Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy's Role in Psychopathology Back to Jaspers and an Appeal to Grow PracticalThe author reports no conflicts of interest.In "Philosophy's role in theorizing psychopathology," Gibson presents a defense of the continued relevance of philosophy to psychopathology, and a non-exhaustive framework for the role of philosophy in this domain (Gibson, 2024). I find it hard to disagree that psychopathology is soaked in philosophy from its origins, and that to try (...) and dry it out would be both unwise and impossible.In this commentary, I go back to Karl Jaspers' account of the role of philosophy in his General Psychopathology. In doing so, I do not find that Gibson adds anything new, but instead gives us a well-illustrated reminder that philosophy "is operative within every living science" (Jaspers, 1997, p. 770).Situated Psychopathological TheorizingGibson addresses a broad 'we' who might be engaged with psychopathological theorizing. This seems to encompass three main settings, from which examples are drawn.1. Everyday and regulative social practices (ordinary and legal setting).2. Empirically driven disciplines which work with psychopathological constructs (academic setting).3. Psychiatry and psychotherapy (clinical setting).In my view, it is a mistake not to map the terrain where psychopathological theorizing is situated. In each setting psychopathological theorizing has its own set of aims and constraints. In the ordinary setting, the aim might be to know whether to blame a loved one for their action. In the legal setting it might be to decide whether treatment or punishment is appropriate. In the clinical setting, the aim is usually a therapeutic assessment, and moral stance taking is often best kept at bay. In the academic setting, we might want to ensure our concepts are reliable and valid, opening them up to investigation using objective scientific methods. [End Page 13]Beyond what can be said in the most general terms, the role of philosophy will look different in these different situations.Understanding Is Not (Just) a Philosophical ToolUnderstanding is a mode of knowing that is concerned with the particular, rather than the general, and accessed inter-relationally, relying on tacit knowledge and empathetic imagination. Gibson introduces the concept as an elementary form of social intuition, used in ordinary life to make sense of social relations and other people's behaviors and reactions. I agree with Gibson, drawing on Strawson, that Understanding is a mode of knowledge that involves the subject of enquiry as a participant (Strawson, 1982). There is a moral imperative to take this stance, which drives us to value the expansion of what we are able to understand of other people's mental states. This at least partly motivates the agenda when we theorize about psychopathology.At times throughout his argument, Gibson seems to be arguing for the role of Understanding in psychopathological theorizing, in place of his explicit aim of arguing for the role of philosophy. However it is not at all clear that this replacement can be made. Accepting the picture drawn, Understanding is not any more the expertise or domain of the philosopher than the author, police officer, or sociologist. We are surely not meant to take Understanding as a uniquely philosophical tool, but rather a mode of knowing available to all social agents, integral to social reasoning in ordinary life and in the human studies.What philosophy can distinctively do is point to and defend the existence of forms of intersubjective and tacit knowledge within human studies such as psychopathology. For Jaspers, Understanding can be a scientific tool, albeit one that reminds us that knowledge in psychopathology is not all of one kind. One role for philosophy therefore is to help us to "distinguish the different modes of knowing," so that we might "order knowledge into a comprehensive whole" (Jaspers, 1997, p. 769). This is akin to the 'synthetic' role that Gibson proposes.Philosophy and ScienceJaspers defines scientific knowledge broadly as knowledge with "general validity, convincing insights (which can be proved), clarity of method, and the possibility for a meaningful discussion" (Jaspers, 1997, p. 768).We do not get such a definition from Gibson, but in the sections of... (shrink)

This paper begins with a recognition that questions of climate change, environmental degradation, and our relations to the natural world are increasingly significant and requiring of a response not only as philosophers of education but also as citizens of the planet. As such the paper explores five of the key journals in philosophy of education in order to identify the extent, range, and content of current discussions related to the environment. It then organizes and summaries the articles that were located (...) while seeking to identify the extent, possibilities, and limitations of current discussions relating to the environment in the philosophy of education community. The hope is that ultimately this work is an invitation to anyone, regardless of tradition, orientation, and expertise, to contribute to the expansion and deepening of both theory and practice in the face of this most serious of challenges. (shrink)

The system of free expression John Milton defends in Areopagitica, a pamphlet against prior restraint in publishing, is often characterized as merely a proto-liberal, truth-based marketplace of ideas theory. But this represents a misunderstanding of Milton’s views on the freedoms of conscience, speech, and the press. The tendency in political theory, philosophy, and law to reduce the “free speech Milton” to Areopagitica, and the reduction of that essay to several soundbites, has meant sidelining both the significant exceptions to expressive liberties (...) that Milton calls for and also the role of the social in his theory. This incomplete characterization has enabled Milton’s misuse in First Amendment discourse and jurisprudence, where he is made to support hierarchical approaches to free speech that privilege public political speech and are therefore ill-equipped to address the full range of communicative experiences. More comprehensive readings of Milton, however, reveal both certain limits to free expression, and also deep consideration for a wide range of speech acts. By reading Milton’s theory of expressive liberties in light of the justifications he provides for those freedoms—i.e., virtue-building and Truth-seeking—this essay provides a fuller account of his views. What emerges is a distinctly Miltonian, virtue-driven “political theory of everyday talk” that locates value in even the most ordinary communicative acts. This theory—embracing both verbal and nonverbal expression—not only complements existing political theories of the everyday but can also help illuminate contemporary free speech concerns, many of which stem from the libertarian approach to expressive liberties that Milton helped inspire. (shrink)

Psychiatric diagnoses are increasingly seen as viable categories around which self and social identities might be drawn. This introduces a new pressure on the “boundary problem” for psychiatry: when members of the public request diagnoses to affirm their self-identities how should we draw the line between mental disorder and normality? If psychiatrists have the authority to recognize and diagnose mental disorder, how can roles as diagnosers and gate-keepers be balanced in a post-stigma era of mental health care? Focusing on the (...) disorder identified would-be patient who would not attract the diagnosis they seek were they not to seek it, this essay explores what it means to have an identity bound to a psychiatric diagnosis and considers a framework for psychiatrists to negotiate clinical encounters that involve the seeking of identity affirming diagnoses. (shrink)

This commentary argues the case for developmental psychopathology in understanding social learning. Informed by work on “epistemic disruption,” we have described difficulties with social learning associated with many forms of psychopathology. Epistemic disruption manifests in an inability to move between innovation and conformity, and arises from poor mentalizing, which generates difficulties in identifying social cues that trigger the correct stance.

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. (...) -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

There has long been interest in why languages are shaped the way they are, and in the relationship between sign language and gesture. In sign languages, entity classifiers are handshapes that encode how objects move, how they are located relative to one another, and how multiple objects of the same type are distributed in space. Previous studies have shown that hearing adults who are asked to use only manual gestures to describe how objects move in space will use gestures that (...) bear some similarities to classifiers. We investigated how accurately hearing adults, who had been learning British Sign Language for 1–3 years, produce and comprehend classifiers in locative and distributive constructions. In a production task, learners of BSL knew that they could use their hands to represent objects, but they had difficulty choosing the same, conventionalized, handshapes as native signers. They were, however, highly accurate at encoding location and orientation information. Learners therefore show the same pattern found in sign-naïve gesturers. In contrast, handshape, orientation, and location were comprehended with equal accuracy, and testing a group of sign-naïve adults showed that they too were able to understand classifiers with higher than chance accuracy. We conclude that adult learners of BSL bring their visuo-spatial knowledge and gestural abilities to the tasks of understanding and producing constructions that contain entity classifiers. We speculate that investigating the time course of adult sign language acquisition might shed light on how gesture became conventionalized during the genesis of sign languages. (shrink)

In a 1983 interview, Michel Foucault contrasts our contemporary interest in sexual identity with the ancient Greek preoccupation with diet, arguing that sex has replaced food as the privileged medium of self-constitution in the modern West. In the same interview, Foucault argues that modern liberation movements should return to the ancient model of ethics, of which diet was a prime example, as aesthetics or self-transformative practice. In this paper I take up Foucault's argument with respect to the Animal Liberation Movement (...) and the dietetics of ethical vegetarianism. Contra Foucault, I suggest that diet has not been replaced by sexuality in the modern West, and that food choices, along with and intertwined with sexuality, continue to function as practices of self-constitution in both disciplinary and aesthetic fashions. I then consider the implications of this argument for the Animal Liberation Movement, exploring ways in which it might (and to some degree already does) take on aesthetic rather than moral strategies in order to pursue what Foucault once described as “an ethics of acts and their pleasures which would be able to take into account the pleasure of the other.”. (shrink)

An overview of the philosophical and bioethics literature on conscientious refusals by health care professionals to provide abortion and contraceptive services.

In 2017 and 2019, two research teams claimed ‘proof of principle’ for artificial womb technology (AWT). AWT has long been a subject of speculation in bioethical literature, with broad consensus that it is a welcome development. Despite this, little attention is afforded to more immediate ethical problems in the development of AWT, particularly as an alternative to neonatal intensive care. To start this conversation, I consider whether experimental AWT is innovative treatment or medical research. The research–treatment distinction, pervasive in regulation (...) worldwide, is intended to isolate research activities and subject them to a greater degree of oversight. I argue that there is a tendency in the literature to conceptualize AWT for partial ectogenesis as innovative treatment. However, there are sufficiently serious ethical concerns with experimental AWT that mean that it must not be first used on humans on the basis that it is a ‘beneficial treatment’. First, I outline the prospects for translation of AWT animal studies into treatment for human preterms. Second, I challenge the conceptualizations of experimental AWT as innovative treatment. It must be considered medical research to reflect the investigatory nature of the process and guarantee sufficient protections for subjects. Identifying that AWT is research is crucial in formulating further ethico‐legal questions regarding the experimental use of AWT. Third, I demonstrate that clinical trials will be a necessary part of the clinical translation of AWT because of requirements laid out by regulators. I consider the justification for clinical trials and highlight some of the crucial ethical questions about the conditions under which they should proceed. (shrink)

Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised (...) exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings. (shrink)

Drawing on the work of Foucault and Western confessional writings, this book challenges the transhistorical and commonsense views of confession as an innate impulse resulting in the psychological liberation of the confessing subject. Instead, confessional desire is argued to be contingent and constraining, and alternatives to confessional subjectivity are explored.

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses of (...) the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

The authors of the Target article, Shen and colleagues (2024) argue that there is a need for an ethical framework to help analyze when it is appropriate to return individualized research results (I...

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some community (...) miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

This paper provides an overview of Michel Foucault's continually changing observations on familial power, as well as the feminist-Foucauldian literature on the family. It suggests that these accounts offer fragments of a genealogy of the family that undermine any all-encompassing or transhistorical account of the institution. Approaching the family genealogically, rather than seeking a single model of power that can explain it, shows that far from this institution being a quasi-natural formation or a bedrock of unassailable values, it is in (...) fact a continually contested fiction that masks its own histories of becoming. (shrink)

The Musical Emotion Discrimination Task (MEDT) is a short, non-adaptive test of the ability to discriminate emotions in music. Test-takers hear two performances of the same melody, both played by the same performer but each trying to communicate a different basic emotion, and are asked to determine which one is “happier”, for example. The goal of the current study was to construct a new version of the MEDT using a larger set of shorter, more diverse music clips and an adaptive (...) framework to expand the ability range for which the test can deliver measurements. The first study analysed responses from a large sample of participants (N = 624) to determine how musical features contributed to item difficulty, which resulted in a quantitative model of musical emotion discrimination ability rooted in Item Response Theory (IRT). This model informed the construction of the adaptive MEDT. A second study contributed preliminary evidence for the validity and reliability of the adaptive MEDT, and demonstrated that the new version of the test is suitable for a wider range of abilities. This paper therefore presents the first adaptive musical emotion discrimination test, a new resource for investigating emotion processing which is freely available for research use. (shrink)

Most mainstream feminist anti-rape scholarship and activism may be described as carceral feminism, insofar as it fails to engage with critiques of the criminal punishment system and endorses law-and-order responses to sexual and gendered violence. Mainstream feminist anti-rape scholars and activists often view increased conviction rates and longer sentences as a political goal—or, at the very least, are willing to collaborate with police and lament cases where perpetrators of sexual violence are given “light” or non-custodial sentences. Prison abolitionists, on the (...) other hand, have tended to insist that most lawbreakers are non-violent and that the “dangerous” are “few”, thus avoiding serious engagement with the widespread phenomenon of sexual violence. Despite the prevalence of carceral feminism, to my knowledge no feminist scholar has explicitly embraced this label, and the closest I have found to a defense of carceral feminism is feminist legal scholar Lise Gotell’s “critique of the critique of carceral feminism”. For this reason, it is with Gotell’s article that I primarily engage in defending anti-carceral feminism and prison abolitionism even in the difficult case of sexual assault. (shrink)

Many disabled individuals adamantly oppose medical assistance in dying, quite rightly referencing pervasive ableism and, euthanasia’s dark history in the Aktion T4 program of Nazi Germany in which...

Cet article propose le repérage et l’analyse de trois manières distinctes de conceptualiser la prière dans les travaux de sciences humaines et sociales qui la prennent pour objet à compter de la publication de l’essai de Marcel Mauss (1909). Ces trois conceptualisations de prière mises en débat dès le XXe siècle sont déterminées par une variation des stratégies discursives et des rapports au théologico-religieux. Normalisée, la prière est définie selon sa forme jugée idéale. Enchantée, elle est mise au service des (...) théories de l’homo religiosus. Désenchantée, elle est ramenée à une construction socio-psychologique. En relevant les intérêts comme les limites analytiques de chacune de ces options théoriques, l’objectif est de faire apparaître leur complémentarité afin d’esquisser les traits d’une nouvelle manière possible d’étudier la prière. (shrink)

Focusing on Foucault's work on “infamous men” and the “dangerous individual,” this chapter argues that there are other instances in Foucault's oeuvre in which he is similarly insensitive to violence against women, although these cases have drawn less critical attention. The two‐fold aim of the chapter is, first, to examine what is at stake for Foucault in his writings on infamous men and dangerous individuals whose infamy and dangerousness involved violence against women, and, second, to problematize Foucault's failure to attend (...) to gendered power relations in these texts. Foucault's most sustained consideration of a monomania diagnosis concerns the case of Pierre Rivière. The chapter argues that some of the aspects of existence that Foucault fails to see in his dogged focus on what he reads as agonistic medical‐iegal battles and power relations between men include the family, gender relations, the victimization of women and children, suffering, and love. (shrink)

In 2017 and 2018 [Name of research project] organized two transnational youth resistance art workshops. These workshops addressed online social justice issues and placed emphasis on pushing back against technology-facilitated violence and surveillance in networked spaces. Our engagement with these workshops raised three dilemmas associated with these sorts of resistive social justice art projects. This article explores these dilemmas, which include how to enable the production of digital art in a manner that is attentive to intersectional issues of digital literacy (...) and access; artistic appropriations of sexually explicit, discriminatory or hateful speech and their relation to cultural appropriation; and defamation, privacy, copyright and trademark considerations relating to artistic appropriations. In addressing these dilemmas, examples of regulatory frameworks shaping resistance opportunities and social justice initiatives are highlighted, along with suggestions for addressing these dilemmas for those who may wish to facilitate or engage in youth resistance art workshops in future. (shrink)

This is the first volume to apply insights from the material turn in philosophy to the study of play and games. At a time of renewed interest in analogue gaming, as scholars are looking beyond the digital and virtual for the first time since the inception of game studies in the 1990s, Material Game Studies not only supports the importance of the turn to the analogue, but proposes a materiality of play more broadly. Recognizing the entanglement of physical materiality with (...) cultural meaning, the authors in this volume apply a range of theoretical approaches, from material eco-criticism to animal studies, to examine games and play as existing within worlds of matter. Different chapters focus on the material properties of board, card and role-playing games, how they are designed and made, how they are touched and played with, and how they connect with other human and nonhuman things. Bringing together international scholars, Material Game Studies defines a new field of material game studies and demonstrates how it is a valuable addition to wider debates about the material turn and the place of embodied humans in a material world. (shrink)

Theoretical perspectives on non-suicidal self-injury have long underscored the affective regulating properties of NSSI. Less attention has been given to the processes through which individuals choose to engage in NSSI, specifically, to regulate their distress. In the present study, we tested one theoretical model in which recent stressful experiences facilitates NSSI through emotional reactivity. Further, we tested whether the indirect link between stressful experiences and NSSI was moderated by several NSSI specific risk factors. Given the widespread prevalence of NSSI among (...) community-based samples of adolescents and emerging adults, we surveyed 1,125 emerging adults in first-year university at a large academic institution. Participants completed an online survey three times, reporting on their recent stressful experiences in university, emotional reactivity, NSSI, as well as three NSSI specific risk factors. As expected, path analysis revealed that there was a significant indirect effect of recent stressful experiences on NSSI engagement, through emotional reactivity. However, this effect was maintained across moderator analyses. These novel findings underscore the salient role of proximally occurring stressors in the prediction of NSSI among emerging adults in university, and can inform developing theoretical perspectives on NSSI. (shrink)

Félix Guattari spent his entire working life at La Borde psychiatric clinic where a radicalised form of psychoanalysis, ‘schizoanalysis’, was applied, based on the theory that emerged in Anti-Oedipus and was elaborated in A Thousand Plateaus. In the medium of this non-Oedipalised therapeutic plane lies the ‘body without organs, a body not fully organised but open to every form of expression and metamorphosis. The ideas and practice involved in schizoanalysis, which have now been in effect for fifty years in every (...) social and cultural field, have produced a new hybrid of Lacanian analysis and schizoanalysis, with the recent queering psychoanalysis expanding further the revolutionary character of the latter. The general logic and the determinate ideas of A Thousand Plateaus were applied as a reciprocal presupposition between content and form: free expression, interconnectedness, becoming-woman and -imperceptible, a deterritorialisation of models, roles and relations. (shrink)

C’est en Corée du Sud que le sport électronique est né et s’est développé de la façon la plus spectaculaire, contribuant à la visibilité du pays auprès de la communauté internationale des joueurs. Cet article questionne la catégorisation sportive du jeu vidéo en Corée, en esquissant ses dimensions économiques, les circonstances historiques de sa mise en place, et en la confrontant à la pluralité des discours locaux.Electronic sports first emerged in South Korea, where their development has been the most spectacular, (...) contributing to the country’s notoriety in the international video gaming community. In this article, we investigate South Korea’s classification of video gaming as a sport, discussing its economic dimensions, the historical circumstances in which it emerged and comparing it with the different types of local discourse. (shrink)

Focusing on imagination and the social context in the generation of conviction narratives, we propose that these elements are dynamically related to one another, and crucially that it is the nature of this relationship that determines individuals' level of epistemic openness and capacity to respond adaptively to update their narratives in a way that increases the possibility of more successful decision-making.