Monothematic delusions are delusions whose contents pertain to a single subject matter. Examples include Capgras delusion, the delusion that a loved one has been replaced by an impostor, and Cotard delusion, the delusion that one is dead or does not exist. Two-factor accounts of such delusions hold that they are the result of both an experiential deficit, for instance flattened affect, coupled with an aberrant cognitive response to that deficit. In this paper we develop a new expressivist two-factor account of (...) delusion. In contrast to existing endorsement and explanationist accounts, which treat delusions as either explanations or endorsements of the contents of these disordered experiences, we hold that delusional beliefs have an expressive function: they characterize, in impressionistic terms, what the subject’s experience is like for them. We show how our account improves upon existing two-factor views in explaining the central features of monothematic delusions, in particular the way in which delusional subjects fall short of the ideal of rationality. (shrink)

The DNA in a eukaryotic nucleus is packaged into a nucleosome array, punctuated by variations in the regular pattern. The local chromatin structure of inducible genes appears to fall into two categories: preset and remodeling. Preset genes are those in which the binding sites for trans‐acting factors are accessible (;i.e. in a non‐nucleosomal, DNase I hypersensitive configuration) prior to activation. In response to the activation signal, positive factors bind to cis‐acting regulatory elements and trigger transcription with no major alterations (...) in the chromatin structure of the promoter region. In contrast, remodeling genes are those in which some of the required cis‐acting regulatory elements are packaged into nucleosomes. The nucleosomes must be perturbed in response to an activation signal in order for the trans‐acting factors to gain access to cis‐acting elements; a chromatin remodeling process which forms DNase I hypersensitive sites must occur. In both cases, precise positioning of nucleosomes along the promoter region of a gene appears to be critical for appropriate regulation of expression. (shrink)

In The Decline and Fall of the Catholic Church in America, the sociologist David Carlin offers insightful explanations for why Catholicism began to unravel in the 1960s. Facing the aftershocks of Vatican II, the collapse of their cohesive urban neighborhoods, and the onslaught of the cultural revolution, American Catholics experienced a “perfect storm” from which they have yet to recover. Carlin sees little reason for optimism about the future. Among other things, he notes thebishops’ “appallingly poor” handling of the (...) sex abuse scandal and their tolerance of homosexuality in the seminaries. While agreeing with mostof Carlin’s analysis, this reviewer is more optimistic about the future prospects of the Church in America. (shrink)

This chapter surveys recent work on philosophical issues raised by religious diversity or pluralism. It focuses on four topics. The first is the epistemological challenge of religious diversity. The rationality of commitment to any particular religious tradition seems to be threatened by the existence of rival traditions. The second is the political problem of religious toleration. Religious conflict throughout the world suggests a need for better arguments against religious intolerance than those currently available. The third is the task of understanding (...) the concept of religion. Religious pluralism fuels debate about whether the concept of religion can be defined in terms of necessary and sufficient conditions or, if it cannot, whether it must be analyzed in terms of family resemblances. And the fourth is the enterprise of making constructive comparisons in religious ethics. Similarities and differences between the virtue theories of diverse religious traditions illuminate strengths and weaknesses in the ethical thought of the religions subjected to comparison. The chapter argues from these examples to the conclusion that religious diversity gives rise to several exciting and important problems that ought to be high on the agenda of philosophy of religion. (shrink)

In this article I will address the question of determining the moral limits of reproductive decisions. In so doing I will examine the contributions made by John Harris, who has over the years consistently addressed the ethical implications of advancing reproductive technologies. In addressing these matters, Harris has centred his arguments on the principle of harm and with this in mind has set out a specific theoretical framework from which decisions about disability and causing harm, as in the case of (...) reproductive decisions, can be rationally addressed. This discussion will attempt to question the conceptual scheme that he proposes. The aim here is not to present an alternative theoretical contribution to the morality of reproductive choice. Rather, in the attempt to follow some of the directives in Wittgenstein’s later philosophy, the aim is to demonstrate some of the pitfalls of what Wittgenstein has described as the “craving for generality” in contemporary philosophy. I propose that this craving can distort, in this instance, our ordinary usage of concepts such as harm, suffering and disability and their role in the moral vocabulary of reproductive decision making. (shrink)

In “Epistemology in Philosophy of Religion,” Philip Quinn focuses on the central problem of religious epistemology for monotheistic religions: the epistemic status of belief in the existence of God. He explores what epistemic conditions arguments for God's existence would have to satisfy to be successful and whether any arguments satisfy those conditions. Turning to the claims of reformed epistemology about belief in God, Quinn assesses Alvin Plantinga's claim that belief in God is for many theists properly basic, that (...) is, has positive epistemic status even when it is not based on arguments or any other kind of propositional evidence. Quinn distinguishes two versions of this claim. According to the first, emphasized in Plantinga's earlier work, theistic belief is properly basic with respect to justification or rationality, while according to the second version, prominent in Plantinga's more recent work, theistic belief is properly basic with respect to warrant. (shrink)

This chapter defends a divine command theory consisting of two central claims. First, a kind of action is morally obligatory just in case God has commanded that actions of that kind be performed. Second, God’s commanding that a kind of action be performed is what makes it obligatory. God’s commands bring it about that the wrong actions are wrong, and the required actions are required. Moreover, God’s goodness ensures that His commands are not arbitrary. God is the standard of Goodness. (...) Something is good just in case it resembles God in a relevant way. Since God resembles Himself, He is good, and His commands are suited to ground moral obligations. Deontic or duty-related properties depend on God’s commands, but axiological or evaluative properties, such as goodness, do not. (shrink)

McCradden and colleagues' (2022) argues that machine learning in health care poses new challenges to appropriate evaluation for safe use in clinical care. It also claims that “the longstanding syst...

In this paper I argue that warrant for Lewis’ principle of recombination presupposes warrant for a combinatorial analysis of intrinsicality, which in turn presupposes warrant for the principle of recombination. This, I claim, leads to a vicious circularity: warrant for neither doctrine can get off the ground.

On getting a clear view -- Belief and proof -- The role of ethics in learning and teaching -- Learning, teaching and thinking for oneself -- The problem of life and the problems of life -- Studying oneself.

In this paper I argue against three leading accounts of self-deception in the philosophical literature and propose a heretofore overlooked route to self-deception. The central problem with extant accounts of self-deception is that they are unable to balance two crucial desiderata: (1) to make the dynamics of self-deception (e.g., the formation of self-deceptive beliefs) psychologically plausible and (2) to capture self-deception as an intentional phenomenon for which the self-deceiver is responsible. I argue that the three leading views all fail on (...) one or both counts. However, I claim that many or most cases of self-deception conform to a different model, which I call ‘Self-deception as Omission’. In these cases, the process of self-deceptive belief formation and the intentional act for which the self-deceiver is responsible come apart, allowing us to meet both desiderata. Self-deceptive beliefs are often formed by unconscious mechanisms closely analogous to the 'System 1' processes of dual-systems psychology, or by other mechanisms of motivated reasoning. The nascently self-deceptive subject then acquiesces in the comforting belief and commits an epistemic failure by allowing it to persist. If this is done for motivationally biased reasons — e.g., preferring that the belief in question be true — then the subject is self-deceived and is blameworthy for her epistemic omission. (shrink)

The consideration of the problem of healthcare allocation as a special case of distributive justice is especially alluring when we only consider consequentialist theories. I articulate here an alternative Rawlsian non-consequentialist theory which prioritizes the fairness of healthcare allocation procedures rather than directly setting distributive parameters. The theory in question stems from Rawlsian commitments that, it is argued, have a better Rawlsian pedigree than those considered as such by Tännsjö. The alternative framework is worthy of consideration on its own merits, (...) but it also casts light on two related difficulties with Tännsjö’s approach: (i) the limits of his supposedly ecumenical methodology, which is revealed to be dialectically suspect and (ii) issues with the type of abstraction and idealization from actual judgements and preferences which the approach requires. (shrink)

Major Depressive Disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a “brain disease.” What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of (...) MDD to the claim that brain dysfunction causes the symptoms of MDD. I argue that this consequence of the brain disease conception of MDD is false. It incorrectly rules out genuine instances of content-sensitive causation between adverse conditions in the world and the characteristic symptoms of MDD. Empirical evidence shows that the major causes of depression are genuinely psychological causes of the symptoms of MDD. This rules out, in many cases, the “brute” causation required by the brain disease conception. The existence of cases of MDD with non-brute causes supports the reinstatement of the old nosological distinction between endogenous and exogenous depression. (shrink)

Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide (...) advice. However, device representatives have a dual role: functioning as commissioned sales representatives at the same time as providing advice on approaches to treatment. This duality raises the concern that clinical decision-making may be unduly influenced by commercial imperatives. In this paper, we identify three key ethical concerns raised by the relationship between device representatives and health professionals: impacts on healthcare costs, the outsourcing of expertise and issues of accountability and informed consent. These ethical concerns can be addressed in part through clarifying the boundary between the support and sales aspects of the roles of device representatives and developing clear guidelines for device representatives providing support in clinical spaces. We suggest several policy options including hospital provision of expert support, formalising clinician conduct to eschew receipt of meals and payments from industry and establishing device registries. (shrink)

This paper argues that many so-called digital technologies can be construed as notational technologies, explored through the example of Monegraph, an art and digital asset management platform built on top of the blockchain system originally developed for the cryptocurrency bitcoin. As the paper characterizes it, a notational technology is the performance of syntactic notation within a field of reference, a technologized version of what Nelson Goodman called a “notational system.” Notational technologies produce abstracted entities through positive and reliable, or constitutive, (...) tests of socially acceptable meaning. Accordingly, this account deviates from typical narratives of blockchains, instead demonstrating that blockchain technologies are effective at managing digital assets because they produce abstracted identities through the performance of notation. Since notational technologies rely on configurations of socially acceptable meaning, this paper also provides a philosophical account of how blockchain technologies are socially embedded. (shrink)

Despite how he begins, suggesting that it is somehow a problem for me that I think "there is such a thing as philosophy, which could then be useful for psychopathology," ultimately it is clear that the possibility of philosophy is not the issue for Ghaemi. Rather, his issue is with academic philosophy of psychiatry, as he sees it, and with my failure to ask what underlying assumptions typically operate in it.I do not dispute that someone like Jaspers would want to (...) ask such a question, nor do I dispute that it is, in general, a perfectly good question. But Ghaemi thinks that my paper is missing out on something by not posing it. The reason he thinks this is because he thinks my paper is an instance of a pattern in the discipline against which he evidently has an axe to grind. In particular, he thinks philosophy in general should be more attendant to the ways in which Diagnostic and Statistical Manual of Mental Disorders (DSM) categories are (problematically) socially constructed. The fact that philosophers have failed to critically point this out allegedly shows philosophy of psychiatry's— and my—unexamined sympathy with the postmodern tendencies—understood as tendencies toward "relativism about truth" and "skepticism about science"—of psychiatry itself. This is odd for a number of reasons, especially in the present context. Firstly, I am not presently in a position to exhaustively defend all of philosophy of psychiatry on the charge of 'postmodernism,' or on the charge of failure to critically engage with the DSM, but it is worth simply stating that I find these to be rather patently unsubstantiated charges. Prominent works that falsify the latter and easily come to mind are by Tsou (2011), Cooper (2004, 2007), Horwitz and Wakefield (2007), Murphy (2006), Poland and von Eckhardt (2013), and Lalumera (2016). Of these, only Lalumera is interested in defending a DSM-style descriptivism (which perhaps Ghaemi would call a kind of "social constructionism"), but even she limits her defense of DSM categories to their role as reference-fixing representations. It is also true that Tsou's paper is an argument that the practical considerations which go into shaping the DSM categories sometimes represent values that permissibly operate in psychiatry. Perhaps this could be construed as a kind of social constructionism as well, and presumably Ghaemi would disagree with it, but no one here is guilty of a failure to engage critically with the DSM and its history. Further, whichever position is taken by these theorists on whether the DSM does, or even one day could, cut nature at its joints, or whether some of the values that shape its construction do so permissibly or impermissibly, one's acceptance or rejection of relativism about truth is an entirely logically independent matter. (shrink)

Increasingly, policymakers within biomedicine argue that “non-financial” interests should be given equal scrutiny to individuals’ financial relationships with industry. Problematized as “non-financial conflicts of interest,” interests, ranging from intellectual commitments to personal beliefs, are managed through disclosure, restrictions on participation, and recusal where necessary. “Non-financial” interests, though vaguely and variably defined, are characterized as important influences on judgment and thus, are considered risks to scientific objectivity. This article explores the ways that “non-financial interests” have been constructed as an ethical problem (...) and the implications for research integrity. I conducted an interpretive, qualitative study, which triangulated two data sources: documents (including published accounts of identifying and managing “non-financial” interests and conflict of interest policies) and in-depth interviews with 16 leaders within evidence-based medicine, responsible for contributing to, directing, or overseeing conflict of interest policy development and implementation. This article outlines how evolutions in the definition of conflict of interest have opened the door to include myriad “non-financial” interests, resulting in the generalisation of a statistical concept—risk of bias—to social contexts. Consequently, biases appear equally pervasive among participants while in reality, a politics of objectivity is at play, with allegations of conflict of interest used as a means to undermine others’ credibility, or even participation. Iterations of the concept of conflict of interest within biomedicine have thus consistently failed to articulate or address questions of accountability including whose interests are able to dominate or distort evidence-led processes and why. Consequently, current policy solutions meant to mitigate bias may instead serve exclusionary purposes under the guise of impartiality while remaining vulnerable to interference from powerful stakeholders. (shrink)

This article recounts the backlash against the neoliberal constitutionalism that locked in free trade and capital rights through the multilateral treaty organizations of the 1990s. It argues that we can find important forces in the disruption of the status quo among the elite losers of the 1990s settlement. Undercut by competition from China, the US steel industry, in particular, became a vocal opponent of unconditional free trade and a red thread linking all of Trump’s primary advisers on matters of trade. (...) Steel lobbyists themselves helped frame a critique of actually existing neoliberal globalism, which Trump both adopted and acted on as part of his trade war. By searching for the contemporary attack on neoliberal constitutionalism among the disgruntled corporate elite, we find that our current crisis must be framed as a backlash from above as well as one from below. (shrink)

Polynomial clone reducibilities are generalizations of the truth-table reducibilities. A polynomial clone is a set of functions over a finite set X that is closed under composition and contains all the constant and projection functions. For a fixed polynomial clone ${\fancyscript{C}}$ , a sequence ${B\in X^{\omega}}$ is ${\fancyscript{C}}$ -reducible to ${A \in {X}^{\omega}}$ if there is an algorithm that computes B from A using only effectively selected functions from ${\fancyscript{C}}$ . We show that if A is Kurtz random and ${\fancyscript{C}_{1} (...) \nsubseteq \fancyscript{C}_{2}}$ are polynomial clones, then there is a B that is ${\fancyscript{C}_{1}}$ -reducible to A but not ${\fancyscript{C}_{2}}$ -reducible to A. This implies a generalization of a result first proved by Lachlan (Z Math Logik Grundlagen Math 11:17–44, 1965) for the case |X| = 2. We also show that the same result holds if Kurtz random is replaced by Kolmogorov–Loveland stochastic. (shrink)

This paper raises a slightly uncomfortable question: are some delusional subjects responsible for their delusions? This question is uncomfortable because we typically think that the answer is pretty clearly just ‘no’. However, we also accept that self-deception is paradigmatically intentional behavior for which the self-deceiver is prima facie blameworthy. Thus, if there is overlap between self-deception and delusion, this will put pressure on our initial answer. This paper argues that there is indeed such overlap by offering a novel philosophical account (...) of self-deception. The account offered is independently plausible and avoids the main problems that plague other views. It also yields the result that some delusional subjects are self-deceived. The conclusion is not, however, that those subjects are blameworthy. Rather, a distinction is made between blameworthiness and ‘attributability’. States or actions can be significantly attributable to a subject—in the sense that they are expressions of their wills—without it being the case that the subject is blameworthy, if the subject has an appropriate excuse. Understanding delusions within this framework of responsibility and excuses not only illuminates the ways in which the processes of delusional belief formation and maintenance are continuous with ‘ordinary’ processes of belief formation and maintenance, it also provides a way of understanding the innocence of the delusional subject that does not involve the denial of agency. (shrink)

Philippa Foot is one of the most original and widely respected philosophers of our time; her work has exerted a lasting influence on the development of moral philosophy. In tribute to her, twelve leading philosophers from both sides of the Atlantic have contributed essays exploring the various topics in moral philosophy to which she has made a distinctive contribution--virtue ethics, naturalism, non-cognitivism, relativism, categorical requirements, and the role of rationality in morality.

It is a mistake to think that any philosophical contribution to the study of psychopathology is otiose. I identify three non-exhaustive roles that philosophy can and does occupy in the study of mental disorder, which I call the agenda-setting role, the synthetic role, and the regulative role. The three roles are illustrated via consideration of the importance of Jaspers' notion of understanding and its application to specific examples of mental disorder, including delusions of reference, Capgras delusion and other monothematic delusions, (...) and clinical depression. Together the three roles assign to philosophy of psychopathology the task of determining how to situate the varieties of mental disorder within the system of interpretive and evaluative concepts that partially make up the dynamic but indispensable manifest image. (shrink)

I welcome many of the conclusions of May's book, but I offer a suggestion – and with it what I take to be a complementary strategy – concerning the core commitments of rationalism across the domains of moral psychology in the hopes of better illuminating why a rationalist picture of the mind can deliver us from pessimism.

Conflicts of interest, stemming from relationships between health professionals and the pharmaceutical industry, remain a highly divisive and inflammatory issue in healthcare. Given that most jurisdictions rely on industry to self-regulate with respect to its interactions with health professionals, it is surprising that little research has explored industry leaders’ understandings of conflicts of interest. Drawing from in-depth interviews with ten pharmaceutical industry leaders based in Australia, we explore the normalized and structural management of conflicts of interest within pharmaceutical companies. We (...) contrast this with participants’ unanimous belief that the antidote to conflicts of interest with health professionals were “informed consumers.” It is, thus, unlikely that a self-regulatory approach will be successful in ensuring ethical interactions with health professionals. However, the pharmaceutical industry’s routine and accepted practices for disclosing and managing employees’ conflicts of interest could, paradoxically, serve as an excellent model for healthcare. (shrink)

Harms and risks to groups and third-parties can be significant in the context of research, particularly in data-centric studies involving genomic, artificial intelligence, and/or machine learning technologies. This article explores whether and how United States federal regulations should be adapted to better align with current ethical thinking and protect group interests. Three aspects of the Common Rule deserve attention and reconsideration with respect to group interests: institutional review board (IRB) assessment of the risks/benefits of research; disclosure requirements in the informed (...) consent process; and criteria for waivers of informed consent. In accordance with respect for persons and communities, investigators and IRBs should systematically consider potential group harm when designing and reviewing protocols, respectively. Research participants should be informed about any potential group harm in the consent process. We call for additional public discussion, empirical research, and normative analysis on these issues to determine the right regulatory and policy path forward. (shrink)

(2006). The Normative Justification of Traditional Chinese Authoritarianism. Critical Review of International Social and Political Philosophy: Vol. 9, No. 3, pp. 379-397.

‘Chance’ is arguably a context‐sensitive expression, a fact that some have thought bears upon the debate about the compatibility of determinism with objective, non‐trivial chances (chances with values other than 0 or 1). In this paper, I argue that this attempted move from context sensitivity to compatibilism is misguided, for a number of reasons. First, it relies on a theory of context sensitivity that we have independent reason to reject. Second, the resulting compatibilist position leaves unanswered precisely the sorts of (...) questions we reasonably expect a metaphysical account of chance to answer. (shrink)