ABSTRACT: Abilify MyCite was granted regulatory approval in 2017, becoming the world’s first “smart pill” that could digitally track whether patients had taken their medication. The new technology was introduced as one that had gained the support of patients and ethicists alike, and could contribute to solving the widespread and costly problem of patient nonadherence. Here, we offer an in-depth exploration of this narrative, through an examination of the origins and development of Abilify, the drug that would later become (...) MyCite. This history illuminates how an antipsychotic can become a top-selling drug and maintain its blockbuster status for more than a decade. It also provides a detailed case study for how knowledge is constructed within the logic of biomedical capitalism, providing impetus to reexamine claims regarding how MyCite addresses patient nonadherence, engenders patient support, and is ethicist-approved. (shrink)

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, (...) digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care. (shrink)

Psychopharmacology - a remarkable development -- Philosophical questions raised by psychopharmacology -- How to think about science, language, and medicine : classical, critical, and integrated perspectives -- Conceptual questions about psychotropics -- Explanatory questions about psychotropics -- Moral questions about psychotropics.

In an age of modern technology and an increasing movement towards a 24-h working culture, life for many is becoming more stressful and demanding. To help juggle these work commitments and an active social life, nootropic medication, (the so-called ‘smart pills’) have become a growing part of some people’s lives. Users claim that these drugs allow them to reach their maximal potential by becoming more efficient, smarter and requiring less sleep. The use of these medications and the role (...) of health professionals in their distribution raises many ethical questions. (shrink)

The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by contrasting (...) classical and critical concepts of categories, and then puts forward an integrative position that is based on cognitive-affective research. This position can in turn be used to consider the debate between pharmacological Calvinism (which may adopt a moral metaphor of disorder) and psychotropic utopianism (which may emphasize a medical metaphor of disorder). I argue that psychiatric treatment of serious psychiatric disorders is justified, and that psychotropics are an acceptable kind of intervention. The use of psychotropics for sub-threshold phenomena requires a judicious weighing of the relevant facts (which are often sparse) and values. (shrink)

Neuroscience opens new avenues to alleviate neurological and psychiatric disorders and presents targeted ways to control and enhance vegetative as well as mood and cognitive behaviors. It considers a general trend to obtain improved memory and comprehension capacities through “smart pills,” rewards from technical progress. The article shows that currently available drugs will not only change some quantitative aspects of neural activities, whose improvement implies no problem, but also the global internal economy of cognition. Cognitive enhancers do not (...) only change the amplitude of a given brain capacity, i.e. memory, but also the balance between emotional and rational networks. This article argues that the real risk resides in a hypertrophy of the self, losing essential feedback from the eyes of the others. These fundamental changes provide an understanding of the driving forces of “neurotechnological gourmandize”. (shrink)

Der Wunsch nach Stimmungsaufhellung und Verbesserung oder PerfektionierungPerfektionierung des Menschen des körperlichen Erscheinungsbildes und der kognitiven LeistungsfähigkeitHirndoping hat Menschen zu allen Zeiten begleitet. In den letzten Jahrzehnten haben wissenschaftlich-medizinische Entwicklungen die Voraussetzungen dafür geschaffen, diesem Streben durch chirurgische Eingriffe oder Einsatz psychopharmazeutischer Mittel nachzuhelfen. Bis in die Boulevardmedien werden Vor- und Nachteile von Schönheitsoperationen, von Smart Drugs, Happy Pills und anderen Mitteln zur Leistungssteigerung diskutiert.

The emergence of large-scale social media systems, such as Wikipedia, Facebook, and Twitter, has given rise to a new multi-disciplinary effort based around the concept of social machines. For the most part, this research effort has limited its attention to the study of Web-based systems. It has also, perhaps unsurprisingly, tended to highlight the social scientific relevance of such systems. The present paper seeks to expand the scope of the social machine research effort to encompass the Internet of Things. One (...) advantage of this expansion is that it helps to reveal some of the links between the science of social machines and the sciences of the mind. A second advantage is that it furthers our conceptual understanding of social machines and supports the quest to derive a philosophically-robust definition of the term “social machine.” The results of the present analysis suggest that social machines are best conceived as systems in which a combination of social and technological elements play a role in the mechanistic realization of system-level phenomena. The analysis also highlights the relevance of cognitive science and the philosophy of mind to our general understanding of systems that transcend the cyber, physical, and social domains. (shrink)

Non-invasive prenatal testing is at the forefront of prenatal screening. Current uses for NIPT include fetal sex determination and screening for chromosomal disorders such as trisomy 21. However, NIPT may be expanded to many different future applications. There are a potential host of ethical concerns around the expanding use of NIPT, as examined by the recent Nuffield Council report on the topic. It is important to examine what NIPT might be used for before these possibilities become consumer reality. There is (...) limited research exploring views of women on possible future uses of NIPT, particularly those of women who have undergone NIPT. In this study, we examined the views of women who undertook NIPT previously on the acceptability of and interest levels in using NIPT for a number of current and possible future applications. These included several medical conditions encompassing psychiatric, neurodevelopmental and adult-onset conditions as well as non-medical traits such as intelligence. One thousand women were invited to participate and 235 eligible surveys were received. Women generally reported an interest in using NIPT for medical conditions that severely impacted quality of life and with an onset earlier in life and stressed the importance of the accuracy of the test. Concerns were raised about the use of NIPT for non-medical traits. Respondents indicated that termination of pregnancy was not their only reason for testing, particularly in the case of sex. These results can further inform the ethical debate around the increasing integration of NIPT into healthcare systems. (shrink)

This article explores the notion of the Web-extended mind, which is the idea that the technological and informational elements of the Web can sometimes serve as part of the mechanistic substrate that realizes human mental states and processes. It is argued that while current forms of the Web may not be particularly suited to the realization of Web-extended minds, new forms of user interaction technology as well as new approaches to information representation do provide promising new opportunities for Web-based forms (...) of cognitive extension. In addition, it is suggested that extended cognitive systems often rely on the emergence of social practices and conventions that shape how a technology is used. Web-extended minds may thus depend on forms of socio-technical co-evolution in which social forces and factors play just as important a role as do the processes of technology design and development. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

Context: Maturana’s lifework is extensive, and consists of a coherent network of interlinked ideas the consequences of which have not been fully explored. Problem: What does it take to understand Maturana’s work? Is “learning” Maturana as arduous as learning a completely different language, or is there sufficient value in learning selected elements of his network of ideas? Method: We discuss these fundamental questions and relate them to aspects of understanding, word meaning and the scientific method. Results: While getting only partially (...) familiar with Maturana can have its merits in certain contexts, there is a clear danger of trying to understand Maturana on the basis of words such as autopoiesis, consciousness, cognition, and science. Implications: We identify three directions in which Maturana’s ideas can be further explored: preparing social media videos, finding ever new domains of application, and their historical-conceptual relativization. (shrink)

The central concern of this book is us human beings. The authors’ basic question is: ‘How is it that we can live in mutual care, have ethical concerns, and at the same time deny all that through the rational justification of aggression?’ The authors answer this basic question indirectly by providing a look into the fundaments of our biological constitution, concentrating on what they term emotioning, that is the flow of emotions in daily life that guides the flow of the (...) systemic conservation of a manner of living. Maturana and Verden-Zoller claim that the fundamental emotion that gave rise to humans as sapient languaging beings was love, and that this remains our fundament even when other emotions become socially prevalent. (shrink)

What Druzhinin, in the target article, names as “counterfactuals” are stories that an observer claims are more valid than another story. Normally, we treat such conjectures lightly, though all ….

Ambitiously undertaking to develop a strategy for making the study of religion "scientific," Ninian Smart tackles a set of interrelated issues that bear importantly on the status of religion as an academic discipline. He draws a clear distinction between studying religion and "doing theology," and considers how phenomenological method may be used in investigating objects of religious attitudes without presupposing the existence of God or gods. He goes on to criticize projectionist theories of religion and theories of rationality in (...) both religion and anthropology. On this basis he builds a theory of religious dynamics which gives religious ideas and entities an autonomous place in the sociology of knowledge. His overall purpose is thus "to indicate ways forward in the study of religion which free it from being crypto-apologetics or elevating poetry." Originally published in 1973. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

The identity theory of mind holds that states and processes of the mind are identical to states and processes of the brain. Strictly speaking, it need not hold that the mind is identical to the brain. Idiomatically we do use ‘She has a good mind’ and ‘She has a good brain’ interchangeably but we would hardly say ‘Her mind weighs fifty ounces’. Here I take identifying mind and brain as being a matter of identifying processes and perhaps states of the (...) mind and brain. Consider an experience of pain, or of seeing something, or of having a mental image. The identity theory of mind is to the effect that these experiences just are brain processes, not merely correlated with brain processes. (shrink)

In this article I try to refute the so-called "libertarian" theory of free will, and to examine how our conclusion ought to modify our common attitudes of praise and blame. In attacking the libertarian view, I shall try to show that it cannot be consistently stated. That is, my dscussion will be an "analytic-philosophic" one. I shall neglect what I think is in practice an equally powerful method of attack on the libertarian: a challenge to state his theory in such (...) a way that it will fit in the modern biology and psychology, which are becoming increasingly physicalistic. (shrink)

Smart introduced the phrase that a miracle is ’an occurrence of a non-repeatable counter-instance to a law of nature’. See Swinburne 1989, 78.

Without doubt Michel Foucault was one of the 20th century's towering intellectuals. His work on organization of knowledge, sexuality, power, discipline, medicine, madness, identity, and politics has left an idelible mark on contemporary thinking in these fields. Edited by one of the world's most distinguished Foucault scholars, Barry Smart, this collection sets Foucault's work in the the appropriate historical and intellectual context by orgaizing the material thematically with introductions that quide the reader through the complexities of the essays. These (...) volumes will be essential reading wherever the work of Foucault is debated and applied. (shrink)

Context: Humberto Maturana has generated a coherent and extensive explicatory matrix that encompasses his research in neurophysiology, cognition, language, emotion, and love. Purpose: Can we formulate a map of Maturana’s work in a manner that is consistent with the systemic matrix it represents and that serves as an aid for understanding Maturana’s philosophy without reifying its representation? Method: Our arguments are based on experience gained from teaching and presentations. Results: We present a map that that represents Maturana’s main contributions as (...) clusters of notions clustered according to how we see them to be related to each other as a projection of a matrix of ideas onto a two-dimensional space. We claim that there are many paths through these clusters of ideas. Though ideas relevant to individuals are obtained from various partial perspectives, a deep understanding of any element is dependent on an understanding of the whole matrix. Furthermore, we summarize the contributions to this special issue on Maturana. (shrink)

Two essays on utilitarianism, written from opposite points of view, by J. J. C. Smart and Bernard Williams. In the first part of the book Professor Smart advocates a modern and sophisticated version of classical utilitarianism; he tries to formulate a consistent and persuasive elaboration of the doctrine that the rightness and wrongness of actions is determined solely by their consequences, and in particular their consequences for the sum total of human happiness. In Part II Bernard Williams offers (...) a sustained and vigorous critique of utilitarian assumptions, arguments and ideals. He finds inadequate the theory of action implied by utilitarianism, and he argues that utilitarianism fails to engage at a serious level with the real problems of moral and political philosophy, and fails to make sense of notions such as integrity, or even human happiness itself. This book should be of interest to welfare economists, political scientists and decision-theorists. (shrink)

Many necessitarians about cause and law (Armstrong 1983; Mumford 2004; Bird 2007) have argued that Humeans are unable to justify their inductive inferences, as Humean laws are nothing but the sum of their instances. In this paper I argue against these necessitarian claims. I show that Armstrong is committed to the explanatory value of Humean laws (in the form of universally quantified statements), and that contra Armstrong, brute regularities often do have genuine explanatory value. I finish with a Humean attempt (...) at a probabilistic justification of induction, but this fails due to its assumption that the proportionality syllogism is justified. Although this attempt fails, I nonetheless show that the Humean is at least as justified in reasoning inductively as Armstrong. (shrink)

Patricia Smart; Education: an art or a science?, Journal of Philosophy of Education, Volume 8, Issue 1, 30 May 2006, Pages 61–75, https://doi.org/10.1111/j.146.

A theory of punishment should give some account of mercy and yet it is true to say that very little has been said about it at all. It is commonly regarded as a praiseworthy element in moral behaviour—something to be practised occasionally both for the good of the one who punishes and the one who is punished. The suffering that punishment involves is unpleasant for all concerned, and if it is possible to avoid it or lessen it without moral injustice, (...) then it is desirable to do so. We condemn as hard and unbending the judge who never shows mercy and the suggestion is that the poor unfortunates whose lot it is to be judged by him are poor unfortunates indeed. This is reflected in the fact that the opposite of merciful—merciless—means cruel. Presumably there are occasions when it is appropriate to show mercy to an offender, and other occasions when it is not. What are the conditions for the appropriate exercising of mercy, how do we decide how much mercy is appropriate, and when is a judge morally obliged to be merciful, if ever? (shrink)

We analyze a series of interviews with Estonian humanities researchers to explore topics related to the beginning of academic careers and the relationships with supervisors and mentors. We show how researchers strive to have meaningful relationships and produce what they consider quality research in the conditions of a system that is very strongly oriented towards internationalization and project-based funding, where their efforts are compromised by a lack of policies helping them establish a stable position in academia. Leaving researchers to face (...) these obstacles alone places a great burden on them and may lead to a loss of talent in academia. Identifying and addressing these issues is thus important for both the well-being of early career researchers and the future of academia. (shrink)

This paper is partly to get rid of some irritation which I have felt at the quite common tendency of philosophers to elucidate (for example) ‘is red’ in terms of ‘looks red’. For a relatively recent example see, for example, Frank Jackson and Robert Pargetter, ‘An Objectivist′s Guide to Subjectivism about Colour’. However rather than try to make a long list of references, I would rather say ‘No names, no pack drill’. I have even been disturbed to find the use (...) of the words ‘looks red’ that I am opposing ascribed to me by Keith Campbell in his useful article ‘David Armstrong and Realism about Colour’. I am not saying that such talk is necessarily wrong. Talk of ‘looks red’ may be a way of harmlessly referring to the behavioural discriminations with respect to colour of a human percipient. Where it is dangerous, at least to those of us who wish to argue for a broadly physicalist account of the mind, is that it may have concealed overtones of reference to epiphenomenal and irreducibly psychic properties of experiences. Moreover even if it does not do so it may be fence sitting on this issue and liable to misinterpretation. (shrink)