My doctoral project is a study of epistemological and ethical issues in Evidence-Based Medicine, a movement in medicine which emphasizes the use of randomized controlled trials. Much of the research on EBM suggests that, for a large part of the movement's history, EBM considered expertise, mechanisms, and values to be forces contrary to its goals and has sought to remove them, both from medical research and from the clinical encounter. I argue, however, that expertise, mechanisms and values have important epistemological (...) and ethical roles to play and can be incorporated into the current EBM movement. (shrink)

A debate persists over how to distinguish manic states from non-manic ones (such as depressions). A lacuna exists amongst these efforts, where a specifically agentive account of mania would sit. An agentive account centers the manic person’s view of practical reasons, rationalizing their actions in the same way that sympathetic understandings rationalize the actions of more neurotypical agents. In this paper, I argue that mania restructures our agency by creating a pervasive sense of urgency. This urgency changes the kind of (...) handling that our practical reasons seem to call out for. Whilst this can make us less reliable as agents, I argue that this does not undermine the basic capacities on which personal autonomy is founded. The greater threat to manic agents’ autonomy is nonrecognition of this restructured agency, undermining autonomy in its social dimensions. Without an agentive account, we will fail to recognize distinctly manic agency when we see it, limiting our understanding of autonomy, and withholding recognition, fundamental to autonomy in its social dimensions, from manic agents. (shrink)