Experimental philosophy’s much-discussed ‘restrictionist’ program seeks to delineate the extent to which philosophers may legitimately rely on intuitions about possible cases. The present paper shows that this program can be (i) put to the service of diagnostic problem-resolution (in the wake of J.L. Austin) and (ii) pursued by constructing and experimentally testing psycholinguistic explanations of intuitions which expose their lack of evidentiary value: The paper develops a psycholinguistic explanation of paradoxical intuitions that are prompted by verbal case-descriptions, and presents (...) two experiments that support the explanation. This debunking explanation helps resolve philosophical paradoxes about perception (known as ‘arguments from hallucination’). (shrink)

The aim of the article is to show how the use of diagnostic methods allows identifying patterns and problems of corporations functioning, providing identification of directions and strategies for further development of their business. Theoretical and methodological basis of the research is a scientific works of scientists in the field of business diagnostics and strategic development, who studied diagnostics in the system of responding to business development problems, identifying areas for improving strategic management, financial statements of corporations of Daimler (...) Group (Germany), Tesla Motors (USA) and Toyota Motor (Japan) and own research results. The methodological basis of the study is a set of general and special methods used to achieve the goal of the research and includes: theoretical generalization and synthesis – in analyzing the content of scientific works on business diagnostics and strategic management; observation – to obtain primary information about the state of business of automotive companies in the world; indicator and integrated assessment – to assess the state of business and the effectiveness of strategic management of automotive corporations; information and logical analysis – when determining the issues and patterns of business development of corporations; problem-target method – to justify the choice of business development strategies; causation-result method – to obtain definitive conclusions. The results of the study of the state of business of the world's leading automotive corporations revealed the dependence of business efficiency on the degree of efficiency of strategic management of their activities, and identified types of strategies that will promote further development of automotive corporations – integrated, concentrated, diversified or globalized growth. The practical significance of the obtained results lies in their usefulness for strategic management for Daimler Group, Tesla Motors, Toyota Motor Corporation. (shrink)

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs written (...) by people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)

Aims: The Research Diagnostic Criteria for Temporomandi¬bular Disorders (RDC/TMD) Axis I diagnostic algorithms were demonstrated to be reliable but below target sensitivity and specificity. Empirical data supported Axis I algorithm revisions that were valid. Axis II instruments were shown to be both reliable and valid. An international consensus workshop was convened to obtain recommendations and finalization of new Axis I diagnostic algorithms and new Axis II instruments. Methods: A comprehensive search of published TMD diagnostic literature was (...) followed by review and consensus via a formal structured process by a panel of experts for revision of the RDC/TMD. Results: The recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for pain diagnoses and valid criteria for the most common pain-related TMDs and for one intra-articular disorder. The Axis II protocol retains selected RDC/TMD screening instruments augmented with new instruments to better assess the interactions between pain and psychosocial functioning. A comprehensive classification system is also presented. Conclusion: The recommended evidence-based DC/TMD protocol is appropriate for use in both the clinical and research settings. Simple Axis I and II screening tests augmented by validated Axis I and Axis II instruments allow for identification of simple to complex TMD patients. (shrink)

This paper reviews the recent (post-DSM) history of subjective and semi-structured methods of psychiatric diagnosis, as well as evidence for the superiority of structured and computer-aided diagnostic techniques. While there is evidence that certain forms of therapy are effective for alleviating the psychiatric suffering, distress, and dysfunction associated with certain psychiatric disorders, this paper addresses some of the difficult methodological and ethical challenges of evaluating the effectiveness of therapy.

In order to ensure stable functioning and development of the enterprise, they evaluate the effectiveness of economic activity. An effective tool for assessing economic activity in modern conditions is economic diagnostics, which allows you to analyze the main indicators of the enterprise, to explore the factors that led to the change in the relevant results and adversely affected the activities of the enterprise. Agricultural enterprises also need such methodological tools for economic diagnostics. However, the existing tools for assessing the effectiveness (...) of economic activity does not allow for a comprehensive assessment of indicators. In addition, the management system of agricultural enterprises raises the requirements for providing a more effective and justified system of evaluating indicators using economic diagnostics. (shrink)

The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, (...) we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail. (shrink)

Modern business conditions require from economic entities to use appropriate methodological tools for assessing their activities. In economics science a fairly significant set of approaches, methods and techniques are now known that positively contribute to solving problems regarding ensure of competitiveness the economic entities. However, active influence of the internal and external environment on their activities, as well as the specificity of economic management the economic entities, requires the use of more effective methodological tools that can identify threats of the (...) external environment and explore the strengths of activity the economic entities. (shrink)

This paper indicates how continental philosophy may contribute to a diagnostics of contemporary life sciences research, as part of a “diagnostics of the present”. First, I describe various options for an oblique reading of emerging scientific discourse, bent on uncovering the basic “philosophemes” of science. Subsequently, I outline a number of radical transformations occurring both at the object-pole and at the subject-pole of the current knowledge relationship, namely the technification of the object and the anonymisation or collectivisation of the subject, (...) under the sway of automation, ICT and big machines. Finally, I further elaborate the specificity of the oblique perspective with the help of Lacan’s theorem of the four discourses. Philosophical reflections on contemporary life sciences concur neither with a Master’s discourse, nor with university discourse, nor with what Lacan refers to as hysterical discourse, but rather with the discourse of the analyst, listening with evenly-poised attention to the scientific files in order to bring to the fore the cupido sciendi which both inspires and disrupts contemporary life sciences discourse. (shrink)

We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is particularly (...) apparent in this case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine. (shrink)

Advanced medical imaging, such as CT, fMRI and PET, has undergone enormous progress in recent years, both in accuracy and utilization. Such techniques often bring with them an illusion of immediacy, the idea that the body and its diseases can be directly inspected. In this paper we target this illusion and address the issue of the reliability of advanced imaging tests as knowledge procedures, taking positron emission tomography in oncology as paradigmatic case study. After individuating a suitable notion of reliability, (...) we argue that PET is a highly theory-laden and non-immediate knowledge procedure, in spite of the photographic-like quality of the images it delivers; the diagnostic conclusions based on the interpretation of PET images are population-dependent; PET images require interpretation, which is inherently observer-dependent and therefore variable. We conclude with a three-step methodological proposal for enhancing the reliability of advanced medical imaging. (shrink)

The authors of the book have come to the conclusion that it is necessary to effectively use modern management mechanisms and development strategies of economic entities in order to increase the efficiency of their activities. Basic research focuses on diagnostics threat of bankruptcy, assessment of bioenergy potential, intellectual property, efficiency of corporate governance, use of information support, ensuring competitiveness of banking institutions, functioning of the tax system and its decentralization, assessment of the investment climate and investment risks, functioning of a (...) small business. The research results have been implemented in the different models of cluster structures, mechanisms for monitoring the quality of health care, predicting the convergence of economic development, innovative development models, and development strategies of economic entities in various sectors of the economy in the context of euro integration. The results of the study can be used in decisionmaking at the level of international business, ministries and departments that regulate the processes development of economic systems, ensuring stability and efficiency. The results can also be used by students and young scientists in modern concepts of the development of economic entities in the context of institutional transformations of the global environment. (shrink)

(English then french abstract) -/- This article, which can be read by non-psychoanalysts, intends to browse in four stages through the issue offered to our thinking : two (odd-numbered) stages analyzing the argument that provides its context, and two (even-numbered) of propositions presenting our views on what could be the content of the analytic discourse in the coming years. After this introduction, a first reading will point by point but informally review the argument of J.-P. Journet by showing that each (...) of its clauses may generate a “bifurcated” comment able to serve or go against the analytic discourse. Hence the interest of the “differential diagnosis” mentioned in our title, which makes glimpse the traps that the homonymy may set to this speech. Then, to prepare a second scan which sticks neither to the analytical doxa, nor to the even authoritative opinions of our tenors and seniors, it will be proposed two attempts at redefinitions (“apophatic” and “recursive”) of what psychoanalysis is, as well as methodological tools operating downstream from these redefinitions to thwart the obstacles of “external” and “internal” homonymy (starting from a syllogism which can make consensus).The third stage will precisely be made of our second scan of the issue, whose elements will be reviewed and analyzed more methodically :“external differential diagnosis” between the analytic discourse and psychology, philosophy, sociology, and modern science, and “internal differential diagnosis” on the entanglement between theoretical advances of psychoanalysts and the repeated survival of fantasmatic elements...Finally, a fourth part will present propositions and perspectives resulting from these analysis (principle of economy as to the source of psychoanalytical theorizations; dialogue with the other fields, but without compromising; specific relations with the discourse of science), all this leading to an invitation, beyond disputes, to renew the content of the analytic discourse on some points... -/- --------------------------------------------------------------------- -/- Cet article, qui se veut lisible aux non-analystes, se propose de parcourir en quatre temps la problématique offerte à notre réflexion : deux temps (de rang impair) d'analyse de l'argument qui en fournit le contexte, et deux (de rang pair) de propositions présentant nos vues sur ce que pourrait être la teneur du discours analytique dans les prochaines années. Après cette introduction, un premier parcours réexaminera point par point mais informellement l'argument de J.-P. Journet en montrant que chacune de ses propositions peut donner lieu à un commentaire “bifide” à même de servir ou de desservir le discours analytique. D'où l'intérêt du “diagnostic différentiel” évoqué dans notre titre, qui fait entrevoir les pièges que l'homonymie peut tendre à ce discours.Puis, pour préparer un second balayage qui ne s'en tienne ni à la doxa analytique, ni aux opinions même autorisées de nos ténors et seniors, il sera proposé deux tentatives de redéfinitions (“apophatique” et “récursive”) de ce qu'est l'analyse, ainsi que des outils méthodologiques fonctionnant en aval de ces redéfinitions pour déjouer les embûches de l'homonymie “externe” et “interne” (à partir d'un syllogisme pouvant faire consensus). Le troisième temps sera fait justement de ce second balayage de la problématique, dont les éléments seront reconsidérés et analysés plus méthodiquement : “diagnostic différentiel externe” entre le discours analytique et les discours psychologique, philosophique, sociologique et celui de la science moderne ; et “diagnostic différentiel interne” portant sur l'intrication entre avancées théoriques des analystes et survivance à répétition d'éléments fantasmatiques...Enfin une quatrième partie exposera propositions et perspectives résultant de ces analyses (principe d'économie quant à la source des théorisations analytiques ; dialogue avec les autres champs, mais sans compromissions ; relations spécifiques avec le discours de la science), l'ensemble débouchant sur une invitation, au delà des différends, à renouveler sur certains points la teneur du discours analytique... (shrink)

This article solves the problem of ensuring database decision-making in conditions of growing uncertainty and risks based on the results of business diagnostics is solved in this article. The main purpose of the research is to further develop the methodology of forming an analytical database for making management decisions. The following methods formed the methodological basis of the research: abstract-logical – used to generalize theoretical approaches and confirm the practical significance of solving the problem of decision-making in conditions of uncertainty (...) and risk; system analysis – when building a model of decision-making while coordinating areas and methods of business diagnostics; generalization – when drawing conclusions based on research results. The results of solving the problem of decision-making by improving the methodological approach in selecting areas and methods of business diagnostics in the conditions of growing uncertainty and risks are given in the article. The results of the research have practical value for companies that seek to reduce uncertainty and risk in the decision-making process in business management. (shrink)

There is a need recognized by the National Institute of Dental & Craniofacial Research and the National Cancer Institute to advance basic, translational and clinical saliva research. The goal of the Salivaomics Knowledge Base (SKB) is to create a data management system and web resource constructed to support human salivaomics research. To maximize the utility of the SKB for retrieval, integration and analysis of data, we have developed the Saliva Ontology and SDxMart. This article reviews the informatics advances in saliva (...) diagnostics made possible by the Saliva Ontology and SDxMart. (shrink)

The purpose of the article is to solve an important scientific problem – further development of the basics of management decisions on the implementation of export-import activities based on the results of enterprise symptomatic diagnostics in disruption conditions of sustainable development of the world economy. The essence of enterprise symptomatic diagnostics in the context of management activity is specified by the results of the critical analysis of the scientific publications. The study of the features of the symptomatic diagnostics process of (...) enterprise export-import activity might become the basis for the development of a comprehensive approach to its implementation, which reveals the interaction of the theoretical, scientific and methodological basis and the targeted direction of managers` actions in the diagnostics process. Generalization of symptomatic complex of export-import activity of enterprises-manufacturers of BOPP films – Terichem Tervakoski, a.s. and Xpro India Ltd, helped to identify issues that are reducing its performance. A set of measures was explored in order to avoid the negative symptoms of export-import activity of Terichem Tervakoski and Xpro India Ltd. The authors revealed some dependency respecting that the more negative symptoms of export-import activity realization lead to decline the efficiency of its implementation. The results of the study might clarify the impact of symptoms on the results of the enterprise export-import performance. Symptomatic diagnostics of enterprise export-import activity is considered as the basis of a sequence of management measures in order to avoid negative symptoms of export-import activity. (shrink)

Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

In somatic medicine, diagnostic terms often refer to the disease processes that are the causes of patients' symptoms. The language used in some clinical textbooks and health information resources suggests that this is also sometimes assumed to be the case with diagnoses in psychiatry. However, this seems to be in tension with the ways in which psychiatric diagnoses are defined in diagnostic manuals, according to which they refer solely to clusters of symptoms. This paper explores how theories of (...) reference in the philosophy of language can help to resolve this tension. After the evaluation of descriptive and causal theories of reference, I put forward a conceptual framework based on two-dimensional semantics that allows the causal analysis of diagnostic terms in psychiatry, while taking seriously their descriptive definitions in diagnostic manuals. While the framework is presented as a solution to a problem regarding the semantics of psychiatric diagnoses, it can also accommodate the analysis of diagnostic terms in other medical disciplines. (shrink)

The failure of psychiatry to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the structure and content of the Diagnostic and Statistical Manual of Mental Disorders. Here I argue that in fact what has retarded biomedical approaches to psychopathology is unwarranted optimism about diagnostic discrimination: the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I consider the (...) Research Domain Criteria framework as a new paradigm for classifying objects of psychiatric research that solves some of the challenges brought on by this assumption. (shrink)

Editor’s Note: If all goes as planned, the American Psychiatric Association will release a new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013. Since 1980, the DSM has provided a shared diagnostic language to clinicians, patients, scientists, school systems, courts, and pharmaceutical and insurance companies; any changes to the influential manual will have serious ramifications. But, argues Dr. Steven Hyman, the DSM is a poor mirror of clinical and biological realities; a fundamentally new approach to (...) diagnostic classification is needed as researchers uncover novel ways to study and understand mental illness. (shrink)

Cardiotocography data uncertainty is a critical task for the classification in biomedical field. Constructing good and efficient classifier via machine learning algorithms is necessary to help doctors in diagnosing the state of fetus heart rate. *e proposed neutrosophic diagnostic system is an Interval Neutrosophic Rough Neural Network framework based on the backpropagation algorithm. It benefits from the advantages of neutrosophic set theory not only to improve the performance of rough neural networks but also to achieve a better performance than (...) the other algorithms. *e experimental results visualize the data using the boxplot for better understanding of attribute distribution. *e performance measurement of the confusion matrix for the proposed framework is 95.1, 94.95, 95.2, and 95.1 concerning accuracy rate, precision, recall, and F1-score, respectively. WEKA application is used to analyse cardiotocography data performance measurement of different algorithms, e.g., neural network, decision table, the nearest neighbor, and rough neural network. *e comparison with other algorithms shows that the proposed framework is both feasible and efficient classifier. Additionally, the receiver operation characteristic curve displays the proposed framework classifications of the pathologic, normal, and suspicious states by 0.93, 0.90, and 0.85 areas that are considered high and acceptable under the curve, respectively. Improving the performance measurements of the proposed framework by removing ineffective attributes via feature selection would be suitable advancement in the future. Moreover, the proposed framework can also be used in various real-life problems such as classification of coronavirus, social media, and satellite image. (shrink)

Cet article s’intéresse aux injustices épistémiques à l’œuvre dans le milieu médical et en particulier dans la pratique du diagnostic. Il s’inscrit dans la continuité des discussions philosophiques liées aux injustices épistémiques, et résonne en particulier avec le travail de Miranda Fricker sur l’injustice herméneutique1. Le but principal est de montrer que l’accès au diagnostic est un enjeu de justice épistémique. Les critiques de la médicalisation dénoncent depuis longtemps des torts épistémiques causés par le milieu médical – par (...) exemple la pathologisation liée au diagnostic. Tout en reconnaissant ces dangers, nous montrons, à travers une analyse de témoignages et de contenus produits par des personnes diagnostiquées de différentes conditions, que des bénéfices épistémiques peuvent aussi découler d’un diagnostic. Ainsi, nous proposons de distinguer entre bienfait thérapeutique et bienfait herméneutique du diagnostic. Ensuite, nous défendons que certains déficits de diagnostics constituent des injustices herméneutiques structurelles. Nous avançons finalement l’idée qu’une approche reconnaissant et valorisant les bienfaits épistémiques du diagnostic peut avoir un impact positif sur nos pratiques médicales, et peut également jeter un éclairage nouveau, plus charitable, sur les pratiques d’autodiagnostic. (shrink)

What makes a high-quality biomarker experiment? The success of personalized medicine hinges on the answer to this question. In this paper, I argue that judgment about the quality of biomarker experiments is mediated by the problem of theoretical underdetermination. That is, the network of biological and pathophysiological theories motivating a biomarker experiment is sufficiently complicated that it often frustrates valid interpretation of the experimental results. Drawing on a case-study in biomarker diagnostic development from neurooncology, I argue that this problem (...) of underdetermination can be overcome with greater coordination across the biomarker research trajectory. I then sketch an account for how coordination across a research trajectory can be evaluated. I ultimate conclude that what makes a high-quality biomarker experiment must be judged by the epistemic contribution it makes to this coordinated research effort. (shrink)

This monograph contributes to the scientific misconduct debate from an oblique perspective, by analysing seven novels devoted to this issue, namely: Arrowsmith by Sinclair Lewis (1925), The affair by C.P. Snow (1960), Cantor’s Dilemma by Carl Djerassi (1989), Perlmann’s Silence by Pascal Mercier (1995), Intuition by Allegra Goodman (2006), Solar by Ian McEwan (2010) and Derailment by Diederik Stapel (2012). Scientific misconduct, i.e. fabrication, falsification, plagiarism, but also other questionable research practices, have become a focus of concern for academic communities (...) worldwide, but also for managers, funders and publishers of research. The aforementioned novels offer intriguing windows into integrity challenges emerging in contemporary research practices. They are analysed from a continental philosophical perspective, providing a stage where various voices, positions and modes of discourse are mutually exposed to one another, so that they critically address and question one another. They force us to start from the admission that we do not really know what misconduct is. Subsequently, by providing case histories of misconduct, they address integrity challenges not only in terms of individual deviance but also in terms of systemic crisis, due to current transformations in the ways in which knowledge is produced. Rather than functioning as moral vignettes, the author argues that misconduct novels challenge us to reconsider some of the basic conceptual building blocks of integrity discourse. (shrink)

Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions of being (...) treated in a dignified and respectful way in various healthcare decision contexts. Participants were subject to a 2 (human or AI decision maker) x 2 (positive or negative decision outcome) x 2 (diagnostic or resource allocation healthcare scenario) factorial design. We found evidence of a “human bias” (i.e., a preference for human over AI decision makers) and an “outcome bias” (i.e., a preference for positive over negative outcomes). However, we found that for perceptions of respectful and dignified interpersonal treatment, it matters more who makes the decisions in diagnostic cases and it matters more what the outcomes are for resource allocation cases. We also found that humans were consistently viewed as appropriate decision makers and AI was viewed as dehumanizing, and that participants perceived they were treated better when subject to diagnostic as opposed to resource allocation decisions. Thematic coding of open-ended text responses supported these results. We also outline the theoretical and practical implications of these findings. (shrink)

Rodrigues and Banzato related the validity of diagnostic categories to their meaningfulness and I wish to explore this relation further without attempting to make criticisms. To commence, if a diagnostic category is to be valid, it must mean something.

This paper is a preliminary step towards the assessment of an alarming widespread belief that victims of the novel coronavirus SARS-CoV-2 include the quality and accuracy of scientific publications about it. Our initial results suggest that this belief cannot be readily ignored, denied, dismissed or refuted, since some genuine supporting evidence can be forwarded for it. This evidence includes an obvious increase in retractions of papers published about the COVID-19 pandemic plus an extra-ordinary phenomenon of inconsistency that we report herein. (...) In fact, we provide a novel method for validating any purported set of the four most prominent indicators of diagnostic testing (Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value), by observing that these indicators constitute three rather than four independent quantities. This observation has virtually been unheard of in the open medical literature, and hence researchers have not taken it into consideration. We define two functions, which serve as consistency criteria, since each of them checks consistency for any set of four numerical values (naturally belonging to the interval [0.0,1.0]) claimed to be the four basic diagnostic indicators. Most of the data we came across in various international journals met our criteria for consistency, but in a few cases, there were obvious unexplained blunders. We explored the same consistency problem for some diagnostic data published in 2020 concerning the ongoing COVID-19 pandemic and observed that the afore-mentioned unexplained blunders tended to be on the rise. A systematic extensive statistical assessment of this presumed tendency is warranted. (shrink)

In this paper we argue that dissociative identity disorder (DID) is best interpreted as a causal model of a (possible) post-traumatic psychological process, as a mechanical model of an abnormal psychological condition. From this perspective we examine and criticize the evidential status of DID, and we demonstrate that there is really no good reason to believe that anyone has ever suffered from DID so understood. This is so because the proponents of DID violate basic methodological principles of good causal modeling. (...) When every ounce of your concentration is fixed upon blasting a winged pig out of the sky, you do not question its species' ontological status. James Morrow, City of Truth (1990). (shrink)

Synthetic biology is often seen as the engineering turn in biology. Philosophically speaking, entities created by synthetic biology, from synthetic cells to xenobots, challenge the ontological divide between the organic and inorganic, as well as between the natural and the artificial. Entities such as synthetic cells can be seen as hybrid or transitory objects, or neo–things. However, what has remained philosophically underexplored so far is the impact these hybrid neo–things will have on (our phenomenological experience of) the living world. By (...) extrapolating from Walter Benjamin’s account of how technological reproducibility affects the aura of art, we embark upon an exploratory inquiry that seeks to fathom how the technological reproducibility of life itself may influence our experience and understanding of the living. We conclude that, much as technologies that enabled reproduction corroded the aura of original artworks (as Benjamin argued), so too will the aura of life be under siege in the era of synthetic lifeforms. This article zooms in on a specific case study, namely the research project Building a Synthetic Cell (BaSyC) and its mission to create a synthetic cell–like entity, as autonomous as possible, focusing on the properties that differentiate organic from synthetic cells. (shrink)

Dear Editor, in a previous paper we have tried to delve into what validity means in the context of psychiatric nosology, arguing for a pragmatic view of it. Here we want to briefly reassert the basic points of our analysis, make a few clarifications and address some issues raised by commentators.

The typical habitat of overt nominative subjects is in finite clauses. But infinitival complements and infinitival adjuncts are also known to have overt nominative subjects, e.g. in Italian (Rizzi 1982), European Portuguese (Raposo 1987), and Spanish (Torrego 1998, Mensching 2000). The analyses make crucial reference to the movement of Aux or Infl to Comp, and to overt or covert infinitival inflection. This working paper is concerned with a novel set of data that appear to be of a different sort, in (...) that they probably do not depend on either rich infinitival inflection or on movement to C. (shrink)

A large part of the controversy surrounding the publication of DSM-5 stems from the possibility of replacing the purely descriptive approach to classification favored by the DSM since 1980. This paper examines the question of how mental disorders should be classified, focusing on the issue of whether the DSM should adopt a purely descriptive or theoretical approach. I argue that the DSM should replace its purely descriptive approach with a theoretical approach that integrates causal information into the DSM’s descriptive (...) class='Hi'>diagnostic categories. The paper proceeds in three sections. In the first section, I examine the goals (viz., guiding treatment, facilitating research, and improving communication) associated with the DSM’s purely descriptive approach. In the second section, I suggest that the DSM’s purely descriptive approach is best suited for improving communication among mental health professionals; however, theoretical approaches would be superior for purposes of treatment and research. In the third section, I outline steps required to move the DSM towards a hybrid system of classification that can accommodate the benefits of descriptive and theoretical approaches, and I discuss how the DSM’s descriptive categories could be revised to incorporate theoretical information regarding the causes of disorders. I argue that the DSM should reconceive of its goals more narrowly such that it functions primarily as an epistemic hub that mediates among various contexts of use in which definitions of mental disorders appear. My analysis emphasizes the importance of pluralism as a methodological means for avoiding theoretical dogmatism and ensuring that the DSM is a reflexive and self-correcting manual. (shrink)

The fifth text-revised iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) defines paraphilia as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners”. Paraphilic disorders specifically denote a paraphilia that is “currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others”. A diagnosis of paraphilic disorder either demands the (...) personal distress and/or impairment of function that is caused by the atypical sexual urges and fantasies to be present, or the status of non-consent of the other person that these sexual fantasies and urges are directed towards when acted upon by the patient. This paper discusses how consent not only becomes the standard for permissible and legal sexual activity with other persons, but also, when the diagnostic criteria are taken at face-value, for sexual pathology in the DSM-5-TR when the patient acts on their sexual urges. After a close investigation of various possible interpretations of the element of non-consensuality in the diagnostic criteria for paraphilic disorders, this paper concludes that the DSM-5-TR does not offer a clarifying explanation on how mental health professionals should under-stand its approach to diagnosing paraphilic disorders, leaving us with an ambiguous, unclear and unsettled conceptualisation of what it would mean to fulfil its diagnostic criteria. (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 paper addresses philosophical issues concerning whether mental disorders are natural kinds and how the DSM should classify mental disorders. I argue that some mental disorders (e.g., schizophrenia, depression) are natural kinds in the sense that they are natural classes constituted by a set of stable biological mechanisms. I subsequently argue that a theoretical and causal approach to classification would provide a superior method for classifying natural kinds than the purely descriptive approach adopted by the DSM since DSM-III. My argument (...) suggests that the DSM should classify natural kinds in order to provide predictively useful (i.e., projectable) diagnostic categories and that a causal approach to classification would provide a more promising method for formulating valid diagnostic categories. (shrink)

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)

In two recent papers, Rose and Nichols present evidence in favor of the view that humans represent category essences in terms of a telos, such as honey-making, and not in terms of scientific essences, such as bee DNA. In this paper, I challenge their interpretation of the evidence, and show that it is directly predicted by the main theory they seek to undermine. I argue that their results can be explained as instances of diagnostic reasoning about scientific essences.

Current health care standards, in many countries, Australia included, are regrettably poor. Surprisingly, practitioners and treating teams alike in mental health and disability sectors, in particular, make far too many basic care-related mistakes, in addition to the already abundant diagnostic mistakes that cause and amplify great harm. In part, too many practitioners also fail to distinguish adverse effects for what they are and all too often treat adverse effects, instead, as comorbidities. Diagnostic failures are dangerous, the result of (...) which generates and perpetuates harms that are extremely costly in terms of patient welfare, in addition to the financial burden placed on everyone. In this essay, I contend that the authority bestowed upon psychiatry is misplaced. Subsequently, this misplaced authority affects the governing and investigatory institutions reliant and informed by psychiatry. The examination process undertaken in this investigation traces the metaphysics of psychiatric disorders relative to the Diagnostic-Statistical-Manual (DSM) in all its iterations and to the epistemological construction process that serves to underpin the fundamentals of psychiatric practice. There exists a crisis of confidence in psychiatric practice and I urge drastic reform be undertaken to arrest the damage. (shrink)

In this chapter, I provide an overview of phenomenological approaches to psychiatric classification. My aim is to encourage and facilitate philosophical debate over the best ways to classify psychiatric disorders. First, I articulate phenomenological critiques of the dominant approach to classification and diagnosis—i.e., the operational approach employed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). Second, I describe the type or typification approach to psychiatric classification, which I distinguish into three (...) different versions: ideal types, essential types, and prototypes. I argue that despite their occasional conflation in the contemporary literature, there are important distinctions among these approaches. Third, I outline a new phenomenological-dimensional approach. I show how this approach, which starts from basic dimensions of human existence, allows us to investigate the full range of psychopathological conditions without accepting the validity of current diagnostic categories. (shrink)

Invited commentary on Nicole A. Vincent and Emma A. Jane, “Interrogating Incongruence: Conceptual and Normative Problems with ICD-11’s and DSM-5’s Diagnostic Categories for Transgender People” Australasian Philosophical Review, in press. -/- The core of Vincent and Jane’s Interrogating Incongruence is critical of the appeal to the concept of incongruence in DSM-5 and ICD-11 characterisations of trans people, a critique taken to be ground-clearing for more trans-positive, psychiatrically-infused medical interventions. I concur with Vincent and Jane’s ultimate goals but depart from (...) the view developed in the paper on two fronts. The first is that I remain sceptical about the overall prospects for truly trans-positive psychiatry. Trans should follow homosexuality and other categories of sexual orientation that have been abandoned rather than reformed as constituents of psychiatric diagnosis and categorisation. The second is that I think that the authors’ central criticisms of the appeal to incongruence are misplaced. (shrink)

Since the dawn of the internet, pornography has effectively become ubiquitous, pervasive, and increasingly normalised. Study findings show remarkable similarities in how the brain reacts to pornography, and other known addictive substances, and indicate that consuming pornography is comparable to consuming other known addictive substances. Moreover, two of the biggest risk factors for addiction are the substance’s availability and its easy accessibility, particularly in the case of younger persons. To date, pornography addiction has been conceptualised as a behavioural addiction. However, (...) the body of research data on pornography addiction does not provide conclusive support for behavioural addiction. The aim of this thesis is to put forward the idea that pornography can, and should, be conceptualised as an addictive substance, and, that when pornography is consumed, an addictive substance is consumed. In order to support this claim, there are many factors that must be addressed. I first clarify what pornography entails by exploring how it is conceptualised, what pornography ‘does’, and what it means to be a pornography consumer. Secondly, I examine the conceptualisations of substances, substance consumption and addiction, respectively, as well as the subsequent difference between substance and behavioural addiction. Thirdly, I give an inclusive overview of pornography addiction by not only examining the most recent perspectives of researchers, but also of pornography consumers. I conclude by suggesting how we should go about conceptualising pornography addiction, and then propose how the set of diagnostic criteria for pornography use disorder should be formulated for a future iteration of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. I argue that, given the abundance of academic research on substance addiction, compared to the scarcity of research on behavioural addiction, conceptualising pornography as an addictive substance is more likely to create a sense of urgency for the future research of pornography addiction than would be the case if it is considered a potential behavioural addiction. Furthermore, I argue that the classification of pornography as an addictive substance, and the inclusion of pornography use disorder in a future iteration of the DSM, will raise awareness of the potential adverse effects of pornography consumption and, therefore, the harmful consequences of pornography use disorder. (shrink)

Objective: microRNAs (miRNAs) have important potential as biomarkers in the diagnosis and prognosis of ischemia/reperfusion (I/R) injury in coronary artery bypass grafting surgery (CABG). This study investigated the relationship between preoperative (preop) and postoperative (post-op) cardiac parameters and miRNA expressions in CABG. -/- Methods: We analyzed a total of 94 individuals (CABG, n= 46 and healthy control, n=48). Quantitative real-time polymerase chain reaction (qRT) was performed to determine plasma miRNA expressions (miR-21, miR-181a, miR-199a, miR-199b, and miR-320a-5p) in triplicates: before surgery, (...) 1 hour after surgery, and 24 hours after surgery. The target genes and pathways of miRNA were determined using bioinformatic analysis. The biomarker potentials of miRNAs were evaluated with receiver operating characteristic (ROC) curve analysis. -/- Results: All miRNAs were significantly downregulated (p < 0.05). Troponin I, LVEF, CPK, and CK-MB were found to be statistically significant for operation groups (p < 0.05). miRNA expressions and cardiac markers were associated with troponin I and/or CK-MB. In ROC analyses, miR-199a was a good diagnostic marker. CREBRF and ZNF704 genes may be a target for these miRNAs. -/- Conclusions: Downregulation of miR-199a has a regulatory role in ischemia/reperfusion. They may contribute to CABG pathology through these two genes involved in signaling cascades to turn on protein response and ion binding. (shrink)

This paper was written to study the order of medical advances throughout history. It investigates changing human beliefs concerning the causes of diseases, how modern surgery developed and improved methods of diagnosis and the use of medical statistics. Human beliefs about the causes of disease followed a logical progression from supernatural causes, such as the wrath of the Gods, to natural causes, involving imbalances within the human body. The invention of the microscope led to the discovery of microorganisms which were (...) eventually identified as the cause of infectious diseases. Identification of the particular microorganism causing a disease led to immunization against the disease. Modern surgery only developed after the ending of the taboo against human dissection and the discovery of modern anesthesia and the discovery of the need for anti-septic practices. Modern diagnostic practices began with the discovery of x-rays and the invention of medical scanners. Improved mathematics, especially in probability theory, led to statistical studies which led to a much greater ability, to identify the causes of disease, and to evaluate the effectiveness of treatments. These discoveries all occurred in a necessary and inevitable order with the easiest discoveries being made first and the harder discoveries being made later. The order of discovery determined the course of the history of medicine and is an example of how social and cultural history has to follow a particular course determined by the structure of the world around us. (shrink)

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care (...) to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs. (shrink)

A diagnostic process is an investigative process that takes a clinical picture as input and outputs a diagnosis. We propose a method for distinguishing diagnoses that are warranted from those that are not, based on the cognitive processes of which they are the outputs. Processes designed and vetted to reliably produce correct diagnoses will output what we shall call ‘warranted diagnoses’. The latter are diagnoses that should be trusted even if they later turn out to have been wrong. Our (...) work is based on the recently developed Cognitive Process Ontology and further develops the Ontology of General Medical Science. It also has applications in fields such as intelligence, forensics, and predictive maintenance, all of which rely on vetted processes designed to secure the reliability of their outputs. (shrink)

Abstract Theories are metaphysically equivalent just if there is no fact of the matter that could render one theory true and the other false. In this paper I argue that if we are judiciously to resolve disputes about whether theories are equivalent or not, we need to develop testable criteria that will give us epistemic access to the obtaining of the relation of metaphysical equivalence holding between those theories. I develop such ?diagnostic? criteria. I argue that correctly inter-translatable theories (...) are metaphysically equivalent, and what we need are ways of determining whether a putative translation is correct or not. To that end I develop a number of tools we can employ to discern whether a translation is a correct one. (shrink)

This article develops a diagnostic lens to make sense of the still baffling development of a ‘humanitarian marketplace’. Ambivalently hybrid initiatives such as volunteer tourism, corporate social responsibility or even fair trade do not strictly obey a distributive logic of market exchange, social reciprocity or philanthropic giving. They engender a type of ‘economy’ that must be apprehended in its own terms. The article argues that the large-scale collaborative effects of such a dispersed market can be theorized without resorting to (...) the classical biopolitical move of simplified agency/holistic reification. The argument proceeds counterintuitively, by appropriating the notion of symbiosis as redefined by contemporary biology, contending through historical contextualization and conceptual work that nature itself offers the best example to grasp spontaneous collaboration among unrelated human beings as a non-automatically balanced and intrinsically political affair that calls for critical management through an ex post facto interventionist policy of selective cultivation. (shrink)