Mental health research and care in the twenty first century faces a series of conceptual and ethical challenges arising from unprecedented advances in the neurosciences, combined with radical cultural and organisational change. The Oxford Textbook of Philosophy of Psychiatry is aimed at all those responding to these challenges, from professionals in health and social care, managers, lawyers and policy makers; service users, informal carers and others in the voluntary sector; through to philosophers, neuroscientists and clinical researchers. Organised around a series (...) of case studies in five key topic areas - concepts of disorder, the philosophical history of psychopathology, philosophy of science, ethics and philosophical value theory, and philosophy of mind - the book provides a detailed introduction to the field and a framework for study and skill development. Each case study is supported by selected readings from both philosophy and mental health, thinking skills exercises, self-test questions, key learning points and detailed guides to further reading. There is an introduction for philosophers to classification and descriptive psychopathology, and for practitioners to philosophical methods (including logic). The philosophical topics covered include philosophical methods (analytic and Continental); phenomenology, hermeneutics and existentialism, logical empiricism and its successors; idealism and realism; reasons and causes; and modern theories of mind and brain, free will and personal identity. Topics from mental health include psychiatry and 'anti-psychiatry'; Jaspers' psychopathology and the new neurosciences; the future of psychiatric classifications; strengths-based approaches, recovery practice, social inclusion and diversity; and key topics in psychopathology, such as delusion, autism, disorders of volition, thought insertion and other experiences in schizophrenia. The Oxford Textbook of Philosophy of Psychiatry aims to secure the skills-base of the discipline by bringing philosophers closer to the realities of practice in mental health, and mental health practitioners closer to the resources of philosophy as a partner to the sciences in responding to the challenges of twenty-first century mental health and social care. (shrink)

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined (...) for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy. (shrink)

In mirror mark tests dolphins twist, posture, and engage in open-mouth and head movements, often repetitive. Because postures and an open mouth are also dolphin social behaviours, we used self-view television as a manipulatable mirror to distinguish between self-examination and social behavior. Two dolphins were exposed to alternating real-time self-view and playback of the same to determine if they distinguished between them. The adult male engaged in elaborate open-mouth behaviors in mirror mode, but usually just watched when playing back the (...) same material. Mirror mode behavior was also compared to interacting with real dolphins . Mark tests were conducted, as well as switches from front to side self-views to see if the dolphins turned. They presented marked areas to self-views to see if the dolphins turned. They presented marked areas to the self-view television and turned. The results suggest self-examination over social behavior. (shrink)

Couples should not be allowed to select either for or against deafnessRecently, a US couple deliberately attempted to ensure the birth of a deaf child via artificial insemination.1 In opposing this action, I wish to focus on one argument they employ to support it, namely that in trying to have a deaf child, the women see themselves as no different from parents trying to have a girl. Girls can be discriminated against the same as deaf people and “black people have (...) harder lives”, one of them argues. They compare themselves to a minority group.2In using this argument to justify their attempt to secure the birth of a deaf child, they make four claims: It is not wrong to deliberately try to have a child who is expected to experience harm when the harms the child will experience are socially imposed. As a group experiencing socially imposed harms, the deaf are to be understood as a minority group. Women and people of colour also experience social harms, and are to be understood as minority groups. Because the deaf, women, and people of colour are all groups experiencing socially imposed harms, distinctions should not be made between attempts to have a child who will be a member of one of these groups.In reply, I will advance two arguments. First, I will argue that this couple’s decision is inherently just. Here I will acknowledge that this couple’s position draws a great deal of strength from its appeal to the experiences of women. My second argument will contend, however, that despite the reasonableness of this choice, the intentional selection of deaf children is indefensible. Granting this couple’s contestable assertion that the deaf ought to be understood as a minority cultural group, allowing individuals to secure the birth of deaf …. (shrink)

DaB fUr die Entwicklung der Phanomenologie Husserls nicht zuletzt auch,wissenschaftstheoretische' Motive ausschlaggebend waren, ist hinreichend bekannt. Umso mehr verwundert es, daB die Husserl-Rezeption sich diese Motive nur selten zueigen gemacht hat. Zwar sind in einer Reihe von Einzel­ wissenschaften, wie in der Literaturwissenschaft, der Sozialwissenschaft und besonders auch der Psychologie, phanomenologische Motive wirksam gewor­ den. Versuche einer ausdriicklichen wissenschaftskritischen Anwendung der Husserlschen Philosophie auf einzelwissenschaftliehe Theorien jedoch, wie sie z.B. Alfred Schiitz in seinem friihen Werk zur phanomenologischen Grundlegung der "verstehenden (...) Soziologie"l ansatzweise unternommen hat, sind rar. Freilich ging auch Husserl hier nieht eben mit gutem Beispiel voran. Auch er selbst hat seine wissenschaftstheoretische Programmatik nirgends einer ernsthaften Bewahrungsprobe unterzogen. Die vorliegende Untersuchung will diese Frage einer wissenschaftstheore­ tischen Anwendbarkeit der transzendentalen Phiinomenologie paradigmatisch im Hinblick auf die Problemstellungen der Geschiehtswissenschaft iiberprii­ fen. Was also kann die Phanomenologie fUr die Historik leisten? DaB sieh fiir eine solche Absieht gerade die geschichtstheoretischen Perspektiven in Hus­ serls Werk anbieten, hat vor allem zwei Griinde. (shrink)

Why do we persist in the relentless pursuit of artificial nourishment and other treatments to maintain a permanently unconscious existence? In facing the future, if not the present world-wide reality of a huge number of persistent vegetative state (PVS) patients, will they be treated because of our ethical commitment to their humanity, or because of an ethical paralysis in the face of biotechnical progress? The PVS patient is cut off from the normal patterns of human connection and communication, with a (...) life unlike other forms of human existence. Why the struggle to justify ending a life which, it is said, has suffered an irreversible loss of the content of consciousness? Elsewhere, the authors have addressed the ethical controversies and confusion engendered by ambiguous terminology, misuse of medical facts and the differing interpretations of what constitutes 'effective' treatment: in particular, the issue of whether in fact artificial nutrition and hydration is a medical treatment, or simply part of the obligatory care owed to all patients, permanently unconscious or not. In this paper, we intend to argue that recent analyses of medical futility, its meaning and ethical implications, despite an absence of public consensus, permit some tentative re-evaluation of our ethical obligations to the PVS patient. (shrink)

The present study investigated the role of thought suppression in incubation, using a delayed incubation paradigm. A total of 301 participants were tested over five conditions, viz., continuous work control, incubation with a mental rotations interpolated task, focussed suppression, unfocussed suppression and a conscious expression condition. Checks were made for intermittent work during the incubation condition. The target task was alternative uses for a brick. In the incubation and suppression conditions, participants worked for 4 minutes, then had a break during (...) which suppression or the mental rotations interpolated task was carried out for 3 minutes before conscious work was resumed for a further 4 minutes on the alternative uses task. Results indicated that both incubation with an interpolated distractor task and incubation with suppression were effective in enhancing performance relative to controls. The intermittent work hypothesis (that effects of an incubation period are simply due to illicit con.. (shrink)

Nature and Narrative is the launch volume in a new series of books entitled International Perspectives in Philosophy and Psychiatry. Nature(representing interest in the causes of a problem) and Narrative (for understanding its meanings) will introduce the field and the series, by touching on a range of issue relevant to this interdisciplinary 'border country'.

In the current climate of dramatic advances in the neurosciences, it has been widely assumed that the diagnosis of mental disorder is a matter exclusively for value-free science. Starting from a detailed case history, this paper describes how, to the contrary, values come into the diagnosis of mental disorders, directly through the criteria at the heart of psychiatry's most scientifically grounded classification, the American Psychiatric Association's DSM (Diagnostic and Statistical Manual). Various possible interpretations of the prominence of values in psychiatric (...) diagnosis are outlined. Drawing on work in the Oxford analytic tradition of philosophy, it is shown that, properly understood, the prominence of psychiatric diagnostic values reflects the necessary engagement of psychiatry with the diversity of individual human values. This interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values (also derived from analytic philosophy) called 'values-based practice.' Developments in values-based practice in training, policy and research in mental health are briefly outlined. The paper concludes with an indication of how the integration of values-based with evidence-based approaches provides the basis for psychiatric practice in the twenty-first century that is both science-based and person-centred. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dogs and MonstersObservations on the Evacuation of Afghanistan and the Intersection of Human Rights and the AnthropoceneK. M. Ferebee (bio)On August 28, 2021, former Royal Marine and charity worker Pen Farthing was evacuated from Afghanistan with almost two hundred dogs and cats that his Kabul animal charity, Nowzad Dogs, had rescued. The role of the British government in this evacuation remains hotly contested: At the time, the British Ministry (...) of Defence tweeted (Fig. 1) that Farthing's escape had been assisted by the British military, but Farthing later disputed this claim and argued that his rescue was not the result of high-level intervention in the British government. In January 2022 controversy erupted around the emergence of documents suggesting that Prime Minister Boris Johnson had lied to Parliament about the personal role that he played in just such an intervention. Notably, Nowzad's Afghan staff members were not evacuated alongside Farthing and the animals, though they would eventually escape to Pakistan. Following Farthing's escape, the British government failed to evacuate hundreds of British citizens and residents (Merriman and Ghouri), as well as many more Afghans who had worked on behalf of British forces. The Nowzad Dogs evacuation became a site of symbolic struggle over Britain's respect (or lack thereof) for human rights. "What a story to tell the world: Britain values dogs more than Afghan people," the headline of an opinion piece in the Guardian (Hinsliff) read.The story of Nowzad Dogs is interesting to me not only as a tale of human-nonhuman relations, but also because I was, at the time it occurred, volunteering within the Afghan aid community to assist relatives of a friend, British Afghans who had been visiting Kabul when the government [End Page 52] collapsed. The family repeatedly asked for assistance from the British Foreign, Commonwealth and Development Office—assistance that never appeared. Ultimately, due to the generosity of donors and the coordination of a volunteer team, the family was able to flee to Pakistan, where they boarded a commercial flight to London. This case was a particularly stark and powerful illustration of the negotiations of rights and value that took place during and following the evacuation. It seemed nonsensical, in August 2021, to suppose that British citizens, including British children (the family I worked with included a six- and an eleven-year-old who were British citizens), would be abandoned while Afghan dogs had their rights prioritized. As I hope to demonstrate here, however, such an incident becomes comprehensible and even logical when it is understood as part of a specifically Anthropocene manifestation of subjectivity.Upendra Baxi suggests that 1948's Universal Declaration of Human Rights (UDHR) marks a broad shift from the era of "modern" (42) human rights (which began with the American and French Revolutions) to the era of "contemporary" (42) human rights. His periodization links these eras in human rights to shifts in the ideology of capitalism and empire. The "modern" era of human rights, he writes, "signals a whole variety of ideological 'justifications' for colonization and world domination" and "provides a register of major development in industrial capitalism" (42), while the "contemporary" era of human rights "is based on the premise of radical self-determination" (46). Such a periodization also brings human rights into close alignment with the Anthropocene, which is rooted in the capitalist-colonial Enlightenment and Industrial Revolution, yet often dated most concretely to the circa-1950 shift that some (such as J. R. McNeill and Peter Engelke) label the "Great Acceleration." Indeed, one could reasonably appropriate Baxi's terms and speak of "modern" and "contemporary" Anthropocenes mapped identically onto the global timeline.I propose to use the 2021 Afghan evacuation as a site from which to explore how human rights and the Anthropocene have together coproduced certain forms of subjectivity that are essential for the continued smooth functioning of world-ecological capitalism. These new forms of subjectivity are necessary to sustain the important fiction of individual [End Page 53] agency and value and conceal the ways in which the Anthropocene moment renders this fiction meaningless. Ultimately, I paint a picture of an Anthropocene without any human agency at all. I want... (shrink)

An Institute of Medical Ethics working party argues that an ethically desirable relationship of mutual empowerment between patient and clinician is more likely to be achieved if patients understand the ground rules of medical confidentiality. It identifies and illustrates ambiguities in the General Medical Council's guidance on AIDS and confidentiality, and relates this to the practice of different doctors and specialties. Matters might be clarified, it suggests, by identifying moral factors which tend to recur in medical decisions about maintaining or (...) breaching confidentiality. The working party argues that two such factors are particularly important: the patient's need to exercise informed choice and the doctor's primary responsibility to his or her own patients. (shrink)

Wexler and Specker (2023) offer a review of criticisms directed against what they describe as the relatively new field of neuroethics and offer as solution the development of a more “integrated, in...

Context: The journal Constructivist Foundations celebrates ten years of publishing articles on constructivist approaches, in particular radical constructivism. Problem: In order to preserve the sustainability of radical constructivism and regain its appeal to new generations of researchers, we set up a new course of action for and with the radical constructivist community to study its innovative potential. This new avenue is “second-order science.” Method: We specify two motivations of second-order science, i.e., the inclusion of the observer, and self-reflexivity that allows (...) second-order science to operate on the products of normal or first-order science. Also, we present a short overview of the contributions that we have collected for this inaugural issue on second-order science. Results: These six initial contributions demonstrate the potential of the new set of approaches to second-order science across several disciplines. Implications: Second-order science is believed to be a cogent concept in the evolution of science, leading to a new wave of innovations, novel experiments and a much closer relationship with current research in the cognitive neurosciences in particular, and with evolutionary and complexity theories in general. (shrink)

It is shown that a Clifford algebra formalism provides a unifying description of spin-0, -1/2, and-1 fields. Since the operators and operands are both expressed in terms of the same Clifford algebra, the formalism obtains some results which are considerably different from those of the standard formalisms for these fields. In particular, the conservation laws are obtained uniquely and unambiguously from the equations of motion in this formalism and do not suffer from the ambiguities and inconsistencies of the standard methods.

Kwaku Marfo, Danielle Garcia, Saira Khalique, Karen Berger, Amy LuMontefiore Medical Center, Bronx, NY, USABackground: Medication errors are a prime concern for all in healthcare. As such the use of information technologies in drug prescribing and administration has received considerable attention in recent years, with the hope of improving patient safety. Because of the complexity of drug regimens in renal transplant patients, occurrence of medication errors is inevitable even with a well adopted computerized physician order entering system. Our objective was (...) to quantify medication error type and frequency in an inpatient renal transplant unit.Methods: Systemic evaluation of all medication errors during an initial 10-day audit and a 28-day follow-up audit in an inpatient renal transplant unit. Each error was concurrently evaluated for potential to result in adverse patient consequences, error type and associated medication class.Results: A total of 103 clinically significant medication errors were detected during the 10-day and 28-day audit time periods. The most common errors were wrong medication dose ordered and wrong time of drug administration. Thirty-six out of 66 prescribing/ordering errors reached the patient.Conclusions: Even with utilization of computerized physician order entry system in an inpatient renal transplant unit, post-kidney transplant patients are at risk for adverse outcomes due to medication errors. The risk factors may be multifactorial and will require both organizational and technical approaches to resolve.Keywords: medication errors, CPOE, inpatient, renal transplant patients. (shrink)

The article examines the algorithms for JPEG and JPEG-2000 compression of various graphic images. The main steps of the operation of both algorithms are given, their advantages and disadvantages are noted. The main differences between JPEG and JPEG-2000 are analyzed. It is noted that the JPEG-2000 algorithm allows re-moving visually unpleasant effects. This makes it possible to highlight important areas of the image and improve the quality of their compression. The features of each step of the algorithms are considered and (...) the difficulties of their implementation are compared. The effectiveness of each algorithm is demonstrated by the example of a full-color image of the BSU emblem. The obtained compression ratios were obtained and shown in the corresponding tables using both algorithms. Compression ratios are obtained for a wide range of quality values from 1 to ten. We studied various types of images: black and white, business graphics, indexed and full color. A modified LZW-Lempel-Ziv-Welch algorithm is presented, which is applicable to compress a variety of information from text to images. The modification is based on limiting the graphic file to 256 colors. This made it possible to index the color with one byte instead of three. The efficiency of this modification grows with increasing image sizes. The modified LZW-algorithm can be adapted to any image from single-color to full-color. The prepared tests were indexed to the required number of colors in the images using the FastStone Image Viewer program. For each image, seven copies were obtained, containing 4, 8, 16, 32, 64, 128 and 256 colors, respectively. Testing results showed that the modified version of the LZW algorithm allows for an average of twice the compression ratio. However, in a class of full-color images, both algorithms showed the same results. The developed modification of the LZW algorithm can be successfully applied in the field of site design, especially in the case of so-called flat design. The comparative characteristics of the basic and modified methods are presented. (shrink)