While philosophical questions about health and disease have attracted much attention in recent decades, and while opinions are divided on most issues, influential accounts seem to embrace negativism about health, according to which health is the absence of disease. Some subscribe to unrestricted negativism, which claims that negativism applies not only to the concepts of health and disease as used by healthcare professionals but also to the lay concept that underpins everyday thinking. Whether people conceptualize health in this manner has (...) implications for medical care and public health, and so we set out to examine this claim in two studies. Participants were asked to assess and compare the health states of two people presented in two vignettes. We found that both lay people and medical students conceptualize health as something more than the absence of disease. We argue that our findings highlight a need to rethink unrestricted negativism and indicate a need to rethink the way the debate has traditionally focused on disease. (shrink)

The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a biomedical (...) understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

We sometimes fail unwittingly to do things that we ought to do. And we are, from time to time, culpable for these unwitting omissions. We provide an outline of a theory of responsibility for unwitting omissions. We emphasize two distinctive ideas: (i) many unwitting omissions can be understood as failures of appropriate vigilance, and; (ii) the sort of self-control implicated in these failures of appropriate vigilance is valuable. We argue that the norms that govern vigilance and the value of self-control (...) explain culpability for unwitting omissions. (shrink)

It is common to distinguish between “holist” and “reductionist” views of brain function, where the former envisions the brain as functioning as an indivisible unit and the latter as a collection of distinct units that serve different functions. Opposing reductionism, a number of researchers have pointed out that cortical network architecture does not respect functional boundaries, and the neuroanatomist V. Braitenberg proposed to understand the cerebral cortex as a “great mixing machine” of neuronal activity from sensory inputs, motor commands, and (...) intrinsically generated processes. In this paper, we offer a contextualization of Braitenberg’s point, and we review evidence for the interactions of neuronal activity from multiple sensory inputs and intrinsic neuronal processes in the cerebral cortex. We focus on new insights from studies on audiovisual interactions and on the influence of respiration on brain functions, which do not seem to align well with “reductionist” views of areal functional boundaries. Instead, they indicate that functional boundaries are fuzzy and context dependent. In addition, we discuss the relevance of the influence of sensory, proprioceptive, and interoceptive signals on cortical activity for understanding brain-body interactions, highlight some of the consequences of these new insights for debates on embodied cognition, and offer some suggestions for future studies. (shrink)

Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than constantly moving the line (...) between life and death. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...) were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

En este capítulo se analiza la figura de la obtención vegetal: su alcance, dimensión, requisitos y caracterización frente a otros derechos de propiedad intelectual, para así abordar su ámbito de protección y su tratamiento en el ámbito internacional. Se pretende en este sentido plantear que la tendencia regulatoria en materia de obtenciones vegetales en Colombia no sólo va en contravía de los intereses de los pueblos indígenas, sino además de su patrimonio colectivo que les ha garantizado una gran diversidad que (...) hoy por hoy es sustento de su alimentación. Con lo anterior se lleva a cabo un singular esfuerzo para tratar de forma comprensiva este asunto, buscando la primacía del consentimiento libre, previo e informado de las comunidades potencialmente afectadas. (shrink)

[ENGLISH] This article discusses the potential of synthetic biology to address fundamental questions in the philosophy of biology regarding the nature of life and biological functions. Synthetic biology aims to reduce living organisms to their simplest forms by identifying the minimal components of a cell and also to create novel life forms through genetic reprogramming, biobrick assembly, or novel proteins. However, the technical success of these endeavors does not guarantee their conceptual success in defining life. There is a lack of (...) consensus among researchers on how to define and classify the entities produced in the lab, whether they should be considered living or categorized differently. The criteria for minimal cells and minimal life are subject to arbitrary choices and varying interpretations. The concept of function, crucial to synthetic biology, is also difficult to define. The article highlights the need to consider the minimal set of functions that characterize life before determining the smallest genomes that code for those functions. The arbitrary nature of defining both life and function complicates the understanding and classification of these entities. The article suggests that the traditional dichotomy between the living and the non-living may no longer be valid and that the concept of life itself may not require precise scientific definition. As synthetic biology advances, the article emphasizes the importance of redefining or constructing new categories to encompass the expanding possibilities and creations in the field. The ability to create new life forms raises questions about recognition, identification, and ethical implications, requiring a conceptual and philosophical engagement beyond the technical achievements of synthetic biology. -/- [FRENCH] L'article aborde le potentiel de la biologie synthétique pour répondre à des questions fondamentales de la philosophie de la biologie concernant la nature de la vie et des fonctions biologiques. La biologie synthétique vise à réduire les organismes vivants à leurs formes les plus simples en identifiant les composants minimaux d'une cellule et à créer de nouvelles formes de vie grâce à la reprogrammation génétique, à l'assemblage de biobriques ou à des protéines nouvelles. Cependant, le succès technique de ces approches ne garantit pas leur réussite conceptuelle dans la définition de la vie. Il n'y a pas de consensus parmi les chercheurs sur la façon de définir et de classer les entités produites en laboratoire, qu'elles doivent être considérées comme vivantes ou catégorisées différemment. Les critères des cellules minimales et de la vie minimale sont soumis à des choix arbitraires et à des interprétations variables. La notion de fonction, essentielle en biologie synthétique, est également difficile à définir. L'article met en évidence la nécessité de prendre en compte l'ensemble minimal de fonctions qui caractérisent la vie avant de déterminer les plus petits génomes qui codent ces fonctions. La nature arbitraire de la définition de la vie et de la fonction complique la compréhension et la classification de ces entités. L'article suggère que la dichotomie traditionnelle entre le vivant et le non-vivant pourrait ne plus être valable et que le concept même de vie ne nécessite pas une définition scientifique précise. À mesure que la biologie synthétique progresse, l'article souligne l'importance de redéfinir ou de construire de nouvelles catégories pour englober les possibilités et créations croissantes dans le domaine. La capacité à créer de nouvelles formes de vie soulève des questions de reconnaissance, d'identification et d'implications éthiques, nécessitant une réflexion conceptuelle et philosophique au-delà des avancées techniques de la biologie synthétique. (shrink)

Finality, design and purpose have started to be excluded from the language of the natural sciences since the XVIIth century. Darwin succeeded in excluding them from his theory of evolution appealing to a blind and mechanical natural selection. Today, the most usual definitions for the concept of biological function take for granted that functions: 1) are not dependent on a goal; 2) are not dependent on observers, but only on nature; 3) are explicable in causal terms, either with reference to (...) the causal history of the organ (etiological definition), or with reference to its present structure and causal capabilities (dispositional definition). However, we shall see that such presuppositions cannot take into account the normative character of the concept of biological function. We show that a generalization of the concept of scientific objectivity lets us affirm that functions: 1’) are dependent on a goal; 2’) are dependent on both observers and nature; 3’) cannot be reduced to causality, nor break the laws of physics; and yet, 4) are truly objective. (shrink)

Este texto nace de la necesidad de aproximarse a reflexiones desde América Latina frente al debate comercio- cultura puesto que se ha encontrado que a nivel internacional hay dos posiciones claramente definidas. De una parte, los Estados Unidos defienden la liberalización cultural por considerarla un bien y servicio más. De otra parte, regiones como Canadá, Francia, Quebec -y en diferentes grados la Unión Europea- defienden la excepción cultural. Sin embargo este camino de transición entre la excepción hacia la diversidad cultural (...) estuvo plagado de luchas sociales. (shrink)

It is widely agreed that obsessive-compulsive disorder involves irrationality. But where in the complex of states and processes that constitutes OCD should this irrationality be located? A pervasive assumption in both the psychiatric and philosophical literature is that the seat of irrationality is located in the obsessive thoughts characteristic of OCD. Building on a puzzle about insight into OCD (Taylor 2022), we challenge this pervasive assumption, and argue instead that the irrationality of OCD is located in the emotions that are (...) characteristic of OCD, such as anxiety or fear. In particular, we propose to understand the irrationality of OCD as a matter of harboring recalcitrant emotions. We argue that this account not only solves the puzzle about insight, but also makes better sense of how OCD sufferers experience and describe their condition and helps explain some otherwise puzzling features of compulsive behavior. (shrink)

This article identifies a novel challenge to standard understandings of responsibility practices, animated by experimental studies of biases and heuristics. It goes on to argue that this challenge illustrates a general methodological challenge for theorizing about responsibility. That is, it is difficult for a theory to give us both guidance in real world contexts and an account of the metaphysical and normative foundations of responsibility without treating wide swaths of ordinary practice as defective. The general upshot is that theories must (...) either hew more closely to actual practice than they appear to, or they must provide some normative foundation for responsibility that does not go through actual practice. (shrink)

Body checking, characterized by the repeated visual or physical inspection of particular parts of one’s own body (e.g. thighs, waist, or upper arms) is one of the most prominent behaviors associated with eating disorders, particularly Anorexia Nervosa (AN). In this paper, we explore the explanatory potential of the Recalcitrant Fear Model of AN (RFM) in relation to body checking. We argue that RFM, when combined with certain plausible auxiliary hypotheses about the cognitive and epistemic roles of emotions, is able to (...) explain key characteristics of body checking, including how body checking behavior becomes habitual and compulsive. (shrink)

While research on Attention Deficit Hyperactivity Disorder (ADHD) has traditionally focused on cognitive and behavioral deficits, there is increasing interest in exploring possible resources associated with the disorder. In this paper, we argue that the attention-patterns associated with ADHD can be understood as expressing an alternative style of inquiry, or “zetetic” style, characterized mainly by a lower barrier for becoming curious and engaging in inquiry, and a weaker disposition to regulate curiosity in response to the cognitive and practical costs associated (...) with inquiry. Exploring this zetetic style from an epistemological perspective, we show that it is often epistemically rational and can be advantageous in important respects. We close by suggesting that the very aspects of the zetetic style that might at times render it disadvantageous from the point of view of individual subjects with ADHD, will often confer epistemic benefits to the social group that the subjects are part of. (shrink)

Proponents of manipulation arguments against compatibilism hold that manipulation scope (how many agents are manipulated) and manipulation type (whether the manipulator intends that an agent perform a particular action) do not impact judgments about free will and moral responsibility. Many opponents of manipulation arguments agree that manipulation scope has no impact but hold that manipulation type does. Recent work by Latham and Tierney (2022, 2023) found that people's judgments were sensitive to manipulation scope: people judged that an agent was less (...) free and responsible when a manipulation was existential (impacting at least one but not all agents) than when the manipulation was universal (impacting every agent). This study examines people's judgements about existential and universal manipulation cases that involve both intentional and non‐intentional outcomes. We found that manipulation scope also affects people's free will and responsibility judgments in manipulation cases involving both intentional and non‐intentional outcomes. Interestingly, we also found that manipulation type influences the effect that manipulation scope has on people's free will judgments but not their moral responsibility judgments, which indicates that people's free will and responsibility judgments can come apart. This puts pressure on the prevalent assumption that judgments about free will and moral responsibility are conceptually bound together. (shrink)

Este artículo aborda, desde la relectura del trabajo de Alfred Schütz “La ejecución musical conjunta” (“Makingmusictogether”), la idea de intersubjetividad como sintonía en las relaciones sociales explorando en los elementos señalados por el autor, como la dimensión temporal, el cara a cara y la sincronización con el Otro. Se abre así una posibilidad de comprensión de los procesos intersubjetivos, en la perspectiva del reconocimiento de la alteridad (Levinas) como constitutiva de intersubjetividad, y se plantea la pregunta de si es posible, (...) en contextos de exclusión, avanzar hacia la constitución de sintonía entre sociedad y Estado. (shrink)

Respiratory rhythms sustain biological life, governing the homeostatic exchange of oxygen and carbon dioxide. Until recently, however, the influence of breathing on the brain has largely been overlooked. Yet new evidence demonstrates that the act of breathing exerts a substantive, rhythmic influence on perception, emotion, and cognition, largely through the direct modulation of neural oscillations. Here, we synthesize these findings to motivate a new predictive coding model of respiratory brain coupling, in which breathing rhythmically modulates both local and global neural (...) gain, to optimize cognitive and affective processing. Our model further explains how respiratory rhythms interact with the topology of the functional connectome, and we highlight key implications for the computational psychiatry of disordered respiratory and interoceptive inference. (shrink)

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

The European project European and Latin American Systems of Ethics Regulation of Biomedical Research Project (EULABOR) has carried out the first comparative analysis of ethics regulation systems for biomedical research in seven countries in Europe and Latin America, evaluating their roles in the protection of human subjects. We developed a conceptual and methodological framework defining ‘ethics regulation system for biomedical research’ as a set of actors, institutions, codes and laws involved in overseeing the ethics of biomedical research on humans. This (...) framework allowed us to develop comprehensive national reports by conducting semi-structured interviews to key informants. These reports were summarised and analysed in a comparative analysis. The study showed that the regulatory framework for clinical research in these countries differ in scope. It showed that despite the different political contexts, actors involved and motivations for creating the regulation, in most of the studied countries it was the government who took the lead in setting up the system. The study also showed that Europe and Latin America are similar regarding national bodies and research ethics committees, but the Brazilian system has strong and noteworthy specificities. (shrink)

El daño ambiental ha despertado el interés de la doctrina en Colombia, aunque aún no se aborda con rigor y profundidad. La razón, entre otras, es la omisión de los avances que ha dado el derecho comparado, donde la concepción del rol de las instituciones jurídicas va hasta una comprensión integral del daño a partir de la alteración funcional de los sistemas. Existe hoy cierto consenso respecto al deber ser del régimen de responsabilidad aplicable a esta noción integral del daño (...) ambiental, capaz de hacer frente a los componentes del medio natural y a todos los que lo conforman. El libro busca aportar al estudio del daño ambiental desde los avances antes descritos en la materia. (shrink)

Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --and acritically assumed by most of societies-- as a (...) scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent : what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed. (shrink)

Fac simile of documents [mostly letters & dedications] from & to FELIX SOMLÓ (1873–1918) (including by Leonidas Pitamic and Adolf Merkl, among others) & JULIUS MOÓR (1888–1950) (including by M. Stockhammer, Wilhelm Sauer, Karl Petraschek, among others), followed by HANS KELSEN’s Selbstbiographie [February 1927] (15–22 w/ letter, 23) & ILMAR TAMMELO’s only surviving copy of his PhD thesis in his own translation on Kritik zu Prof. Kliimann’s normativistischer Unterscheidung des Privat- und des öffentlichen Rechts [Dorpat, 1942] (63–145), both prepared to (...) the latter; w/ Bibl. & Preface [1995/e] x–xv, as well as documentation in Hungarian on how the Editor could save their rich personal professional library of several thounds volumes and making acquired them by the Library of Parliament in Budapest as its special collection in Anhang (147–156); Personenverzeichnis. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

In response to Ruud ter Meulen’s contribution, it is argued that, although the relationship between these concepts is both tight and complex, solidarity should be carefully distinguished from justice. Although ter Meulen wants to defend a normative conception of solidarity, the relation to its descriptive component is not always very clear. As a normative concept it should not collapse into that of justice; and as a descriptive notion it is obviously defective. In order to successfully navigate between these unhappy alternatives, (...) ter Meulen rightfully turns to critical theory. But then it is still not entirely clear how the normative considerations that ter Meulen wants to defend follow from this promising framework. (shrink)

Este paper examina en detalle el marco constitucional dispuesto en 1991 para la protección del medio ambiente y la configuración del Estado colombiano frente a los nuevos retos que plantea la protección ambiental. Lo anterior, a partir de dos elementos claves para entender el papel de los mecanismos jurídicos en la defensa de la naturaleza y el ambiente: la participación ambiental y el acceso a la justicia ambiental, ello, con el fin de conocer los instrumentos que reconfiguran el Estado para (...) que la ciudadanía y las organizaciones sociales puedan ejercer una defensa jurídica del medio ambiente, que aporte a la construcción de la justicia ambiental. (shrink)

En el presente artículo se presenta el panorama y algunos de los más importantes avances que en Colombia se han dado en materia ambiental desde la Constitución Política de 1991. La metodología llevada a cabo es descriptiva y analítica, en tanto se estudian no sólo las normas sino las sentencias más relevantes que se han constituido en un hito en la protección de los derechos ambientales. En tal sentido, lo que se pretende evidenciar es la existencia de un panorama de (...) constitucionalización de los derechos ambientales con signicativos avances tales como el rol preponderante que ha adquirido el principio de precaución o el reconocimiento de la función ecológica de la propiedad. (shrink)

Aunque la problemática de los daños ambientales ha atraído el interés sustancial de profesionales y académicos de diversas disciplinas, los motivos que impulsan esas prácticas han recibido poca atención en la literatura jurídica colombiana. Especialmente desde la perspectiva de la responsabilidad. Este capítulo presenta unas reflexiones preliminares de la responsabilidad por daños ambientales, para introducir el estudio de diversos temas, hacia una construcción doctrinal enmarcada no sólo en el deber de evitar el progresivo deterioro ambiental causado por el hombre, sino (...) para salvaguardar las especies vivas que habitan y habitarán este planeta, así como el legado que le quedará a las generaciones venideras. (shrink)

El paper realiza una exposición sobre el concepto y contenido de la nulidad y el restablecimiento del derecho como medio de control a la luz de la Ley 1437 de 2011; enfocándola en asuntos ambientales a través del estudio de la licencia ambiental.

Laura Specker Sullivan (2022) makes a fairly compelling case for the value of the perspectives of Buddhist practitioners in neuroethics. In this study, Tibetan Buddhist monks have been asked, among other things, whether consciousness, in brain-injured patients in a minimally conscious state, entails a duty to preserve life. In our view, some of the participants’ responses could be used to inform the bioethical debate on death determination.

In this paper, we draw on developmental findings to provide a nuanced understanding of background emotions, particularly those in depression. We demonstrate how they reflect our basic proximity (feeling of interpersonal connectedness) to others and defend both a phenomenological and a functional claim. First, we substantiate a conjecture by Fonagy & Target (International Journal of Psychoanalysis 88(4):917–937, 2007) that an important phenomenological aspect of depression is the experiential recreation of the infantile loss of proximity to significant others. Second, we argue (...) that proximity has a particular cognitive function that allows individuals to morph into a cohesive dyadic system able to carry out distributed emotion regulation. We show that elevated levels of psychological suffering connected to depressive background emotions may be explained not only in terms of a psychological loss, but also as the felt inability to enter into dyadic regulatory relations with others—an experiential constraint that decreases the individual’s ability to adapt to demanding situations. (shrink)

Authenticity has become a widespread ethical ideal that represents a way of dealing with normative gaps in contemporary life. This ideal suggests that one should be true to oneself and lead a life expressive of what one takes oneself to be. However, many contemporary thinkers have pointed out that the ideal of authenticity has increasingly turned into a kind of aestheticism and egoistic self-indulgence. In his book, Varga systematically constructs a critical concept of authenticity that takes into account the reciprocal (...) shaping of capitalism and the ideal of authenticity. Drawing on different traditions in critical social theory, moral philosophy and phenomenology, Varga builds a concept of authenticity that can make intelligible various problematic and potentially exhausting practices of the self. (shrink)

The DSM‐5 highlights two essential psychological features of anorexia nervosa (AN): recalcitrant fear of gaining weight and body image disturbance. Prominent accounts grant false beliefs about body weight and shape a central role in the explanation of AN behavior. In this article, we propose a stronger emphasis on recalcitrant fear. We show that such fear can explain AN behavior without the intermediary of a false belief, and thus without the associated explanatory burdens and conceptual difficulties. We illustrate how shifting the (...) emphasis from false belief to recalcitrant fear can supplement a number of different non‐doxastic models of AN. (shrink)

Si bien al hablar de igualdad y derechos colectivos nos situamos aparentemente en dos espectros distintos de los derechos humanos, siguiendo a VASAK y su teoría de las tres generaciones, de un lado en el rango de un derecho fundamental, y del otro, en toda una amplia gama de derechos de tercera generación, es en realidad, en una misma órbita en donde debemos ubicarnos: en la del Estado de Social Derecho. Y es allí, donde la capacidad que éste tenga para (...) hacer frente a los desafíos que trae consigo su cumplimiento -sin olvidar el de los derechos económicos, sociales y culturales-, se convierte en el mejor elemento de juicio para determinar su éxito o fracaso, en una sociedad fracturada por un sinnúmero de fenómenos que atentan cada vez más contra las garantías y libertades de los ciudadanos. En este contexto, en el marco del programa de actividades formativas del Doctorado en Estudios Interdisciplinares de Género y Políticas de Igualdad, se organizó un Foro Académico cuya pretensión no era otra sino la de presentar a la comunidad una serie de reflexiones sobre algunos de estos mencionados fenómenos, a partir de la visión aquí propuesta. (shrink)

Scaffolded Minds offers a novel account of cognitive scaffolding and its significance for understanding mental disorders. The book is part of the growing philosophical engagement with empirically informed philosophy of mind, which studies the interfaces between philosophy and cognitive science. It draws on two recent shifts within empirically informed philosophy of mind: the first, toward an intensified study of the embodied mind; and the second, toward a study of the disordered mind that acknowledges the convergence of the explanatory concerns of (...) psychiatry and interdisciplinary inquiries into the mind. The book sets out to accomplish a dual task: theoretical mapping of cognitive scaffolding; and the application/calibration of fine-grained philosophical distinctions to empirical research. It introduces the notion of actively scaffolded cognition (ASC) and offers a taxonomy that distinguishes between intrasomatic and extrasomatic scaffolding. It then shows that ASC offers a productive framework for considering certain characteristic features of mental disorders, focusing on altered bodily experience and social cognition deficits. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...) two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Recent criticisms of medicine converge on fundamental questions about the aim of medicine. The main task of this paper is to propose an account of the aim of medicine. Discussing and rejecting the initially plausible proposal according to which medicine is pathocentric, the paper presents and defends the Autonomy Thesis, which holds that medicine is not pathocentric, but sanocentric, aiming to promote health with the final aim to enhance autonomy. The paper closes by considering the objection that the Autonomy Thesis (...) is overly permissive and allows many highly controversial procedures as legitimate parts of medicine. (shrink)

La prevención de riesgos laborales y la responsabilidad social empresarial son disciplinas que están directamente relacionadas, ya que dentro de sus objetivos se encuentra garantizar el bienestar, la seguridad y salud de los trabajadores en calidad de grupo de interés prioritario. En este sentido, el propósito del presente texto yace en demostrar el papel que tiene la gestión de los riesgos asociados al trabajo en la implementación de estrategias de responsabilidad social en las organizaciones, analizando las iniciativas más reconocidas que (...) existen al respecto, de tal modo que sirva de base para las empresas que están en el camino hacia una gestión integral y socialmente responsable. (shrink)

Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of medicine. Further (...) work making medicine’s internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino’s account of the aim of medicine as well as the Hastings Center’s consensus report. (shrink)

Philosophical accounts denying that temporal passage is an objective feature of reality face an explanatory challenge with respect to why it appears to us as though time passes. Recently, two solutions have surfaced. Cognitive illusionism claims that people experience the passage of time due to their belief that time passes. Cognitive error theory claims that we do not experience the passage of time, but hold the belief that we do, which we have acquired through making an inference from the prior (...) belief that time passes. These approaches suppose that belief and passage experience are explanatorily connected, and they depend on the claims that people who experience the passage of time or at least believe that they do also believe that time passes. To test these claims, we probed the beliefs of populations of individuals with depression and schizotypy, thus conditions that are strongly associated with alterations in temporal phenomenology. Depression was assessed with the Beck Depression Inventory (BDI) and schizotypy with the short Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). While cognitive illusionism and inferentialist cognitive error theory would predict a strong association between BDI and O-LIFE scores and beliefs about time passage, our study found no such association. The experience of passage does not seem to be explanatorily connected to beliefs about the passage of time. (shrink)

The classification of preserved hypothalamic activity in brain death and brainstem death as functional or non-functional has become a subject of debate. While proponents of the neurological criterion claim that these activities lack functional significance (Shemie et al. 2014), Nair-Collins and Joffe (2023) argue for their functional physiological role. However, the interpretation of the term "function" within the medico-legal framework, where death is characterized by the irreversible cessation of all brain functions, remains unclear. -/- My intention here is not to (...) engage in a debate over the validity of different viewpoints regarding the functional significance of preserved activities in the hypothalamus or the heart. Rather, I aim to highlight the critical importance of exploring and defining the concept of function in medicine, which currently lacks clarity. My point is that, whatever our position in the brain death debate, reaching a consensus on this conceptual matter would minimize misunderstandings and establish a robust foundation for further insightful analysis. (shrink)

Grief is often described as characterized by a particular emotional response to another person’s death. While this is true of paradigm cases, we argue that a broader notion of grief allows accommodating forms of this emotional experience that deviate from the paradigmatic case. The bulk of the paper explores such a nonparadigmatic form of grief, anticipatory-vicarious grief, which is typically triggered by pondering the inevitability of our own death. We argue that AV-grief is a particular moral emotion that serves a (...) unique function and is indissolubly linked to the practical identities of human agents. An agent’s AV-grief is about the harm that occurs to individuals whose practical identities depend on the agent. (shrink)

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we find that (...) people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

Today’s exponential advancement of information and communication technologies is reconfiguring participatory urban development practices. The use of digital technology implies new forms of decentralised governance, collaborative knowledge production, and social activism. The digital transformation has the potential to overcome shortcomings in citizen participation, make participatory processes more deliberative, and enable collaborative approaches for making cities. While digital tools such as digital mapping, e‐participation platforms, location‐based games, and social media offer new opportunities for the various actors and may act as a (...) catalyst for renegotiating urban space and collective goods, digitalisation can also perpetuate or even attenuate existing inequalities and exclusion. This editorial introduces the thematic issue “Citizen Participation, Digital Agency, and Urban Development” which focuses on the trajectories and (dis)continuities of citizen participation through digitalisation and elaborates this with examples from Europe and Asia on how the digital transformation impacts, challenges, or reproduces hegemonic power relations in urban development. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis is that grasping a mechanistic explanation of a condition is necessary for a biomedical understanding of (...) that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothesis is that clinical understanding combines biomedical understanding of a _disease_ or pathological condition with understanding _illness,_ which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources _in addition_ to those involved in biomedical understanding. (shrink)

El capítulo parte por ubicar el contexto social y político en el que se enmarca el cambio constitucional de 1991 en Colombia, asimismo, sus antecedentes jurídicos-políticos, a fin de dar cuenta de las diversas estrategias utilizadas para su aprobación y desarrollo. Seguidamente, nos ocupamos de las discusiones que al interior de la ANC se dan sobre la salud, y la forma bajo la cual se configuran las políticas sociales bajo la nueva forma de Estado Social de Derecho, para presentar finalmente (...) algunos elementos de discusión. (shrink)

The Philosophy of Psychiatry is a unique area of research because the nature of the subject matter leads to quite distinct methodological issues. Naturalism, Interpretation, and Mental Disorder is an original new work focusing on the challenges we face when trying to interpret and understand mental illness. The book integrates a hermeneutical perspective, and shows how such an approach can reveal important facts about historical sources in psychiatry and the nature of dialogue in the therapeutic encounter. In addition, the book (...) demonstrates how such an approach can be valuable for understanding the concept of mental disorder itself. Naturalism, Interpretation, and Mental Disorder brings fresh thinking to the philosophy of psychiatry, and will be of interest to students and scholars in the fields of Mental Health and Philosophy. (shrink)

Debates about the genuine disease status of controversial diseases rely on intuitions about a range of factors. Adopting tools from experimental philosophy, this paper explores some of the factors that influence judgments about whether low sexual desire should be considered a disease and whether it should be medically treated. Drawing in part on some assumptions underpinning a divide in the literature between viewing low sexual desire as a genuine disease and seeing it as improperly medicalized, we investigate whether health and (...) disease judgments are affected by factors such as an individual’s gender, the cause of the low desire, whether the desire is high or low, and both personal and societal valuations of the condition. Our main findings indicate that (a) the cause of a condition influences whether it is judged a disorder, (b) how the individual values the condition influences whether the condition is seen as a proper target of medical intervention, and (c) perceived dysfunction influences judgments regarding health, disorder classification, medicalization, and medical intervention. Our findings help further illuminate the intricate interplay of factors that influence judgments about health and disease in controversial conditions. (shrink)