, a strong connection between the McCabe and Treviño articles emerged from the co-citation analysis on academic dishonesty, and also a strong relationship between Pennycook, 201–230, 1996) and Pecorari, 317–345, 2003), suggesting that these articles are strongly connected. Results suggest that these are the most influential authors and articles of the field. (shrink)

ABSTRACTTime-consciousness has long been a focus of research in phenomenology and phenomenological psychology. We advance and extend this tradition of research by focusing on the character of temporal experience under conditions of mania. Symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight-of-ideas, hyperactivity. But what is the underlying structure of temporal experience in manic episodes? We tackle this question using a strategically hybrid approach. We recover and reconstruct three hypotheses (...) regarding manic temporality that were advanced and modeled by two pioneers of clinical phenomenology: Eugène Minkowski and Ludwig Binswanger. We then test, critique, and refine these hypotheses using heterophenomenological methods in an interview-based study of persons with a history of bipolar and a current diagnosis of acute mania. Our conclusions support a central hypothesis due to Minkowski... (shrink)

Child maltreatment not only leads to epigenetic changes, but also increases the risk of related behavioral deficits and mental disorders. These issues presumably are most closely associated with epigenetic changes in the brain, but epigenetic changes in peripheral tissues like blood are often examined instead, due to their accessibility. As such, the reliability of using the peripheral epigenome as a proxy for that of the brain is imperative. Previously, our lab has found aberrant methylation at the Brain-derived neurotrophic factor gene (...) in the prefrontal cortex of rats following aversive caregiving. The current study examined whether aversive caregiving alters Bdnf DNA methylation in the blood compared to the prefrontal cortex. It was revealed that DNA methylation associated with adversity increased in both tissues, but this methylation was not correlated between tissues. These findings indicate that group trends in Bdnf methylation between blood and the brain are comparable, but variation exists among individual subjects. (shrink)

On the 13th June 2014, the Centre for the Humanities and Health (CHH) at King’s College London hosted a one-day workshop on ‘Parentalism and Trust.’ This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. The term ‘Parentalism’ rather than paternalism is chosen and used throughout because of some of the derisory and unfortunate gender connotations associated with paternalism (and/or its counterpart ‘maternalism’). (...) Medical Parentalism is the position that unwanted interference with a patient’s choices and actions in order to protect and promote her best interests is morally justified. Whilst there are many problems with its justification and implementation, the workshop addressed how such interference depends on a trusting relationship between the doctor and patient, and the extent to which parentalist interferences might undermine this trust. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

In many animal species, the early development of the embryo follows a stereotypic pattern of cell cleavage, lineage allocation and generation of tissue asymmetry leading to delineation of the body plan with three primary embryonic axes. The mammalian embryo has been regarded as an exception and primary body axes of the mouse embryo were thought to develop after implantation. However, recent findings have challenged this view. Asymmetry in the fertilised oocyte, as defined by the position of the second polar body (...) and the sperm entry point, can be correlated with the orientation of the animal–vegetal and the embryonic–abembryonic axes in the preimplantation blastocyst. Studies of the pattern of morphogenetic movement of cells and genetic activity in the peri‐implantation embryo suggest that the animal–vegetal axis of the blastocyst might presage the orientation of the anterior–posterior axis of the gastrula. This suggests that the asymmetry of the zygote that is established at fertilisation and early cleavage has a lasting impact on the delineation of body axes during embryogenesis. BioEssays 23:508–517, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Teleological explanations (TEs) account for the existence or properties of an entity in terms of a function: we have hearts because they pump blood, and telephones for communication. While many teleological explanations seem appropriate, others are clearly not warranted-for example, that rain exists for plants to grow. Five experiments explore the theoretical commitments that underlie teleological explanations. With the analysis of [Wright, L. (1976). Teleological Explanations. Berkeley, CA: University of California Press] from philosophy as a point of departure, we examine (...) in Experiment 1 whether teleological explanations are interpreted causally, and confirm that TEs are only accepted when the function invoked in the explanation played a causal role in bringing about what is being explained. However, we also find that playing a causal role is not sufficient for all participants to accept TEs. Experiment 2 shows that this is not because participants fail to appreciate the causal structure of the scenarios used as stimuli. In Experiments 3-5 we show that the additional requirement for TE acceptance is that the process by which the function played a causal role must be general in the sense of conforming to a predictable pattern. These findings motivate a proposal, Explanation for Export, which suggests that a psychological function of explanation is to highlight information likely to subserve future prediction and intervention. We relate our proposal to normative accounts of explanation from philosophy of science, as well as to claims from psychology and artificial intelligence. (shrink)

Taiji – sport, méditation, art martial , préservation de la santé, philosophie de vie et voie de l’illumination – est l’une des caractéristiques du daoïsme chinois les plus connues. Cet article cherche à saisir la portée des notions daoïstes classiques, telles que dao , qi et wuwei , ainsi que leur mise en application dans les principes de Taiji tel que pratiqué aujourd’hui à travers le monde entier. Issues de la première génération du daoïsme , ces notions représentent le point (...) central de ses écrits fondateurs et constituent les bases de la philosophie daoïste qui a réussi à préserver son authenticité, malgré de nombreuses évolutions historiques et influences religieuses pendant mille ans, justement grâce à l’application de ces axiomes. Une pratique régulière de Taiji, avec pour but mens sana in corpore sano, et le respect des principes de dao, qi et wuwei, conduisent à la souplesse, la force et la pondération de l’esprit et du corps, puis mènent vers des niveaux de conscience plus élevés où il est possible d’atteindre l’unité de la perfection physique et mentale. C’est ainsi que le « sport » Taiji revêt sa dimension intégrale et transcendante. (shrink)

Le terme ktitor accompagne souvent la représentation d'un acte de don dans la peinture murale byzantines et post-byzantines. Même si le terme "ktitor" a été traduit le plus souvent par "fondateur", sémantiquement et historiquement, on retrouve dans le mot le sens de possession. Les ktitores - des propriétaires modaux, offrent leurs dons, dont le destinataire final est Dieu. Les panneaux votifs de Théodore Métochite , du sebastokrator Kalojan , de Stefan Uroš III , de Mircea l'Ancien témoignent des droits, des (...) intentions et de la foi du ktitor. Avec le christianisme, le sens du don s'est inversé et out don humain n'est qu'un contre-don à Dieu pour son sacrifice premier. (shrink)

En hommage à la longévité universitaire du sociologue et philosophe Jacques Leenhardt - professeur à l'École des hautes études en sciences sociales depuis 1966, fondateur des Archives de la critique d'art, créateur et directeur du Centre d'art contemporain de Crestet -, cet ouvrage réunit des contributions de sociologues, philosophes, artistes et écrivains qui retracent plusieurs débats marquants liés aux sciences humaines, à la littérature et aux arts, en France et aux Amériques à partir des années 1970. Le riche parcours du (...) chercheur français, né à Genève, se dessine à travers autant de rencontres intellectuelles et de sensibilités artistiques en partage--Page 4 of cover. (shrink)

Background: Job satisfaction is largely associated with organizational aspects, including improved working environments, worker’s well-being and more effective performance. There are many definitions regarding job satisfaction in the existing scholarly literature: it can be expressed as a positive emotional state, a positive impact of job-related experiences on individuals, and employees’ perceptions regarding their jobs. Aims: No reliable scales in Arabic language to assess job satisfaction in the sports and physical education field exist.This study aimed to trans-culturally adapt and validate the (...) Pepe’s “Teacher Job Satisfaction Scale” 9 items (TJSS-9), creating the “Teacher of Physical Education Job Satisfaction Inventory” (TPEJSI) in Arabic language. This scale was administered to a Tunisian population of sports and physical education teachers and analyzed according to the Pepe’s theoretical model.. More in detail, this investigation systematically tested its factor structure, in terms of internal consistency/reliability, predictive validity, sensitivity and convergent validity. Methods: A total of 417 Tunisian teachers of sports and physical education participated voluntarily in this study. The sample comprised of 258 males and of 159 females. More in detail, 189 were teachers teaching in primary schools of physical education, 105 teaching in secondary schools, and 123 were university teachers. Both exploratory (EFA) and confirmatory (CFA) factor analyses were performed on random-split halves of the sample. Results: The three-dimensional alpha coefficients of the TPEJSI were all greater than 0.80: for satisfaction with colleagues, alpha was 0.865; for satisfaction with parents, alpha was 0.856 and for satisfaction with students alpha was 0.860. The CFA fit indices were satisfactory. Conclusions: Given the good EFA factor loadings, the CFA fit indices, the correlation matrix, the sensitivity analysis, the convergent validity and the excellent internal consistency, it can be concluded that the TPEJSI is a good psychometric tool that can be used to quantitatively assess the job satisfaction level among teachers of sports and physical education in the Arabic-speaking world. (shrink)

La autora argumenta sobre la necesidad de pensar en un desarrollo humano sostenible por las profundas transformaciones de la sociedad contemporánea a partir de la globalización de la economía, y la reestructuración productiva que ello genera. Sostiene que del presente concepto de desarrollo no podemos esperar alcanzar la calidad de vida como es concebida y esperada por cada sociedad, y presenta tres propuestas que sí reúnen las condiciones para responder de manera más adecuada a un desarrollo socialmente deseable. Ellas son (...) el Ecodesarrollo, el Desarrollo Sostenible y el Desarrollo Endógeno. Tras ello, postula la relevancia de generar investigación participativa para dirigirse al desarrollo deseado, y ejemplifica con varios proyectos de desarrollo local en el Brasil. (shrink)

Amie L. Thomasson; The Ontology of Art and Knowledge in Aesthetics: Thomasson The Ontology of Art and Knowledge in Aesthetics, The Journal of Aesthetics and Art.

The pioneering anthology Home Girls features writings by Black feminist and lesbian activists on topics both provocative and profound. Since its initial publication in 1983, it has become an essential text on Black women's lives and writings. This edition features an updated list of contributor biographies and an all-new preface that provides a fresh assessment of how Black women's lives have changed-or not-since the book was first published. Contributors are Tania Abdulahad, Donna Allegra, Barbara A. Banks, Becky Birtha, Julie (...) Carter, Cenen, Cheryl Clarke, Michelle Cliff, Michelle T. Clinton, Willie M. Coleman, Toi Derricotte, Alexis De Veaux, Jewelle L. Gomez, Akasha (Gloria) Hull, Patricia Jones, June Jordan, Audre Lorde, Raymina Y. Mays, Deidre McCalla, Chirlane McCray, Pat Parker, Linda C. Powell, Bernice Johnson Reagon, Spring Redd, Gwendolyn Rogers, Kate Rushin, Ann Allen Shockley, Barbara Smith, Beverly Smith, Shirley O. Steele, Luisah Teish, Jameelah Waheed, Alice Walker, and Renita Weems. (shrink)

The purpose of this paper is to examine the distinction between "negative" and "positive" duties. Special attention will be given to certain criticism raised against this distinction by Michael Tooley.

Depuis quelques années le nombre de publications en français sur la Chine s’est accéléré. En 2010, la revue Travail Genre et sociétés (n° 23) a consacré un dossier intitulé « Traditions et ruptures chinoises » (avec une carte et une chronologie de l’histoire de la Chine depuis 1949 tout à fait utiles). L’article de Tania Angeloff sur « La Chine au travail (1989-2009) : emploi, genre, migrations », comme l’ouvrage de Tania Angeloff et Marylène Lieber, nous permet de (...) donner un cadre général, av... (shrink)

This article won the Mind prize essay competition announced last year, for an essay defending the academic pursuit of philosophy. The author is at present a free-lance philosopher; at the time of writing the paper he was a part time lecturer at the University of Newcastle upon Tyne, in the department that has since closed. His collection of aphorisms, Sentences and Slogans has recently been published privately (for details, see 'Books Received').

I criticize the particular argument for evolutionary progressivism which is based on the concept of a series of "dominant life forms." My procedure is to show that there is no rigorous definition for the concept of "dominant life form." I examine several attempts to define this concept by Julian Huxley and a new formulation of the concept by G. G. Simpson and show that none of the criteria either of these men develop for determining which groups of organisms can be (...) classified as dominant are adequate to exclude any groups of organisms from the classification. The concept proves so broad as to be meaningless. Since it is a key concept in the particular argument for progressivism that I discuss, the criticism of the concept demonstrates the argument to be invalid. (shrink)