The diagnostic category of borderline personality disorder (BPD) has come under increasing criticism in recent years. In this paper, we analyze the role and impact of epistemic injustice, specifically testimonial injustice, in relation to the diagnosis of BPD. We first offer a critical sociological and historical account, detailing and expanding a range of arguments that BPD is problematic nosologically. We then turn to explore the epistemic injustices that can result from a BPD diagnosis, showing how they can lead to experiences (...) of testimonial injustice which impede patient engagement in meaning-making activities, thereby undermining standard therapeutic goals. We conclude by showing how our arguments bolster ongoing efforts to replace the diagnostic category of BPD with alternatives such as complex post-traumatic stress disorder. (shrink)

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

Noradrenergic pathways are involved in mediating the central and peripheral effects of physiological arousal. The aim of the present study was to investigate the role of noradrenergic transmission in moral decision-making. We studied the effects in healthy volunteers of propranolol (a noradrenergic beta-adrenoceptor antagonist) on moral judgement in a set of moral dilemmas pitting utilitarian outcomes (e.g., saving five lives) against highly aversive harmful actions (e.g., killing an innocent person) in a double-blind, placebo-controlled, parallel group design. Propranolol (40 mg orally) (...) significantly reduced heart rate, but had no effect on self-reported mood. Importantly, propranolol made participants more likely to judge harmful actions as morally unacceptable, but only in dilemmas where harms were ‘up close and personal’. In addition, longer response times for such personal dilemmas were only found for the placebo group. Finally, judgments in personal dilemmas by the propranolol group were more decisive. These findings indicate that noradrenergic pathways play a role in responses to moral dilemmas, in line with recent work implicating emotion in moral decision-making. However, contrary to current theorising, these findings also suggest that aversion to harming is not driven by emotional arousal. Our findings are also of significant practical interest given that propranolol is a widely used drug in different settings, and is currently being considered as a potential treatment for post-traumatic stress disorder in military and rescue service personnel. (shrink)

According to the established orthodoxy, the law of private wrongs—especially common law torts—fails to map onto our moral universe. Four objections in particular have caught the imagination of skeptics about the moral foundations of tort law: They purport to cast doubt over the moral appeal of the duty of care element; they target the seemingly inegalitarian objective standard of care; they object to the morally arbitrary elements of factual causation and harm; and they complain about the unnecessary extension of liability (...) under the guise of the proximate cause element. Analyzing these four prevailing arguments concerning the a-moral (and, with regard to some interpretations, anti-moral) character of tort law, I shall seek to show that the normative structure of tort law can, nonetheless, be reconstructed so as to reflect, to an important extent, our considered judgments about basic moral principles. (shrink)

Sylvia Berryman offers a fresh understanding of Aristotle's ethical theory, challenging the common belief that he aimed to give it a biological foundation in human nature. Berryman reinterprets Aristotle's views as a 'middle way' between the metaphysical grounding offered by Platonists and sceptical or subjectivist alternatives.

This collection of essays analyzes relations of social inequality that appear to be logical extensions of a "natural order," and in the process demonstrates that a revitalized feminist anthropology of the 1990s has much to offer the field of feminist theory. Fashioned as a response to the lack of cultural analysis in feminist scholarship, the contributors question the category of gender within the inclusive context of the structural dynamics of inequality. They also examine how cultural identities, domains and institutions affect (...) our perception of gender in society. The first selection of essays addresses how ideas of family and kinship have fostered society's hierarchies and legitimized the status quo. In part two, the essays show how several dimensions of inequality are implicit in the construction of identities that are based upon ideas of social solidarity. Contributors: Susan McKinnon, University of Virginia; Kath Weston, Arizona State West; Rayna Rapp, New School for Social Research; Janet Dolgin, Hofstra University; Harriet Whitehead, Duke University; Carol Delaney, Stanford University; Brackette Williams, University of Arizona; Sylvia Yanagisako, Stanford University; Phyllis Chock, Catholic University; Sherry Ortner, University of Michigan; Anna Tsing, University of California, Santa Cruz. (shrink)

It has long been thought that the ancient Greeks did not take mechanics seriously as part of the workings of nature, and that therefore their natural philosophy was both primitive and marginal. In this book Sylvia Berryman challenges that assumption, arguing that the idea that the world works 'like a machine' can be found in ancient Greek thought, predating the early modern philosophy with which it is most closely associated. Her discussion ranges over topics including balancing and equilibrium, lifting (...) water, sphere-making and models of the heavens, and ancient Greek pneumatic theory, with detailed analysis of thinkers such as Aristotle, Archimedes, and Hero of Alexandria. Her book shows scholars of ancient Greek philosophy why it is necessary to pay attention to mechanics, and shows historians of science why the differences between ancient and modern reactions to mechanics are not as great as was generally thought. (shrink)

Der Begriff »Race«, aus den universitären Kulturwissenschaften stammend, will unbewusste Rassifizierungsprozesse beschreiben, die wir unweigerlich vornähmen und denen wir zugleich ausgesetzt seien. Der vorliegende Beitrag will diesen Begriff für Psychoanalyse und Psychotherapie fruchtbar machen. Zwei Fallvignetten illustrieren, welche Fallstricke für Psychoanalytiker und Patienten bereit lägen, wenn »Race« in Übertragung und Gegenübertragung verleugnet werden müsse. Tauchen negativ konnotierte »racial« Phantasien auf, könne die Angst, rassistisch zu denken oder zu agieren, zum Stillstand und sogar Scheitern einer Behandlung führen. Da rassifizierte Projektionen nach (...) Ansicht der Autorin unvermeidbar seien, sieht sie die Entstehung des Gefühls einer »racial Melancholia« als Möglichkeit, dem drohenden Stillstand entgegenzuwirken. (shrink)

Do we need a right to mental privacy? In an era of increasing sophistication in recording, interpreting, and directly intervening on our neural activity – not to mention efforts at combining neural...

I respond to H. M. Collins's claim (1985, 1990, 1993) that experimental inquiry cannot be objective because the only criterium experimentalists have for determining whether a technique is "working" is the production of "correct" (i.e., the expected) data. Collins claims that the "experimenters' regress," the name he gives to this data-technique circle, cannot be broken using the resources of experiment alone. I argue that the data-technique circle, can be broken even though any interpretation of the raw data produced by techniques (...) is theory-dependent. However, it is possible to break this circle by eliminating dependence on even those theoretical presuppositions that are shared by an entire scientific community through the use of multiple independently theory-dependent techniques to produce robust bodies of data. Moreover, I argue, that it is the production of robust bodies of data that convinces experimentalists of the objectivity of their data interpretations. (shrink)

The pseudonymous works Kierkegaard wrote during the period 1843–46 have been responsible for establishing his reputation as an important philosophical thinker, but for Kierkegaard himself, they were merely preparatory for what he saw as the primary task of his authorship: to elucidate the meaning of what it is to live as a Christian and thus to show his readers how they could become truly Christian. The more overtly religious and specifically Christian works Kierkegaard produced in the period 1847–51 were devoted (...) to this task. In this book Sylvia Walsh focuses on the writings of this later period and locates the key to Kierkegaard’s understanding of Christianity in the “inverse dialectic” that is involved in “living Christianly.” In the book’s four main chapters, Walsh examines in detail how this inverse dialectic operates in the complementary relationship of the negative qualifications of Christian existence—sin, the possibility of offense, self-denial, and suffering—to the positive qualifications—faith, forgiveness, new life/love/hope, and joy and consolation. It was Kierkegaard’s aim, she argues, “to bring the negative qualifications, which he believed had been virtually eliminated in Christendom, once again into view, to provide them with conceptual clarity, and to show their essential relation to, and necessity in, securing a correct understanding and expression of the positive qualifications of Christian existence.”. (shrink)

This essay argues that ideals of cooperation or adversariality in argumentation are not equally attainable for women. Women in argumentation contexts face oppressive limitations undermining argument success because their authority is undermined by gendered norms of politeness. Women endorsing or, alternatively, transgressing feminine norms of politeness typically defend their authority in argumentation contexts. And yet, defending authority renders it less legitimate. My argument focuses on women in philosophy but bears the implication that other masculine dis- course contexts present similar double (...) binds that urge social and political change. (shrink)

Neoclassical and Austrian/evolutionary economic paradigms have different implications for integrating corporate social responsibility (corporate citizenship) and competitive strategy. porter's "Five Forces" model implicitly rests on neoclassical theory of the firm and is not easily reconciled with corporate social responsibility. Resource-based models of competitive strategy do not explicitly embrace a particular economic paradigm, but to the extent their conceptualization rests on neoclassical assumptions such as imperfect factor markets and profits as rents, these models also imply a trade-off between competitive advantage and (...) corporate social responsibility. Differences in Austrian/evolutionary economic model's assumptions about equilibrium, profits, and other economic concepts allow this paradigm to embrace alternative views of strategy such as the activities or dynamic capabilities views. These alternative views of strategy focus on learning and adaptation; they align more easily with corporate social responsibility. In practice this alignment comes about because social engagement facilitates the learning and adaptation that are a source of competitive advantage. Among the many business arguments for CSR such as improved employee morale/productivity or brand differentiation, this view prioritizes innovation. (shrink)

Sylvia Burrow explores self-confidence as integral to autonomy development within everyday contexts threatening gender violence, arguing that self-defense training is significant to resistance and resilience. -/- Choice Reviews, December 2022 Issue: “Gender Violence explores the myths and realities of the threat of gender-based violence and active forms of resistance to it…. She advocates specifically for martial arts and self-defense programs rooted in feminist frameworks. These are the most successful because they resist rape culture while increasing the capacities of women (...) and other people with marginalized identities who face high risk for sexual violence. This book is a must-read for anyone working at the intersections of gender-based violence prevention and somatic practice. Essential. All levels.”. (shrink)

Arguments in the neuroenhancement debate are sometimes based upon idealistic scenarios involving the assumption of using a drug that has no or negligible side effects. At least it is often implicitly assumed – as technology and scientific knowledge advances - that there soon will be a drug with no or negligible side effects. We will review evidence from neuroscience, complex network research and evolution theory and demonstrate that - at least in terms of psychopharmacological intervention – on the basis of (...) our understanding of brain function it seems inconceivable that there ever will be a drug that has the desired effect without undesirable side effects. We will illustrate this by reference to enhancing edge detection in V2 in monkeys and demonstrate that even for this localised single neuron coded function there would be numerous side effects. Taking the more realistic case of pharmacological enhancement that is inevitably associated with side effects will change consequentialist arguments for neuroenhancement and have implications for the conception of autonomy, specifically in the case of performance enhancement. We conclude that a neuroethics debate that aims to inform policy decisions should take these findings into account. We hope that our article will precipitate more interdisciplinary research in neuroscience and philosophy. (shrink)

Cesarean delivery rates have been steadily increasing worldwide. In response, many countries have introduced target goals to reduce rates. But a focus on target goals fails to address practices embedded in standards of care that encourage, rather than discourage, cesarean sections. Obstetrical standards of care normalize use of technology, creating an imperative to use technology during labor and birth. A technological imperative is implicated in rising cesarean rates if physicians or patients fear refusing use of technology. Reproductive autonomy is at (...) stake since a technological imperative undermines patients’ ability to choose cesareans or refuse use of technology increasing the likelihood of cesareans. To address practices driven by a technological imperative I outline three physician obligations that are attached to respecting patient autonomy. These moral obligations show that a focus on respect for autonomy may prove not only an ideal ethical response but also an achievable practical response to lowering cesarean rates. (shrink)

This article discusses how the concept of a fair finite lottery can best be extended to denumerably infinite lotteries. Techniques and ideas from non-standard analysis are brought to bear on the problem.

This article contributes to the revision of the concept of system in social theory using complexity theory. The old concept of social system is widely discredited; a new concept of social system can more adequately constitute an explanatory framework. Complexity theory offers the toolkit needed for this paradigm shift in social theory. The route taken is not via Luhmann, but rather the insights of complexity theorists in the sciences are applied to the tradition of social theory inspired by Marx, Weber, (...) and Simmel. The article contributes to the theorization of intersectionality in social theory as well as to the philosophy of social science. It addresses the challenge of theorizing the intersection of multiple complex social inequalities, exploring the various alternative approaches, before rethinking the concept of social system. It investigates and applies, for the first time, the implications of complexity theory for the analysis of multiple intersecting social inequalities. Key Words: complexity theory • inequality • intersectionality • social theory. (shrink)

BackgroundDeep brain stimulation is approved for treating refractory obsessive-compulsive disorder in adults under the US Food and Drug Administration Humanitarian Device Exemption, and studies hav...

The most powerful response to growing skepticism about the intelligibility of the idea of private ownership has been cast in terms of an owner's rights to the exclusive use of an object. In these pages, I argue that this response suffers from three basic deficiencies—rather than merely explanatory gaps—that render it unable to overcome the specter of skepticism. These deficiencies reflect a shared want of attention to the normative relationship that ownership engenders between owners and nonowners. In place of the (...) right to exclusive use, I set out to develop an account of private ownership that seeks to defeat skepticism concerning this idea. The proposed account insists that the idea of private ownership picks out a special authority relation between an owner and a nonowner involving the normative standing of the latter in relation to an object owned by the former. I further demonstrate the important place of this idea in shaping the contours of normative disagreements about the point of ownership rights and responsibilities. (shrink)

Entrevista realizada durante a conferência proferida por Sylvia Serbin nas atividades do “Congresso Internacional Territorialidade e Saude: desigualdades raciais e sociais em contextos locais e globais”, organizado e coordenado pelo Nucleo de Estudos e Pesquisa em Psicanalise, Identidade, Negritude e Sociedade, ocorrido de 03 a 7 de setembro de 2014, no Centro de Ciências da Saude da Universidade Federal do Recôncavo da Bahia, em Santo Antonio de Jesus/BA.

This paper emanates from the concept of empathy as understood by the German philosopher Edith Stein. It begins by highlighting different interpretations of empathy. According to the German philosopher Martin Buber, empathy cannot be achieved as an act of will. In contrast, the psychologist Carl Rogers believes that empathy is identical with dialogue and is the outcome of a cognitive act of active listening. The empathy concept of Edith Stein, philosopher and follower of Edmund Husserl's phenomenology, goes beyond these conflicting (...) views and offers a more complex interpretation, with relevance for both healthcare and nursing education. When studying Stein's three‐level model of empathy, a field of tension between perspectives of closeness and distance becomes apparent. The paper concludes by suggesting Stein's model of empathy as a strategy to overcome the tension and meet the demands of empathy. (shrink)

Tort law does many things—it determines substantive rights, decides what counts as violating these rights, recognizes rights of repair, and grants rights of redress. Two non-instrumentalist conceptions of tort law appear to dominate how we are supposed to understand and discharge these tasks. One conception takes tort law to be the law of wrongs, whereas the other conception identifies tort law with the law of victim recourse. I argue that both conceptions (including a combination of both) mischaracterize what tort law (...) does and what it should be doing. By contrast, the conception I shall defend—viz., the conflict theory of tort law—takes the basic task of tort law to be identifying the value of the conflict to which it responds (or which it shapes). In fact, there are three types of conflicts: inherently valuable, tolerably valuable, and valueless. Each type of conflict calls for a qualitatively different response by the law of torts. The conflict theory, I argue, changes the way we understand and determine the rights, duties, liabilities, and remedies that arise in and around tort law. I demonstrate this claim in connection with the tort of battery and then extend the analysis to capture the tort law of workplace and, in particular, trespass law as it applies to nonconsensual access to the workplace by organizers and by workers. (shrink)

Current models of autobiographical memory suggest that self-identity guides autobiographical memory retrieval. Further, the capacity to recall the past and imagine one’s self in the future can influence social problem solving. We examined whether manipulating self-identity, through an induction task in which students were led to believe they possessed high or low self-efficacy, impacted episodic specificity and content of retrieved and imagined events, as well as social problem solving. Compared to individuals in the low self efficacy group, individuals in the (...) high self efficacy group generated past and future events with greater specificity, positive words, and self-efficacious statements, and also performed better on social problem solving indices. A lack of episodic detail for future events predicted poorer performance on social problem solving tasks. Strategies that increase perceived self-efficacy may help individuals to selectively construct a past and future that aids in negotiating social problems. (shrink)

Sylvia Walsh explores Kierkegaard's understanding of Christianity and the existential mode of thinking theologically appropriate to it in the context of the ...

IntroductionDeep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in “last resort” intervention scenarios such as DBS for refractory conditions.ObjectiveThis study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.Materials and MethodsSemi-structured interviews (...) with clinicians (n = 29) and caregivers (n = 44) were conducted, transcribed, and coded.ResultsUsing thematic content analysis, four major themes from clinician interviews and five major themes from caregiver interviews related to hopes and expectations were identified. Clinicians expressed concerns about caregiver false hopes (86%, 25/29) and desperation (68.9%, 20/29) in light of DBS being a last resort. As a result, 68.9% of clinicians (20/29) expressed that they intentionally tried to lower caregiver expectations about DBS outcomes. Clinicians also expressed concern that, on the flip side, unrealistic pessimism drives away some patients who might otherwise benefit from DBS (34.5%, 10/29). Caregivers viewed DBS as the last option that they had to try (61.3%, 27/44), and 73% of caregivers (32/44) viewed themselves as having high hopes but reasonable expectations. Fewer than half (43%, 19/44) expressed that they struggled setting outcome expectations due to the uncertainty of DBS, and 50% of post-DBS caregivers (14/28) expressed some negative feelings post treatment due to unmet expectations. 43% of caregivers (19/44) had experiences with clinicians who tried to set low expectations about the potential benefits of DBS.ConclusionThoughtful clinician-stakeholder discussion is needed to ensure realistic outcome expectations. (shrink)

Rasmussen (1993) argues that, because electron microscopists did not use robustness and would not have been warranted in using it as a criterion for the reality or the artifactuality of mesosomes, the bacterial mesosome serves as a test case for robustness that it fails. I respond by arguing that a more complete reading of the research literature on the mesosome shows that ultimately the more robust body of data did not support the mesosome and that electron microscopists used and were (...) warranted in using robustness as a criterion for the artifactuality of mesosomes. (shrink)

Traditional approaches to theory structure and theory change in science do not fare well when confronted with the practice of certain fields of science. We offer an account of contemporary practice in molecular biology designed to address two questions: Is theory change in this area of science gradual or saltatory? What is the relation between molecular biology and the fields of traditional biology? Our main focus is a recent episode in molecular biology, the discovery of enzymatic RNA. We argue that (...) our reconstruction of this episode shows that traditional approaches to theory structure and theory change need considerable refinement if they are to be defended as generally applicable. 1This paper emerged from discussions between us, and we are both equally responsible for its errors. We would like to thank Yvonne Paterson for helpful comments. (shrink)

For private property to be legitimately recognized as a universal human right, its meaning should pass the test of self-imposability by an end. In this Essay, we argue, negatively, that the prevailing understanding of private property cannot plausibly meet this demanding standard; and develop, affirmatively, a liberal conception which has a much better prospect of meeting property’s justificatory challenge. Private property, on our account, is an empowering device, which is crucial both to people’s personal autonomy and to their relational equality. (...) The liberal conception of the human right to property has both vertical and horizontal significance — it implies respect from both the public authority and other individuals — which means that it is thoroughly political but not necessarily statist. Our account generates important implications, both domestic and transnational. Domestically, it implies that whereas some property rights should be subject to strong constitutional protection, state law should facilitate other types of private and non-private property institutions, and these property institutions may well be subject to non-owners’ claims to access and, more broadly, to being treated respectfully. Furthermore, our conception of the human right to property requires that everyone have the unusual authority typical of full-blown private ownership. Transnationally, our analysis highlights a freestanding dimension of relational justice, which is relevant across borders even given that our distributive obligations are statist. This injunction of relational justice in transnational interactions brings into question the adequacy of the current state of the law, according to which these interactions are mainly governed by choice-of-law rules that conceptualize them as wholly subsumed under the capacities of the parties as citizens of their respective polities. (shrink)

The debate about what constitutes the discipline of ethics and who qualifies as an ethics consultant is linked unavoidably to a debate that is potentiated by the reality of a rapidly changing and high-stakes health care consultation marketplace. Who we are and what we can offer to the moral gesture that is medicine is shaped by our fundamental understanding of the place of expert knowledge in the transformation of social reality. The struggle for self-definition is particularly freighted since clinical ethics (...) consultation aspires to be more than academic contemplation. Two recent books (Ethics Consultation by John La Puma and David Schiedermayer and The Health Care Ethics Consultant: A Practical Guide, edited by Francoise Baylis) exemplify the two most popular but most widely divergent positions on these issues. We argue that while useful, neither book addresses fully the particular and distinct role of the professional ethicist. (shrink)

Non-Archimedean probability functions allow us to combine regularity with perfect additivity. We discuss the philosophical motivation for a particular choice of axioms for a non-Archimedean probability theory and answer some philosophical objections that have been raised against infinitesimal probabilities in general.