Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.

Even though sign-systems are a crucial part of society, critical realism, as developed by Roy Bhaskar, does not yet have an adequate theory of signs and semiosis. The few suggestions that Bhaskar offers can be advanced through the semiotics of C.S. Peirce. In doing so, however, it becomes necessary to reconsider Bhaskar's ontological domains of the real, the actual, and the subjective, and expand the last domain into one of semiosis. This new understanding of ontological domains, incorporating Peirceian semiotics, provides (...) the basis for rethinking the ontology of society: the customary dyad structures/agents becomes the triad structures/agents/discourses, each of which possesses material, sociological, and meaningful aspects. (shrink)

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is (...) substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obviousa priorigrounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions ofhumannature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges. (shrink)

Most work on reflexivity has focused on individuals exercising their reflexivity through discourse. However, agents have three major aspects (intentionality, causal efficacy and embodiment) and they are fundamentally social. This article examines the possibility of collective reflexivity conducted not just by saying, but also by doing—that is, through their embodiment. By expanding the concept of ‘performatives’ to encompass not just speech acts but also acts that speak (i.e. embodied activities as socially meaningful) and applying the work of Charles S. Peirce (...) in order to develop an ontology of embodied reflexivity, it becomes possible to determine several criteria defining embodied collective reflexivity. Assessing possibilities such as legislative debate, political demonstrations, religious ritual and dramatic performance reveals that a certain set of practices does in fact meet those criteria and discloses additional aspects of what constitutes embodied collective reflexivity. (shrink)

Medical Officers serving with their national contingents in peacekeeping operations are faced with difficult ethical decisions in regard to their obligations to the local civilian population. Such populations may be under-resourced in regard to medical care, and vulnerable to abuse and exploitation. Though the medical officer may support the local medical services, he/she should never undermine these resources. Adopting a human rights approach and observing the requirements of ethical medicine, aids the doctor in prioritising his/her duties. At times there may (...) be conflict with one’s own military superiors. It is wise to discuss potential difficulties prior to setting out on the mission. Human rights abuses cannot be ignored. The medical officer has a duty to do his/her best to report their observations so as to prevent abuse or to bring it to an end. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 347-350 [Access article in PDF] Book Review The Sin of Knowledge: Ancient Themes and Modern Variations, The Sin of Knowledge: Ancient Themes and Modern Variations, by Theodore Ziolkowski; xvi & 222 pp. Princeton: Princeton University Press, $29.95. After thirty-five years of teaching and administrating at Princeton University, dozens of books, and innumerable articles, the eminent Germanist Theodore Ziolkowski has turned his attention to a (...) theme appropriate for someone so immersed in the intellectual life: the sorrow and grief that accompany human knowledge. Although Ziolkowski has made great contributions in standard studies of genre (notably the elegy and the twentieth-century novel) and authors (Mann, Hesse, and Broch), he became especially well known for his theorization and implementation of thematic studies, ranging from the sublime--fictionalizations of the life of Jesus--to the humorous--talking animals in literature. The figures whom Ziolkowski has selected for analysis of the sin of knowledge are Adam, Prometheus, and Faust, each of whom he views through both an ancient and a modern lens.All three of these mythic heroes violate "divine prohibitions against the new knowledge" (p. 69). Less heroically, all of these myths treat women misogynistically. Generally, Ziolkowski sees each of these stories as having emerged in a time of crisis, when new opportunities presented humanity with knowledge both alluring and disruptive. Because these are highly elastic myths, able to provide meaning in a variety of contexts, they have all mutated in modern times. Adam's Fall comes to represent the human transition from innocence to consciousness, Prometheus becomes a symbol for socialism's promise, and Faust turns into a representative of the American way of life.Looking at the ancient legend of Adam, Ziolkowski notes that sexuality and wisdom are linked in many of the oldest texts in humanity's recorded history. The emphasis on knowledge, however, is especially strong in the Hebrew myth. While many Near Eastern traditions have stories with similarities to the Biblical account of Adam and Eve, only Hebrew mythology has the Tree of Knowledge. For Ziolkowski, the fact that this story was probably set down during the reign of King Solomon explains this emphasis on knowledge. Because the Age of Solomon was a time of unparalleled wealth and power for the Hebrews, [End Page 347] Ziolkowski argues that the tale of Adam and Eve is the kind of myth "produced by cultures that have reached a certain level of sophistication... and look back with a degree of nostalgia at an imagined simpler, happier existence" (p. 23). According to Ziolkowski, knowledge becomes a sin for the Hebrews as they come to terms with the limitations of everything that their knowledge has brought them even at the height of their power and glory.In the modern era, Ziolkowski continues, the story of Adam has become secularized, representing the transition of humanity from a state of innocence to one of consciousness. He finds references to the Fall in Voltaire's Candide, Kleist's The Broken Pitcher, E. T. A. Hoffmann's The Golden Pot, Melville's Billy Budd, and Hesse's Demian. The overall trend of these representations of the rise of consciousness has been increasingly negative, culminating in sentiments like those expressed by the East German author Günter Kunter, who argues that "our whole present misery and all the problems of industrial civilization" can be linked to "the moment when man used the first firestone as a tool, the Fall" (p. 107). As Ziolkowski concludes: "Two centuries of secularization have brought the modern Adam to a depressing end" (p. 108).Citing Nietzsche, who compared Prometheus to Adam (and Pandora to Eve), Ziolkowski looks first at Hesiod's depiction of Prometheus as a trickster and then to Aeschylus' hero. Unlike the authors of the story of Adam and Eve, though, Aeschylus depicts Prometheus' claim to divine knowledge in a positive light: "Rather than a humankind declining from a glorious golden age to the present deplorable iron age, Aeschylus sees humanity progressing by means of knowledge--the crafts, arts, and sciences--from blindness and ignorance... (shrink)

From oral culture, through the advent of literacy, to the introduction of printing, to the development of electronic media, communication structures have radically altered culture in profound ways. As the first book to take a critical realist approach to culture, Theatre, Communication, Critical Realism examines theatre and its history through the interaction of society’s structures, agents, and discourses. Tobin Nellhaus shows that communication structure—a culture’s use and development of speech, handwriting, printing, and electronics—explains much about why, when, and how (...) theatre has transformed. (shrink)

Offering the perspectives of some of the most respected thinkers in transpersonal psychology and consciousness studies, this book explores the farther reaches ...

"First published by Oxford University Press, 1916."--Title page verso.

Does all conscious experience essentially involve self-consciousness? In his Subjectivity and Selfhood: Investigating the First-Person, Dan Zahavi answers “yes”. I criticize three core arguments offered in support of this answer—a well-known regress argument, what I call the “interview argument,” and a phenomenological argument. Drawing on Sartre, I introduce a phenomenological contrast between plain experience and self-conscious experience. The contrast challenges the thesis that conscious experience entails self-consciousness.

Since the very beginning, Confucianism has been troubled by a serious gap between its political ideals and the reality of societal circumstances. Contemporary Confucians must develop a viable method of governance that can retain the spirit of the Confucian ideal while tackling problems arising from nonideal modern situations. The best way to meet this challenge, Joseph Chan argues, is to adopt liberal democratic institutions that are shaped by the Confucian conception of the good rather than the liberal conception of (...) the right.Confucian Perfectionism examines and reconstructs both Confucian political thought and liberal democratic institutions, blending them to form a new Confucian political philosophy. Chan decouples liberal democratic institutions from their popular liberal philosophical foundations in fundamental moral rights, such as popular sovereignty, political equality, and individual sovereignty. Instead, he grounds them on Confucian principles and redefines their roles and functions, thus mixing Confucianism with liberal democratic institutions in a way that strengthens both. Then he explores the implications of this new yet traditional political philosophy for fundamental issues in modern politics, including authority, democracy, human rights, civil liberties, and social justice.Confucian Perfectionism critically reconfigures the Confucian political philosophy of the classical period for the contemporary era. (shrink)

Joseph J. Fins calls for a reconsideration of severe brain injury treatment, including discussion of public policy and physician advocacy.

The primacy of practice in the development of knowledge is one of materialism’s fundamental tenets. Most arguments supporting it have been strictly philosophical. However, over the past thirty years cognitive science has provided mounting evidence supporting the primacy of practice. Particularly striking is its finding that thought is fundamentally metaphoric—that images emerging from everyday embodied activities not only make ordinary experiences intelligible, but also underpin our more abstract engagements with the world, elaborated in disciplines such as ethics and science. Cognitive (...) science’s implications must now be absorbed into critical realism. Cognitive science bolsters critical realism by providing a scientifically-grounded analysis of the passage from body to mind and the fundamental unity between them, while sustaining their distinctiveness. Its implications for critical realism ripple out in four waves: first, critical realism’s understanding of the mind/body relationship; second, its concepts of the process that connects theory and practice, and what that means for critical realism’s view of intellectual production, the place of metaphor in scientific theorization, and cultural development; its view of culture as a complexwhole; and finally, its theory of human agency as embodied and intentional. (shrink)

The primacy of practice in the development of knowledge is one of materialism's fundamental tenets. Most arguments supporting it have been strictly philosophical. However, over the past thirty years cognitive science has provided mounting evidence supporting the primacy of practice. Particularly striking is its finding that thought is fundamentally metaphoric—that images emerging from everyday embodied activities not only make ordinary experiences intelligible, but also underpin our more abstract engagements with the world, elaborated in disciplines such as ethics and science. Cognitive (...) science's implications must now be absorbed into critical realism. Cognitive science bolsters critical realism by providing a scientifically-grounded analysis of the passage from body to mind and the fundamental unity between them, while sustaining their distinctiveness. Its implications for critical realism ripple out in four waves: first, critical realism's understanding of the mind/body relationship; second, its concepts of the process that connects theory and practice, and what that means for critical realism's view of intellectual production, the place of metaphor in scientific theorization, and cultural development; its view of culture as a complex whole; and finally, its theory of human agency as embodied and intentional. (shrink)

José Benardete developed a famous paradox involving a beginningless set of items each member of which satisfies some predicate just in case no earlier member satisfies it. The Grim Reaper version of this paradox has recently been employed in favor of various finitist metaphysical theses, ranging from temporal finitism to causal finitism to the discrete nature of time. Here, I examine a new challenge to these finitist arguments—namely, the challenge of implying that the future cannot be endless. In particular, I (...) develop future-oriented Benardete paradoxes and examine their epistemic symmetry with past-oriented paradoxes. (shrink)

Rigid designators for concrete objects and for properties -- On the coherence of the distinction -- On whether the distinction assigns to rigidity the right role -- A uniform treatment of property designators as singular terms -- Rigid appliers -- Rigidity - associated arguments in support of theoretical identity statements: on their significance and the cost of its philosophical resources -- The skeptical argument impugning psychophysical identity statements: on its significance and the cost of its philosophical resources -- The skeptical (...) argument further examined: on resources, allegedly overlooked, for confirming psychological identities. (shrink)

Benardete paradoxes involve a beginningless set each member of which satisfies some predicate just in case no earlier member satisfies it. Such paradoxes have been wielded on behalf of arguments for the impossibility of an infinite past. These arguments often deploy patchwork principles in support of their key linking premise. Here I argue that patchwork principles fail to justify this key premise.

The paper argues that normative reasons are of two fundamental kinds, practical which are value related, and adaptive, which are not related to any value, but indicate how our beliefs and emotions should adjust to fit how things are in the world. The distinction is applied and defended, in part through an additional distinction between standard and non-standard reasons (for actions, intentions, emotions or belief).

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is (...) substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obviousa priorigrounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions ofhumannature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges. (shrink)

Drawing from our interdisciplinary qualitative study of LGBTI conservative Christians and their allies, we name an especially toxic form of shame—what we call sacramental shame—that affects the lives of LGBTI and other conservative Christians. Sacramental shame results from conservative Christianity's allegiance to the doctrine of gender complementarity, which elevates heteronormativity to the level of the sacred and renders those who violate it as not persons, but monsters. In dispensing shame as a sacrament, nonaffirming Christians require constant displays of shame as (...) proof that LGBTI church members love God and belong in the community. Part of what makes this shame so harmful is that parents and pastors often dispense it with sincere expressions of care and affection, compounding the sense that one's capacity to give and receive love is damaged. We foreground LGBTI Christian movements to overcome sacramental shame by cultivating nonhubristic pride, and conclude by discussing briefly their new understandings of love and justice that could have far‐reaching benefits. (shrink)

This is the first of two companion articles drawn from a larger project, provisionally entitled Undisciplining Moral Epistemology. The overall goal is to understand how moral claims may be rationally justified in a world characterized by cultural diversity and social inequality. To show why a new approach to moral justification is needed, it is argued that several currently influential philosophical accounts of moral justification lend themselves to rationalizing the moral claims of those with more social power. The present article explains (...) how discourse ethics is flawed just in this way. The article begins by identifying several conditions of adequacy for assessing reasoning practices designed to achieve moral justification and shows that, when used in contexts of cultural diversity and social inequality, discourse ethics fails these conditions. It goes on to argue that the failure of discourse ethics is rooted in its reliance on a broader conception of moral epistemology that is invidiously idealized. It concludes by pointing to the need to rethink both the mission and the method of moral epistemology. (shrink)

Belief storage is often modeled as having the structure of a single, unified web. This model of belief storage is attractive and widely assumed because it appears to provide an explanation of the flexibility of cognition and the complicated dynamics of belief revision. However, when one scrutinizes human cognition, one finds strong evidence against a unified web of belief and for a fragmented model of belief storage. Using the best available evidence from cognitive science, we develop this fragmented model into (...) a nascent theory of the cognitive architecture of belief storage. (shrink)

I defend a new argument for causal finitism, the view that nothing can have an infinite causal history. I begin by defending a number of plausible metaphysical principles, after which I explore a host of novel variants of the Littlewood-Ross and Thomson’s Lamp paradoxes that violate such principles. I argue that causal finitism is the best solution to the paradoxes.

The thesis of self-elusiveness says, roughly, that the self fails to be phenomenally manifest from the first-person perspective. This thesis has a long history. Yet many who endorse it do so only in a very specific sense. They say that the self fails to be phenomenally manifest as an object from the first-person perspective; they say that self-experience is not a species of ‘object-consciousness’. Yet if consciousness outstrips object-consciousness, then we are left with the possibility that there is another sense (...) in which the self is phenomenally manifest. Alas, efforts to articulate just what this form of self-experience comes to—often a holy grail of sorts for those in, and influenced by, the phenomenological tradition—have remained stubbornly obscure. This essay attempts a partial remedy. Taking a cue from Bernard Lonergan, I suggest that self-experience, while not a species of object-consciousness, is nonetheless partially grounded in it. The result is a view that is compatible with self-experience being representational and relational, contra tradition. (shrink)

From Information to Transformation is about remembering what matters in education and in life. In many ways, it concerns who we are and how we know. Drawing from the wisdom traditions, transpersonal psychology, consciousness studies, and pedagogy, a map of the depths of knowing and learning is constructed that unfolds through six interrelated layers: information, knowledge, intelligence, understanding, wisdom, and transformation. This provides both a process and a direction for education that can prepare students for the extraordinary demands of the (...) twenty-first century. Entering into these depths offers an education that is both practical and remarkable, one that replaces radical disconnection with radical amazement. This integrated approach includes the education of the mind and the heart, balances intuition with the analytic, mastery with mystery, and emphasizes developing wisdom over the mere accumulation of facts. (shrink)

Analytic debates about truth are wide-ranging, but certain key themes tend to crop up time and again. The three themes that we will examine in this paper are (i) the nature and behaviour of the ordinary concept of truth, (ii) the meaning of discourse about truth, and (iii) the nature of the property truth. We will start by offering a brief overview of the debates centring on these themes. We will then argue that cross-linguistic experimental philosophy has an indispensable yet (...) underappreciated role to play in all of these debates. Recognising the indispensability of cross-linguistic experimental philosophy should compel philosophers to significantly revise the ways in which they inquire about truth. It should also prompt analytic philosophers more generally to consider whether similar revisions might be necessary elsewhere in the field. (shrink)