Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...) the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy. Analysis: The primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta-analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population. Discussion: The arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well-reasoned rather than simply evidence-based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law-like, prescriptive generalizations. (shrink)

The new field of meta-research investigates industry bias, publication bias, contradictions between studies, and other trends in medical research. I argue that its findings should be used as meta-evidence for evaluating therapies. ‘Meta-evidence’ is evidence about the support that direct ‘first-order evidence’ provides the hypothesis. I consider three objections to my proposal: the irrelevance objection, the screening-off objection, and the underdetermination objection. I argue that meta-research evidence works by rationally revising our confidence in first-order evidence and, consequently, in the hypothesis—typically, (...) downward. (shrink)

Over the past 25 years, several new “medicines” have come screeching onto health care’s various platforms, including narrative medicine, personalized medicine, precision medicine and person-centred medicine. Philosopher Miriam Solomon calls the first three of these movements different “ways of knowing” or “methods,” and argues that they are each a response to shortcomings of methods that came before them. They should also be understood as reactions to the current dominant model of medicine. In this article, I will describe our dominant model, (...) which I call “the new medical model.” I will argue that several towering problems in modern medicine can be traced to its philosophical foundations, which calls for philosophical analysis. (shrink)

Over the past several decades, we devoted much energy to generating, reviewing and summarizing evidence. We have given far less attention to the issue of how to thoughtfully apply the evidence once we have it. That’s fine if all we care about is that our clinical decisions are evidence-based, but not so good if we also want them to be well-reasoned. Let us not forget that evidence based medicine (EBM) grew out of an interest in making medicine ‘rational’, with the (...) idea that rational clinical evaluations should be evidence-based. I agree with the uncontroversial statement that the best decision is supported, at least in part, by the best available evidence. Rationality, however, is constituted by reasoning, not evidence. Complete arguments are necessary for rational evaluations, arguments that begin with general evidence and end in a conclusion about a particular patient. In order to traverse these inferential gaps, medicine must address the issue of how to establish, as an intermediate premise, what the evidence has to say about the efficacy of an intervention for particular patients in a particular practice setting. (shrink)

It is sometimes thought that randomized study group allocation is uniquely proficient at producing comparison groups that are evenly balanced for all confounding causes. Philosophers have argued that in real randomized controlled trials this balance assumption typically fails. But is the balance assumption an important ideal? I run a thought experiment, the CONFOUND study, to answer this question. I then suggest a new account of causal inference in ideal and real comparative group studies that helps clarify the roles of confounding (...) variables and randomization. 1Confounders and Causes2The Balance Assumption3The CONFOUND Study 3.1CONFOUND 13.2CONFOUND 24Disjunction C and the Ideal Study 4.1The ultimate ‘other cause’: C4.2The ideal comparative group study4.3Required conditions for causal inference5Confounders as Causes, Confounders as Correlates6Summary. (shrink)

Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe distinct (...) perspectives on the same phenomenon, each perspective capturing a different level of contrastive analysis. (shrink)

What meaning does epidemiological evidence have for the individual? In evidence-based medicine, epidemiological evidence measures the patient’s risk of the outcome or the change in risk due to an intervention. The patient’s risk is commonly understood as an individual probability. The problem of understanding epidemiological evidence and risk thus becomes the challenge of interpreting individual patient probabilities. I argue that the patient’s risk is interpreted ontically, as a propensity. After exploring formidable problems with this interpretation in the medical context, I (...) propose an epistemic reinterpretation of individual patient probabilities as credences. On this view, epidemiological evidence informs medical uncertainty. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

This chapter begins with an empirical analysis of attitudes towards the law, which, in turn, inspires a philosophical re-examination of the moral status of the rule of law. In Section 2, we empirically analyse relevant survey data from the US. Although the survey, and the completion of our study, preceded the recent anti-police brutality protests sparked by the killing of George Floyd, the relevance of our observations extends to this recent development and its likely reverberations. Consistently with prior studies, we (...) find that people’s ascriptions of legitimacy to the legal system are predicted strongly by their perceptions of the procedural justice and lawfulness of police and court officials’ action. Two factors emerge as significant predictors of people’s compliance with the law: (i) their belief that they have a (content-independent, moral) duty to obey the law (which is one element of legitimacy, as defined here); and (ii) their moral assessment of the content of specific legal requirements (‘perceived moral content of laws’). We also observe an interactive relationship between these two factors. At higher levels of perceived moral content of laws, felt duty to obey is a better predictor of compliance. And, similarly, perceived moral content of laws is a better predictor of compliance at higher levels of felt duty to obey. This suggests that the moral content incorporated in specific laws interacts with the normative force people ascribe to legal authorities by virtue of other qualities, specifically here procedural justice and lawfulness. In Section 3, the focus shifts to a philosophical analysis, whereby we identify a parallel (similarly interactive) modality in the way that form and content mutually affect the value of the rule of law. We advocate a distinctive alternative to two rival approaches in jurisprudential discourse, the first of which claims that Lon Fuller’s eight precepts of legality embody moral qualities not contingent on the law’s content, while the second denies any independent moral value in these eight precepts, viewing them as entirely subservient to the law’s substantive goals. In contrast, on the view put forward here, Fuller’s principles possess (inter alia) an expressive moral quality, but their expressive effect does not materialise in isolation from other, contextual factors. In particular, the extent to which it materialises is partly sensitive to the moral quality of the law’s content. (shrink)

This paper focuses on an underexplored challenge in infinite ethics. On realistic assumptions, if our universe is infinite, every nomologically possible history is actual and nothing we ever do makes a difference to the moral quality of the world as a whole. Call this thought Every History. This paper unpacks Every History and explores some of its ethical implications. Specifically, I argue that if Every History is true and the universe turns out to be infinite (1) our lives are globally (...) insignificant, (2) moral principles enjoining the promotion of value need to be given an appropriately scope-restricted interpretation, and (3) impersonal consequentialism faces a serious challenge. (shrink)

According to an intriguing though somewhat enigmatic line of thought first proposed by Jonathan Bennett, if humanity went extinct any time soon this would be unfortunate because important business would be left unfinished. This line of thought remains largely unexplored. I offer an interpretation of the idea that captures its intuitive appeal, is consistent with plausible constraints, and makes it non-redundant to other views in the literature. The resulting view contrasts with a welfare-promotion perspective, according to which extinction would (...) be bad because it would come at a massive opportunity cost in terms of feasibly achievable welfare over the lifetime of our species. (shrink)

This paper looks at Gregory of Nyssa's so-called "bundle theory" sensible individuals and matter (as recently argued by Gerd Van Riel and Thomas Wauters in a 2020 article) amidst the broader context of Gregory's view of created beings and his reception of Neoplatonist, Stoic, and Aristotelian conceptions of particulars and matter. I argue that Gregory's position is closer to an Aristotelian position, despite the parallels to Plotinus and other contemporaneous bundle theory positions: in arguing against prime matter, and insofar as (...) he emphasizes the identity of each kind of created being with its material substrate—understood as a "bundle" of properties—Gregory inadvertently upholds a reading of Aristotle that refutes an ontological notion of prime matter. (shrink)

Altruistic deception (or the telling of “white lies”) is common in humans. Does it also exist in non-human animals? On some definitions of deception, altruistic deception is impossible by definition, whereas others make it too easy by counting useful-but-ambiguous information as deceptive. I argue for a definition that makes altruistic deception possible in principle without trivializing it. On my proposal, deception requires the strategic exploitation of a receiver by a sender, where “exploitation” implies that the sender elicits a behaviour in (...) the receiver that is beneficial in a different type of situation and is expressed only because the signal raises the probability, from the receiver’s standpoint, of that type of situation. I then offer an example of a real signal that is deceptive in this sense, and yet potentially altruistic (and certainly cooperative): the purr call of the pied babbler. Fledglings associate purr calls with food, and adults exploit this learned association, in the absence of food, to lead fledglings away from predators following an alarm call. I conclude by considering why altruistic deception is apparently so rare in non-human animals. (shrink)

In evolutionary medicine and other related fields, the concept of evolutionary mismatch is used to explain phenomena whereby traits reduce in adaptive value and eventually become maladaptive as the environment changes. This article argues that there is a similar problem of persistent adaptivity—what has been called the problem of evolutionary novelty—and it introduces the concept of mismatch resistance in order to explain phenomena whereby traits retain their adaptive value in novel environments that are radically different from the organisms’ environment of (...) evolutionary adaptedness (EEA). The possible role of variability selection in the evolution of mismatch-resistant traits is discussed, and it is suggested that mismatch resistance provides a useful tool for making progress on certain issues related to evolutionary theory, such as the modularity debate, cases of adaptivity outside of organisms’ ancestral environment, and the viability of naturalism as an overarching philosophical framework for understanding the natural world. (shrink)

Research on the capacity to understand others' minds has tended to focus on representations ofbeliefs,which are widely taken to be among the most central and basic theory of mind representations. Representations ofknowledge, by contrast, have received comparatively little attention and have often been understood as depending on prior representations of belief. After all, how could one represent someone as knowing something if one does not even represent them as believing it? Drawing on a wide range of methods across cognitive science, (...) we ask whether belief or knowledge is the more basic kind of representation. The evidence indicates that nonhuman primates attribute knowledge but not belief, that knowledge representations arise earlier in human development than belief representations, that the capacity to represent knowledge may remain intact in patient populations even when belief representation is disrupted, that knowledge (but not belief) attributions are likely automatic, and that explicit knowledge attributions are made more quickly than equivalent belief attributions. Critically, the theory of mind representations uncovered by these various methods exhibits a set of signature features clearly indicative of knowledge: they are not modality-specific, they are factive, they are not just true belief, and they allow for representations of egocentric ignorance. We argue that these signature features elucidate the primary function of knowledge representation: facilitating learning from others about the external world. This suggests a new way of understanding theory of mind – one that is focused on understanding others' minds in relation to the actual world, rather than independent from it. (shrink)

Non‐governmental aid programs are an important source of health care for many people in the developing world. Despite the central role non‐governmental organizations play in the delivery of these vital services, for the most part they either lack formal systems of accountability to their recipients altogether, or have only very weak requirements in this regard. This is because most NGOs are both self‐mandating and self‐regulating. What is needed in terms of accountability is some means by which all the relevant stakeholders (...) can have their interests represented and considered. An ideally accountable decision‐making process for NGOs should identify acceptable justifications and rule out unacceptable ones. Thus, the point of this paper is to evaluate three prominent types of justification given for decisions taken at the Dutch headquarters of Médecins sans Frontières. They are: population health justifications, mandate‐based justifications and advocacy‐based justifications. The central question at issue is whether these justifications are sufficiently robust to answer the concerns and objections that various stakeholders may have. I am particularly concerned with the legitimacy these justifications have in the eyes of project beneficiaries. I argue that special responsibilities to certain communities can arise out of long‐term engagement with them, but that this type of priority needs to be constrained such that it does not exclude other potential beneficiaries to an undesirable extent. Finally, I suggest several new institutional mechanisms that would enhance the overall equity of decisions and so would ultimately contribute to the legitimacy of the organization as a whole. (shrink)

In the exceptional book _Divine Holiness and Divine Action_, Mark Murphy defends what he calls the _holiness framework _for divine action. The purpose of our essay-response to Murphy’s book is to consider an alternative framework for divine action, what we call the _agapist framework_. We argue that the latter framework is more probable than Murphy’s holiness framework with respect to_ select _theological desiderata.

In this paper I examine a recent incarnation of common objection to evidentialism. According to this common objection, evidentialism gives the wrong verdicts in cases where the subject has been irresponsible in inquiry. Sandy Goldberg (2021) has argued that a particularly vivid instance of this problem occurs when an individual violates normative expectations that have been placed on them in their inquiry. Having laid out Goldberg’s case, I argue that the desirable verdicts can be better attained by endorsing evidentialism and (...) supplementing it with an account of robust justification that I have defended elsewhere. (shrink)

What makes fast, cumulative cultural evolution work? Where did it come from? Why is it the sole preserve of humans? We set out a self-assembly hypothesis: cultural evolution evolved culturally. We present an evolutionary account that shows this hypothesis to be coherent, plausible, and worthy of further investigation. It has the following steps: (0) in common with other animals, early hominins had significant capacity for social learning; (1) knowledge and skills learned by offspring from their parents began to spread because (...) bearers had more offspring, a process we call CS1 (or Cultural Selection 1); (2) CS1 shaped attentional learning biases; (3) these attentional biases were augmented by explicit learning biases (judgements about what should be copied from whom). Explicit learning biases enabled (4) the high-fidelity, exclusive copying required for fast cultural accumulation of knowledge and skills by a process we call CS2 (or Cultural Selection 2), and (5) the emergence of cognitive processes such as imitation, mindreading and metacognition – ‘cognitive gadgets’ specialised for cultural learning. This self-assembly hypothesis is consistent with archaeological evidence that the stone tools used by early hominins were not dependent on fast, cumulative cultural evolution, and suggests new priorities for research on ‘animal culture’. (shrink)

Consent theory in sexual ethics, Jonathan Ichikawa argues, has a Euthyphro problem. -/- It is widely held that sexual violations are explicable in terms of nonconsensual sexual contact. But a notion of consent adequate to explain many moral judgments typical of sexual ethics — a notion that vindicates the idea that consent cannot be coerced, that it must be sober, that children cannot consent to sex with adults, etc. — cannot, Ichikawa argues, be articulated, motivated, or explained in a (...) way independently of moral judgments about sexual wrongs. Consequently, if there is as tight a connection between consent and sexual violation as many people think there is, there is good reason to suppose that that connection must ultimately explain consent in terms of sexual wronging, rather than vice versa. The paper highlights some costs and drawbacks to this horn of the Euthyphro dilemma in sexual ethics. One central upshot of the argument will be that mainstream accounts of sexual ethics fail in their explanatory ambitions. Consent cannot play its canonical explanatory role. (shrink)

Peter Carruthers has recently argued for a surprising conditional: if a global workspace theory of phenomenal consciousness is both correct and fully reductive, then there are no substantive facts to discover about phenomenal consciousness in nonhuman animals. I present two problems for this conditional. First, it rests on an odd double-standard about the ordinary concept of phenomenal consciousness: its intuitive non-gradability is taken to be unchallengeable by future scientific developments, whereas its intuitive determinacy is predicted to fall by the wayside. (...) Second, it relies on dismissing, prematurely, the live empirical possibility that phenomenal consciousness may be linked to a core global broadcast mechanism that is shared by a wide range of animals. Future developments in the science of consciousness may lead us to reconsider the non-gradability of phenomenal consciousness, but they are unlikely to lead us to accept that there are no facts to discover outside the paradigm case of a healthy adult human. (shrink)

This is a response to the nine commentaries on our target article “Unlimited Associative Learning: A primer and some predictions”. Our responses are organized by theme rather than by author. We present a minimal functional architecture for Unlimited Associative Learning that aims to tie to together the list of capacities presented in the target article. We explain why we discount higher-order thought theories of consciousness. We respond to the criticism that we have overplayed the importance of learning and underplayed the (...) importance of spatial modelling. We decline the invitation to add a negative marker to our proposed positive marker so as to rule out consciousness in plants, but we nonetheless maintain that there is no positive evidence of consciousness in plants. We close by discussing how UAL relates to development and to its material substrate. (shrink)

This article is a response to William Lynch’s, ‘Social Epistemology Transformed: Steve Fuller’s Account of Knowledge as a Divine Spark for Human Domination,’ an extended and thoughtful reflection on my Knowledge: The Philosophical Quest in History. I grant that Lynch has captured well, albeit critically, the spirit and content of the book – and the thirty-year intellectual journey that led to it. In this piece, I respond at two levels. First, I justify my posture towards my predecessors and contemporaries, (...) which Lynch shrewdly sees as my opposition to deference. However, most of the response concerns an elaboration of my theodicy-focussed sense of social epistemology, which is long-standing but only started to become prominent about ten years ago, in light of my involvement in the evolution controversies. Here I aim to draw together a set of my abiding interests – scientific, theological and philosophical – in trying to provide a normative foundation for the future of humanity. (shrink)

When agents violate norms, they are typically judged to be more of a cause of resulting outcomes. In this paper, we suggest that norm violations also affect the causality attributed to other agents, a phenomenon we refer to as "causal superseding." We propose and test a counterfactual reasoning model of this phenomenon in four experiments. Experiments 1 and 2 provide an initial demonstration of the causal superseding effect and distinguish it from previously studied effects. Experiment 3 shows that this causal (...) superseding effect is dependent on a particular event structure, following a prediction of our counterfactual model. Experiment 4 demonstrates that causal superseding can occur with violations of non-moral norms. We propose a model of the superseding effect based on the idea of counterfactual sufficiency. (shrink)

This article offers an account of moods as distinctive kinds of personal level affective-evaluative states, which are both intentional and rationally intelligible in specific ways. The account contrasts with those who claim moods are non-intentional, and so also arational. Section 1 provides a conception of intentionality and distinguishes moods, as occurrent experiential states, from other states in the affective domain. Section 2 argues moods target the subject’s total environment presented in a specific evaluative light through felt valenced attitudes (the Mood-Intentionality (...) thesis). Section 3 argues some moods are experienced as rationally intelligible responses, and so epistemically appropriate, to the way ‘the world’ presents itself (the Mood-Intelligibility thesis). Finally, section 4 discusses the epistemology of moods. (shrink)

According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues that (...) standard accounts of SDM actually undermine patient autonomy. It also provides an overview of the obligations generated by the principle of respect for relational autonomy that have not been captured in standard accounts of SDM and which are necessary to ensure consistency between clinical practice and respect for patient autonomy. (shrink)

Citizens of liberal, affluent societies are regularly encouraged to support reforms meant to improve conditions for badly-off people in the developing world. Our economic and political support is solicited for causes such as: banning child labor, implementing universal primary education, closing down sweatshops and brothels, etc. But what if the relevant populations or individuals in the developing world do not support these particular reforms or aid programs? What if they would strongly prefer other reforms and programs, or would rank the (...) various benefits that might be offered differently than seems reasonable to the Western, liberal supporters of these campaigns and organizations? What is the proper liberal response here? I argue that the proper liberal response is to support those programs and reforms that the global poor most value. The bulk of the paper is devoted to arguing against the popular liberal argument which states that we can safely disregard the preferences of the oppressed when they seem very unreasonable because these individuals suffer from “adaptive preferences.” This typically is taken to mean that their preferences are “not their own” in an important sense. I put forward various different proposals for why adaptive preferences can be safely dismissed, but ultimately argue that they are not persuasive. And if it is no longer legitimate to appeal to adaptive preferences as a basis for disregarding what oppressed people want, then I argue that to do so is straightforward paternalism, and so is unjustifiable in all but the most extreme cases. Finally, I argue for the following concrete recommendations: Given that resources are not infinite, we should (1) Support programs that give oppressed people increased access to information, such as access to technology, (2) support those reforms and aid programs that the oppressed themselves regard as most important, with special emphasis on those opportunities for education that they deem valuable, and (3) refrain from supporting coercive policies intended to thwart adaptive preferences. (shrink)

When two agents engage in a joint action, such as rowing together, they exercise joint know-how. But what is the relationship between the joint know-how of the two agents and the know-how each agent possesses individually? I construct an “active mutual enablement” account of this relationship, according to which joint know-how arises when each agent knows how to predict, monitor, and make failure-averting adjustments in response to the behaviour of the other agent, while actively enabling the other to make such (...) adjustments. I defend the AME account from three objections, and I then use this account as the platform for an examination of the reducibility of joint know-how to joint propositional knowledge. A summative account of joint propositional knowledge is incompatible with the reduction of joint know-how to joint propositional knowledge, whereas a distributive account is not. I close by highlighting some open questions the AME account brings into view concerning the evolutionary origin and scaling up of joint know-how. (shrink)

According to the Ontological Innocence Thesis (OIT), grounded entities are ontologically innocent relative to their full grounds. I argue that OIT entails a contradiction, and therefore must be discarded. My argument turns on the notion of “groundmates,” two or more numerically distinct entities that share at least one of their full grounds. I argue that, if OIT is true, then it is both the case that there are groundmates and that there are no groundmates. Therefore, so I conclude, OIT is (...) false. Moreover, once we have seen why OIT is false, only three heterodox views about reality's structure remain. So this paper’s second conclusion is that, even after we have discarded OIT, we are in for an additional surprise. (shrink)

Many philosophers have understood the representational dimension of affective states along the model of sense-perceptual experiences, even claiming the relevant affective experiences are perceptual experiences. This paper argues affective experiences involve a kind of personal level affective representation disanalogous from the representational character of perceptual experiences. The positive thesis is that affective representation is a non-transparent, non-sensory form of evaluative representation, whereby a felt valenced attitude represents the object of the experience as minimally good or bad, and one experiences that (...) evaluative standing as having the power to causally motivate the relevant attitude. I show this view can make sense of distinctive features of affective experiences, such as their valence and connection to value in a way which moves beyond current evaluativist views of affect. (shrink)

Self-interest voting is irrational when it has even a small cost, but it can be rational for those who care about others; its expected utility (EU) may exceed its cost. For cosmopolitan voters (those who care about outsiders), the EU of voting increases with the number of affected others. The EU of voting for the good of the world now and in the future can thus be large. In some cases, the EU of parochial voting (e.g., considering only one's nation) (...) may not cross the cost threshold, but cosmopolitan voting can cross it. I apply these principles to various kinds of voting. And I compare voting to charity. Voting has the advantage of enlisting the coercive power of the state, but charity can be more focused on effective policies. I discuss campaign contributions, and I conclude with a discussion of the existence of utilitarian voters. (shrink)

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the (...) DSM's diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

This article responds to two arguments against ‘Epistemic Perceptualism’, the view that emotional experiences, as involving a perception of value, can constitute reasons for evaluative belief. It first provides a basic account of emotional experience, and then introduces concepts relevant to the epistemology of emotional experience, such as the nature of a reason for belief, non-inferentiality, and prima facie vs. conclusive reasons, which allow for the clarification of Epistemic Perceptualism in terms of the Perceptual Justificatory View. It then challenges two (...) arguments which purport to show that emotional experience is not a source of reasons for evaluative belief. The first argument claims that because normative why-questions are always appropriate in the case of emotions, then emotions can never be conclusive reasons for corresponding evaluative beliefs. The second purports to show that appeal to emotional experience as a source of reasons for evaluative beliefs renders emotions problematically self-justifying, and since emotions cannot be self-justifying, they cannot provide any sort of reason for corresponding evaluative beliefs. This article responds to these arguments, and in doing so shows there is still much to be learned about the epistemology of emotional experience by drawing analogies with perceptual experience. (shrink)

In this paper, we defend Lucretian Presentism. Although the view faces many objections and has proven unpopular with presentists, we rehabilitate Lucretianism and argue that none of the objections stick.

Recently, some have attempted to reformulate debates in first-order metaphysics, particularly in the metaphysics of time and modality, for reasons due to Williamson. In this paper, we focus on the ways in which the likes of Cameron, Correia and Rosenkranz, Deasy, Ingram, Tallant, Viebahn, inter alia, have initiated and responded to attempts to capture the core of presentism using a formal, logical machinery. We argue that such attempts are doomed to fail because there is no theoretical core to presentism. There (...) is no single view or family of views that is presentism. (shrink)