Important features of the self-concept can be located outside of the individual and inside close or related others. The authors use this insight to reinterpret data previously said to support the empathy-altruism model of helping, which asserts that empathic concern for another results in selflessness and true altruism. That is, they argue that the conditions that lead to empathic concern also lead to a greater sense of self-other overlap, raising the possibility that helping under these conditions is not selfless but (...) is also directed toward the self. In 3 studies, the impact of empathic concern on willingness to help was eliminated when oneness--a measure of perceived self-other overlap--was considered. Path analyses revealed further that empathic concern increased helping only through its relation to perceived oneness, thereby throwing the empathy-altruism model into question. The authors suggest that empathic concern affects helping primarily as an emotional signal of oneness. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

With growth in the quantity of business ethics journals in recent years, assessments of journal quality are helpful to ethics researchers and administrators, as researchers consider available publication venues, and administrators consider the value of faculty research. The few published evaluations of business ethics journals have predominantly utilized two methods of journal quality determination: citation analysis and surveys of active researchers. This study employs a novel method to assess business ethics journals: 83 Association to Advance Collegiate Schools of Business business (...) schools provided their internally developed journal lists that were used to evaluate faculty research, and the submitted lists were then analyzed for the presence and assessment of business ethics journals. This analysis yielded a ranking of 24 business-ethics-centric journals, and this ranking reflects the collective judgments of AACSB business school faculties. The results of this study are pragmatic in that the journal evaluation data employed metrics actually used by business schools to determine the quality of business ethics journals. These findings also provide additional impetus for the recognition of business ethics as a distinct business discipline and business ethics research as a unique field of scholarly endeavor. While studies of business ethics may be influential when they are published in non-BEC journals, such studies may be more powerfully impactful when published in BEC journals. (shrink)

Few automated legal reasoning systems have been developed in domains of law in which a judicial decision maker has extensive discretion in the exercise of his or her powers. Discretionary domains challenge existing artificial intelligence paradigms because models of judicial reasoning are difficult, if not impossible to specify. We argue that judicial discretion adds to the characterisation of law as open textured in a way which has not been addressed by artificial intelligence and law researchers in depth. We demonstrate that (...) systems for reasoning with this form of open texture can be built by integrating rule sets with neural networks trained with data collected from standard past cases. The obstacles to this approach include difficulties in generating explanations once conclusions have been inferred, difficulties associated with the collection of sufficient data from past cases and difficulties associated with integrating two vastly different paradigms. A knowledge representation scheme based on the structure of arguments proposed by Toulmin has been used to overcome these obstacles. The system, known as Split Up, predicts judicial decisions in property proceedings within family law in Australia. Predictions from the system have been compared to those from a group of lawyers with favourable results. (shrink)

Mindfulness based interventions are rapidly emerging in health care settings for their role in reducing stress and improving physical and mental health. In such settings, the religious roots and affiliations of MBIs are downplayed, and the possibilities for developing spiritual, even mystical, states of consciousness are minimized. This article helps rebalance this trend by using the tools of medical humanities and narrative medicine to explore MBI as a bridge between medical and spiritual approaches to health related suffering. My narrative medicine (...) method draws insights from the arts and humanities that are rarely used in standard clinical research but are increasingly common among medical humanities and narrative medicine scholars. The specific path I take will be to work through historical, linguistic, and philosophic dimensions of mindfulness and mysticism as relevant to illness, suffering, death, and dying. I close with two case examples in which mindfulness is used as an intentionally spiritual practice for health concerns. (shrink)

The contemporary brain disorders debate echoes a century-long conflict between two different approaches to mental suffering: one that relies on natural sciences and another drawing from the arts and humanities. We review contemporary neuroimaging studies and find that neither side has won. The study of mental differences needsboththe sciences and the arts and humanities. To help develop an approach mindful of both, we turn to physician-writer Anton Chekhov’s story “A Nervous Breakdown.” We review the value of the arts and humanities (...) as a coequal partner with natural sciences in the creation of a robust mental health humanities. (shrink)

Plagiarism strikes at the heart of academe, eroding the fundamental value of academic research. Recent evidence suggests that acts of plagiarism and awareness of these acts are on the rise in academia. To address this issue, a vein of research has emerged in recent years exploring plagiarism as an area of academic inquiry. In this new academic subject, case studies and analysis have been one of the most influential methodologies employed. Case studies provide a venue where acts of plagiarism can (...) be discussed and analyzed in a constructive manner, and that is the primary purpose of this article. Unlike previous studies, however, we focus on the role of the publisher, a key player in dealing with acts of plagiarism, but one who has received little attention in the academic literature. Specifically, we examine how an academic publisher addressed allegations of plagiarism and how the publisher’s decision-making affected the outcome. We analyze the case by applying the guidelines from different frameworks and ethical theory and develop recommendations from the lessons evidenced, the second main objective of our article. This analysis advances the dialog on academic plagiarism by exploring the role of the publisher from a deontological perspective of ethical absolutism. (shrink)

Plagiarism strikes at the heart of academe, eroding the fundamental value of academic research. Recent evidence suggests that acts of plagiarism and awareness of these acts are on the rise in academia. To address this issue, a vein of research has emerged in recent years exploring plagiarism as an area of academic inquiry. In this new academic subject, case studies and analysis have been one of the most influential methodologies employed. Case studies provide a venue where acts of plagiarism can (...) be discussed and analyzed in a constructive manner, and that is the primary purpose of this article. Unlike previous studies, however, we focus on the role of the publisher, a key player in dealing with acts of plagiarism, but one who has received little attention in the academic literature. Specifically, we examine how an academic publisher addressed allegations of plagiarism and how the publisher’s decision-making affected the outcome. We analyze the case by applying the guidelines from different frameworks and ethical theory and develop recommendations from the lessons evidenced, the second main objective of our article. This analysis advances the dialog on academic plagiarism by exploring the role of the publisher from a deontological perspective of ethical absolutism. (shrink)

Narrative medicine is one of medicine’s most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many (...) of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context. (shrink)

The coronavirus pandemic has shattered our world with increased morbidity, mortality, and personal/social sufferings. At the time of this writing, we are in a biomedical race for protective equipment, viral testing, and vaccine creation in an effort to respond to COVID threats. But what is the role of health humanities in these viral times? This article works though interdisciplinary connections between health humanities, the planetary health movement, and environmental humanities to conceptualize the emergence of “planetary health humanities.” The goal of (...) this affinity linkage is to re-story health humanities toward promotion of planetary health and community well-being. Wellbeing is critical because the main driver of environmental destruction and decreasing planetary health is coming from non-sustainable definitions of wellbeing. We need the arts and humanities to help reimagine the possibility of a sustainable community wellbeing. For health humanities, a basic role and narrative identity starts to emerge—we should become a planetary health humanities. (shrink)

Psychiatry, as a subspecialty of medicine, is a quintessentially modernist project. Yet across the main campus, throughout the humanities and social sciences, there is increasing postmodern consensus that modernism is a deeply flawed project. Psychiatry, the closest of the medical specialties to the humanities and social sciences, will be the first to encounter postmodern theory. From my reading, psychiatry, though likely defensive at first, will eventually emerge from a postmodern critique, not only intact, but rejuvenated. Postmodern theory, at its best, (...) provides a liberating effect on modernist practices, freeing them from an enslavement to Method and Objectivity in order to allow the more human (all charges of antihumanism not withstanding) to emerge as valued and respected. The net result could be the evolution of a new postmodern psychiatry and a new model of medicine which would be much more enjoyable to practice and much more connected to the concerns of patients. (shrink)

This article introduces cultural studies of medicine to medical humanities readers. Rather than offer extended definitions of cultural studies of medicine or provide a detailed history of the domain, I have organized this introduction around a close reading and review of three recently published texts in the field. These three texts, dealing respectively with cyborg technology, AIDS, and the medical management of sexual identity problems, represent excellent examples of the opportunities and possibilities of applying cultural studies approaches to medical topics. (...) After working through these texts (and the semiotic theories which animate them), I devote my conclusion to a broader consideration of the role of cultural studies of medicine for both medical practice and medical humanities scholarship. (shrink)

The fact that especially few women survive in a subject that attracts roughly equal numbers of male and female undergraduates suggests that, while bothsexes are equally drawn to philosophy, there is something about the discipline that is discouraging to women.

Working through the lens of Donna Haraway's cyborg theory and directed at the example of Prozac, I address the dramatic rise of new technoscience in medicine and psychiatry. Haraway's cyborg theory insists on a conceptualization and a politics of technoscience that does not rely on universal “Truths” or universal “Goods” and does not attempt to return to the “pure” or the “natural.” Instead, Haraway helps us mix politics, ethics, and aesthetics with science and scientific recommendations, and she helps us understand (...) that (without recourse to universal truth or universal good) questions of legitimacy in science come down to local questions of effect and inclusion. What, in the case of my example, are the effects of Prozac? And for whom? Who is included and empowered to create legitimate psychiatric knowledge? Who is excluded and why? And, what political strategies will increase the democratic health of psychiatric science and practice? (shrink)

George Engel designed his biopsychosocial model to be a broad framework for medicine and psychiatry. Although the model met with great initial success, it now needs conceptual attention to make it relevant for future generations. Engel articulated the model as a version of biological systems theory, but his work is better interpreted as the beginnings of a richly nuanced philosophy of medicine. We can make this reinterpretation by connecting Engel’s work with the tradition of American pragmatism. Engel initiates inquiry like (...) a pragmatist, he understands theory and philosophy like a pragmatist, he justifies beliefs like a pragmatist, and he understands the world like a pragmatist. By drawing out these similarities, medical and psychiatric scholars can revitalize the biopsychosocial model, and they can open medicine and psychiatry to a rich philosophic heritage and a flourishing interdisciplinary tradition. (shrink)

Ginger Hoffman and Jennifer Hansen’s study of gender dynamics in psychiatric disability memoirs makes several fruitful moves for the study of psychic diversity. Perhaps the most important is that the article encourages analytic philosophers to contribute to understanding how individual mental life is affected by the larger cultural context—which we can think of as the “mind/culture” problem. This is an important move because, for the most part, analytic philosophers have paid more attention to the mind/body problem than they have to (...) the mind/culture problem. Hoffman and Hansen are right that it would be valuable for analytic philosophy to join in the study of this equally complicated conceptual problem.... (shrink)

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and overmedication. (...) Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy. (shrink)

Inspired by a passage from Kate Chopin’s The Awakening, this article considers the possibility of a “medical sublime.” It works through a history of the sublime in theory and in the arts, from ancient times to the present. It articulates therapeutic dimensions of the sublime and gives contemporary examples of its medical relevance. In addition, it develops the concept of sublime-based stress-reduction workshops and programs. These workshops bring the sublime out of the library and the museum into the lives of (...) the healthcare community—patients, families, clinicians, staff, concerned others—in the service of better navigating human vulnerability and finitude. Opening the cannon of aesthetic theory and the arts as resources for the human condition is at the heart of health humanities. The sublime can be an invaluable tool in this task. (shrink)

The information contained in this teaching module and the accompanying PowerPoint slides is appropriate for use in a survey public health law course or seminar. The purpose of this lesson is two-fold. The first objective is to provide law students with an overview of the authority public health agencies have to set and enforce policies necessary to keep the population healthy. The second objective is to inform law students about the legal constraints courts have placed upon the actions of those (...) agencies. The module ends with a project designed to give law students the opportunity to apply the law to a “real world” situation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:George Engel’s Legacy for the Philosophy of Medicine and PsychiatryBradley Lewis (bio)KeywordsBiopsychosocial model, George Engel, pragmatism, philosophy of medicine, philosophy of psychiatryEach of the respondents to this paper raises critical and important concerns. I am grateful for the quality of their insights. David Brendel’s response, along with his recent book, Healing Psychiatry: Bridging the Science/Humanism Divide, resembles my efforts in several ways. Like Brendel, I too believe that the (...) American pragmatic philosophy can be helpful in healing the splits and divisions within psychiatry. And, like Brendel, I believe that psychiatry would benefit from what he calls the “four ps” of pragmatism. Where we differ with regard to George Engel and his biopsychosocial model seems to be less about philosophy and more about strategy. Brendel argues that Engel was too scientistic in his manifest reasoning to be considered a pragmatist. I agree with this description of Engel. But, strategically, we can go beyond Engel’s manifest reasoning to draw out the implications of Engel’s writings in a pragmatic fashion. I am not saying that Engel did this himself; I am only saying that it is very possible to reinterpret Engel along these lines.Brendel also argues that the biopsychosocial model itself needs improvement. But, just as it is possible to update Engel’s theoretical scaffold, we can also update Engel’s biopsychosocial model. Along the lines of Brendel’s concerns, we can easily revise the model so that we remember that not all problems need complex analysis and interventions. Some problems are relatively simple and can have a simple solution. We can also revise the model so we include questions of consumer participation and the provisional nature of the clinical encounter. I see nothing in the biopsychosocial model that contradicts either of these concerns. Yes, the biopsychosocial model needs to be updated, refurbished, expanded, and reimagined. That is my point in the paper.The traction of Brendel’s concerns is not can we reinterpret Engel? or can we refresh the biopsychosocial model?—of course we can. The traction of his concern seems to be “should we?” To this strategic question, Brendel’s answer is no and my answer is yes. I argue that it is a good idea to refresh and refurbish Engel and his biopsychosocial model because it helps to create a connection with an important tradition within both medicine and psychiatry: the tradition of balanced, broadminded, nuanced, patient-centered and anti-reductionistic [End Page 327] care. This tradition is important because medicine and psychiatry seem perpetually vulnerable to the temptations of reductionist approaches and to what Engel, and Nassir Ghaemi more recently, call “dogmatism” (Engel 1977, 130; Ghaemi, 2003, 301). Whether reductionism and dogmatism take the form of biopsychiatry, or psychoanalysis, or antipsychiatry, or cognitive-behavioral therapy, the problems of dogmatism are the same.I am sure Brendel would agree with this, which is why he raises pluralism to such a prominent position in his own reasoning. The difference is that Brendel believes we can better get to this kind of balanced clinical care by letting go of the past figures like Engel and moving into the bright light of the twenty-first century. Maybe so. But my thinking when I wrote the paper goes the other way around. For me, if clinical medicine and psychiatry more carefully tended to its history and tradition, it would be less likely to fall sway to the next Johnny-come-lately reductionistic model.Jeffery Spike’s memories of George Engel during the years they worked together at the University of Rochester School of Medicine provide a good sense of why Engel is an important figure to remember and to pay homage. As Spike puts it, Engel was not only a “legendary figure” with an “almost mythical diagnostic ability,” Engel “probably had more influence on the philosophy of medicine in the United States than any other person, physician, or philosopher.” Both of these accomplishments help to explain why Engel is worth remembering.Those of us in medicine and psychiatry all know mythical clinicians and teachers—the ones who seem like Michael Jordan used to seem on the basketball court, able to somehow make even... (shrink)

“We know that the children who have been through sustained Philosophy with Children improve in almost every other academic area. Philosophers aretraditionally asked awkward questions and to come up with alternative answers, and it really breeds independent thinking. If we want a generation of people who will begin to tackle and solve the problems we have, we need people who think for themselves and who think differently.”.

Examines the nature of historical knowledge, study, and writing and their functions and purposes in human societies through descriptions and illustrations of the three types of history, commemorative, critical, and invented.