Traditional understanding of how psychotropic drugs work emphasize highly specific actions at subcellular levels. This model appears to have implications that seriously conflict with our usual view of human agency and autonomy, raising not just theoretical quandaries but contributing to patient reluctance to utilize these drugs. Furthermore, it discourages both meaningful treatment integration and appreciation of the uniqueness of patients. Through a consideration of antidepressants in particular, this paper argues for a more comprehensive model based on nonlinear dynamics and chaos (...) theory that can be applied across multiple domains. This model yields important suggestions for reconciling perspectives in neuroscience with traditional views of human agency. It also encourages real integration of clinical and research approaches in psychiatry, and further defines the components of respectful treatment of patients. (shrink)

Recent years have witnessed an intensification of historical and philosophical research on the link between psychotropic drugs and psychiatric theories. For example, Kendler and Schaffner detailed how the dopamine hypothesis of schizophrenia was intimately linked to the dopamine theory of antipsychotic drug action. Here, a related case is explored: the use of antidepressants' neurochemical effects to speculate about the pathophysiology of depression.This rationale was central to American psychiatrist Schildkraut's landmark article on the catecholamine hypothesis of affective disorders. Accordingly, the (...) paper's hypothesis—that depressions may relate to decreased... (shrink)

When the University of Toronto withdrew a contract it held with me in December 2000, it initiated a sequence of events that led to a public letter to the University from senior figures in the world psychopharmacology community protesting against the infringement of academic freedom involved and a first ever legal action, undertaked by this author, seeking redress for a violation of academic freedom. The issues of academic freedom surrounding this case have been intertwined with a debate about the (...) possibility that the selective serotonin reuptake inhibitor (SSRI) group of antidepressants have the potential to trigger suicidality in a subgroup of patients. Whether the SSRIs do trigger suicidality or not, exploration of this issue has given rise to a number of worrying sets of observations. First, in my view, there is evidence that pharmaceutical companies have miscoded raw data on suicidal acts and suicidal ideation. Second, this author also maintains that there is a growing body of examples of ghostwriting of articles in the therapeutics domain. Many of the tensions evident in this case, therefore, can be linked to company abilities to keep clinical trial data out of the public domain — this is the point at which the pharmaceutical python gets a grip on academia. (shrink)

Philosophers have long been involved in the pursuit of a goal shared by researchers in psychiatry and the cognitive sciences: understanding the relationship between the functioning of the human mind and human well-being or suffering. For this reason there is a very large area of overlap between philosophical and psychiatric research. The overlap is particularly significant in the domain of practical ethics, which is concerned with understanding the moral dimension of policies and actions in the real world. This chapter reviews (...) two distinct domains in which psychiatry and practical ethics overlap. First, issues in practical ethics arise out of new advances in psychopharmacology, including clinical and non-clinical use of new antidepressants drugs, the clinical use of placebo medications, and psychiatric drugs which enhance human cognition; these issues are frequently grouped under the banner of "neuroethics." Second, the understanding of fundamental questions in moral philosophy is being driven forward by evidence from psychology and psychiatry. Evidence from autism and the personality disorders is shedding light on the nature of moral motivation, while evidence from addiction and compulsion is generating progress in understanding moral responsibility. Finally, some areas are highlighted in which the science of psychiatry may benefit from the application of existing work in moral philosophy and practical ethics. (shrink)

Obtaining informed consent before providing treatment is a routine part of modern clinical practice. For some treatments, however, there may be disagreement over the requirements for ‘informed’ consent. Electroconvulsive therapy (ECT) is one such example. Blease argues that patients ‘should surely be privy to the matters of fact that: (1) there is continued controversy over the effectiveness of ECT; (2) there is orthodox scientific consensus that there is currently _no_ acknowledged explanation for ECT and (3) there is a serious (mainstream) (...) debate over whether the response to ECT may be a placebo response.’ Before embracing these suggestions, two key questions must be asked. Are these claims a reasonable representation of current ECT research? And if so, will this information be of benefit to patients? The evidence-based support for ECT from both National Institute for Health and Care Excellence and the Royal College of Psychiatrists appears to undermine the validity of claims (1) and (3), and therefore the rationale for providing this information. Concerning assertion (2), it is true that the mechanism by which ECT has its therapeutic effect is not yet established, although the importance of conveying this fact to the patient is questionable. Of greater certainty is that the same irresolution surrounds the mechanism of action of pharmaceutical antidepressants, and so a double standard in patient care should be mindfully avoided if provision of this information is deemed a prerequisite for proper ‘informed’ consent. (shrink)

Global challenge-led research seeks to contribute to solution-generation for complex problems. Multicultural, multidisciplinary, and multisectoral teams must be capable of operating in highly deman...

Judging by our folk appraisals, then, knowledge and action are intimately related. The theories of rational action with which we are familiar leave this unexplained. Moreover, discussions of knowledge are frequently silent about this connection. This is a shame, since if there is such a connection it would seem to constitute one of the most fundamental roles for knowledge. Our purpose in this paper is to rectify this lacuna, by exploring ways in which knowing something is related to (...) rationally acting upon it, defending one particular proposal against anticipated objections. (shrink)

The extensive involvement of nonconscious processes in human behaviour has led some to suggest that consciousness is much less important for the control of action than we might think. In this article I push against this trend, developing an understanding of conscious control that is sensitive to our best models of overt action control. Further, I assess the cogency of various zombie challenges—challenges that seek to demote the importance of conscious control for human agency. I argue that though (...) nonconscious contributions to action control are evidently robust, these challenges are overblown. (shrink)

I argue that the neural realizers of experiences of trying are not distinct from the neural realizers of actual trying . I then ask how experiences of trying might relate to the perceptual experiences one has while acting. First, I assess recent zombie action arguments regarding conscious visual experience, and I argue that contrary to what some have claimed, conscious visual experience plays a causal role for action control in some circumstances. Second, I propose a multimodal account of (...) the experience of acting. According to this account, the experience of acting is a temporally extended, co-conscious collection of agentive and perceptual experiences, functionally integrated and structured both by multimodal perceptual processing as well as by what an agent is, at the time, trying to do. (shrink)

'Working Memory, Thought, and Action' is the magnum opus of one of the most influential cognitive psychologists of the past 50 years. This new volume on the model he created discusses the developments that have occurred within the model in the past twenty years, and places it within a broader context.

Ecological and sensorimotor theories of perception build on the notion of action-dependent invariants as the basic structures underlying perceptual capacities. In this paper we contrast the assumptions these theories make on the nature of perceptual information modulated by action. By focusing on the question, how movement specifies perceptual information, we show that ecological and sensorimotor theories endorse substantially different views about the role of action in perception. In particular we argue that ecological invariants are characterized with reference (...) to transformations produced in the sensory array by movement: such invariants are transformation-specific but do not imply motor-specificity. In contrast, sensorimotor theories assume that perceptual invariants are intrinsically tied to specific movements. We show that this difference leads to different empirical predictions and we submit that the distinction between motor equivalence and motor-specificity needs further clarification in order to provide a more constrained account of action/perception relations. (shrink)

Abstract:When I throw a ball at you, do you see it as catch‐able? Do we perceive objects as edible, climbable or Q‐able in general? One could argue that it is just a manner of speaking to say so: we do not reallyseean object as edible, we only infer on the basis of its other properties that it is. I argue that whether or not an object is edible or climbable is indeed represented perceptually: weseeobjects as edible, and do not just (...) believe that they are. My argument proceeds in two steps. First, I argue that in order to perform an action Q with respect to an object, we need to represent this object as Q‐able and, second, I argue that we represent objects as having these propertiesperceptually. (shrink)

It is sometimes claimed that Gricean communication is necessarily a form of cooperative or ‘joint’ action. A consequence of this Cooperative Communication View is that Gricean communication could not itself contribute to an explanation of the possibility of joint action. I argue that even though Gricean communication is often a form of joint action, it is not necessarily so—since it does not always require intentional action on the part of a hearer. Rejecting the Cooperative Communication View (...) has attractive consequences for our theorising about human cognitive development, since it opens up the possibility of appealing to communicative interaction to explain the emergence of joint action in phylogeny. (shrink)

Contemporary research on mindreading or theory of mind has resulted in three major findings: There is a difference in the age of passing of the elicited-response false belief task and its spontaneous–response version; 15-month-olds pass the latter while the former is passed only by 4-year-olds. Linguistic and social factors influence the development of the ability to mindread in many ways. There are cultures with folk psychologies significantly different from the Western one, and children from such cultures tend to show different (...) timetables of mindreading development. The traditional accounts of the data are nativism, rational constructivism, and two-systems theory. In this paper, we offer criticism of these traditional cognitivist accounts and explore an alternative, action-based framework. We argue that even though they all seem to explain the above empirical data, there are other, theoretical reasons why their explanations are untenable. Specifically, we discuss the problem of foundationalism and the related problem of innateness. Finally, we explore an alternative, action-based framework that avoids these theoretical limitations and offer an interpretation of the empirical data from that perspective. (shrink)

One central debate in recent literature on epistemic normativity concerns the epistemic norm for action. This paper argues that this debate is afflicted by a category mistake: strictly speaking, there is no such thing as an epistemic norm for action. To this effect, I introduce a distinction between epistemic norms and norms with epistemic content; I argue that while it is plausible that norms of the latter type will govern action in general, epistemic norms will only govern (...) actions characteristically associated with delivering epistemic goods. (shrink)

David Hume’s theory of action is well known for several provocative theses, including that passion and reason cannot be opposed over the direction of action. In Hume, Passion, and Action, the author defends an original interpretation of Hume’s views on passion, reason and motivation that is consistent with other theses in Hume’s philosophy, loyal to his texts, and historically situated. This book challenges the now orthodox interpretation of Hume on motivation, presenting an alternative that situates Hume closer (...) to “Humeans” than many recent interpreters have. Part of the strategy is to examine the thinking of the early modern intellectuals to whom Hume responds. Most of these thinkers insisted that passions lead us to pursue harmful objects unless regulated by reason; and most regarded passions as representations of good and evil, which can be false. Understanding Hume’s response to these claims requires appreciating his respective characterizations of reason and passion. The author argues that Hume’s thesis that reason is practically impotent apart from passion is about beliefs generated by reason, rather than about the capacity of reason. Furthermore, the argument makes sense of Hume’s sometimes-ridiculed description of passions as “original existences” having no reference to objects. The author also shows how Hume understood morality as intrinsically motivating, while holding that moral beliefs are not themselves motives, and why he thought of passions as self-regulating, contrary to the admonitions of the rationalists. (shrink)

Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike (...) action, identifying relative strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

In this paper, I explore the questions of how and to what extent new antidepressants (selective serotonin-reuptake inhibitors, or SSRIs) could possibly affect the self. I do this by way of a phenomenological approach, using the works of Martin Heidegger and Thomas Fuchs to analyze the roles of attunement and embodiment in normal and abnormal ways of being-in-the-world. The nature of depression and anxiety disorders — the diagnoses for which treatment with antidepressants is most commonly indicated — is also explored (...) by way of this phenomenological approach, as are the basic structures of self-being. Special attention is paid in the analysis to the moods of boredom, anxiety and grief, since they play fundamental roles in depression and anxiety disorders and since their intensity and frequency appear to be modulated by antidepressants. My conclusion is that the effect of these drugs on the self can be thought of in terms of changes in self-feeling, or, more precisely, self-vibration of embodiment. I present the idea of a spectrum of bodily resonance, which extends from the normal resonance of the lived body, in which the body is able to pick up a wide range of different moods; continuing over various kinds of sensitivities, preferences and idiosyncrasies, in which certain moods are favored over others; to cases that we unreservedly label pathologies, in which the body is severely out of tune, or even devoid of tune and thus useless as a tool of resonance. Different cultures and societies favor slightly differently attuned self-styles as paradigmatic of the normal and good life, and the popularity of the SSRIs can therefore be explained, not only by defects of embodiment, but also by the presence of certain cultural norms in our contemporary society. (shrink)

We can easily discriminate self-produced from externally generated sensory signals. Recent studies suggest that the prediction of the sensory consequences of one’s own actions made by forward model can be used to attenuate the sensory effects of self-produced movements, thereby enabling a differentiation of the self-produced sensation from the externally generated one. The present study showed that attenuation of sensation occurred both when participants themselves performed a goal-directed action and when they observed experimenter performing the same action, although (...) they clearly reported that the tones were produced by other during action observation and by themselves during their own action. These results suggest that sensory prediction of action modulates ongoing auditory processing irrespective of who produces the sounds and that the explicit judgment of agency does not necessarily rely on the same mechanisms on which implicit perceptual measures such as sensory attenuation rely. (shrink)

According to Rosalind Hursthouse’s virtue based account of right action, an act is right if it is what a fully virtuous person would do in that situation. Robert Johnson has criticized the account on the grounds that the actions a non-virtuous person should take are often uncharacteristic of the virtuous person, and thus Hursthouse’s account of right action is too narrow. The non-virtuous need to take steps to improve themselves morally, and the fully virtuous person need not take (...) these steps. So Johnson argues that any virtue based account of right action will have to find a way to ground a moral obligation to improve oneself. This paper argues that there is an account of virtue that can offer a partial solution to Johnson’s challenge, an account where virtue is a type of practical skill and in which the virtuous person is seen as having expertise. The paper references the account of skill acquisition developed by Hubert and Stuart Dreyfus. Their research demonstrates that novices in a skill have to employ different strategies to act well than the strategies used by the experts, and so the ‘virtue as skill’ thesis provides support for Johnson’s claim that the actions of the non-virtuous will differ from the virtuous. On the other hand, their research suggests that there is no separating the commitment to improve yourself from the possession of expertise, and so the ‘virtue as skill’ thesis has the resources for grounding the obligation to improve oneself in an account of virtue. (shrink)

This paper argues that the role of knowledge in the explanation and production of intentional action is as indispensable as the roles of belief and desire. If we are interested in explaining intentional actions rather than intentions or attempts, we need to make reference to more than the agent’s beliefs and desires. It is easy to see how the truth of your beliefs, or perhaps, facts about a setting will be involved in the explanation of an action. If (...) you believe you can stop your car by pressing a pedal, then, if your belief is true, you will stop. If it is false, you will not. By considering cases of unintentional actions, actions involving luck and cases of deviant causal chains, I show why knowledge is required. By looking at the notion of causal relevance, I argue that the connection between knowledge and action is causal and not merely conceptual. (shrink)

What is the significance of bodily awareness for bodily action? The orthodox philosophical account from O'Shaughnessy claims that bodily awareness is necessary for bodily action. Whilst O'Shaughnessy's account appears to be consonant with the phenomenology of ordinary agency, it falls afoul to empirical counterexamples. The failure of O'Shaughnessy's account and its cousins might suggest that bodily action does not depend on bodily awareness. On the contrary, I argue that the contrast between the character of afferented and deafferented (...) agency shows that bodily awareness is crucial to explaining the distinctive character of bodily action in neurologically normal agents. In particular, the capacity to feel one's body ‘from the inside’ appears to be a condition on the capacity to act with one's body in a way that is not like remote control. This dependency of capacities is at once empirically adequate and in tune with the phenomenology of ordinary agency. (shrink)

A traditional view of perception and action makestwo assumptions: that the causal flow betweenperception and action is primarily linear or one-way,and that they are merely instrumentally related toeach other, so that each is a means to the other.Either or both of these assumptions can be rejected. Behaviorism rejects the instrumental but not theone-way aspect of the traditional view, thus leavingitself open to charges of verificationism. Ecologicalviews reject the one-way aspect but not theinstrumental aspect of the traditional view, so (...) thatperception and action are seen as instrumentallyinterdependent. It is argued here that a betteralternative is to reject both assumptions, resultingin a two-level interdependence view in whichperception and action co-depend on dynamicallycircular subpersonal relations and as a result may bemore than merely instrumentally interdependent. Thisis illustrated by reference to motor theories ofperception and control theories of action. (shrink)

There has been a resurgence of interest lately within philosophy of mind and action in the category of mental action. Against this background, the present paper aims to question the very possibility, or at least the theoretical significance, of teasing apart mental and bodily acts. After raising some doubts over the viability of various possible ways of drawing the mental act/bodily act distinction, the paper draws some lessons from debates over embodied cognition, which arguably further undermine the credibility (...) of the distinction. The insignificance of the distinction is demonstrated in part by showing how the focus on ‘inner’ acts hampers fruitful discussion of Galen Strawson’s skepticism of mental agency. Finally, the possibility is discussed that a distinction between covert and overt action should supplant the one between mental and bodily action. (shrink)

A serious attempt to integrate ethics in management was done by Professor Juan Antonio Pérez López (1934–1996). His thought represents a break with current scholarly thinking on these subjects. The purpose of this article is to explain some of the most significant aspects of his theories, relating basically to his recourse to ethics as what defines the characteristic behavior of human beings, considered as individuals and as members of organizations. Pérez López used the anthropological conception underlying the ethics of Aristotle (...) and Thomas Aquinas to build a solid base for that ethics, starting from the decision-making process. He then used that ethical base to point to the kind of action theory and organization theory that could most effectively assist the human development of people and organizations. (shrink)