The old duality that eventually came to produce the mind/body-problem indicates the problem of transcendental subjectivity. The enduring significance of this problem shows itself in a provocation of any paradigm that has become too objectivistic, too naturalistic – even too idealistic in a certain sense – and too forgetful of its own departure from a perspective always presumed. Analytic philosophy bears a tendency towards such a ‘view from nowhere’ which denies a fundamental subjective connection. The rebuttal of this position entails (...) accepting the interrelation between first- and third-person-perspective; we call this the ‘view from somewhere’. Tracing the tension between the subjective and the objective we find this “view” embraced in the phenomenological tradition. At the same time we find the mind/body-problem seemingly dissolved through, among other key concepts, the introduction of the ‘lived body’. We will see, however, that this is no thorough solution; a fundamental mind/world polarity escapes the phenomenological framework and ends up mounting a critical threat to its own stability. A demonstration is attempted of how both the process of objectification and the process of subjectification falls into regressive patterns. This is due to the interplay of the gaze and the source, the ‘from’ and the ‘towards’: Ajin. Later this argumentation calls for a discussion of the pre-reflective sphere of consciousness. Finally we show the alignment between conclusions driven forth in our own dialectic and the ones found in the philosophy of Nāgārjuna. The transcendental interconstitution of subjectivity and objectivity, perspective and world, has a name in emptiness. (shrink)
We advocate an analysis of meaning that departs from the pragmatic slogan that “meaning is use”. However, in order to avoid common missteps, this claim is in dire need of qualification. We argue that linguistic meaning does not originate from language use as such; therefore we cannot base a theory of meaning only on use. It is important not to neglect the fact that language is ultimately reliant on non-linguistic factors. This might seem to oppose the aforementioned slogan, but it (...) will be made clear how this opposition is chimerical. We propose that meaning traces back to the relation between subjectivity and intersubjectivity, which is at the heart of the matter by inducing strong interdependency between intention and interpretation. But to base a full-fledged analysis of meaning in communicative dyads alone is also insufficient. What needs to be further acknowledged is that meaning sharing becomes regulated by the interactions of a community. This we call consensus and it is at play in framing all communicative acts. Hence arises a triadic structure – we call this the meaningsharing network. The main motivation behind this model is to capture that meaning is not “in the head”, nor is it autonomous of the individual members that constitute it. (shrink)
This essay first outlines a philosophical theory of concepts and then applies it to two areas of relevance to psychiatrists, especially forensic psychiatrists. In the philosophical theory, the respective roles of verbal and non-verbal definitions are illuminated, and the importance of the phenomenon of division of semantic labour is stressed. It is pointed out that vagueness and ambiguity of a term often result when the term is used for several practical purposes at the same time. Such multi-purpose uses of terms (...) may explain both the current problems associated with the Swedish forensic-psychiatric concept of a severe mental disorder and some of the shortcomings of DSM-IV. 2009 Elsevier Ltd. All rights reserved. (shrink)
To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: (...) the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research. (shrink)
En Representaciones mentales, Liza Skidelsky se propone poner de manifiesto la completa escisión que existe entre los fenómenos de la intencionalidad de los estados mentales y el contenido de las representaciones mentales. Por un lado, la autora defiende una elucidación internista del contenido de las representaciones mentales postuladas por la ciencia cognitiva. Por otro lado, nos propone concebir la intencionalidad como un fenómeno vinculado al lenguaje y a las prácticas comunicativas. Esta reformulación permitiría establecer los cimientos para un proyecto (...) naturalista ampliado, según el cual las ciencias humanas y sociales ofrecerían el marco interdisciplinario adecuado para la explicación de la intencionalidad. En esta nota crítica, sostengo que el proyecto naturalista cientificista todavía cuenta con algunos recursos conceptuales, provenientes de la neurociencia cognitiva y de la neurociencia computacional, que pueden eventualmente saldar la brecha entre la representación y la intencionalidad. (shrink)
There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance (...) in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need.. (shrink)
If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.
A logic of diagnosis proceeds in terms of a set of data and one or more (prioritized) sets of expectancies. In this paper we generalize the logics of diagnosis from  and present some alternatives. The former operate on the premises and expectancies themselves, the latter on their consequences.
According to immunology’s prevailing paradigm, immunity is based on self/nonself discrimination and thus requires a construction of identity. Two orientations vie for dominance: The original conception, conceived in the context of infectious diseases, regards the organism as insular and autonomous, an entity that requires defense of its borders. An alternate view places the organism firmly in its environment in which both benign and onerous encounters occur. On this latter relational account, active tolerance allows for cooperative relationships with other organisms in (...) the larger ecological economy. These contending orientations —one derived from biomedicine and the other from the ecological sciences— have drawn the attention of social scientists and culture critics. On the one hand, feminists have portrayed immune theory as based upon borrowed social notions of identity that reflect male aggressive values and thus distort more balanced accounts of immunity; and, on the other hand, other commentary projects immune theory as a framework in which analysis of Western societies putatively reveals analogous patterns of ‘self’ and ‘other’ interactions, where autoimmunity and immunization are understood as expressions of the insular understanding of identity. Here, a meta-interpretation is presented that shows how these critiques place the immune self on a spectrum stretching from its formulation as an autonomous agent, a modernist conception of the independent individual, to a postmodern portrayal in which this conception of selfhood has been deconstructed. Accordingly, immunology is drawn into a wide-ranging debate about agency, where differing interpretations of immunity serves as a template in which competing understandings of human social intercourse is modeled.Según el paradigma dominante en inmunología, la inmunidad está basada en la discriminación entre yo/noyo y requiere, por tanto, una construcción de la identidad. Dos orientaciones compiten por dominar: la concepción original, concebida en el contexto de las enfermedades infecciosas contempla al organismo como aislado y autónomo, como una entidad que necesita defender sus fronteras. Una visión alternativa sitúa firmemente al organismo en su entorno, en el cual suceden tanto encuentros beneficiosos como costosos. En este enfoque relacional, la tolerancia activa permite relaciones cooperativas con otros organismos en una economía ecológica más amplia. Estas orientaciones en liza —una derivada de la biomedicina y otra de las ciencias ecológicas— han llamado la atención de los científicos sociales y de los críticos de la cultura. Por una parte, el feminismo ha descrito la teoría inmunológica como basada en nociones sociales prestadas de identidad que reflejan los valores agresivos del macho y que, de este modo, impiden una explicación más equilibrada de la inmunidad. Por otra parte, otro comentario proyecta la teoría inmunológica como un marco en el que el análisis de las sociedades occidentales revela aparentemente patrones análogos de interacciones ‘yo’ y ‘otros’, en las que la autoinmunidad y la inmunización son entendidas como expresiones de la comprensión insular de la identidad. Se ofrece aquí una meta-representación que muestra cómo estas críticas sitúan al yo inmune en un espectro que va desde su formulación cómo un agente autónomo, una concepción modernista del individuo independiente, a una visión postmoderna en la que esta concepción de la identidad ha sido deconstruida. De acuerdo con esto, la inmunología recoge un amplio debate sobre la agencia en el que diferentes interpretaciones de la inmunidad sirven como molde en el que se modelan comprensiones competidoras de la comprensión de las relaciones sociales humanas. (shrink)
Philosophers of literature do not take much of an interest in autobiography.1 In one sense this is not surprising. As a certain prejudice has it, autobiography is, along with biography, the preferred reading of people who do not really like to read. The very words can conjure up images of what one finds on bookshelves in Florida retirement communities and in underfunded public libraries, books with titles like Under the Rainbow: The Real Liza Minnelli or Me: Stories of My (...) Life (Katharine Hepburn).2 Hardly rousing material, at least from the philosophical point of view. But on a moment’s reflection, it becomes clear that the initial prejudice is unfounded. Never mind the fact that there are obviously .. (shrink)
This article seeks to advance ethical dialogue on choosing standards of prevention in clinical trials testing improved biomedical prevention methods for HIV. The stakes in this area of research are high, given the continued high rates of infection in many countries and the budget limitations that have constrained efforts to expand treatment for all who are currently HIV-infected. New prevention methods are still needed; at the same time, some existing prevention and treatment interventions have been proven effective but are not (...) yet widely available in the countries where they most urgently needed. The ethical tensions in this field of clinical research are well known and have been the subject of extensive debate. There is no single clinical trial design that can optimize all the ethically important goals and commitments involved in research. Several recent articles have described the current ethical difficulties in designing HIV prevention trials, especially in resource limited settings; however, there is no consensus on how to handle clinical trial design decisions, and existing international ethical guidelines offer conflicting advice. This article acknowledges these deep ethical dilemmas and moves beyond a simple descriptive approach to advance an organized method for considering what clinical trial designs will be ethically acceptable for HIV prevention trials, balancing the relevant criteria and providing justification for specific design decisions. (shrink)
In this paper Grice's requirements for assertability are imposed on the disjunction of Classical Logic. Defining material implication in terms of negation and disjunction supplemented by assertability conditions, results in the disappearance of the most important paradoxes of material implication. The resulting consequence relation displays a very strong resemblance to Schurz's conclusion-relevant consequence relation.
We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)
This paper is a contribution to the program of constructing formal representations of pragmatic aspects of human reasoning. We propose a formalization within the framework of Adaptive Logics of the exclusivity implicature governing the connective 'or'.
In many regions around the world, those at highest risk for acquiring HIV are young adults and adolescents. Young men who have sex with men in the USA are the group at greatest risk for HIV acquisition, particularly if they are part of a racial or ethnic minority group.1 Adolescent girls and young women have the highest incidence rates of any demographic subgroup in sub-Saharan Africa.2 To reverse the global AIDS pandemic’s toll on these high-risk groups, it is important to (...) deploy the most effective HIV prevention tools to young MSM in the USA, to adolescent girls and young women in sub-Saharan Africa, and to any other adolescents and young adults at high risk for HIV as products are proven to be safe and efficacious. Although prevention interventions with proven efficacy, such as oral pre-exposure prophylaxis, are available,3–8 they have not been sufficient to stem the tide and an expanded prevention toolkit is urgently needed to serve these populations. The field of HIV prevention continues to identify promising leads in the development of new biomedical prevention products, either delivering antiviral drug topically or systemically. The dapivirine ring has been shown to provide modest protection and is currently being tested in open label studies while injectable cabotegravir is being tested in a large efficacy trial for preventing HIV acquisition. Advances in the field of HIV prevention mean that scientists and regulators must plan for how they will bring prevention tools to populations at high risk for HIV as they conduct efficacy and effectiveness trials. For instance, safety data from younger age groups can also be used in combination with efficacy data from adult studies, where appropriate, as bridging studies to expand labelling to younger ages. If these …. (shrink)
Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)
In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs, 1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process. 2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV (...) as well as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the... (shrink)