Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants (...) with a history of depression, currently in remission (N= 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N= 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse. (shrink)

The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale.

Robert Rupert argues against the view that human cognitive processes comprise elements beyond the boundary of the organism, developing a systems-based conception in place of this extended view. He also argues for a conciliatory understanding of the relation between the computational approach to cognition and the embedded and embodied views.

Causal theories of mental content (CTs) ground certain aspects of a concept's meaning in the causal relations a concept bears to what it represents. Section 1 explains the problems CTs are meant to solve and introduces terminology commonly used to discuss these problems. Section 2 specifies criteria that any acceptable CT must satisfy. Sections 3, 4, and 5 critically survey various CTs, including those proposed by Fred Dretske, Jerry Fodor, Ruth Garrett Millikan, David Papineau, Dennis Stampe, Dan Ryder, and the (...) author himself. The final section considers general objections to the causal approach. (shrink)

The recent literature on mental causation has not been kind to nonreductive, materialist functionalism (‘functionalism’, hereafter, except where that term is otherwise qualified). The exclusion problem2 has done much of the damage, but the epiphenomenalist threat has taken other forms. Functionalism also faces what I will call the ‘problem of metaphysically necessary effects’ (Block, 1990, pp. 157-60, Antony and Levine, 1997, pp. 91-92, Pereboom, 2002, p. 515, Millikan, 1999, p. 47, Jackson, 1998, pp. 660-61). Functionalist mental properties are individuated partly (...) by their relation to the very effects those properties’ instantiations are thought to cause. Consequently, functionalist causal generalizations would seem to have the following problematical structure: The state of being, among other things, a cause of e (under such-andsuch conditions) causes e (under those conditions).3 The connection asserted lacks the contingency one would expect of a causal generalization. Mental states of the kind in question are, by metaphysical necessity, causes of e; any state that does not cause e is thereby a different kind of state. Yet, a mental state’s being the sort of state it is must play some causal role if functionalism is to account for mental causation.4 In what follows, I first articulate more fully the problem of metaphysically necessary effects. I then criticize three functionalist attempts to solve the problem directly. Given the failure of functionalist efforts to meet the problem head-on, I consider less direct strategies: these involve formulating functionalism or its causal claims in such a way that they appear not to generate the problem of metaphysically necessary effects. I argue against these indirect solutions, in each case concluding either that the problem still arises or that avoiding it requires the adoption of an unorthodox form of functionalism (itself a surprising result). In the final.. (shrink)

We seek to change the conversation about brain death by highlighting the distinction between brain death as a biological concept versus brain death as a legal status. The fact that brain death does not cohere with any biologically plausible definition of death has been known for decades. Nevertheless, this fact has not threatened the acceptance of brain death as a legal status that permits individuals to be treated as if they are dead. The similarities between “legally dead” and “legally blind” (...) demonstrate how we may legitimately choose bright-line legal definitions that do not cohere with biological reality. Not only does this distinction bring conceptual coherence to the conversation about brain death, but it has practical implications as well. Once brain death is recognized as a social construction not grounded in biological reality, we create the possibility of changing the social construction in ways that may better serve both organ donors and recipients alike. (shrink)

Normothermic regional perfusion (NRP) is a relatively new approach to procuring organs for transplantation. After circulatory death is declared, perfusion is restored to either the thoracoabdominal organs (in TA-NRP) or abdominal organs alone (in A-NRP) using extracorporeal membrane oxygenation. Simultaneously, surgeons clamp the cerebral arteries, causing a fatal brain injury. Critics claim that clamping the arteries is the proximate cause of death in violation of the dead donor rule and that the procedure is therefore unethical. We disagree. This account does (...) not consider the myriad other factors that contribute to the death of the donor, including the presence of a fatal medical condition, the decision to withdraw life support, and the physician's actions in withdrawing life support and administering medication that may hasten death. Instead, we claim that physicians play a causative role in many of the events that lead to a patient's death and that these actions are often ethically and legally justified. We advance an “all things considered” view according to which TA-NRP may be considered ethically acceptable insofar as it avoids suffering and respects the wishes of the patient to improve the lives of others through organ donation. We conclude with a series of critical questions related to the practice of NRP and call for the development of national consensus on this issue in the United States. (shrink)

_A moving meditation on recent geopolitical crises, viewed through the lens of ancient and modern tragedy__ “Spare, elegant and poignant.... If there is a single contemporary book that should be pressed into the hands of those who decide issues of war and peace, this is it.”—John Gray, _New Statesman_ “It is tragic that Robert D. Kaplan’s luminous _The Tragic Mind_ is so urgently needed.”—George F. Will_ Some books emerge from a lifetime of hard-won knowledge. Robert D. Kaplan has (...) learned, from a career spent reporting on wars, revolutions, and international politics in Europe, the Middle East, and East Asia, that the essence of geopolitics is tragedy. In _The Tragic Mind_, he employs the works of ancient Greek dramatists, Shakespeare, German philosophers, and the modern classics to explore the central subjects of international politics: order, disorder, rebellion, ambition, loyalty to family and state, violence, and the mistakes of power. The great dilemmas of international politics, he argues, are not posed by good versus evil—a clear and easy choice—but by contests of good versus good, where the choices are often searing, incompatible, and fraught with consequences. A deeply learned and deeply felt meditation on the importance of lived experience in conducting international relations, this is a book for everyone who wants a profound understanding of the tragic politics of our time. (shrink)

Savulescu and colleagues have provided interesting insights into how the UK public view the ‘best interests’ of children like Charlie Gard. But is best interests the right standard for evaluating these types of cases? In the USA, both clinical decisions and legal judgments tend to follow the ‘harm principle’, which holds that parental choices for their children should prevail unless their decisions subject the child to avoidable harm. The case of Charlie Gard, and others like it, show how the USA (...) and the UK have strikingly different approaches for making decisions about the treatment of severely disabled children. (shrink)

forthcoming in P. Robbins and M. Aydede (eds.), The Cambridge Handbook of Situated Cognition (Cambridge UP).

This paper engages critically with anti-representationalist arguments pressed by prominent enactivists and their allies. The arguments in question are meant to show that the “as-such” and “job-description” problems constitute insurmountable challenges to causal-informational theories of mental content. In response to these challenges, a positive account of what makes a physical or computational structure a mental representation is proposed; the positive account is inspired partly by Dretske’s views about content and partly by the role of mental representations in contemporary cognitive scientific (...) modeling. (shrink)

The concept of brain death has become deeply ingrained in our health care system. It serves as the justification for the removal of vital organs like the heart and liver from patients who still have circulation and respiration while these organs maintain viability. On close examination, however, the concept is seen as incoherent and counterintuitive to our understandings of death. In order to abandon the concept of brain death and yet retain our practices in organ transplantation, we need to either (...) change the definition of death or no longer maintain a commitment to the dead donor rule, which is an implicit prohibition against removing vital organs from individuals before they are declared dead. After exploring these two options, the author argues that while new definitions of death are problematic, alternatives to the dead donor rule are both ethically justifiable and potentially palatable to the public. Even so, the author concludes that neither of these approaches is likely to be adopted and that resolution will most probably come when technological advances in immunology simply make the concept of brain death obsolete. (shrink)

This special report is published in commemoration of the fiftieth anniversary of the “Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death,” a landmark document that proposed a new way to define death, with implications that advanced the field of organ transplantation. This remarkable success notwithstanding, the concept has raised lasting questions about what it means to be dead. Is death defined in terms of the biological failure of the organism to (...) maintain integrated functioning? Can death be declared on the basis of severe neurological injury even when biological functions remain intact? Is death essentially a social construct that can be defined in different ways, based on human judgment? These issues, and more, are discussed and debated in this report by leading experts in the field, many of whom have been engaged with this topic for decades. (shrink)

This entry addresses the question of group minds, by focusing specifically on empirical arguments for group cognition and group cognitive states. Two kinds of positive argument are presented and critically evaluated: the argument from individually unintended effects and the argument from functional similarity. A general argument against group cognition – which appeals to Occam’s razor – is also discussed. In the end, much turns on the identification of a mark of the cognitive; proposed marks are briefly surveyed in the final (...) section. (shrink)

This paper uses an environmental justice framework to examine government response to weather-related disasters dating back some eight decades. It places the 2005 Hurricane Katrina disaster in socio-historical context of past emergencies with an emphasis on race and class dynamics and social vulnerability. Key questions explored include: What went wrong? Can it happen again? Is government equipped to plan for, mitigate against, respond to, and recover from natural and manmade disasters? Can the public trust government response to be fair? Why (...) are so many African Americans Alocked out@ of New Orleans= post-Katrina rebuilding, reconstruction, and recovery? (shrink)

Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been considered irreversible; (...) in fact, there has never been a case of a person correctly diagnosed as brain‐dead who improved to the point that the person no longer fulfilled the diagnostic criteria. If the neurologist Alan Shewmon is correct that, prior to her cardiac arrest in June 2018, McMath no longer met the criteria for brain death and was actually in a minimally conscious state, this case could have momentous implications for how we think about this diagnosis going forward. In this essay, I will offer a hypothesis that could, perhaps, explain both these aspects of the case. The hypothesis is based on differences in how we distinguish between biological and legal categories. The law tends to prefer to draw bright‐line distinctions between categories, whereas biological categories tend to fall along a spectrum, without sharp distinctions. (shrink)

Historically, the practice of medicine has been a physically intimate endeavor. Physicians have used their hands to palpate and reveal the secrets hidden within the body. Smelling the breath for the ketosis of diabetes or tasting the skin for the saltiness of cystic fibrosis were among the physician's essential practices. Today, perhaps the most defining characteristic of a brilliant clinician is the ability to synthesize many images—from electrocardiograms, ultrasounds, CT scans, and so forth—into a coherent picture that can guide our (...) diagnosis and treatment. Yet this is rapidly becoming a Sisyphean task. Just as we are about to drown in a deluge of data, AI is throwing us a life preserver, to save not only our patients but ourselves. But where will AI take us? (shrink)

The Jeffreys–Lindley paradox displays how the use of a \ value ) in a frequentist hypothesis test can lead to an inference that is radically different from that of a Bayesian hypothesis test in the form advocated by Harold Jeffreys in the 1930s and common today. The setting is the test of a well-specified null hypothesis versus a composite alternative. The \ value, as well as the ratio of the likelihood under the null hypothesis to the maximized likelihood under the (...) alternative, can strongly disfavor the null hypothesis, while the Bayesian posterior probability for the null hypothesis can be arbitrarily large. The academic statistics literature contains many impassioned comments on this paradox, yet there is no consensus either on its relevance to scientific communication or on its correct resolution. The paradox is quite relevant to frontier research in high energy physics. This paper is an attempt to explain the situation to both physicists and statisticians, in the hope that further progress can be made. (shrink)

In a study that sweeps from Classical Antiquity to the seventeenth century, Robert D. Huerta explores the common intellectual threads that link the art of Johannes Vermeer to the philosophy of Plato.

After a brief overview of the author's phenomenological-contextualist psychoanalytic perspective, the paper traces the evolution of the author’s conception of emotional trauma over the course of three decades, as it developed in concert with his efforts to grasp his own traumatized states and his studies of existential philosophy. The author illuminates two of trauma’s essential features: (1) its context-embeddedness—painful or frightening affect becomes traumatic when it cannot find a context of emotional understanding in which it can be held and integrated, (...) and (2) its existential significance—emotional trauma shatters our illusions of safety and plunges us into an authentic Being-toward-death, wherein we must face up to our finitude and the finitude of all those we love. The paper also describes the impact of trauma on the phenomenology of time and the sense of alienation from others that accompanies traumatic temporality. The author contends that the proper therapeutic comportment toward trauma is a form of emotional dwelling. He concludes with a discussion of the implications of all these formulations for the development of an ethics of finitude. (shrink)

Philosophers of mind commonly draw a distinction between the personal level – the distinctive realm of conscious experience and reasoned deliberation – and the subpersonal level, the domain of mindless mechanism and brute cause and effect. Moreover, they tend to view cognitive science through the lens of this distinction. Facts about the personal level are given a priori, by introspection, or by common sense; the job of cognitive science is merely to investigate the mechanistic basis of these facts. I argue (...) that this view misrepresents the structure of cognitive-scientific enquiry. Taken at face value, cognitive science makes no commitment to the existence of a distinctive level at which persons or selves appear. Thus, in the age of cognitive science, we should not expect to find the self in an ontologically distinct realm. Instead, we should expect to locate it in cognitive-scientific models themselves. In closing, I indicate likely results of this approach. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 56-57, September‐October 2021.

A theory of cognitive systems individuation is presented and defended. The approach has some affinity with Leonard Talmy's Overlapping Systems Model of Cognitive Organization, and the paper's first section explores aspects of Talmy's view that are shared by the view developed herein. According to the view on offer -- the conditional probability of co-contribution account (CPC) -- a cognitive system is a collection of mechanisms that contribute, in overlapping subsets, to a wide variety of forms of intelligent behavior. Central to (...) this approach is the idea of an integrated system. A formal characterization of integration is laid out in the form of a conditional-probabilitybased measure of the clustering of causal contributors to the production of intelligent behavior. I relate the view to the debate over extended and embodied cognition and respond to objections that have been raised in print by Andy Clark, Colin Klein, and Felipe de Brigard. (shrink)

Robert Cummins argues that any causal theory of mental content (CT) founders on an established fact of human psychology: that theory mediates sensory detection. He concludes,.

This paper evaluates the Natural-Kinds Argument for cognitive extension, which purports to show that the kinds presupposed by our best cognitive science have instances external to human organism. Various interpretations of the argument are articulated and evaluated, using the overarching categories of memory and cognition as test cases. Particular emphasis is placed on criteria for the scientific legitimacy of generic kinds, that is, kinds characterized in very broad terms rather than in terms of their fine-grained causal roles. Given the current (...) state of cognitive science, I conclude that we have no reason to think memory or cognition are generic natural kinds that can ground an argument for cognitive extension. (shrink)

Stolorow and his collaborators' post-Cartesian psychoanalytic perspective – intersubjective-systems theory – is a phenomenological contextualism that illuminates worlds of emotional experience as they take form within relational contexts. After outlining the evolution and basic ideas of this framework, Stolorow shows both how post-Cartesian psychoanalysis finds enrichment and philosophical support in Heidegger's analysis of human existence, and how Heidegger's existential philosophy, in turn, can be enriched and expanded by an encounter with post-Cartesian psychoanalysis. In doing so, he creates an important psychological (...) bridge between post-Cartesian psychoanalysis and existential philosophy in the phenomenology of emotional trauma. (shrink)

Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case‐based method for teaching ethics, grounding the ethical reasoning in an amalgam of theories drawn from (...) moral philosophy, including consequentialism, deontology, and principlism.In this article we hope to make a case for augmenting the focus of education in medical ethics. We propose complementing the traditional approach to medical ethics with a more embedded approach, one that has been described by others as “microethics,” the ethics of everyday clinical practice. (shrink)

forthcoming in R. Menary (ed.), The Extended Mind.