The purpose of this paper is to offer a distinct contribution to recent attempts to understand Peirce’s normative thinking. Scholars have interpreted the real tensions in Peirce’s normative thought by conflating passages from different moments in the development of his philosophy. Extracts from Peirce’s famous 1898 lectures (when he dismissed ethics as useless) are frequently combined with later passages from 1902 onwards, when he changed his mind. This paper proceeds by tracing the growth of Peirce’s thinking about ethics and correlating (...) his conflicting positions with his theory of the categories. The approach offered here is diachronic. A diachronic approach is necessary to correct some efforts to resolve the inconsistencies in Peirce’s moral theory. Also, a categorical account is understood as essential to perceive the inner coherence of his moral philosophy and to support the view that Peirce moved from a nominalist to a realist position in ethics. By connecting Peirce’s conceptions of ethics to his theory of the categories I hope to have provided a better understanding of the structure of his normative realism. (shrink)

El artículo propone una concepción no individualista de la justifi cación epistémica de las decisiones judiciales. Sugiere que la epistemología jurídica debe reconsiderar su teoría de la justifi cación epistémica con el fi n de dar cuenta de la posibilidad de que juzgadores racionales carezcan de autonomía intelectual. Sostiene que la dependencia epistémica es una de las propiedades que distinguen el razonamiento jurídico sobre los hechos, y que los juzgadores tienen buenas razones para aceptar una proposición sobre la base de (...) la experiencia cognitiva de otras personas. Después de hacer algunas precisiones terminológicas acerca de los conceptos de “testimonio” y “evidencia”, el trabajo explica la estructura de la dependencia epistémica, aborda los debates normativos actuales acerca de la justifi cación epistémica en casos de testimonio, y propone una posición externalista distinta, el antiindividualismo. Al fi nal, se explora una variación sobre el tema, que consiste en la integración de la noción de dependencia epistémica en una teoría de la autoridad en el derecho. (shrink)

If funding allocation is an indicator of a field’s priorities, then the priorities of the field of bioethics are misaligned because they perpetuate injustice. Social justice mandates priority for the factors that drive systematic disadvantage, which tend not to be the areas supported by funding within academic bioethics. Current funding priorities violate social justice by overemphasizing technologies that aim to enhance the human condition without addressing underlying structural inequalities grounded in racism, and by deemphasizing areas of inquiry most frequently pursued (...) by Scholars of Color. This lack of attention to upstream determinants of health in bioethics research perpetuates a gap in the resources needed to understand the experiences of communities disproportionately experiencing poor health, which is itself a form of epistemic injustice. Both social and epistemic injustices are apparent in the impact of these funding priorities on people of color, both in the public and in the bioethics community. (shrink)

A major goal of this work is to specify some steps of the process by which participants maintain coherency in their conversations.The underlying element of the analysis is a construct called a “context space.” Roughly, a group of utterances that refers to a single issue or episode forms the basis for a context space. Superficially, a conversation is a sequence of utterances; at a deeper level it is a structured entity whose utterances can be parsed into hierarchically related context spaces.As (...) a conversation proceeds, each conversant builds a discourse model that includes the conversation's context space structure, a notion of the present discourse topic, and a list of items being focused upon. Conversational coherency depends upon a lack of conflict between the respective models of the participants. Conflicts are prevented by speakers following high level syntactic and semantic relational rules that enable listeners to identify their discourse models. These rules, given in the study, are highly integrated with the view of conversation presented here—a hierarchy of related context spaces. (shrink)

Bioethics has entered a new era: as many commentators have noted, the familiar mantra of autonomy, beneficence, nonmaleficence, and justice has proven to be an overly simplistic framework for understanding problems that arise in modern medicine, particularly at the intersection of public policy and individual preferences. A tradition of liberal pluralism grounds respect for individual preferences and affirmation of competing conceptions of the good. But we struggle to maintain (or at times explicitly reject) this tradition in the face of individual (...) preferences that we find distasteful, suspect, or even repugnant, especially where the broader social good or respect for equality is at stake. Directed donation presents us with such a dilemma: can we uphold the right of self-determination through respect of individual preferences regarding disposition of transplantable organs while at the same time maintaining an allocation system that reflects values of equity and justice claimed to underlie the socially negotiated practice of transplantation? Or are some preferences simply to be deemed unethical and not respected, even if that leads to a reduction in the number of transplantable organs available and to an apparent disregard for the autonomous decisions of the recently deceased? (shrink)

Extensive and diverse conceptual work towards developing a definition of ‘mental disorder’ was motivated by the declassification of homosexuality from the Diagnostic and Statistical Manual in 1973. This highly politicised event was understood as a call for psychiatry to provide assurances against further misclassification on the basis of discrimination or socio-political deviance. Today, if a definition of mental disorder fails to exclude homosexuality, then it fails to provide this safeguard against potential abuses and therefore fails to do an important part (...) of the work it was intended to do. We argue that fact-based definitions of mental disorder, relying on scientific theory, fail to offer a robust definition of mental disorder that excludes homosexuality. Definitions of mental disorder based on values do not fare better: these definitions are silent on questions about the diagnostic status of individuals in oppressive societies and over-inclusive of mental or behavioural states that happen to be negatively valued in the individual's social context. We consider the latest definition proposed for the Diagnostic and Statistical Manual-5 in light of these observations. We argue that definition fails to improve on these earlier deficiencies. Its inclusion in the manual may offer false reassurance against repetition of past misclassifications. We conclude with a provocation that if candidate definitions of mental disorder are unable to exclude homosexuality, it might perhaps be preferable not to attempt a definition at all. (shrink)

Platonic arguments often have premises of a particular form which is misunderstood. These sentences look like universal generalizations, but in fact involve an implicit qua phrase which makes them a fundamentally different kind of predication. Such general implicit redoubled qua predications (girqps) are not an expression of Plato's proprietary views; they are also very common in everyday discourse. Seeing how they work in Plato can help us to understand them.

We discuss a case where medically optimal investigations of health problems in a donor-conceived child would require their egg donor to participate in genetic testing. We argue that it would be justified to contact the egg donor to ask whether she would consider this, despite her indicating on a historical consent form that she did not wish to take part in future research and that she did not wish to be informed if she was found to be a carrier of (...) a ‘harmful inherited condition’. We suggest that we cannot conjecture what her current answer might be if, by participating in clinical genetic testing, she might help reach a diagnosis for the donor-conceived child. At the point that she made choices regarding future contact, it was not yet evident that the interests of the donor-conceived child might be compromised by her answers, as it was not foreseen that the egg donor’s genome might one day have the potential to enable diagnosis for this child. Fertility consent forms tend to be conceptualised as representing incontrovertible historical boundaries, but we argue that rapid evolution in genomic practice means that consent in such cases is better seen as an ongoing and dynamic process. It cannot be possible to compel the donor to aid in the diagnosis of the donor-conceived child, but she should be given the opportunity to do so. (shrink)

Four experiments and 2 corpus-based studies demonstrate that negation is a determinant factor affecting novel nonliteral utterance-interpretation by default. For a nonliteral utterance-interpretation to be favored by default, utterances should be potentially ambiguous between literal and nonliteral interpretations. They should therefore be (a) unfamiliar, (b) free of semantic anomaly or any kind of internal incongruity, and (c) unbiased by contextual information. Experiments 1–3 demonstrate that negative utterances, meeting these 3 conditions, were interpreted metaphorically (This is not a safe) or sarcastically (...) (Ambitious she is not) when presented in isolation and were therefore processed faster in contexts strongly biasing them toward their nonliteral than toward their (equally biased) literal interpretation. Experiment 4 reduces the possibility that it is structural markedness on its own that induces nonliteralness. Two corpus-based studies provide corroborating evidence, supporting the view of negation as an operator generating nonliteral interpretations by default. (shrink)

This paper attributes to Nietzsche a theory of cultural development according to which pyramid societies—steeply hierarchical societies following a unified morality—systematically alternate with motley societies, which emerge when pyramid societies encounter other cultures or allow their strict mores to relax. Motley societies contain multiple value systems due to individual innovation or intercultural contact, and are less stringent in dictating individuals' roles. Consequently, many people are torn between incompatible values and lack direction, so they are drawn to a morality of mediocrity, (...) which offers the modest goals of comfort and conformity. However, the need to mediate between conflicting values also tends to yield exceptional individuals who create new values, and can reshape the society into a new pyramid society governed by those values. I argue that Nietzsche favors neither type of society at the expense of the other, but believes the alternation itself is valuable: a pyramid society develops a value system to its full potential; then, when it encounters alternative values, the extraordinary individuals in the resulting motley society synthesize the competing systems into a fuller vision of human flourishing. (shrink)

It is necessary to recognize the variety of levels at which values and norms may inappropriately affect the equity of the transplantation process, including candidate selection. Using a revised, richer concept of objectivity, adopted from Longino's work in the philosophy of science and empirical studies of candidate selection, this paper examines what sort of objectivity can be obtained in the transplant candidate selection process, and the closely related question of how selection can occur in an equitable manner. This concept of (...) objectivity requires that transformative criticism occur so that (1) the conceptual and normative commitments underlying selection may be articulated and perhaps challenged, and (2) the relationship between those commitments and criteria for candidate selection may be examined and justified, or revised. Through such transformative criticism, a greater degree of objectivity may be attained, which in turn will increase the likelihood of equity. (shrink)

This article describes a new prenatal genetic test that is painless, early, and increasingly available. State legislatures have reacted by prohibiting abortion for reason of fetal sex or of fetal diagnosis and managing genetic counseling. This article explores these legislative responses and considers how physicians and genetic counselors currently communicate post-testing options. The article then examines the challenges ahead for genetic counseling, particularly in light of the troubling grip of abortion politics on conversations about prenatal diagnosis.

This paper presents results from a survey of 344 individuals who engage in climate change mitigation action, contributing to debates about whether it is necessary to promote 'nature experiences' and biospheric values to encourage pro-environmental behaviour. We investigate three factors - values, motivations and formative experiences - that underlie such behaviour, but that usually have been considered in isolation from each other. In contrast to previous studies of environmentalists' significant life experiences, outdoor/nature experiences were not frequently mentioned as being influential. (...) Altruistic concerns about climate change impacts on future human generations and on poorer or more vulnerable people were considered more motivating than other reasons for action. There was no significant difference in how respondents rated altruistic and biospheric values. Variations in responses from those involved in 'biospherically-oriented' organisations (such as traditional environmental or conservation organisations) versus those involved in climate change groups suggest that there are different routes into climate change mitigation action, and our results show that it is not essential to cultivate biospheric values or the love of nature to encourage such action. (shrink)

Cultural forces such as film create and reinforce rigidly-defined images of a doctor's identity for both the public and for medical students. The authoritarian and hierarchical institution of medical school also encourages students to adopt rigidly-defined professional identities. This restrictive identity helps to perpetuate the power of the patriarchy, limits uniqueness, squelches inquisitiveness, and damages one's self-confidence. This paper explores the construction of a physician's identity using cultural theorists' psychoanalytic analyses of gender and race as a framework of analysis. Cultural (...) theorists' politically-motivated work provides an excellent point of departure for destabilizing parts of the authoritarian medical hierarchy that can damage a student's professional development. Drawing on such discourse, this paper examines the processes by which a doctor's identity becomes rigidly defined and fixed by daily training. It finally proposes a way for a medical student to extrapolate himself from the current definitions of this identity and create a broader, more malleable concept of professional identity by defining himself from outside of, rather than through, difference. (shrink)

It is tempting to hold that guilt‐tripping is morally wrong, either because it is objectionably manipulative, or because it involves gratuitously aiming to make another person suffer, or both. In this article, I develop a picture of guilt according to which guilt is a type of pain that incorporates a commitment to its own justification on the basis of the subject's wrongdoing. This picture supports the hypothesis that feeling guilty is an especially efficient means for a wrongdoer to come to (...) more deeply understand why her behavior was wrong; it is precisely because guilt is painful and involves a self‐reflexive justificatory element that it is able to play this role. Such a picture, moreover, preserves the possibility that deliberately making others feel guilty needn't involve aiming gratuitously to harm them and needn't be objectionably manipulative. It follows that we should be surprisingly sanguine about the practice of inducing guilt in wrongdoers as a means of facilitating their moral edification. (shrink)

A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain’s point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of (...) damaging them beyond repair? (shrink)

In this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed in Sanity, Madness and the Family, social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems. In this article, I consider the grounds on which such claims might be supported. I argue that problems should not (...) be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson’s argument—that schizophrenia is not within diagnosed patients—does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment. (shrink)

Can we feel emotions about abstract objects, assuming that abstract objects exist? I argue that at least some emotions can have abstract objects as their intentional objects and discuss why this conclusion is not just trivially true. Through critical engagement with the work of Dacher Keltner and Jonathan Haidt, I devote special attention to awe, an emotion that is particularly well suited to show that some emotions can be about either concrete or abstract objects. In responding to a possible objection, (...) according to which we can only feel emotions about things that we take to matter to our flourishing, and thus cannot feel emotions about causally inefficacious abstract objects, I explore how abstract objects can be relevant to human flourishing and discuss someemotions other than awe that can be about abstract objects. I finish by explaining somereasons why my conclusion matters, including the fact that it presents a challenge to perceptual theories of emotion and causal theories of intentionality. (shrink)

Kant claims in the third Critique that one can make about wine the merely subjective judgment that it is agreeable but never the universally valid judgment that it is beautiful. This follows from his views that judgments of beauty can be made only about the formal (spatiotemporal) features of a representation and that aromas and flavors consist of formless sensory matter. However, I argue that Kant's theory permits judgments of beauty about wine because the experience displays a temporal structure: the (...) aromas and flavors evolve over the course of a tasting from the bouquet through the palate to the finish. An analogy with music, which Kant describes as 'a play of sensations in time', illuminates how wine qualifies as an object of pure judgments of taste: the 'structure' of a wine can be compared to harmonic structure, and its development throughout the taste can be compared to the unfolding of melody and harmonic progression. (shrink)

In recent years there has been a powerful resurgence of settler colonialism as an interpretive framework through which to understand the Israeli-Palestinian conflict. Attached to the burgeoning field of settler colonial studies, this so-called ‘turn’ to settler colonialism has seen Israel-Palestine increasingly compared alongside New World white settler societies like Australia, Canada and the United States. In seeking to undercut the lens of exceptionalism through which the conflict has conventionally been viewed, the settler colonial paradigm has some important counter-hegemonic implications (...) for reframing Israel-Palestine, not least of which is its prescription for decolonization. However, it is paradoxically in the context of decolonization that the limits of the settler colonial paradigm become most apparent. I argue that these limitations are connected to the dominance of Patrick Wolfe’s structural account of settler colonialism, which leaves very little room for transformation, and to the particular connotations settler colonial studies has acquired from the New World contexts in which it is most often articulated. This is particularly the case in Israel-Palestine, where these connotations preclude engagement with the national aspects of the conflict and leave under-examined the unique resonances of the settler/native distinction, which need reckoning with in any serious account of decolonization. (shrink)

Hume’s moral philosophy makes sentiment essential to moral judgment. But there is more individual consistency and interpersonal agreement in moral judgment than in private emotional reactions. Hume accounts for this by saying that our moral judgments do not manifest our approval or disapproval of character traits and persons “only as they appear from [our] peculiar point of view... ” Rather, “we fix on some steady and general points of view; and always, in our thoughts, place ourselves in them, whatever may (...) be our present situation” (T 581-82), in order to “correct” our situated sentiments. This seems to create two serious difficulties for Hume’s theory. First, moral evaluations become inductive, empirical beliefs about what we would feel if we really occupied the imagined common point of view, and hence are the deliverances of causal reason; this contradicts Hume’s claim that the making of a moral evaluation is not an activity of reason but of sentiment. Secondly, given Hume’s thesis that the passions do not represent anything else, he cannot say that our moral evaluations will better represent the object being judged if they are made from the common point of view. This leaves no clear reason to adopt it, rather than making judgments from our real position. Hume says that left to our particular points of view, we will encounter contradictions and be unable to communicate, but it is hard to see why.My interpretation resolves these two difficulties. I argue that every time we reflect upon someone’s character from the common point of view, we feel an actual sentiment of approbation or disapprobation, which may alter and merge with the situated sentiment or may fail to do so, leaving two different feelings about the same character. Furthermore, whenever we make moral evaluations we also simultaneously make objective, causal judgments about the love and hatred, pride and humility that the trait will produce. We routinely take up the common point of view in order to achieve truth and consistency in our causal judgments, to avoid grave practical problems. (shrink)

BackgroundPatients with COVID-19 may feel under pressure to participate in research during the pandemic. Safeguards to protect research participants include ethical guidelines [e.g. Declaration of Helsinki and good clinical practice (GCP)], legislation to protect participants’ privacy, research ethics committees (RECs) and informed consent. The International Committee of Medical Journal Editors (ICMJE) advises researchers to document compliance with these safeguards. Adherence to publication guidelines has been suboptimal in other specialty fields. The aim of this rapid review was to determine whether COVID-19 (...) human research publications report compliance with these ethical safeguards.MethodsA rapid systematic literature review was conducted in MEDLINE using the search term ‘COVID-19’. The search was performed in April 2020 with no start date and repeated to include articles published in November 2020. Filters were ‘Full free text available’ and ‘English Language’. Two reviewers assessed article title, abstracts and full texts. Non-COVID-19 articles and non-clinical studies were excluded. Independent reviewers conducted a second assessment of a random 20% of articles. The outcomes included reporting of compliance with the Declaration of Helsinki and GCP, REC approval, informed consent and participant privacy.ResultsThe searches yielded 1275 and 1942 articles of which 247 and 717 were deemed eligible, from the April search and November respectively. The majority of journals had editorial policies which purported to comply with ICMJE ethical standards. Reporting of compliance with ethical guidelines was low across all study types but was higher in the November search for case series and observational studies. Reporting of informed consent for case studies and observational studies was higher in the November search, but similar for case series. Overall, participant confidentiality was maintained but some case studies included a combination of details which would have enabled participant identification. Reporting of REC approval was higher in the November search for observational studies.ConclusionsWhile the majority of journal’s editorial policies purported to support the ethical safeguards, many COVID-19 clinical research publications identified in this rapid review lacked documentation of these important safeguards for research participants. In order to promote public trust, ethical declarations should be included consistently. (shrink)

Recognition theory attempts to conceptualize interpersonal relationships and their normative political implications. British social philosopher Gillian Rose developed her own version of recognition rooted in the work of Georg Hegel. This article applies Rose's theory of recognition to care, arguing that its emphasis on lack of identity, the dynamic process of recognition and the existential risks involved accurately describes the relationship between nurse and patient. Rose's version is compared to both contemporary notions of the interpersonal in healthcare literature, other forms (...) of recognition theory and Emmanuel Levinas's vision of intersubjective relationships, a traditional philosophical basis for nursing care. In each case, I will argue that Rosean recognition is a fuller, more complex and ultimately more satisfying view of the relationships involved. (shrink)

Egypt of the Hellenistic and Roman periods remains the most thoroughly documented multilingual society in the ancient world, because of the wealth of texts preserved on papyrus in Egyptian, Greek, Latin and other languages. This makes the scarcity of interpreters in the papyrological record all the more curious. This study reviews all instances in the papyri of individuals referred to as hermēneus in Greek, or references to the process of translation/interpreting. It discusses the terminological ambiguity of hermēneus, which can also (...) mean a commercial mediator; the position of language mediators in legal cases in Egyptian, Greek and Latin; the role of gender in language mediation; and concludes with a survey of interpreting in Egyptian monastic communities in Late Antiquity. (shrink)

Hellenistic and Roman acrostich inscriptions are usually full of verbal and visual clues, which point the reader in the direction of the ‘hidden message’ contained in the vertical lines of the text. The authors of such inscriptions want their audiences to appreciate the skill that has gone into their composition. There are several complementary ways in which the presence of an acrostich might be signalled to the reader or viewer and their attention directed towards it. These include direct verbal statements, (...) or more subtle allusions, within the text of the inscription. But, even without having read its text, the viewer of an inscription containing a ‘hidden message’ is often immediately aware that some kind of wordplay is at work. Acrostichs, palindromes and various kinds of word square are all graphically striking, or their appearance may be enhanced to make them more so. Regular spacing, the repetition of the acrostich in a separate column and the use of painted or incised grids are all ways in which the layout of the text on the stone can invite the viewer to play a word game. In some cases, as I will argue in this paper, acrostich makers envisaged—even intended—the participants in this game to include the illiterate as well as the literate. (shrink)

Despite the known positive effects of acute exercise on cognition, the effects of a competitive team sport match are unknown. In a randomized crossover design, 20 female and 17 male field hockey players completed a battery of cognitive tests prior to, at half-time, and immediately following a competitive match ; with effect sizes presented as raw ES from mixed effect models. Blood samples were collected prior to and following the match and control trial, and analyzed for adrenaline, noradrenaline, brain derived (...) neurotrophic factor, cathepsin B, and cortisol. The match improved response times for a simple perception task at full-time and response times on the complex executive function task improved at half-time. Working memory declined at full-time on the match. The change in working memory was negatively correlated with increases in cortisol, as was the change in simple perception response time and the change in noradrenaline concentration. This study is the first to highlight the effects a competitive hockey match can have on cognition. These findings have implications for performance optimization, as understanding the influence on specific cognitive domains across a match allows for the investigation into strategies to improve these aspects. (shrink)

The author shares her insights into the kabbalistic Judaism of her grandfather, serving up a series of inspiring stories about spiritual life.

Drawn from the authors' experiences in the UK, Australia and mainland Europe and with contributions from across the globe, this clear and accessible book includes a wide range of examples. The authors show the reader how to: identify ethical issues which may arise with any research project, gain informed consent, provide information in the right way to participants, and present and disseminate findings in line with ethical guidelines.

BackgroundThe Pacific Islander population is the second fasting growing population in the United States and Arkansas is home to the largest Marshallese population in the continental US. The Marshal...

The past year in bioethics in Australia has been relatively predictable. We continue to struggle with rising healthcare costs, though thankfully not on par with numerous other countries due to a relatively positive economic outlook. We are still fighting difficulties associated with higher medical indemnity costs, which have again caused many physicians to leave private practice, particularly in high-risk and specialty practice areas. In response, the federal government delayed the imposition of the medical indemnity levy for physicians until mid 2005. (...) In May, the Australian Law Reform Commission and the Australian Health Ethics Commission issued their final joint report on genetic testing entitled “Essentially Yours” and endorsed use of genetic tests by insurance companies, despite the concerns of some geneticists and many members of the public about their scientific reliability. However, they also advocated the establishment of the Human Genetics Commission of Australia to oversee such uses of genetic tests in terms of both scientific and actuarial reliability, and debates continue over the implementation of this and a number of their other recommendations. And state governments continue to phase in smoking bans in public places, with most implementing full bans in enclosed restaurants and cafes and planning to require provision of nonsmoking areas in all pubs within the next year. a. (shrink)

Theological ethics, particularly Christian theological ethics, is very well-equipped both to treat the interests and needs of future generations as a genuine and pressing concern – and also to evade some of the questions they pose about temporality, by appealing to judgement beyond history. Phenomenological approaches to the question of future generations are important as a counterbalance to this tendency in theological ethics, insofar as they force us to remain with, and wrestle with, the relation to future persons as future. (...) In this article I show that drawing on phenomenological approaches, in order to attend to temporality, produces an account of justice and responsibility to future generations that is more adequate theologically, as well as ethically. Attending to how the other, the future and the imperative of justice interrelate yields an approach to theological ethics that does not need to assume for the ethicist the God’s-eye view – the view from outside time, narrative or interpersonal encounter – and that is thus able to grapple with the core questions raised by bringing future generations into ethics. (shrink)

This paper asks what it means to say that a disorder is a “real” disorder and then considers whether culture-bound syndromes are real disorders. Following J.L. Austin I note that when we ask whether some supposed culture-bound syndrome is a real disorder we should start by specifying what possible alternatives we have in mind. We might be asking whether the reported behaviours genuinely occur, that is, whether the culture-bound syndrome is a genuine phenomenon as opposed to a myth. We might (...) be wondering whether the condition should rightly be considered a disorder, as opposed to some sort of non-disorder condition. We might want to know whether the culture-bound syndrome is really a distinct disorder, in the sense that scientific classification systems should include it as a separate category, or whether it is just a variant of a universally occurring disorder. I argue that some specific difficulties can arise with determining whether a culture-bound syndrome is a real disorder in each of these three senses. However, the frequent assumption that real disorders will necessarily occur universally, and that those that occur only in certain environments are suspicious is not generally justified. (shrink)

Self‐trust is essential to the well‐being of people with chronic illnesses and those who care for them. In this exploratory essay, we draw on a trove of health narratives to catalyze examination of this important but often overlooked topic. We explore how self‐trust is impeded at both personal and structural levels, how it can best be nourished, and how it is related to self‐advocacy. Because people's ability to trust themselves is intrinsically linked to the trust others have in them, we (...) pay particular attention to the role that allies such as clinical professionals play in the development of self‐trust, highlighting the importance of eliciting patient narratives, of curious listening, and of compassionately raising questions. We also contrast the self‐trust paradigm with that of self‐management, which tends to replace the former's attention to patients’ experiences, abilities, qualities, or judgments with a professionally dominated discourse dedicated to addressing illness through behavior changes prescribed by clinicians. We close with a call to action, exhorting readers to focus on supporting self‐trust in health care settings and on creative research in this critical yet heretofore underrepresented domain. (shrink)