This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (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.

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the (...) end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

Addressing the question of how medicine should engage with people who consider their clinical disease condition to be importantly constitutive of their identity, this article focuses on one group—advocates for the fat acceptance (FA) or body positivity movement in American society. Drawing on philosophical analysis, I try to show that FA and physician communities represent different traditions within the larger culture and that whether obesity should be considered a disease is a culture battle. I argue that diseases (medical) and illnesses (...) (cultural) are 2 different designations of clinical symptoms and that both disease and illness designations can change over time or be uncertain. (shrink)

The number of police departments carrying Narcan keeps increasing at a fast pace throughout the U.S., as it is considered an effective measure to fight the opioid epidemic. However, there have been strong oppositions to the idea of the police Narcan use. Still, in 2018, the nation is debating about it. Though not clearly visible to the public, there are important ethical arguments against the police Narcan use which necessarily involve understanding of the ethical roles and responsibilities of police as (...) the law enforcement agency and apprehension of the moral status of a non-therapeutic opioid use. The authors of the paper investigate, primarily, the existing ethical controversies surrounding the police Narcan use while touching upon the issue of the decriminalizing drug policy in the U.S. The authors conclude that the police can carry and administer Narcan without self-contradiction and that the policymakers’ investigation on the drug decriminalization policy should begin with the understanding of the “common morality” of the American public, the ethical view shared and practiced by the greatest number of people. (shrink)

It seems certain that one day we will allow the genetic technology which will enhance our offspring. A highly effective new tool, called CRISPR, which allows for carving out genes, is already being used to edit the genomes of animals. In July 2017, the FDA legalized that germline drugs for therapeutic purposes could be sold in the market. It is a high time, now, that we need engage in discussions about the ethics of germline intervention. To contribute to the discussion (...) by showing our thought and to educate the public, we write this paper. (shrink)

The 2017 story of Charlie Gard is revisited. Upon the British High Court’s ruling in favor of the physicians that the infant should be allowed to die without the experimental treatment, the view of the public as well as the opinions of bioethicists and Catholic bishops are divided, interestingly along with a cultural line. American bioethicists and Catholic bishops tend to believe that the parents should have the final say while British/European bioethicists and Catholic bishops in general side with the (...) court’s decision. The paper explores the place of culture in bioethical reasoning between the UK/Europe and the US while claiming that cultural differences are more important than geopolitical or religious differences to understand the bioethical positions of a group. In addition, the authors introduce a decision-making program for handicapped neonates which is developed by the American Jesuit Bioethicist, Richard McCormick, and modified further by the contemporary American Jesuit Bioethicist, Peter A. Clark, in an attempt to see if the program’s normatizing categories can contribute to the culture-laden ethical discussions on Charlie’s case. However, it is admitted that the McCormick-Clark device is borne out of the American and Catholic theological context. (shrink)

The Deaf culture in the United States is a unique culture that is not widely understood. To members of the Deaf community in the United States, deafness is not viewed as a disease or pathology to be treated or cured; instead it is seen as a difference in human experience. Members of this community do not hide their deafness; instead they take great pride in their Deaf identity. The Deaf culture in the United States is very communitarian not individualistic. Mary (...) Beth and Dominic are a married couple in their late 20s who are genetically deaf. They are active members in the Deaf community and work as advocates for individuals who are deaf, family members of Deaf people and sign language interpreters who identify with the Deaf culture. Mary Beth and Dominic approach the fertility clinic with a request that they only want a child with the genetic gene for deafness. They would want the embryos that do not have the gene to be destroyed. This would entail creating a child who would have the gene for deafness. Medically and ethically, should the fertility clinic agree to the couple’s request? The authors argue that the couple's request should be denied and provide reasons for it from the perspectives of foundational and clinical ethics. (shrink)

Ebola is a deadly disease with no cure; there is no vaccine developed yet. Many died during the 2014 outbreak in West Africa, and many healthcare professionals went to the virus infected area to treat the patients while placing their lives in danger. Not every medical professional placed in the field is a fully trained specialist, and sometimes one or two under-trained doctors are in charge of the entire clinic with some nurses and operating technicians. When unexpected outbreaks of the (...) virus occur in the places, the doctor(s) would encounter medical and ethical dilemmas. Should they leave or stay? In fact, this dilemma is not confined to the Ebola pandemic but relevant to all similar cases. In this paper, three authors, a medical resident, a clinical bioethicist, and a theoretical bioethicist respond to the dilemma. (shrink)

Investigating an actual case that occurred in a New York state hospital where an Orthodox Jewish patient’s legal proxy demands that the clinicians and hospital administrators should provide aggressive treatment with all available technological resources for the seemingly brain-dead patient with a medically futile condition. The authors argue that a health care policy or regulation should be developed to limit patient’s access to technology in critical care. Otherwise, we will be allowing society to issue a carte blanche to religious autonomy (...) by technology abuse. It is argued that religious autonomy should be restricted when its demand exhibits apparent logical absurdity and/or goes against the common survival of the entire population. (shrink)

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation of (...) Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic. (shrink)

The paper attempts to set a guideline to contemporary common morality debate. The author points out what he sees as two common problems that occur in the field of comparative cultural studies related to a common morality debate. The first problem is that the advocates and opponents of common morality, consciously or unconsciously, define the moral terms in question in a way that their respective meanings would naturally lead to the outcomes that each party desires. The second problem is that (...) the examples each party chooses as the empirical evidences may not be as simple and clear-cut as the researchers think they are, mainly because the situational contexts where the examples are located between two different cultures vastly differ. To prevent these mistakes, the author emphasizes that we should pay attention to a subtle distinction between "thick" and "thin" construed from the levels of "theoretical status" and of "material content". With the conceptual distinctions in mind, the author shows how different cultures (i.e., Western individualist society and East Asian neo-Confucian society) see the moral principles like autonomy and beneficence in different lexical orders. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

REMARKS ON EVOLUTION AND TIME-SCALES, Graham Cairns-Smith; HODGSON'S BLACK BOX, Thomas Clark; DO HODGSON'S PROPOSITIONS UNIQUELY CHARACTERIZE FREE WILL?, Ravi Gomatam; WHAT SHOULD WE RETAIN FROM A PLAIN PERSON'S CONCEPT OF FREE WILL?, Gilberto Gomes; ISOLATING DISPARATE CHALLENGES TO HODGSON'S ACCOUNT OF FREE WILL, Liberty Jaswal; FREE AGENCY AND LAWS OF NATURE, Robert Kane; SCIENCE VERSUS REALIZATION OF VALUE, NOT DETERMINISM VERSUS CHOICE, Nicholas Maxwell; COMMENTS ON HODGSON, J.J.C. Smart; THE VIEW FROM WITHIN, Sean Spence; COMMENTARY ON HODGSON, Henry Stapp.

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

Searle claims that his theory of institutional reality is particularly suitable as a theoretical scheme of individuation for work in the social sciences. We argue that this is not the case. The first problem with regulatory individuation is due to the familiar fact that institutional judgments have constrained revisability criteria. The second problem with regulatory individuation is due to the fact that institutions amend their declarative judgments based on the inferential (syntactic) properties of the judgments and in response to regulatory (...) pressure, and not based on descriptive (semantic) properties and in response to matters of descriptive adequacy. These two problems imply that ‘regulatory kinds' (countries, borders, kings) will almost inevitably be disjunctive kinds that are ill-suited for scientific theorizing. This also explains why the law often makes odd pronouncements, e.g. calling ketchup a vegetable, considering an arm bent fifteen degrees to be straight, and not admitting that Somaliland is a country. (shrink)

Names like ‘Neptune’ and ‘Vulcan’ have lead some Millians to countenance a class of descriptive names. This is so, as, first, the closeness of the association between a descriptive name and its associated descriptive condition seems to show that the link between the name and the description must be semantic, and, second, as Millianism implies that names without bearers make no direct contribution to the propositions expressed by the sentences in which such names occur. In this paper we use the (...) notion of an object-dependent convention to offer a novel motivation for Millianism. We then show that our way of motivating Millianism implies that the above two reasons for treating names like ‘Neptune’ and ‘Vulcan’ as descriptive have little force. (shrink)

Scientists and philosophers alike debate whether various systems such as plants and bacteria exercise cognition. One strategy for resolving such debates is to ground claims about nonhuman cognition in evidence from mathematical models of cognitive capacities. In this article, I show that proponents of this strategy face two major challenges: demarcating phenomenological models from process models and overcoming underdetermination by model fit. I argue that even if the demarcation problem is resolved, fitting a process model to behavioral data is, on (...) its own, not strong evidence for any cognitive process, let alone processes shared with humans. (shrink)

What justifies our beliefs about what other people say? According to epistemic inferentialism​, the justification of comprehension-based beliefs depends on the justification of other beliefs, e.g., beliefs about what words the speaker uttered or even what sounds they produced. According to epistemic non-inferentialism, the justification of comprehension-based beliefs ​does not depend on the justification of other beliefs. This paper offers a new defense of epistemic non-inferentialism. First, I discuss three counterexamples to epistemic non-inferentialism provided recently by Brendan Balcerak Jackson. I (...) argue that only one of Balcerak Jackson’s counterexamples is effective, and that it is effective against only one version of epistemic non-inferentialism, viz. language comprehension dogmatism. Second, I propose an alternative version of epistemic non-inferentialism, viz. comprehension-process reliabilism, which is immune to these counterexamples. I conclude that we should follow Balcerak Jackson in his rejection of language comprehension dogmatism but not all the way to the endorsement of epistemic inferentialism. Comprehension-process reliabilism is superior to both these alternatives. (shrink)

Conversational Artificial Intelligence (CAI) systems (also known as AI “chatbots”) are among the most promising examples of the use of technology in mental health care. With already millions of users worldwide, CAI is likely to change the landscape of psychological help. Most researchers agree that existing CAIs are not “digital therapists” and using them is not a substitute for psychotherapy delivered by a human. But if they are not therapists, what are they, and what role can they play in mental (...) health care? To answer these questions, we appeal to two well-established and widely discussed concepts: cognitive and affective artifacts. Cognitive artifacts are artificial devices contributing functionally to the performance of a cognitive task. Affective artifacts are objects which have the capacity to alter subjects’ affective state. We argue that therapeutic CAIs are a kind of cognitive-affective artifacts which contribute to positive therapeutic change by (i) simulating a (quasi-)therapeutic interaction, (ii) supporting the performance of cognitive tasks, and (iii) altering the affective condition of their users. This sheds new light on why virtually all existing mental health CAIs implement principles and techniques of Cognitive Behavioral Therapy — a therapeutic orientation according to which affective change and, ultimately, positive therapeutic change is mediated by cognitive change. Simultaneously, it allows us to conceptualize better the potential and limitations of applying these technologies in therapy. (shrink)

Joseph Almog pointed out that Kripkean causal chains not only exist for names, but for all linguistic items (Almog 1984: 482). Based on this, he argues that the role of such chains is the presemantic one of assigning a linguistic meaning to the use of a name (1984: 484). This view is consistent with any number of theories about what such a linguistic meaning could be, and hence with very different views about the semantic reference of names. He concludes that (...) the causal theory is ‘rather trivial’ (1984: 487). In this paper I argue that Almog is correct to hold that the causal theory is trivial, but, contra Almog, argue that the triviality of the existence of causal chains is not a matter of such chains having a presemantic role in assigning linguistic meanings to utterances. Instead, such triviality is due to the fact that the causal theory reflects no more than a truism about the epistemology of convention acquisition. (shrink)

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision (...) in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

The majority of our linguistic exchanges, such as everyday conversations, are divided into turns; one party usually talks at a time, with only relatively rare occurrences of brief overlaps in which there are two simultaneous speakers. Moreover, conversational turn-taking tends to be very fast. We typically start producing our responses before the previous turn has finished, i.e., before we are confronted with the full content of our interlocutor’s utterance. This raises interesting questions about the nature of linguistic understanding. Philosophical theories (...) typically focus on linguistic understanding characterized either as an ability to grasp the contents of utterances in a given language or as outputs of this ability—mental states of one type or another. In this paper, I supplement these theories by developing an account of the process of understanding. I argue that it enables us to capture the dynamic and temporal aspect of understanding and reconcile philosophical investigations with empirical research on language comprehension. (shrink)

This article aims to read feminist new materialisms (Barad), together with ‘postulated’ linguistic or cultural primacy of Queer Theory (Butler), to show how both are engaged in similar critical-ethical endeavours. The central argument is that the criticism of Barad and new materialisms misses Butler’s materialistic insights due to a narrow interpretation of Butler's alleged social-constructivist position. There is, therefore, a specific focus on where they both make similar ethical appeals. Moreover, the article relies on Adorno's negative dialectic to highlight an (...) interpretation of Barad and Butler as being part of the same dialectical movement, in which materialism and idealism fluctuate in their mutual criticisms, thus continuing the procession towards 'new knowledge' and emancipation, or freedom, through their motions back and forth. (shrink)

The Caesar problem arises for abstractionist views, which seek to secure reference for terms such as ‘the number of Xs’ or #X by stipulating the content of ‘unmixed’ identity contexts like ‘#X = #Y’. Frege objects that this stipulation says nothing about ‘mixed’ contexts such as ‘# X = Julius Caesar’. This article defends a neglected response to the Caesar problem: the content of mixed contexts is just as open to stipulation as that of unmixed contexts.

In the late 19th century, physiologists such as David Ferrier, Eduard Hitzig, and Hermann Munk argued that cerebral brain functions are localized in discrete structures. By the early 20th century, this became the dominant position. However, another prominent physiologist, Friedrich Goltz, rejected theories of cerebral localization and argued against these physiologists until his death in 1902. I argue in this paper that previous historical accounts have failed to comprehend why Goltz rejected cerebral localization. I show that Goltz adhered to a (...) falsificationist methodology, and I reconstruct how he designed his experiments and weighted different kinds of evidence. I then draw on the exploratory experimentation literature from recent philosophy of science to trace one root of the debate to differences in how the German localizers designed their experiments and reasoned about evidence. While Goltz designed his experiments to test hypotheses about the functions of predetermined cerebral structures, the localizers explored new functions and structures in the process of constructing new theories. I argue that the localizers relied on untested background conjectures to justify their inferences about functional organization. These background conjectures collapsed a distinction between phenomena they produced direct evidence for (localized symptoms) and what they reached conclusions about (localized functions). (shrink)

This paper argues, based on Lewis’ claim that communication is a coordination game (Lewis in Minnesota studies in the philosophy of science, University of Minnesota Press, Minneapolis, pp 3–35, 1975), that we can account for the communicative function of demonstratives without assuming that they semantically refer. The appeal of such a game theoretical version of the case for non-referentialism is that the communicative role of demonstratives can be accounted for without entering the cul de sac of trying to construct conventions (...) of ever-increasing complexity. Instead communication via demonstratives is explained with reference to the general, non-domain specific ability of human beings to solve games of coordination. Furthermore, there is empirical support for such a view. Judgments concerning demonstrative reference have been shown to be sensitive to judgments concerning common ground (Clark et al. in J Verb Learn Verb Behav 22:245–258, 1983), which is exactly what the non-referentialist account would predict. The game theoretical account also allows for an intuitively plausible, non-referentialist treatment of Speaks’ ‘trumping argument’ (Speaks in Philos Stud 174:709–734, 2017), as well as the Carnap/Agnew puzzle (Kaplan in Syntax Semant 9:221–43, 1970). (shrink)

There is a simple, intuitive theory of the semantic reference of proper names that has been unjustly neglected. This is the view that semantic reference is conventionalized speakers reference, i.e. the view that a name semantically refers to an object if, and only if, there exists a convention to use the name to speaker-refer to that object. The theory can be found in works dealing primarily with other issues (e.g. Stine in Philos Stud 33:319–337, 1977; Schiffer in Erkenntnis 13:171–206, 1978; (...) Sainsbury in Erkenntnis 80:195–214, 2015; Sainsbury, Thinking about things, Oxford University Press, 2018), yet these authors provide no sustained discussion of it. Devitt (Designation, Columbia University Press, 1981) did formulate a view on which semantic reference is conventionalized speaker’s reference, yet his views are assimilated to causalist views. This is a mistake. While the conventionalized speaker’s reference view captures much of what is plausible in descriptivism and causalism, it remains distinct from both. (shrink)

Russell claims that ordinary proper names are eccentric, i.e. that the semantic referent of a name is determined by the descriptive condition that the individual utterer of the name associates with the name. This is deeply puzzling, for the evidence that names are subject to interpersonal coordination seems irrefutable. One way of making sense of Russell’s view would be to claim that he has been systematically misinterpreted and did not, in fact, offer a semantic theory at all. Such a view (...) is put forward in Sainsbury Departing from Frege, Routledge, London, 2002). Sainsbury claims that Russellian descriptivism is not the theory that the thought in the mind of the speaker determines the semantic reference of a name, but simply a theory about the thought in the mind of the speaker using a name. I argue that the truth is subtly different, and points the way towards an intuitive explanation of Russell’s eccentricity. (shrink)

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

The nature of linguistic understanding is a much-debated topic. Among the issues that have been discussed, two questions have recently received a lot of attention: (Q1) ‘Are states of understanding direct (i.e. represent solely what is said) or indirect (i.e. represent what is said as being said/asserted)?’ and (Q2) ‘What kind of mental attitude is linguistic understanding (e.g. knowledge, belief, seeming)?’ This paper argues that, contrary to what is commonly assumed, there is no straightforward answer to either of these questions. (...) This is because linguistic understanding cannot be identified with a single mental attitude towards a particular representation. Instead, we should characterize states of linguistic understanding as involving complex representational structures generated by a dual-stream process. The first stream operates on direct representations of what is said, while the second operates on representations of what is said as being said/asserted by a given source. Both these streams feed a situation model, i.e. a complex representation of a state of affairs described by a given piece of discourse. (shrink)

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI (...) systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called “general” or “human-like” AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. (shrink)

It is often suggested that we are equipped with a set of cognitive tools that help us to filter out unreliable testimony. But are these tools effective? I answer this question in two steps. Firstly, I argue that they are not real-time effective. The process of filtering, which takes place simultaneously with or right after language comprehension, does not prevent a particular hearer on a particular occasion from forming beliefs based on false testimony. Secondly, I argue that they are long-term (...) effective. Some hearers sometimes detect false testimony, which increases speakers’ incentives for honesty and stabilizes the practice of human communication in which deception is risky and costly. In short, filtering prevents us from forming a large number of beliefs based on false testimony, not by turning each of us into a high-functioning polygraph but by turning the social environment of human communication into one in which such polygraphs are not required. Finally, I argue that these considerations support strong anti-reductionism about testimonial entitlement. (shrink)

Philosophy is experiencing a resurgence of property (PD) and generic substance dualism (SD). One important argument for SD that has played a role in this resurgence is some version of a modal argument. Until recently, premise (3) of the argument (Possibly, I exist, and no wholly physical objects exist.) has garnered most of the attention by critics. However, more recently, the focus has also been on (2) (Wholly physical objects are essentially, wholly, and intrinsically physical and wholly spiritual substances are (...) essentially, wholly, and intrinsically immaterial.). Andrew Bailey has provided one of the best criticisms of (2) on offer. In what follows, I present and clarify one form of the argument and defend premise (2) by responding to important defeaters proffered by Andrew Bailey and his contingent physicalism. (shrink)

Declarations like “this meeting is adjourned” make certain facts the case by representing them as being the case. Yet surprisingly little attention has been paid to the mechanism whereby the utterance of a declaration can bring about a new state of affairs. In this paper, we use the incentivization account of institutional facts to address this issue. We argue that declarations can serve to bring about new states of affairs as their utterance have game theoretical import, typically in virtue of (...) the utterer signaling a commitment to act in an incentive-changing way. (shrink)

In The Construction of Social Reality, John Searle develops a theory of institutional facts and objects, of which money, borders and property are presented as prime examples. These objects are the result of us collectively intending certain natural objects to have a certain status, i.e. to ‘count as’ being certain social objects. This view renders such objects irreducible to natural objects. In this paper we propose a radically different approach that is more compatible with standard economic theory. We claim that (...) such institutional objects can be fully understood in terms of actions and incentives, and hence the Searlean apparatus solves a non-existent problem. (shrink)

What does being money consist in? We argue that something is money if, and only if, it is typically acquired in order to realise the reduction in transaction costs that accrues in virtue of agents coordinating on acquiring the same thing when deciding what thing to acquire in order to exchange. What kinds of things can be money? We argue against the common view that a variety of things (notes, coins, gold, cigarettes, etc.) can be money. All monetary systems are (...) best interpreted as implementing the same basic protocol. Money, i.e. the thing that we coordinate on acquiring in order to lower our transaction costs, is, in all cases, a set of positions on an abstract mathematical object, namely a relative ratio scale. The things that we ordinarily call ‘money’ are merely records of positions on such a scale. (shrink)

Kripke (1977) views Donnellan's (1966) misdescription cases as cases where semantic reference and speaker's reference come apart. Such cases, however, are also cases where semantic reference conflicts with a distinct species of reference I call "public reference", i.e. the object that the cues publicly available at the time of utterance indicate is the speaker's referent of the utterance. This raises the question: do the misdescription cases trade on the distinction between semantic reference and speaker's reference, or the distinction between semantic (...) reference and public reference? I argue that Kripke's own construal in terms of semantic reference and speaker's reference is at best incomplete, and probably wrong. I also explain the general importance of the notion of 'public reference'. (shrink)

Contemporary discussion concerning institutions focus on, and mostly accept, the Searlean view that institutional objects, i.e. money, borders and the like, exist in virtue of the fact that we collectively represent them as existing. A dissenting note has been sounded by Smit et al. (Econ Philos 27:1–22, 2011), who proposed the incentivized action view of institutional objects. On the incentivized action view, understanding a specific institution is a matter of understanding the specific actions that are associated with the institution and (...) how we are incentivized to perform these actions. In this paper we develop the incentivized action view by extending it to institutions like property, promises and complex financial organisations like companies. We also highlight exactly how the incentivized action view differs from the Searlean view, discuss the method appropriate to such study and discuss some of the virtues of the incentivized action view. (shrink)

Most psychotherapeutic approaches are, to a greater or lesser extent, rooted in the theories and principles of scientific psychology. Nevertheless, in-session psychotherapeutic interaction between a therapist and a client is, at its core, a folk-psychological practice. As such, it is based on folk-psychological skills and competencies. But which ones exactly? This chapter argues that, while we may initially be inclined to perceive the practice of psychotherapy as primarily involving sophisticated mindreading on the part of both the therapist and the client/patient, (...) a complete characterization of psychotherapy must give at least the same amount of attention to different forms of therapeutic mindshaping. Using examples drawn from multiple therapeutic traditions, I illustrate how therapeutic mindreading and mindshaping interact. I conclude by highlighting some of the consequences of this perspective for the ethics and politics of psychotherapy. (shrink)

Contractarians aim to derive moral principles from the dictates of instrumental rationality alone. But it is well-known that contractarian moral theories struggle to identify normative principles that are both uniquely rational and morally compelling. Michael Moehler's recent book, *Minimal Morality* seeks to avoid these difficulties by developing a novel "two-level" social contract theory, which restricts the scope of contractarian morality to cases of deep and persistent moral disagreement. Yet Moehler remains ambitious, arguing that a restricted version of Kant's categorical imperative (...) is a uniquely rational principle of conflict resolution. We develop a formal model of Moehler's informal game-theoretic argument, which reconstructs a valid argument for Moehler's conclusion. This model, in turn, enables us to expose how a successful argument for Moehler's contractarian principle rests on assumptions that can only be justified by subtle yet significant departures from the standard conception of rationality. We thus extend our understanding of familiar contractarian difficulties by showing how they arise even if we restrict the scope of contractarian morality to a domain where its application seems both promising and necessary. We show that the problem lies not in contractarians' immodest ambitions but in the modest resources rationality can offer to satisfy them. (shrink)

Thе оutbrеаk оf thе соrоnаvirus disеаsе 2019 (СОVID-19) саusing milliоns оf pеоplе tо bе infесtеd hаs pоsеd mаjоr publiс hеаlth аnd gоvеrnаnсе сhаllеngеs. This study еvаluаtеs thе еxtеnt tо whiсh thе unаvаilаbility оf intеrnеt fоr сhildrеn tо lеаrn оnlinе during thе pаndеmiс аffесts pаrеntаl psyсhоlоgiсаl wеllbеing. Wе find thаt pаrеnts hаving nо intеrnеt fоr thеir сhildrеn tо lеаrn оnlinе during tо thе pаndеmiс аrе 40.37, 47.22, 43.68, аnd 46.90 pеrсеntаgе pоints mоrе likеly tо fееl аnxiоus, wоrriеd, displеаsеd, аnd dеprеssеd еvеry (...) dаy. Thе study саlls fоr thе еxpаnsiоn оf suppоrts fоr сhildrеn аnd fаmiliеs during thе pаndеmiс, еspесiаlly fоr disprоpоrtiоnаtеly аffесtеd соmmunitiеs. (shrink)

I argue that Kripke’s construal of the distinction between speaker’s reference and semantic reference, in ‘Speaker’s reference and semantic reference’ (Kripke in Midwest Stud Philos 2:255–276, 1977), in conjunction with an intuitive view of the nature of conventions, implies a theory of semantic reference that is distinct from his causal theory. On this theory, semantic reference is conventionalized speaker’s reference. The argument concerning Kripke has two general implications. First, any theory that features a notion of speaker’s reference will have great (...) difficulty in avoiding the view that semantic reference is conventionalized speaker’s reference. Second, theories that deny that there is a viable notion of speaker’s reference, and thereby deny that semantic reference is conventionalized speaker’s reference, will face an uphill battle in meeting certain general constraints originating in the theory of conventions. (shrink)

I advance a type of conceptualist argument for substance dualism – minimally, the view that we are spiritual substances that have bodies – based on the understandability of what it would be for something to be a spirit, e.g. what it would be for God to be a spirit. After presenting the argument formally, I clarify and defend its various premises with a special focus on what I take to be the most controversial one, namely, if thinking matter is metaphysically (...) possible, it is not the case that we have a distinct positive concept of God's being a divine spirit. (shrink)

I-theories of bare demonstratives take the semantic referent of a demonstrative to be determined by an inner state of the utterer. E-theories take the referent to be determined by factors external to the utterer. I argue that, on the Standard view of communication, neither of these theories can be right. Firstly, both are committed to the existence of conventions with superfluous content. Secondly, any claim to the effect that a speaker employs the conventions associated with these theories cannot have any (...) content, i.e. nothing can count as following these conventions. Bare demonstratives may well not be devices of semantic reference at all, i.e. may not actually contribute a referent to the proposition semantically expressed by an utterance. (shrink)

In our earlier work, we argued, contra Searle, that institutional facts can be understood in terms of non-institutional facts about actions and incentives. Butchard and D’Amico claim that we have misinterpreted Searle, that our main argument against him (“the circularity objection”) has no merit and that our positive view cannot account for institutional facts created via joint action. We deny all three charges.

This book is a thesis submitted to the Faculty of Arts of the University of Utrecht. It was prepared under the supervision of Prof. Dr. H. Schultink. I would like to express my gratitude to him for his criticisms of earlier versions which led to many improvements, in particular with respect to the exposition of the argument. To my co-referent Dirk van Dalen, reader in the Department of Philo sophy (,Centrale Interfaculteit') of the University of Utrecht, I am greatly indebted (...) for his valuable and fruitful suggestions about problems relevant to both linguistics and logic. Several ideas developed in this study owe their present concrete form to our many discussions. This thesis originates in syntactic research into the Aspects carried out in 1967 under the supervision of Albert Kraak, professor at the University of Nijmegen, who ever since gave much attention to my work in progress. I am very grateful to him for his careful and stimulating criticism as well as for the continuous support he gave me during these years. The present study closely relates to the work of my colleague Wim Klooster with regard to both its theoretical framework and its subject matter. Our joint work on the measurement of duration in Dutch is an integral part of the argument. I have greatly profited from the numerous discussions we have had. (shrink)